Posted on: March 26, 2009 Posted by: Nicole Harding Comments: 0

A side cramp, also known as a side sticker, a side stitch, or simply a stitch, is an intense stabbing pain just below the ribcage. It is usually felt when running. It’s also sometimes referred to as exercise related transient abdominal pain or ETAP. The main cause of stitch is still unknown, but recent studies have suggested that it’s probably caused by strain on ligaments connecting your liver to the diaphragm. Running or exercise exert a steady downward force on your liver, stretching these ligaments and causing pain. While the pain usually disappears quickly, it can be annoying and interfere with your workout. The following are tips to get rid of stitch and how to prevent them.

Getting Rid of Stitch while Running or Working Out

Since stitch is related to strenuous exercise, the best cure is probably to slow down or stop until the pain is gone. Some people though don’t want the stitch to ruin their momentum, so they keep going even with the stitch. There’s currently no evidence that suggests this is unsafe, so if you want to keep on running or working out despite the stitch, the following tips should help you get rid of the pain quickly.

Step 1: Slow down or reduce your pace once you feel the pain in your lower ribcage.

Step 2: Put your hand on the area where you feel the pain, thumb to the rear and fingers to the front.

Step 3: Squeeze firmly with your hand, then bend at the waist at 45 to 90 degrees while still running.

Step 4: Run a distance of about 15 meters with your body bent at the waist, and then slowly straighten up.

Synchronizing Your Breathing Pattern

One theory on the cause of stitch says that the rhythm of your breathing and running affects the strain on the ligaments that connect the diaphragm to the liver. You usually exhale as your left foot hits the ground when you’re running. This supposedly causes your liver to fall with gravity as your diaphragm rises, stretching the ligaments. According to many runners, the following breathing technique helps reduce or eliminate stitch while running.

Step 1: Try to synchronize your breathing pattern with your running.

Step 2: Determine which side of your body aches, the left or the right. Exhale when your foot on the side that doesn’t ache hits the ground. For example, if you have a stitch in your right side, exhale when your left food touches the ground. Don’t worry about inhalation because if you exhale at the right time, your inhalation should be synchronized too.

Step 3: Keep this breathing pattern until the stitch subsides or disappears. According to the theory, your diaphragm should move downward at the same time as your intestines, reducing the stress on the ligaments.

Other Tips to Get Rid of Stitch

The exact cause of stitch is still unknown, so people have different ways of dealing with it based on their theories. There’s currently no info on which way works best, but you can try the following if the techniques mentioned above don’t work.

  • Avoid breathing shallowly, and use deep breaths while running or working out. This technique is also based on the “strained ligaments theory.” Shallow breathing supposedly keeps the diaphragm consistently raised, putting more stress on the ligaments.
  • Breathe through pursed lips.
  • Slow your breathing pattern while running by synchronizing it with a one or two-step count.
  • Stop what you’re doing, and then walk briskly for a few seconds while concentrating on deep breathing. Continue your activity after the stitch goes away.
  • Stop your running or workout completely, then touch your toes. This one is probably based on another theory that says stitch is caused by trapped gas that has accumulated while running or working out.
  • Drink water or replacement fluids. According to another theory, stitch is caused by dehydration, so washing the organs with fluids will help reduce or get rid of stitch.
  • Grunt when you exhale. Apparently, it gets rid of side stitch by forcing the diaphragm out of its taught exhale position.
  • Poke your diaphragm by pushing your fingers deeply into the area just below your ribcage. At the same time, purse your lips and exhale as hard as you can.

How to Prevent Side Cramps

Preventing stitch is much easier to do than getting rid of it. If you prepare for your workout the right way, your chances of getting a stitch or any other kind of pain or injury should be reduced. The following tips should minimize your risk of getting a stitch while working out.

  • Follow the one hour rule: Wait for at least an hour before exercising if you’ve eaten a meal. Many people usually get side cramps when they run or exercise just a few minutes after eating a heavy breakfast.
  • Avoid eating fatty or caloric foods before running or working out: Eat something that has a lot of complex carbohydrates, like a granola bar or some almonds. Do not eat a whopping burger or a deep-fried pizza before you start on your exercise.
  • Warm up: Having tense muscles before working out doesn’t help your body at all. Do some stretching before running, or some warm-up exercises like jumping jacks before you move on to your main workout. This should loosen your muscles and get the blood and oxygen flowing smoothly through your organs, reducing your risk of stitch.
  • Don’t push yourself too hard: Some people are tempted to do strenuous exercises right away when they work out. They also reach a kind of high when they don’t want to stop exercising or running even when their body has clearly reached its limits. Although pain is a sign that your body is developing, you also don’t want to push it too hard and cause damage than improvement. Take some time to catch your breath when running, or drink a glass of water or a bottle of fluid replacement when you feel exhausted. You’re not a machine, so let your body adjust to the rapid physical changes you’re introducing to it.
  • Try belly breathing: Tim Noakes, professor of exercise and sports science at the University of Cape Town, recommends “belly breathing” to prevent stitch. In belly breathing, your belly rises dramatically with each inspiration and plunges inward with each expiration, while your chest moves less dramatically. Train to breathe this way by lying on your back and putting some books on top of your belly. Breathe until your belly rises to its full height, and then exhale deeply, so your abdomen plunges downward. Noakes says that breathing this way is not easy, and it can take up to several months to train yourself to breathe optimally.
  • Build your abs: The pain is in your belly, so why not build that area to make it more resistant to injury? Strengthen your abs by doing crunches or bent-leg partial sit-ups. You only have to lift your shoulders about six inches from the ground, so it’s less stressful than full sit-ups. You can also lie on your back with your legs stretched out, and then lift them a few inches off the ground. Hold this position for 20 to 30 seconds before lowering your leg back to the ground again.
  • Strengthen your diaphragm. One possible cause of stitch is weak diaphragm and abdominal muscles. Increase the strength and endurance of your diaphragm and abdomen by running fast a couple of times a week. If you’re short on breath, you may try inserting fast running intervals during your regular moderately paced jog.
  • Walk downhill: Running downhill exacerbates side cramps because it increases the downward force exerted on the liver and the entire body with each step. If you’re a novice runner, try walking downhill first instead of running until you’ve mastered the proper breathing technique.
  • Wear a light, wide belt around your waist. This type of belt moves your abdominal contents upward and inward, reducing the stress on the ligaments between the liver and diaphragm.
  • Practice yoga: If you believe the theory that side cramps are caused by strained ligaments in the diaphragm, then you may consider yoga as one of the best ways to prevent stitch. Yoga’s exercises emphasize proper breathing and muscle flexibility, and certain yoga routines can have dramatic positive effects on the strength of your diaphragm and abdominal muscles. Join a yoga club or purchase yoga books and DVDs to learn the discipline.
  • Loosen up: Side cramps are known to ruin runners’ plans for a good race. Try to loosen up before a race, so your abdominal muscles and organs will work perfectly when the gun fires. Have a friendly chat with your fellow runners or tell some jokes. Laughter releases tension in the diaphragm and makes the abdominal muscles loose and ready for strenuous activities.

Don’t be stuck on your stitch. Do the right preparations before exercising, and always be mindful of your body’s condition to prevent side cramps and other physical injuries.

Click here to learn more about how to get rid of side cramps.

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