MinimalistHow to avoid a side stitch when running
To stop a side stitch, slow to a walk, breathe out slowly and fully, and press gently on the painful spot while leaning slightly forward. To prevent one, avoid large meals and big drinks in the two to three hours before running, warm up gradually, and build up your running slowly.
A side stitch — the sharp, stabbing pain just under your ribs, usually on one side — is one of the most common complaints among new runners. It is annoying, sometimes intense, and almost always harmless.
What causes a side stitch?
The honest answer is that nobody knows for certain. Researchers call it exercise-related transient abdominal pain, and several explanations have been proposed:
- Irritation of the abdominal lining. A leading theory is that the thin membrane lining the abdominal wall gets irritated by friction or pressure, especially when the stomach is full.
- Strain on the diaphragm or supporting ligaments. The jolting of running may tug on the tissues that hold your organs in place.
- Reduced blood flow to the diaphragm when you suddenly work harder than your body is ready for.
What is well observed is the pattern: stitches are common in activities with a lot of repetitive up-and-down movement of the torso, like running and horseback riding. They seem to be more common in younger people and beginners, and they often appear after eating or drinking shortly before exercise.
How to get rid of a side stitch mid-run
Try these in order. Most stitches fade within a few minutes.
- Slow down or walk. Reducing the jolting and your breathing rate is the single most effective step.
- Breathe deeply and slowly. Take a full breath in, then breathe out longer than you breathed in, through pursed lips.
- Press on the spot. Push two or three fingers firmly into the painful area while you breathe out.
- Bend forward slightly. Leaning forward from the hips, or bending over briefly with hands on knees, helps many people.
- Stretch the side. Raise the arm on the painful side overhead and lean gently toward the opposite side.
- Change your breathing rhythm. Some runners find that switching which foot lands as they exhale helps. If you always breathe out on your right foot, try timing it with your left for a while.
When the pain has gone, start jogging again very gently. Going straight back to your previous pace often brings it back.
What to eat and drink before running
Food and drink timing is the factor you have the most control over.
| Before your run | Generally fine | More likely to cause trouble |
|---|---|---|
| 2–3 hours | A normal meal | Very large, fatty or heavy meals |
| About 1 hour | A small snack: banana, toast, a few crackers | High-fiber or rich foods |
| Last 30 minutes | A few sips of water | Gulping a large drink, especially sugary juices or soda |
Everyone is a bit different. If you get stitches often, keep a simple note of what you ate and when, and look for a pattern over a couple of weeks. Some people are fine running after breakfast; others need an empty stomach.
Habits that make stitches less likely
Warm up gradually
Starting a run at full pace gives your breathing and abdomen no time to settle. Walk briskly for five minutes first, then begin with a slow jog. Stitches often show up in the first 10 minutes of a run that started too fast.
Keep the effort easy
Fast, ragged breathing seems to make stitches more likely. Running at a pace where you can still talk helps on many fronts — see easy effort for beginners for how to find it.
Build up slowly
Stitches are more common in beginners and tend to become rarer with regular training. A steady plan like our 8-week first 5K plan, with plenty of walking, gives your body time to adapt.
Stand tall
Slouching seems to be linked with more stitches in some people. Run with your chest open and shoulders relaxed rather than hunched forward. Our article on posture and technique has simple cues that apply to running too.
Strengthen your core
There is some suggestion that stronger trunk muscles help. Even if the effect is modest, a few minutes of planks, bird-dogs and dead bugs twice a week are good for running in general.
Is it a stitch or something else?
A typical side stitch is sharp or cramping, sits just under the ribs on one side, sometimes comes with pain at the tip of the shoulder, starts during exercise, and fades within minutes of stopping.
See a doctor if the pain:
- doesn’t go away after you stop exercising,
- is severe or getting worse,
- comes with fever, vomiting, or swelling, or
- happens even when you’re not exercising.
Chest pain, pressure, or pain spreading to the arm, jaw or back is different, especially with shortness of breath, nausea or dizziness. Stop immediately and seek urgent medical help.
FAQ
Why does my stitch always show up on the same side?
Stitches can occur on either side, and many people find theirs tends to return to the same spot. Why that happens isn’t well understood. If the pain is always in one place and also appears when you’re not exercising, mention it to your doctor.
Can walking cause a side stitch?
It can, especially brisk walking soon after a meal, but it is much less common than with running because there is less jolting.
Will side stitches go away as I get fitter?
For most people, yes. They tend to become less frequent with regular training, though they can still show up after a big meal or a fast start.