Preventing The Dreaded Runner’s Side Stitch

Imagine this, you’re half way through a neighborhood run you’ve done a dozen times when all of a sudden—a familiar dreaded, dull pain hits you and grows into a sharp stitch along your right side below your ribs. According to research from the National Institutes of Health, roughly 70-percent of all runners deal with side stitches.

The NIH experts call them bouts of ETAP (or exercise-related transient abdominal pain), which is believed to occur due to either irritation of the parietal peritoneum (the abdominal membrane) or a muscle spasm and ischemia (lack of blood flow) in the diaphragm. The good news is the more you run, the less frequently side stitches will occur. Until then, you can stop side stitches in their tracks with these five tips…

Don’t Forget to Breathe

New runners who constantly suffer side stitches might be forgetting to breathe, and breathe properly. To prevent stabbing side cramps, Runner’s World recommends concentrating on steady, even breathing and points to inconsistent or constricted breathing as the main reason you’re grasping at your side.

Instead, when you feel that telltale dull pain growing on your left or right abdomen, slow your running pace and steady your steps, then let your breathing slow and match your foot strikes. For example, if you’re side stitch is on the right, exhale each time your left foot hits the ground.

Too Full Belly

Running too soon after eating or drinking too much is also a quick way to end up with a painful side stitch, which occur in the diaphragm. Too much food or drink weighing on the diaphragm can cause excess weight, restricted breathing, stomach upset, and cramping.

A 2005 study published in the Journal of Science and Medicine in Sport, points to slow-digesting, fatty foods as a prime culprit. Drinking too many fluids, particularly high fiber juices, too close to a run can also lead to diaphragm distress. That’s why it’s wise to space your meals and runs at least 2- to 3-hours apart.

Replenish Those Electrolytes

Oftentimes side stitches can be fixed with a little electrolyte replacement therapy, which is easier than it sounds since it often just takes a little sprinkle of salt!

Dr. Lewis Maharam, a well-known sport medicine and running expert known as the “Running Doc”, says a little salt can often do the trick to replace lost electrolytes on longer runs.

Stretch Out That Stitch

The best way for runners to combat a side stitch is to take the time to stop and deal with it en route. Instead of continuing on your run and ending up in a great deal of pain, Susan Paul, the Training Program Director at Florida’s Track Shack Foundation suggests taking pause.

Paul recommends stopping to stretch out the pain, while breathing deeply, and  pressing into the point of pain. Stretching exercises that focus on the area of the diaphragm can also prevent future stitches.

Build Core Strength

According to, preventing side stitches means strengthening the surrounding abdominal muscles—notably the rectus abdominis, transversus abdominis, and the internal and external obliques.

These abdominal muscles, as well as the diaphragm, are responsible for balance, posture, and they absorb a lot of shock as you run. To reduce abdominal and diaphragm distress, strengthening the core muscles with targeted exercises may be the key.


Emily Lockhart

Emily Lockhart is a certified yoga instructor and personal trainer. She believes that being healthy is a lifestyle choice, not a punishment or temporary fix to attain a desired fitness or body image goal. Anna helps her clients take responsibility for their own health and wellness through her classes and articles on ActiveBeat.