Stitches in the side • Where does it come from and what to do?

Stitches in the side during sport are particularly noticeable on the right side of the body, less often on the left. In individual cases it can even occur on both sides. The stitch begins with a slight discomfort below the last costal arch. Very soon, however, a severe, stabbing, cramp-like pain occurs – as if someone were digging a knife or an arrow into the side. The shoulder can also be affected by the side stitch. Continuing to walk with a stitch like this is impossible for most.

At a glance:

Simple yoga exercises for a good night’s sleep

Where does the stitch come from?

There are various theories about the causes of the stitch that have not yet been fully scientifically clarified. Different explanatory models are discussed:

• breathing: Many experts assume that the health phenomenon is related to the Respiration and the blood supply to the organs. Oxygen-rich blood is always supplied to the regions in the body that need it most urgently. In sport, these are the muscles responsible for movement. The diaphragm releases pain-causing substances when it is undersupplied with oxygen, according to one explanation for a stitch in the side.

• Organ movements: The stitch in the side could also come from the rhythmic movements when running. With every step, the stomach, liver, intestines, spleen and other internal organs are jolted and pulled downwards. The ligament system inside the body keeps them more or less in place, but these ligaments in turn pull the diaphragm. The diaphragm, which is important for breathing, separates the chest from the abdomen. Each time you exhale, the diaphragm moves upward to force air out of your lungs. The opposing movements of the internal organs (downwards) and the diaphragm (upwards) could cause tension and cramp-like pain in the upper abdomen, which athletes then notice as a stitch in the side.

• posture: An Australian study explains the side stitch with posture while running. Doctors observed that hunched runners were more likely to suffer from side stitches. The hunched position could increase the pressure on the abdominal cavity, causing pain.

• eat: Eating before exercising is not a good idea. Because for the digestive system to work, it needs oxygen-rich blood. But this is needed in the muscles during sport and this leads to an imbalance in the body that could manifest itself as a stitch in the side.

Other reasons for side stitches

• wrong breathing and breathing rhythm
• lack of warm-up
• muscles in the abdomen and torso that are too weak
• Digestive disorders such as gas or constipation
• Meals just before exercise
• too intense training
• tight sportswear that makes breathing difficult

The stitch is usually only temporary and is quickly forgotten at the end of the run. However, if the pain persists, there may be an illness behind it. If pain increases with inhalation and exhalation, the following causes can be considered:

If the pain is constant, i.e. occurs independently of breathing, the cause can also be a heart attack. Frequent left flank pain can also be a symptom of a disease of the pancreas (pancreatitis or pancreatic cancer). Persistent pain on the sides of the trunk, which occurs independently of sporting activities, should therefore always be clarified by a doctor.

What helps with a stitch in the side?

If you are surprised by a stitch while playing sport, you should first reduce your pace or walk a part of the route. It is important that breathing becomes calm and even again. Take a deep breath in your stomach. When you breathe in, you can also press the painful area with your fist and bend your upper body forward. Alternatively, as you inhale, raise your arms above your head and, while exhaling, lower your arms again. With these tips, the stitch should be gone after a few minutes. As you continue to run, you should increase the pace very slowly and continue to breathe evenly and deeply. If the stitch returns, it is better to stop training.

Tips to prevent stitching in your side

Stitches in the side are extremely annoying because they repeatedly interfere with training. However, with a few tips, athletes can prevent the side stitch.

• Breathing: When exercising, make sure that you breathe evenly deeply and into your stomach as much as possible. Breathing exercises, as they are known from yoga, can be carried out at home as a support. These exercises can train the awareness of one’s own breathing and train breathing into the abdomen and costal arch. Beginners in particular should avoid having conversations while running.

• Training: Try to increase your pace moderately during sporting activities and do not start running at full speed straight away. Give your body and breathing time to get used to the stress. When choosing your sporting activities and participating in competitions, consider your physical performance. Warm up appropriately before exercising. Regular stretching and strengthening exercises for the core muscles also create a good posture for running and can help reduce or eliminate side stitches.

• Eat: A full stomach doesn’t like exercising – this wisdom should be heeded if you frequently struggle with side stitch attacks. When the stomach is busy digesting, less blood is available for other body functions. Therefore, do not eat anything immediately before exercise and anything that is difficult to digest two to three hours beforehand at the latest.

Stitches in the side are not a disease – and also harmless. There is no reason not to do sports because of it.