Side Stitches

Side Stitches

What does running in the annual Hermitage, Pennsylvania, Gobble Wobble five-kilometer road race have in common with Cowboy Bob's five-second spin around the rodeo ring on the Widow Maker? Easy: In both events, the enthused contestant is in danger of contracting painful side stitches.

Pounding the pavement, riding a bucking bronco and a host of other wild and crazy antics can easily jostle your diaphragm into a sudden state of spasm.

"When you're breathing out, your diaphragm rises--and that raises tension on ligaments between the diaphragm and your other internal organs," says Owen Anderson, Ph.D., editor of Running Research News in Lansing, Michigan. "If your running foot hits the ground right at that moment, it creates a jolting action that temporarily upsets your diaphragm." Another theory suggests that overexertion--in a race or competition--sometimes taxes the diaphragm, sending it into spasm.

But you don't have to hang up your Keds or hobble your trusty steed to beat side stitches. Here's how to unstitch them before your competitive ambitions come unraveled.

Tone your tummy. Stronger stomach muscles help support the internal organs thought to cause side stitches. One method to get them in shape is with stomach crunches. Lie on your back with your feet on the floor and your knees raised. Fold your hands on your chest. Gently lift your torso and back off the floor about three inches and gently exhale. Then inhale as you slowly lower yourself back down. Repeat 20 times.

Grunt and avoid it. This technique sounds primitive, but Dr. Anderson says grunting at the first sign of a side stitch is a surefire remedy. "When your foot hits the ground and you make a forceful grunt, that helps you allow the diaphragm to be free and relaxed and release some of the tension." It's not necessary to grunt throughout the race, though--unless you want to frighten your fellow runners, says Dr. Anderson.

Go head over heels. Here's another quick fix for severe side stitches from Dr. Anderson: When you feel one coming on, stop running, lie down on your back, and pull your knees over your head. The pain should subside immediately. (If it doesn't, call a doctor, says Dr. Anderson. This kind of pain can be a signal of a heart attack.)

Start belly breathing. Rather than taking short, quick breaths, you want to breathe deeply. The best way to learn: Practice for five minutes each day. Lie down and place a book on your stomach. With every inhalation, try to raise the book before expanding your chest, says Dr. Anderson. That action of your diaphragm automatically creates deep breathing.

Don't eat and run. If you're prone to getting side stitches, avoid eating or drinking for a couple of hours before you go on a run or a bumpy ride. A full stomach pulls on the diaphragm more forcefully, creating greater tension and, as a result, side stitches. "Lots of extra fluids are needed during the longer races such as marathons, but you should be able to get by without them in ten-kilometer races and shorter competitions," says Dr. Anderson. By experimenting with amounts, however, you may find that you're able to tolerate some fluids. The only caution: If you're going to run in the heat for an hour or more, you need to drink about 1 3/4 cups of water (14 ounces) before starting. After that, drink 3 to 4 ounces every ten minutes, if possible, whether you're prone to side stitches or not, he says.

Stay away from carbonated beverages. Some experts believe that one reason side stitches occur is because gas is trapped from bubbly drinks, says Susan Perry, a physical therapist specializing in sports medicine at the Fort Lauderdale Sports Medicine Clinic in Fort Lauderdale, Florida. As a result, it's best to avoid any carbonated drinks within a few hours of participating in the activity, she says.

Moderate your pace. Slowing down may keep your stitches from knocking you out of the race, says Dr. Anderson. "A lot of times, a runner who feels a stitch coming on can simply slow down a bit, try to relax and change breathing patterns. In five minutes, he won't even know he had that initial stitch."

Switch your specialty. If you've tried everything and painful side stitches continue when you run, you might consider riding a bike or walking to get your exercise. "There's much less jolting with biking and walking," explains Dr. Anderson.