What causes a stitch?

What is called a ‘stitch’ is actually a pain felt during a run. Sometimes when we experience a stitch, the pain is felt not only by side but is also felt at the right shoulder tip. This is because the same nerve that connects the liver and diaphragm has the same origin as the nerve that connects the shoulder. Our brain can’t differentiate where the pain is coming from so you might experience a pain at the shoulder tip during a stitch when in fact there is nothing wrong with your shoulder.

There are 3 common theories on what causes a stitch.

Theory 1. During the run there is an increased blood flow through the liver as the blood has to bypass the liver before getting to the heart. With the increase in the heart rate during the run, there is more blood to get through the liver. The liver enlarges secondary to blood engorgement and stretches its capsule. Sometimes the blood flow is so great that it forms a ‘traffic jam’ in the liver and this causes the liver to engorge and expand with blood. This stretches the tight capsule surrounding the liver and since the capsule is full of nerves that are sensitive to stretching, we feel the side pain which we call a ‘stitch’.

Theory 2. Our liver and other organs hang on the diaphragm. It is a large sheet-like muscle that helps us breath. During running, the diaphragm contracts harder and stronger to let us breath deeper. At the same time, the liver and other organs hanging on the diaphragm are bouncing up and down and this causes the diaphragm to cramp up, causing pain which we call a ‘stitch’.

Theory 3. Another less common theory is that during running, the blood supply to the
diaphragm drops because more blood has been directed to the legs to supply more oxygen to the working muscles. This lack of blood to the diaphragm causes it to cramp up, causing the stitch pain.

How to get rid of running stitches?
It can be quite annoying to be experiencing a side stitch in the middle of your run. The sharp pain that accompanies with each step eventually causes you to slow down and walk. The thought of giving up lingers in your mind. Fret not. Here are some ways you can adopt to prevent stitches from ruining your run.

Proper warm up and stretchingEach time before you run, make sure you are properly warmed up to get your muscles prepared for the distance ahead. Do some dynamic stretches and avoid going out at a very fast pace from the start. Going all out without preparing your body for it results in higher chance of you getting a stitch.

Reducing your speed If it’s hurting bad slow down or come to a stop. Focus on your breathing, keeping it long and deep. This will get your muscles to relax and allow the stitch to go away.

Applying pressure on the affected spotAn effective way to soothe the pain is to apply pressure on the spot that is hurting and exhale strongly. This method should relieve the discomfort in a short time.

Eat right and eat lightAvoid heavy meals and foods that are not easily digestible just before starting your run. If you really have to consume something, make sure you keep the portion small. Having a fruit is an ideal choice.

Happy pain free running!

Darren Foo
Fitness & Lifestyle Instructor


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