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crampsYou are running along at a steady pace when suddenly you are gripped with an intensely sharp stabbing pain in your side. With each breath, the pain under the lower edge of your ribcage becomes more intense and you’re forced to stop or slow down.  Side pain (also called side stitch) or what is referred to scientifically as “exercise related transient abdominal pain” has been experienced by every runner at some point in time, and for me, every time I run.  Regardless of the name you choose for it (enter expletive here), what is it that causes that nagging feeling that makes you want to stop running and fold over in pain.

I recently ran a 5K and as per the normal routine, right around the two mile mark, I found myself trying to minimize that sharp pain in my right side.  I spent the last 1.2 miles trying to focus on something other than the pain.  Thankfully for me, it didn’t last very long and I was able to finish the race pain free.  But, there are some of you who have a much harder time shaking the pain, and are forced to stop running because of it.  What is it that causes side pain and what can we as runners do to prevent it from happening? 

What causes side pain when running?

According to a sportsmedicine.about.com “While there is still no definitive explanation for the cause of a side stitch, there are several very convincing theories.  The majority of the researchers believe that it has a lot to do with what we eat before we exercise.” 

According to health.howstuffworks.com “Another explanation may be that exercising intensely decreases blood flow to the diaphragm, causing it to go into spasm. Also, raising the knees to run contracts the belly muscles, which increases pressure inside the belly and presses on the diaphragm from below.  Additionally, during exercise, air tends to get into the lungs more easily than it gets out, so the lungs fill with air and press on the diaphragm from above. The dual pressure may squeeze the diaphragm and briefly shut off its blood flow, resulting in cramping.”

There are far more less complicated studies that have shown that dehydration is a common cause of side stitch.  One study reported that consuming reconstituted fruit juices and beverages high in carbohydrates, either just before or during exercise will trigger the onset of side stitch. 

What I have learned researching is that experts are not really sure what causes side stitch.  The theory that seems to be the most prevalent is that side stitch is believed to be a cramp in the diaphragm, the large, flat, muscular membrane that separates the chest and abdominal organs and helps force air into and out of the lungs during breathing.  Exactly why the diaphragm spasms, however, remains unclear.

 

So what do we do to prevent side stich from happening?

Some experts say stop running and place your hand onto the right side of your abdomen and push up while inhaling and exhaling evenly.  For those of who are running races, this isn’t the answer we are looking for.  Being that there is no real evidence as to what causes side stitch, it is safe to say there are multiple solutions to avoid it from happening.  I suggest experimenting with several suggestions and see what works best for you.  Listed below are options for you to try.

* Drink water or other healthy fluids before running.

* Avoid drinking reconstituted fruit juices and beverages high in carbohydrates before and during your run. 

* Time your pre-race meal to allow it to digest prior to the race.

* Start off slow and then gradually get faster as you run (many of us, including myself, do just the opposite of this).

* While running, try to breathe deeply and slowly from your lower lungs, expanding the belly as well as the upper chest.

* Sometimes, just simple stretching can relieve the pain.  Raise your arm straight up and lean towards the side that isn’t causing you pain.

Let us know what works best for you so we can offer those suggestions to others that are experiencing that same nagging intense stabbing pain that might be discouraging them from running more.