Side Stitches: Understanding, Preventing, and Managing the Runner's Nemesis

We've all experienced that sharp, stabbing pain on the side of our abdomen during a run—the dreaded side stitch. Whether you're a seasoned runner or just starting your fitness journey, side stitches can be an unwelcome and uncomfortable companion. In this article, we'll delve into the causes of side stitches, explore strategies for prevention, and provide tips on how to manage this common ailment if it strikes during your workout.

What are Side Stitches?

A side stitch, medically known as exercise-related transient abdominal pain (ETAP), is a sharp, localized pain that occurs on either side of the abdomen, just below the rib cage. It is most commonly experienced during physical activities like running, but it can also occur during other forms of aerobic exercise. The exact cause of side stitches is not entirely understood, but several theories shed light on why they occur.

Causes of Side Stitches:

  1. Diaphragm Stress: One prevalent theory attributes side stitches to stress placed on the diaphragm—the primary muscle responsible for breathing. During intense exercise, the diaphragm can become fatigued and cramped, leading to the sensation of a side stitch.

  2. Reduced Blood Flow: Another theory suggests that side stitches are a result of reduced blood flow to the diaphragm and other abdominal organs during exercise. Blood is redirected to the working muscles, potentially causing discomfort in the abdominal area.

  3. Eating Before Exercise: Consuming a large meal or drinking a lot of fluids immediately before exercise can contribute to side stitches. Digestion requires blood flow to the stomach and intestines, potentially limiting blood supply to other areas, including the diaphragm.

Preventing Side Stitches:

While the exact cause of side stitches may not be entirely understood, several strategies can help reduce the likelihood of experiencing this discomfort during your workout:

  1. Gradual Warm-Up: Start your exercise routine with a gentle warm-up that includes dynamic stretches and low-intensity movements to prepare your body for more intense activity.

  2. Proper Hydration and Nutrition: Stay adequately hydrated throughout the day and avoid eating large meals close to your workout. Instead, opt for smaller, easily digestible snacks before exercise.

  3. Breathing Technique: Focus on rhythmic breathing while exercising. Inhale and exhale deeply through your mouth or nose, syncing your breath with your stride or movement.

  4. Core Strengthening: Engaging in regular core-strengthening exercises can help support and stabilize the muscles of the abdomen, potentially reducing the occurrence of side stitches.

Managing Side Stitches:

If a side stitch strikes during your workout, there are several techniques you can try to alleviate the discomfort:

  1. Slow Down: Reduce your exercise intensity and pace until the pain subsides. Sometimes, simply easing up on your effort can help alleviate side stitches.

  2. Change Breathing Pattern: Experiment with different breathing patterns to find what works best for you. Some people find relief by exhaling forcefully when the opposite foot strikes the ground.

  3. Press and Breathe: Place your hand on the affected side and apply gentle pressure while taking deep breaths. This can help relax the diaphragm and reduce the pain.

  4. Stretch: Slow down and perform gentle stretches targeting the abdominal area. This can help relieve tension and discomfort.


Side stitches are a common nuisance experienced by many athletes, especially during running or other aerobic exercises. While the exact cause may not be definitively understood, applying preventive strategies such as proper warm-up, hydration, and breathing techniques can help reduce their occurrence. If you do experience a side stitch during your workout, listen to your body, slow down, and try some of the management techniques mentioned above. Remember that each person's experience with side stitches is unique, so it may require some trial and error to find the most effective prevention and management strategies for you. As always, if you have persistent or severe pain, it's essential to consult with a healthcare professional to rule out any underlying medical conditions. With a little awareness and preparation, you can minimize the impact of side stitches and enjoy your workouts more comfortably.