Feeling the first pangs of a stitch in your side when you’re running is one of those frustrating scenarios all runners have dealt with at some point or another. A stitch may be small, but they sure are mighty. When that pain materialises in your stomach, usually just under your ribs, you know about it: a stabbing, cramping, aching sensation that is debilitating enough to stop you in your tracks. 

Usually, people blame themselves for their stitch, thinking it’s a sign of poor fitness levels or bad pacing. But even those who are super fit can get stitches. Case in point: Kerry Dixon, former athlete and founder of The Athlete Method, who has had her fair share of stitches. “Your fitness levels are irrelevant,” she says. “That’s just a myth and also a nice excuse to not give something a try because you’re not ‘fit enough’.”

So if it’s not your fitness, what is the real cause of a stitch? That’s where things get more complicated. “No one knows exactly what causes it,” says Dixon. She says that a stitch can be down to “your muscles becoming over engaged or over-compensating”, for example if you’re leaning to one side or sucking in your abdominals too much. 

“The other theory is that it’s to do with limited blood flow into your lungs and diaphragm [the muscle that helps your lungs expand]. There’s more demand on the body during exercise and if the blood flow can’t get there fast enough, the organs can really struggle to keep up,” Dixon adds. “It could also come down to either the muscles pressing on nerves around that area, the ligament’s and muscle membrane ‘tugging’ on your abdomen thanks to the impact of running, or simply the movement of exercise putting strain on your upper and lower abdomen.”

Essentially, it can be as much about you and your running form as it is one of those weird things that the body sometimes does. 

While we might not fully understand why stitches happen, there do seem to be some things that reduce your risk. The first is staying hydrated. 

“Trying to make sure that you drink plenty of water in the hours leading up to your runs is important. It’s easier and smarter to be hydrated in advance, because if you down a load of water while training it can cause bloating and make the stitch worse,” Dixon explains.  

“Also avoid eating large portions of food before running because, again, it’s might not digest properly. If the bowels are trying to process and break down food while you’re running it can cause irritation, which won’t help.”

Kerry recommends having a meal two or three hours before running, or a light snack an hour or so before heading out.

And her third tip is to ensure that you do a proper warm-up before running to prepare the muscles and get the blood flowing. “Anything that can reduce demand on the muscles is going to help,” Dixon explains.

Knowing how to prevent a stitch is all well and good, but what if you find yourself mid-run, dealing with that familiar stabbing sensation? Pushing through probably isn’t your best bet, Dixon explains.

“Stop or at least slow down for a minute or so and take some deep breaths,” she says. “I always found that lifting my hand overhead – my right hand if the stitch was on my right side – to stretch and decompress the obliques and abdomen really helped. You need to get your diaphragm to relax and once the blood flows into that area, it should stop the pain and allow you to continue moving again.”

Remember: there’s no shame in stopping mid-run if you need to, and you’re not proving anything by pushing through pain. “It’s very difficult to run through a stitch and it doesn’t always help to keep going,” Dixon concludes.

Images: Getty