Side Stitch

Side stitch

A side stitch can usually be felt to one side of the abdomen, more often the right side, around the area of the lower ribs. Many people suffer from stitches when doing sport, particularly running based activities. We explain the possible causes and what you may be able to do about it.

What is a stitch?

  • A side stitch is a sudden onset of pain in the chest or abdomen.
  • It is often described as a sharp or acute pain.
  • Symptoms come on during a period of hard aerobic exercise. It is especially common if the exercise is harder than your body is accustomed to.

Most cases of acute abdominal pain during exercise are referred to as a ‘stitch’ or side stitch. It is also known as an ‘exercise-related transient abdominal pain’ or ETAP. Stitches are very common, especially in runners and swimmers, with up to 70% of runners experiencing a stitch in the previous year.


What causes a side stitch?

Respiratory system

The cause of a stitch is not known. However, there are several theories doing the rounds. These include:

  • Eating too close to exercise.
  • Cramp in the diaphragm (breathing muscle) due to a decrease in blood flow.
  • Not warming up thoroughly.
  • It is also suggested the liver tugs on the ligaments which connect the liver to the diaphragm, hence causing a stitch.

Treatment of side stitch pain

  • In order to relieve stitch pain, try stopping, leaning forwards and breathing out hard whilst pressing into the painful area with your fingers.
  • Other treatments include breathing techniques such as belly breathing and altering which foot hits the ground when you exhale.
  • Most people exhale as the left foot hits the ground – try changing this so it’s the right foot.
  • Other causes of abdominal pain in athletes include pain referred from the thoracic spine.
This article has been written with reference to the bibliography.