Question: Hi Mary,
I am training for my first marathon, but have trouble with frequent side aches. I have given up eating/drinking (other than a little water) before my runs, but still have issues. Any suggestions on what else I can do? If I get a side ache, they are frequently so bad that I must stop running altogether, which is very frustrating. Thank you! Greta
Answer: I did some research, and here is what I found. Personally, I have rarely suffered from side stitches. The only time I can remember is when I would push myself on my hill run and was really breathing hard.
The side stitch is especially common among beginners who are still adapting to the demands of running and may have weak abdominals. But even elite runners get stitches.
What causes stitches is a spasm of the diaphragm, the muscle that controls your breathing. When you’re running too fast or too hard, the diaphragm is deprived of oxygen which results in the spasm. Or another cause is when you breathe exceptionally hard, it forces the diaphragm downward and the ligaments that connect the diaphragm are stretched. Result: Pain.
Whatever the exact cause, if your breathing too hard while running, the diaphragm can often bark back with a stabbing pain. Sometimes in a race you’ll be pushing hard to catch another runner and the straining can cause a stitch. This can also frequently occur when racing downhill because the jarring motion tightens the abdominal muscles. Or, if you are running too soon after eating, your heavy stomach may literally be tugging at the ligaments connected to the diaphragm. Sometimes drinking very cold water during a race has been known to cause stitches.
If you’re hit with a stitch, the best remedy is slow down or stop. Don’t panic, concentrate on getting your breathing under control by belly breathing. That is, force your belly out when you breathe in and relaxing it as you breathe out. Take deep breaths when you inhale and exhale forcibly. Usually this works within a minute or so, but if the pain is just too much to endure and you’re forced to stop, bend over and raise your knee on the side of the stitch while pressing your fingers deep into the painful area and tightening your stomach muscles. Or just walk while belly breathing.
Try and practice belly breathing on shorter training runs so you’ll be prepared for the next stitch. Also, try doing abdominal work after every run. Do bent-knee sit-ups to strengthen the abdominal muscles. Or crunches. Also, make sure you don't eat too close to a run.
I hope this helps.