What actually are Stitches?
Abdominal stitches are a common problem, particularly among joggers.

The current theory suggests that stitches are most likely the result of spasm of the diaphragm (the dome-like muscle which separates the lungs from the abdomen).

It is believed that during running, heavy abdominal organs such as the liver, which is suspended on fascia connected to the diaphragm, will “bounce” around and tug on the diaphragm, causing it to go into a spasm.

As the liver, which is at the heaviest abdominal organ, is at the right side of the abdomen, this could account for the fact that 70% of stitches occurred on the right side.

This could also explain the fact that about 15% of people who have stitches also experience pain radiating to the shoulders, since this area shares a common nerve supply with the diaphragm.

After a heavy meal, the stomach would also be heavier and as it bounces around during exercise, it could also lead to stitches.

When breathing out, the diaphragm dome rises and this creates room for more forceful bouncing of the organs and tugging of the fascia attachments.

Most joggers fall into a regular breathing pattern while jogging, the most common of which is a “2:1” pattern, where one breath is taken every two gait cycles (a gait cycle is measured from the time one foot comes in contact with the ground to the time that same foot touches the ground again).

This would mean that they would repeatedly land on the same foot while breathing out. This would result in the organs on that side being repeatedly bounced more forcefully.

Based on this premise, if you experience stitches while running, the immediate thing to do would be to switch your “breath-out” foot to the other side. If this does not help, then you may have to stop running.

If pain still persists, lie down with your legs resting on a raised object. This will usually relieve a stitch quickly.

Some measures to prevent a stitch:

1. Strengthen your diaphragm. Practise daily “abdominal breathing” exercises. Lie down and breathe with a heavy book on your abdomen. As you breathe in, the book should rise and as you breathe out, the book should sink. Practise the same method of breathing while standing.

2. Strengthen your abdominal muscles by doing abdominal crunches regularly.

3. Avoid heavy meals two-and-a-half hours before exercise.

4. Relax before you run. Tension seems to make things worse.

5. While on the run, switch your “breathe-out” leg frequently.

6. Grunt as you breathe out! Though it may sound a little strange, some runners who are prone to stitches find this useful. Presumably, this reduces the risk of the diaphragm going into a spasm.

7. Exercise regularly. Most runners find that as general fitness improves, stitches become less common.

Back