Reader to Reader: Stitch trouble

Your best thoughts on how to cure a stitch


Posted: 17 March 2007
by Jane Hoskyn


This week's question was emailed to us by forum member Little T, who gets a painful stitch every time she runs.

"I've just returned to running after four months off with an injury. Unfortunately, I'm getting really bad stitch each time I run – always in the same place, just under my ribcage on the right. I've tried everything to stop it – not eating for 2-3 hours before a run, eating a banana half an hour before, breathing out when my left foot strikes the floor, ditto with my right, relaxing my breathing, slowing down... nothing seems to help. I'm getting to the end of my tether!"Little T

Your best answers

  • Take a load off your diaphragm
    The common form of stitch encountered by runners occurs on the right side of the body, and it's due to a spasm of the diaphragm. The reason it happens on the right-hand side is the heavier weight of the organs attached on that side. What happens is that you get into a rhythmn of breathing out as the right foot hits the ground, which increases the load on the diaphragm and causes the spasm. If you encounter the problem, change to breathing out as the left foot hits the ground. To prevent the problem occuring in the first place, develop a breathing pattern that alternates between left and right. – emjaybee
  • Strengthen – and loosen – those abdominals
    I've suffered the same problem for about 10 months now, so I know how frustrating it is. Like you, in my experience it's not food/breathing/drinking/carrying stuff related. The only time I don't get it is if I'm running ONLY uphill, but running uphill all the time isn't really an option! I've seen two physios and a sports doctor, and all have suggested various abdominal/core strength exercises. They think it's perhaps a tight psoas or abdominal muscle, and have tried manually releasing these muscles. (You can do it yourself – basically just push on where it hurts while lying down until it releases a bit.) The latest physio thinks it is more of a postural thing, and that concentrating on running "tall", tilting my pelvis forward, and making sure I don't twist or swing one arm more than the other may help a bit. – Kristin Raw
  • Core strength = stitch-free insides
    I had this problem. I think it was to do with my core stability, as it happened no matter what! Keeping the stomach muscles taut helps keep all your innards from being tugged around. – Mellow Plodder
  • Right stitch = abs, left stitch = food
    Apparently if you get a stitch on your right, your abdominal muscles need strenghening. That'll come with more running or some ab exercises. If you get stitches on your left it's because of food/drink, because that's where your stomach is. – hopeless procrastinator
  • Boost your oxygen
    I was told as a young 'un that stitches are to do with lactic acid build-up, so more oxygen may help. Stay upright, slow down a bit and focus on breathing more deeply. That approach always works for me. – Martin Pace
  • Jab it better
    I've always found that jabbing my hand into my diaphragm, where the pain is, stops it because it stops the muscle cramping. Long, deep breaths, from the diaphragm, also help. – BunnyPhobia
  • Kill it with a pinch of salt
    When I get stitches it seems to be down to a lack of salt, so it may be worth trying to put a little salt into a drink. Other techniques include gripping the opposite hand to the stitch to take your mind off it. – Phillip Turrell
  • Try the three-hour rule
    I get stitch if I eat so much as a mouthful of food for three hours before running. If I try to run through it (as advised), it only makes me more prone to stitch on successive runs. I find the only way to prevent it is to not eat for at least three hours before running. It mkes planning runs all that more important/difficult, but worth it! – Maria Grundy
  • Hang in there – it might be a post-injury thing
    I get this problem whenever I'm starting again after a cold or injury. I've found it useful to cut down on liquid for an hour before my run, then taking water with me and having sips every 10 mins. Someone told me to put my arm up above my head on the opposite side to the stitch – it helps a little, but you usually have to slow down until it stops. Someone also told me to try touch my toes, but that made it worse! Ultimately I don't think there is a cure, just slow down and try jog through it. If you're like me, it'll stop once your fitness levels are back up to pre-injury levels. – Batmouse
  • Suck that gut
    If you have a gut, suck it in as tightly as you can while continuing to run. If you have no gut, pretend that you do, and suck it in tightly while continuing to run with a smug expression on your face! – cloudburst
  • A good bra cured my stitch
    I've been running for four months and have had exactly the same problem as you. Every time I went out I got a stitch no matter what I tried, including not eating/drinking for a couple of hours beforehand. Then two weeks ago I bought an underwired sports bra from M&S – quite expensive but it has done the trick for me and haven't had a stitch since. – Sal the slow
  • A handy tip
    Are you holding a drink in one hand for the whole run? I sometimes get a stitch if I don't change hands with the drinks bottle. – Aly
  • Hit the road in the morning
    I always get stitch when I run in the evenings. Since I changed to early mornings the problem has gone away. I drink water and eat a banana about 30 minutes before I run. – Jane Taylor
  • Breathe out as hard as you can
    I find that if I breathe out as hard as I can, then harder still until there is NO air in my lungs, the stitch will go away. You may need to do this a couple of times, but it never fails for me. – Wilkie
  • Imagine you're about to take a punch
    Try this one... continue running, but tense your stomach as if someone was about to hit you – make sure you keep breathing though! After a few mins the stitch should go away. Not sure about the physiology behind it (my mate came up with this one) but it works for me every time! – katkin
  • Try not to think about it
    I have found that I can prevent the onset of stitch with two things: 1. Start the run off at a slower pace (perhaps to do with the amount of oxygen you take in?); 2. Drink when you're running to avoid dehydration. If stitch does come on, try thinking about something else. The more you focus on it the worse it will feel. Good luck! – love pumpkin


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Hi peeps,

Another Reader to Reader question by email, this time from Little T:

"I've just returned to running after four months off with an injury. Unfortunately, I'm getting really bad stitch each time I run - always in the same place, just under my ribcage on the right. I've tried everything to stop it - not eating for 2-3 hours before a run, eating a banana half an hour before, breathing out when my left foot strikes the floor, ditto with my right, relaxing my breathing, slowing down... nothing seems to help. I'm getting to the end of my tether!" (Little T)

Sounds pretty horrible. Any suggestions, other than "stop running and go and lie down instead"?

cheers!

Posted: 11/03/2007 at 18:44

Get one at 12 mins into a run without fail when I am starting back into running after cold/injury especially If I drink too much fluid before I go out. I Cut down on liquid for an hour before just having sips of water every 10 mins and taking water with me. It helped a bit. Someone told me to put my arm up above my head on the opposite side to stitch. Helps a little but usually have to slow down until it stops. Someone also told me to try touch my toes but that made it worse. I don't think there is a cure, just slow down and try jog through it. Don't give up, its a bit off puting, but if you are like me when you build yor fitness levels back up is might stop.
Posted: 11/03/2007 at 20:03

If you have a gut, suck it in as tightly as you can while continuing to run.

If you have no gut, pretend that you do have a gut, and suck it in tightly while continuing to run with a smug expression on your face.
Posted: 11/03/2007 at 20:48


Thanks for those suggestions...Batmouse, I'll try cutting down on fluids before i run this lunchtime(I do drink an awful lot of water).

Cloudburst - I'm like a big old beanpole I'm afraid - not a sniff of a gut...interested to hear more about your theory though. Surely the worst thing you can do if you have a stitch is tense your abs?
Posted: 12/03/2007 at 08:35

I've always found that jabbing my hand into my diaphragm, where the pain is, stops it. It's all about stopping the muscle from cramping. Long, deep breaths, from the diaphragm, also help. Hope something works!
Posted: 12/03/2007 at 08:48


thanks Bunnyphobia - will try that too. it seems to get worse when i breathe deeply and better when i take shallow breaths. Maybe i'm just deeply weird. it's frustrating because it's the only thing slowing me down at the moment!
Posted: 12/03/2007 at 09:46

Have been running for four months. Had exactly the same problem as you. Every time I went out I got a stitch no matter what I tried, ie not eating/drinking for a couple of hours beforehand. Then two weeks ago I bought an underwired sports bra from M&S - quite expensive but it has done the trick for me and haven't had a stitch since. Hope it helps
Posted: 12/03/2007 at 12:32

A stitch is the diaphragm cramping up, so your looking to stretch it out again via breathing and if you can use your hands to stretch it, go for it! other iversion techniques include gripping the opposite hand to the stitch to take your mind of it.
When i used to and still do get a stitch its usually down to lack of salt so it may be worth trying to put a little salt into a drink to mix it up!

Hope this helps!
:)
Posted: 12/03/2007 at 15:59

As far as I was always told as a young 'un, stitches are all to do with lactic acid build-up and as such are a product of not getting enough oxygen. With this in mind the best strategy is NOT to put your handss on your knees, stay upright, slow down a bit and focus on breathing more to get more oxygen in. I think cramping of the diaphragm is hiccups, which is different. For a stitch, you just have to breathe. Unless I've been mis-informed, but that approach always works for me in any event.
Posted: 12/03/2007 at 16:09

Since lots of people have been told lots of different things about what causes stitches, do we have any physiologists of any variety out there who can help clear it all up?
Posted: 12/03/2007 at 16:12

nowhere near a physiologist but i always thought stitch was cramp of the pancreas, seem to remember being told that at school
Posted: 12/03/2007 at 16:21

The common form of stitch encountered by runners occurs on the right side of the body and is due to a spasm of the diaphragm. The reason it is the right hand side is because of the weight of the organs that are attached here. What happens is that you get into a rhythmn of breathing out as the right foot hits the ground which increases the load on the diaphragm and causing the spasm. If you encounter the problem change to breathing out as the left foot hits the ground. To prevent the problem occuring in the first place develop a breathing pattern that alternates between left and right.
Posted: 12/03/2007 at 17:20

Little T - the suggestion was one I read somewhere; I don't know the source.

I think prevention is the key, here. I have only ever had a stitch when running too soon after a substantial quantity of food or drink.

I have read that the weight of the food / drink pulls down your stomach, causing strains internally, further emphasised by the pounding associated with running.
Posted: 12/03/2007 at 19:20

My stitches are usually a result of trapped wind in the stomach, nothing to do with food, and can happen either on an empty stomach, an hour or two after a snack or when fuelling on a long run. I slow down a little, press in the painful area constantly and wriggle it around and it usually loosens it. A couple of good, sometimes forced hearty burps and then it subsides.
Posted: 12/03/2007 at 20:01


wow - thanks for all your suggestions. emjaybee - i've tried controlling my breathing and breathing out when my left foot strikes the ground, but to no avail.

Sal - i have a good Sportjock bra already - no point in me wearing anything underwired because i have grapes rather than melons ;o) - but thanks ever so much anyhow!

Phillip - i'd never considered that before. i don't actually eat salt on anything (though if i'm going on a long run, i do take isotonic drinks with me), so i shall try your suggestion today.

and if all else fails, i'll be the one running round Hyde Pk this lunchtime belching for Britain :)
Posted: 13/03/2007 at 11:09

When i've spent time with football clubs, before i took to running, i was always made by the physios and nutritionists to have some form of muesli type meal, half an hour after player to utilise the optimum replenishment oppurtunity and sprinkle salt onto it salt is bad for people who don't exercise because they never deplete it.
Hope it works out for you!;)
Posted: 13/03/2007 at 12:37

Hi Little T. I had this problem. I think it was to do with my core stability as it happened no matter what! Keeping the stomach muscles taut helps keep all your innards from being tugged around! Also, I take a short walk, link my hands behind my head and do deep breathing - that seems to help.
Posted: 13/03/2007 at 13:21


well - just got back from my run after having tried the 'salt' method...the stitch was still there but not as bad as it has been, so cheers for that Phillip!

when it did happen, i tried to jab my hand into the painful area like Little Lizard suggested, and my GOD - not only did it hurt, but this huge scary belch erupted and disturbed a flock of pigeons (this can ONLY be a good thing)!!! it's still recurring, but it wasn't as bad today as it has been over the past few weeks.

i've certainly got a lot of different methods to try - thank you all so much.
Posted: 13/03/2007 at 14:08

I get stitch if I eat so much as a mouthful of food for three hours before running. Liek you always on the rigth side under the ribcage. If I try to run through it (as advised) it has made me more prone to stitch on successive runs. I find the only way to prevent stitch is to not eat for at least 3 hours before running. If I eat 2 and half hours before I can almost lay money on getting stitch. Makes planning runs all that more important/difficult but worth it!
Posted: 13/03/2007 at 15:06

I logged on to RW this morning to post a question about this very same thing!

No-one seems to know the answer. Does anyone know what it is in the first place?

Holding my stomach muscles taut definitely helps to control the pain but doesn't remove it. Can Mike Gratton help?
Posted: 14/03/2007 at 09:30

Are you holding a drink in one hand for the whole run? I sometimes get a stitch if I don't change hands with the drinks bottle...hope u get it fixed :-)
Posted: 14/03/2007 at 10:14

I always get stitch when I run in the evenings. Since I changed to early mornings the problem has gone away. Drink water and eat a banana about 30 minutes before I run.
Posted: 14/03/2007 at 13:36


Aly, i don't ever run with a water bottle...i'm doing most of my running over shorter distances at the moment, so that's not a problem. i'm going to try and pretend i have a beer gut when i run today and suck it in...
Posted: 15/03/2007 at 08:31

I have suffered the same problem for about 10 months now, so I know how frustrating it is! I get a stitch without fail, about 10-15mins into every run. Always. It's not food/breathing/drinking/carrying stuff related. The only time I don't get it is if I'm running ONLY uphill. I too have tried everything (and running only uphill all the time isn't really an option!). I've seen two physios and a sports doctor. All have suggested various abdominal/core strength exercises and think it is perhaps a tight psoas or abdominal muscle and have tried manually releasing these muscles. (You can do it yourself - basically just push on where it hurts while lying down until it releases a bit) The latest physio thinks it is more of a postural thing, and that concentrating on running "tall", tilting my pelvis forward, and making sure I don't twist or swing one arm more than the other may help a bit. Can't say any of these things have really helped me so far, but perhaps if you try some you might have some luck?
Posted: 16/03/2007 at 02:44

Apparently if your stitch is on the right then it has nothing to do with what you eat or drink If you get a stitch on your right then it is your abdominal muscles which need strenghening to hold in your organs better, which will come with more running or some ab exercises. If you get stitches on your left this is your food/drink as this is where your stomach is.
Posted: 16/03/2007 at 07:51

I was going to say the same as hopeless procrastinator, I have the same problem and it is always on my right side. I have been advised that this is due to weak ab muscles. This could be relevant as you have had an extended break due to injury - good luck, hope you get it sorted.
Posted: 16/03/2007 at 09:21


h'mmm. Ironically, my abs are pretty good - even though i had to stop running, i kept on doing my core abdominal exercises three times a week - i have to do these because i have lower back problems. i went for a run yesterday - stitch AGAIN - but it did get better after i dug my hand into where it hurt and wiggled it about a bit. the annoying thing is, i've never really suffered from it before! maybe it's just something i'm going to have to get used to...
Posted: 16/03/2007 at 11:54

We're all mental! we're in pain why dont we all just quit and stop punishing ourselves :)
Posted: 16/03/2007 at 12:08


Oh go on then. You've just convinced me to accept an invitation to go for fish and chips with a group of mates this lunchtime rather than going running...well, it is Friday, after all...
Posted: 16/03/2007 at 12:15

if i can play any part in your long term happiness i'm a happy man myself ;)

Enjoy that meal!

Posted: 16/03/2007 at 12:17


Heh heh - well, at least it'll get my salt levels up :o) mmmmmmmmmmmmm...and naturally, will have to be followed by chocolate to balance the sugar levels.

superb.
Posted: 16/03/2007 at 12:20

I wouldn't have suggested any other combination! you'll certainly have to keep in touch to let me know how the running goes! i'll look out for further stitch threads :)

Posted: 16/03/2007 at 12:24


cool - will do Phillip, and thanks for your suggestions - let me know if you find any other info!
Posted: 16/03/2007 at 12:26

I've not read all the posts, so someone may have said this before, but I find that if I breathe out as hard as I can, then harder still until there is NO air in my lungs, the stitch will go away.

You may need to do this a couple of times, but it never fails for me.
Posted: 16/03/2007 at 12:30


Thanks Wilkie, I'll try that when i next go for a run. Which won't be today, as I've filled myself with lard and am currently munching my way through a very nice tub of chocolates :)

I love running - I can have days of eating like this and it just doesn't matter!!
Posted: 16/03/2007 at 14:08

Try this one.... continue running but tense your stomach as if someone was about to hit you - makes sure you keep breathing though! After a few mins the stitch should go away. Not sure about the physiology behind it (my mate came up with this one) but works for me every time!
Posted: 16/03/2007 at 17:57

Hi LT, I have found that I can prevent the onset of stitch with 2 things:

1. Start the run off at a slower pace (prehaps to do with the amount of oxygen you take in?). If I am running with a faster group or at a race I get stitch, if I can control my starting pace, I don't.

2. Drink when your running...I found that dehydration can lead to stitch, but this is on longer runs so maybe not relevant to you right now.

If stitch does come on then try thinking about something else, the more you concentrate on it the worse it will feel.

Good luck!
Posted: 17/03/2007 at 08:31

Loads of great answers here.

My own experience is similar to Jane Taylor's - I stitch like mad if I run any time other than first thing in the morning. I also have loads more energy first thing, so I rarely run in the afternoons now.
Posted: 17/03/2007 at 13:54

Hi LT,

I have a method that stops me getting a stitch. As soon as I feel one coming on, I breathe deeply through my nose. It does take a little getting used to and you will find it difficult to breathe in the same rhythm, but it works every time for me!

Not sure why it works, was once told by my old rowing coach that breaths taken in through the nose oxygenate a deeper, larger area of the lung than breaths taken in through the mouth (more like panting gulps when I run!).


Posted: 22/03/2007 at 13:27


Thanks CNS...unfortunately, i can't breathe properly through my nose when i run(i broke it a few years back and now have rhinitis - i can't take deep enough breaths through it). maybe i should just take a drill to it ;o)
Posted: 27/03/2007 at 10:00

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