A side stitch has ended my run more than once. How can I get rid of one when it hits?

Runner's World (UK) - - Coach/ask -

There are dif­fer­ent the­o­ries re­gard­ing the causes of de­bil­i­tat­ing side stitches, such as ten­sion in the di­aphragm, cramp­ing in the ab­dom­i­nal mus­cles and ir­ri­ta­tion of struc­tures within the ab­dom­i­nal cav­ity.

There are a few things you can do to at­tempt to al­le­vi­ate the prob­lem – but to get the most ben­e­fit you should re­duce your pace while you try them. Gen­tly push your hands into the area of dis­com­fort, just un­der your ribs, to help ease the cramp­ing. Also, try chang­ing your breath­ing pat­tern for a few breaths, tak­ing in a very deep breath, then ex­hal­ing sharply. It may be help­ful to syn­chro­nise your breath­ing with your run­ning – breath­ing out when you foot-strike on the op­po­site side to your pain is said to en­cour­age the ten­sion in the di­aphragm to re­lax. If these strate­gies don’t work, stop run­ning and try stretch­ing: first, stretch to your side away from the site of the pain and then bend for­ward.

There are some mea­sures you can take that may pre­vent a stitch from de­vel­op­ing in the first place. It could be that your stitch is be­ing caused by a bad breath­ing pat­tern, pos­tural prob­lems or weak ab­dom­i­nals. It’s also im­por­tant to re­view your pre-run or pre­race meal – an ir­ri­tated stom­ach can cause a side stitch to de­velop (among other trou­bles…). And make sure you al­ways warm up prop­erly, to ease your body into more in­tense ex­er­cise.

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