You’re out on a run. Have hit you’re groove. And feel like you could carry on for miles.
Then you have to stamp on the brakes as you’re hit by a sudden, intense pinch in the side of your stomach – a damn stitch.
It’s something just about all of us have experienced at some time or another.
But what exactly is a stitch? And more importantly, how can we treat it? Or better yet, prevent it?
Well known but poorly understood
As it turns out, this isn’t a silly question. It’s no reflection of our ignorance.
Despite their common occurrence and the wealth of understanding of our body, the precise cause of a stitch remains unknown.
A handful of different theories have been proposed and investigated. From the pulling of ligaments and tissues that join our abdominal organs to each other and the walls of our abdominal cavity to insufficient blood flow to the diaphragm.
Each possess plausible explanations yet the cause of the seemingly simple stitch remains shrouded in mystery. Although the pulling of ligaments theory currently sits at the top of the leader board.
One thing they can agree on is a fancy scientific name – exercise-related transient abdominal pain (ETAP). That alone surely makes the issue more serious and worthy of investigation.
But the fact of the matter is the transient nature of a stitch has meant they haven’t received much interest or investigation.
Whilst the pain and interruption may only be short-lived, I’m sure all of us would be happy to have the tools to avoid or quickly overcome a stitch when we exercise.
The common threads
So what do we know about a stitch (I’m going to stick with that much simpler title).
Exercise
Despite all of this physiological conjecture, one thing is for sure – it’s caused by exercise. You’d be pretty unlucky to suffer a stitch laying on the couch.
The classic culprit is running but horse-riding is also a common trigger of stitches. This relates to the combination of repetitive torso movement while in an upright posture.
Research on runners have found about 70% of them had experienced a stitch within the past year. And that around one-quarter of participants in a running event suffered a stitch at some point during the race.
This contrasts activities like cycling or basketball, which involve a more stooped posture or variation in torso movements.
Studies have found you’re 10 times more likely to get a stitch while running compared with cycling.
Age
Age always seems to come into the equation when talking about health and particularly exercise. And advancing age always seems to increase your likelihood of suffering.
Well, in a rare but refreshing turn of events, being older is actually a good thing when it comes to stitches.
The prevalence and severity of a stitch actually declines with age.
Which leaves me thrilled because this article comes on the back of experiencing a stitch while I was running on the weekend. Clear evidence I’m still a spring chicken.
Gender and body mass index (BMI)
Research shows both gender and BMI have no effect on the frequency or severity of stitches.
So finally, carrying an extra few kilos isn’t to blame.
Unpicking a stitch
Now we come to what we really want to know:
How we can prevent or treat a stitch so that it doesn’t cause us pain and hamper our exercise performance.
Pre-exercise diet
In view of the most favoured theory related to pulling on and irritation of peritoneal ligaments, it’s recommended that we avoid exercising on a full stomach of food or liquid.
Whilst it’s an individual thing, the recommendation is to limit food in the 2 hours prior to exercise and to avoid chugging down a copious volume of fluid before you set off.
High carbohydrate drinks like fruit juice, soft drinks and sports drinks can also be triggers for cramps due to their action on the gastrointestinal system. So steer clear of them until your exercise is complete.
If you still manage to experience a stitch, trace what you consumed and when in order to determine whether food type, quantity or timing played a role. Then avoid any potential triggers thereafter.
Training
Whilst a stitch can affect anyone, research shows people who exercise more regularly experience them less often. Or put another way, you’re more likely to suffer a stitch if you don’t exercise all that often.
This has been attributed to fitness, core strength and movement technique.
So keep your training consistent and reduce your chances of encountering a stitch.
Bend and flex
In terms of treatment, we’re told to continue what we’re likely to have done instinctively to minimise our suffering.
Slow down a little and see if that eases things. If not, stop exercising and bend forward to flex your torso so that you reduce the pulling strain on your abdominal area.
But rather than trying to relax those crampy abdominal muscles, it’s recommended we tighten them.
So in the midst of suffering that knife in your side, flex that six-pack like you’re one of those gym-junkies posing in front of the mirror.
Regardless of whether you’re a competitive athlete or just amassing your recommended dose of exercise, a stitch is an unwelcome visitor.
For athletes, it could make a monumental difference in performance and the outcome of the event.
For the rest of us, it’d be nice to avoid any pain and discomfort above the workload itself so that we can enjoy exercise and stay motivated to keep it regular.
