Side Stitch: Symptoms, Causes, Treatment, and Prevention

Photo by: Bigstockphoto
Photo by: Bigstockphoto

Side stitch – also known as Exercise-Related Transient Abdominal Pain or ETAP – is a type of muscle spasm that occurs on the side of the midsection. ETAP usually occurs during extreme physical movement, such as exercising, running or engaging in sports. Runners are particularly vulnerable to side stitches. While ETAP is not considered as a sports injury, more than 70% of regular runners suffer from this condition.

Signs and Symptoms of Side Stitches

The most common sign of a side stitch is a sharp, almost stabbing pain under the lower edge of the ribcage. Most times, the pain will shoot up on one side of the midsection or both sides simultaneously. Side stitch has no known cause. But health experts believe it’s brought on by intense physical activity. Usually, exercises that require vigorous up and down movement trigger this condition. People who do a lot of running, jumping or horseback riding are prone to side stitches. A side stitch is also common among amateur athletes.

Causes of Side Stitch

Side stitch affects the dome-shaped muscle within the ribcage called diaphragm. When the diaphragm muscle starts to spasm, pain shoots into the ribcage area. More than 70% of the population exhale when their left foot strikes the ground, less than 30% exhale when their right foot hits the ground.

As you inhale, the lungs start to expand. Because the lungs share a space within the ribcage with the diaphragm, the latter starts to move downward. And this movement is done at a rapid rate especially if you’re running. When you exhale, the diaphragm is pushed down, the muscles that hold the internal organs stretches. This causes pressure on the surrounding muscles and ligaments. These ligaments are attached to your internal organs. So when your right foot strikes the ground, your internal organs are literally pushed downward with it. The pressure from all your organs being pushed downwards triggers pain.

Side Stitch Treatment and Prevention

Stop or Reduce Physical Activity

The best way to treat a side stitch is to stop all physical activity as the pain sets in. If you must exercise, minimize the intensity of your workout. Or give yourself a few minutes to recover from the pain, if possible.

Breathing Exercises

Breathing exercises work great for soothing ETAP. Start by taking deep breaths as you run. Shallow breathing tends to trigger a side stitch. Inhale to fill the lungs then allow the diaphragm to lower down so there’s less stress on the internal organs.

Warm Up Exercises

Warm up exercises are critical to any fitness routine! More so if you are prone to a side stitch. Start by doing rounds of stretching for at least 10 minutes. Warm up exercises condition the muscles, preventing injuries. It also preps the whole body for the intense physical activity ahead.

Hydrate Yourself

Drink water within an hour of a physical exercise. When the body is hydrated, the muscles are less likely to spasm. This minimizes the chances of a side stitch.

Strengthen the Core

A strong core is everything. It allows you to take on intense physical exercises with relative ease. Apart from toning the abdominals, activate the surrounding muscles as well. These muscles include the lower back and the obliques. Stretch these muscles groups too!


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