Avoiding side pains when running
April 5, 2005 6:53 PM   Subscribe

As part of my newly-expanded workout routine, I run/jog on a treadmill. I still have the problem I've had since childhood: what we used to call "stitches" - an internal pain in the side. How can I keep this from happening?
posted by icetaco to Health & Fitness (22 answers total)
A good stretching routine beforehand ought to help prevent that.
posted by Faint of Butt at 6:55 PM on April 5, 2005

core strength and stretching, try taking a few deep breaths when it happens to slow your breathing and heart rate down. the more you run, the easier it will get. give it time.. keep at it, if more people worked out even just a little the world would be a much better place :)
posted by joshgray at 7:00 PM on April 5, 2005

I'm in no way a work-out-y-guy, but I learned way back in gym class that as soon as you feel the stitch coming on, you should put your hands on your head. Seriously. IIRC, that opens up your rib cage/chest cavity, letting you take deeper breaths. It won't eliminate the stitch, but it will lessen it.
posted by Rock Steady at 7:15 PM on April 5, 2005

You need to breathe more deeply. Breathe in between stresses. If you are lifting breathe in on the relaxation. If you are running just concentrate on deep, consistent breathing. Shallow breaths are usually the cause of these pains.
posted by caddis at 7:16 PM on April 5, 2005

The key is using your diaphragm to inhale, it is much more efficient and will let the other muscles relax and not spasm as is currently happening. You will also perform better due to increased oxygen intake.
posted by caddis at 7:24 PM on April 5, 2005

I only have anecdotal evidence for this, but it seems to be (at least somewhat) related to abdominal strength; when I've been neglecting my situps/etc I start getting them. When I have abs'o'steel (under FlabTastic, of course) not even a twinge.
This seems to have been borne out by observing people I train with at TKD.
Of course, my other half (an MD) poo poos this entirely, all the while suffering from stitches and being unable to complete a situp.
posted by coriolisdave at 7:26 PM on April 5, 2005

By "newly-expanded" do you mean you have just started running after a break or something? Because I used to get terrible stitches when I started running and eventually they just went away. Make sure you are adequately hydrated as well.
posted by lucien at 7:48 PM on April 5, 2005

This is going to sound insane, but be sure not to eat or drink too much before your workout.
posted by Doug at 7:50 PM on April 5, 2005

I was told as a kid it was because I was exercising too soon after eating (the mechanism by which you'll aparently drown in an inch of water if you try to swim a mere 58 minutes after a meal. according to mothers around the word :)

So when I got the stitch running, I ensured the next day I left a larger gap between eating and running. It didn't stop the stitch, so the next day left a larger gap. A few weeks later, I was spending half the day not eatiing and still not getting the stitch. So in disgust I had a big meal and went running right away. No stitch.

So from then on, I try to eat something before running, and it greatly reduces the chances of me getting the stitch.

I also infer from this that I would likely survive an attempt to swim across a puddle within an hour of a meal.
posted by -harlequin- at 7:52 PM on April 5, 2005

caddis is right on: You need to "belly-breathe" -- that is, when you inhale, expand your belly. When you exhale, contract your abs. It seems awkward and unnatural at first, but at least for me it works like magic.

My ex (former Danish half-marathon national champ) will back me on this one.
posted by LordSludge at 8:07 PM on April 5, 2005

I have this same problem, and after much trial and error, I figured out that I need to take deeper, slower breaths. What I do is count for several paces while breathing in and then the same out, usually four for a medium jog. Works great and is kind fun after a while.
posted by 445supermag at 8:11 PM on April 5, 2005

Sounds like diaphragm/breathing origin as stated above.
posted by peacay at 8:20 PM on April 5, 2005

Response by poster: Lucien: I just started running. Glad to hear your stitches went away!

I don't eat for several hours beforehand - this is my after-work exercise, and I usually only have lunch around noon (and not a heavy meal then). I do drink water during the day. Sounds like deeper breathing is the answer, and I will try it, and I thank you all!
posted by icetaco at 8:39 PM on April 5, 2005

I was told by my jogging teacher to stand (run) more upright when this happens, and it always worked for me. Similar to what Rock Steady suggested. Oh, and of course drinking too much water while working out will make it worse as well.
posted by Who_Am_I at 8:44 PM on April 5, 2005

Response by poster: Peacay - that's a good article you linked to, but reading it actually made me feel faint!

"Those internal organs - like the liver, stomach, and spleen - aren't exactly riveted in place. Instead, they're supported by flimsy ligaments hanging down from the diaphragm, and with each bounce, the organs pull downward on the diaphragm."

"Porter eventually decided that his caecum, which is the first part of the large intestine, had been rubbing against the inside of his abdominal wall [causing diarrhea]."

I am going to have to try very hard to put these images out of my mind before I run again, that's for sure!
posted by icetaco at 8:49 PM on April 5, 2005

To piggyback: Anyone have any advice for when this happens swimming? I had one today for half my practice. I swim with a team, so I can't just stop, and unlike running, your breathing opportunities with swimming are limited, especially with flip turns. And I'm already as stretched out as I can go.
posted by dame at 8:55 PM on April 5, 2005

All this advice seems good, but one thing that I haven't seen mentioned is the trick I've always used and been told worked best -- In through the nose, out through the mouth.

Focusing on that will usually solve the diaphragm-breathing thing for itself, plus keep your breathing rate slow enough to keep your heart rate under control. At least, it does for me.

If I have problems with getting enough air on the inhale, like on a long run, I'll open my mouth for inhales just slightly, and still get most of the breath through my nose. Works great.
posted by wolftrouble at 10:23 PM on April 5, 2005

I second Doug -- I get them when I drink a lot of water before or during my workout. I try to take only little sips and that definitely helps.
posted by palegirl at 10:24 PM on April 5, 2005

All the different breathing techniques are useful if you're a seasoned runner. If you're a novice runner, then the muscles of your torso are simply weak and will strengthen over time. The stitches are simply fatigue in the muscles of the rib cage or abdominal core. You need muscle strength to breathe hard, and to stabilize the body against the pounding forces that running subjects it to. This strength will come with conditioning.

Just do it.
posted by randomstriker at 11:25 PM on April 5, 2005

peacay's link to that article was, indeed, informative. Here are a couple of things I've tried - and have worked.

Ever since I started using the following method, I've never felt a stitch. To expand on that article, breathing pattern can be key for many people. I used to breathe in perfect sync sync with my stride, but I shifted it so that the start of each breath occurs slightly before the foot strike. I suppose the motion of breathing + jostling of various internal organs (sorry for the image Who_Am_I) exacerbated the problem. Staggering the forces on those ligaments over a longer period seems to ease the stress on them.

When I DID get a stitch, it usually occurred on my right side. I was told it's likely due to the ligaments supporting the liver, one of the larger internal organs. If you feel this, stop running (and walking), place your right fist just under the ribcage on the front-right side of your abdomen, curled fingers and palm in. Place your left hand over the right. Quickly press very hard on that spot (think Heimlich maneuver) while EXhaling hard from the diaphragm and contracting the ab muscles. It may take a couple of tries, but it should work. It seemed to put things back in place for me and the pain disappeared, allowing me to continue running.
posted by galto at 7:36 AM on April 6, 2005

When I began running, I'd get stitches pretty often. I was told to yell "Hah!" on the exhale a couple times to relieve the pain. (I run outside in isolated areas.)
posted by klarck at 9:34 AM on April 6, 2005

The only thing that has ever worked for me is what galto describes in the first paragraph of his comment. My stitches occur in my right side as well, so I match up my breathing (out two three, in two three) with my footfalls (right left right, left right left). This works with any breathing pattern as long as you are inhaling for the same number of beats as you are exhaling.

Additionally, deep breaths make my sideaches worse. I find that I'll take a deep uncontrolled breath in, and exhale in a very controlled manner - this leaves too much air in your lungs. Just try to breathe steadily, making sure you are exhaling fully.
posted by peep at 12:19 PM on April 6, 2005

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