Stitch while running

So, I’ve been getting this problem with stitch while running on a treadmill at the gym. Basic story:

Jump on the treadmill, run happily at 7-10 mile p/hr for 25 minutes or so, just cruising with a steady rythym. Then suddenly, I feel the stitch muscle thing start to tighten, and then literally within two minutes I can hardly walk. This has been happening 90% of the time I use the *#%## thing for the last month or so. SO, anyone know why this may be? I mean I don’t think that it’s a fitness issue; like I said, I’m really cruising at that speed. So what the hell gives (extreme frustration coming through…)?

As a side bar, what even causes stitch? Though I’m sure any answer to the last question will cover that…


Floating Cheese,

I have had your problem and it refers me back a while now to a school cross country I had to run in.

My mother , that morning, had told me to hold my arms out a little more, away fromt he body. I came 9th out of 60 people, and the last year I had come around, well, last…

But thats besides the point. The point is, I dont know how to permanentely cure it, but try runnig with your arms out from your body a little more (width ways) . That should at least last you a little more.


Floating Cheese:

I get that painful stitch too. I do think it has to do with my fitness level, which is pretty low at the moment. Once I establish a pattern of running several times a week it doesn’t happen.

To get rid of it, I purse my lips. I know, it sounds goofy, but it works. I suppose it has to do with the volume of air I’m breathing. (Or maybe there’s a placebo effect going on.) Anyway, after about 5 minutes, the pain subsides.

I’ve also read that the stitch is related to whether you inhale on your left stride or your right stride, but I’ve never quite worked that out.

Runners World has some tips to help cure a side stitch. From what I understand, nobody really knows what causes a cramp because it’s very difficult to study a live muscle in it’s cramped state. Over time, you should be getting them less as your fitness level improves.

The Runners’ World article states that most stitches are caused by spasms of the diaphragm, and then says make sure you have just not eaten. What the latter has to do with the former, I don’t know. You may get a tummy ache if you have just eaten, but not that bane of most runners: a side stitch (on the right side, right?)

Actually,as jet Jaguar stated, no one really knows the etiology of the infamous stitch. I used to get them all the time in races. I don’t any more, probably because I can’t run fast enough. But the fact that I did, and only in races, indicates that breathing and the diaphragm are involved. I’ve read that bending over and breathing out with pursed lips helps.

Many years ago (20?) I had a side stitch while running the Marathon Marathon (sponsored by Marathon) in Terre Haute, Ind. I also had a shoe untied. So as not to impede the runners behind me, I crossed the road, bent over, and tied my shoelaces. When I got up, my stitch was gone. I looked around and all the runners behind me followed me across the road (that was not the route). Shows you what lemmings we are.

Anyway, by bending over I eliminated the stitch. It did not return. My theory, for what it is worth, based on my experiences and what I have read is that it is caused by tension of the ligaments attaching the diaphragm to whatever it is attached to (peritoneum?). That is caused by two factors: (1) Running a faster pace than your body is used to, causing you to breathe faster and harder; (2) Improper breathing. I.e., breathing too shallowly. Try breathing from deep within your torso, with your abdominal muscles helping lift the diaphragm.

Years ago I came across a reference to the runner’s stitch, basically, its your spleen pumping out an additional measure of blood into your system, but I think that explanation is bogus: Some who had their spleens surgically
removed still feel the stitch.

from This page has moved

…hmm? OH!! …wanders off in search of a thimbleful…:wink:

I was always taught that a stitch was a build up of lactic acid, which your body produces when you over exert yourself. The fitter you are, the more punishment you can take before you start to produce it.

So, as I was saying, to eliminate a stitch, do speed work and try breathing deeply within your bowels. If that doesn’t work, bend over and tie your shoelaces.

It’s definitely not lactic acid. No matter how fit you are, you’re going to produce lactic acid at any level of activity, even those which are called purely aerobic, since there is no such thing. You can, however, train your body to withstand higher levels of lactic acid, by doing tempo runs, intervals, and other speed work. Moreover, if it were lactic acid, why does it only affect the diaphragm? And usually on the right side. The fact that it usually occurs on the right side leads credence to my theory, IMHO, that it’s the ligaments, as they are longer on the right.

The spleen and additional blood is also hogwash. If anything, it would be the lack of blood or oxygen that can produce the stitch. It may be that not enough oxygen is getting to either the diaphragm or its ligaments when you’re running faster than you are used to and breathing too shallowly. Not to mention that the spleen does not spurt out blood. That’s why the heart beats faster.

Any chance this is caused by the vibration as my feet strike the ground? This has never happened when riding my bike but happens often when I run. I have flat feet and thus less shock adsorbing ability than other people.


The exact cause for stitches is still up for debate. The reason I have been hearing most support for lately is that the pain is due to stretching of the ligaments which extend downward from your diagphragm to hold your liver in place. When you run, your liver can get jostled about, pulling on the ligaments and causing pain.

The liver is located on the right side of your body, just below the rib cage. As you exhale, the diaphragm moves upward. As you step down on your right foot, your liver (and other organs on the right side of your body) move down. Most walkers or runners tend to have a rhythmic breathing pattern as they exercise — that is, they tend to breathe out on one foot (e.g., “exhale - step - step - step - exhale…”, or “exhale - step - exhale - step” for sprinting.) So, the theory goes, if you’re a right-footed exhaler, you are much more apt to end up with stitches.

So, the first thing to do when you get a stitch is to slow down, and press your fist into your liver, pressing it upward against your diaphragm to release the pressure. (Bending over to tie your shoe like enolancooper could also have the same effect — but generally, it’s not a great idea to drop your head below heart level when your heart is pumping away like that.) Pursing your lips and blowing out forcefully (like you are going to blow out a birthday candle) like enolancooper suggested could also be helpful, because it seems to push the diaphragm downward. Be sure you breathe in deeply, because this lets the diaphragm fully lower to reduce stress on the ligaments.

Making a conscious effort to exhale on your left foot instead of your right foot may help you to prevent stitches. Also, running downhill tends to exacerbate stitches, since you strike with a lot more force when going downhill — so if the forced breathing isn’t doing it for you, either avoid the downhills, or slow it down to a walk then. Your knees will thank you, too. (It’s probably the force of impact rather than vibration that causes the problem, Rufusleaking — that’s why, as you noted, it happens when you run, but not when you bike.)

Why does this happen to you on the treadmill, floating cheese? Probably because you run with a shorter, choppier stride on the treadmill than you would on the open road — thus you have a lot more bouncing up and down. If you’re running on a treadmill with too short a belt, you may be out of luck. If it’s long enough, though, think about lengthening your stride. You should look like you are gliding, not bouncing up and down (Think “Chariots of Fire.”) If you’re in a gym with mirrors, watch your head. Does it bob up and down? If so, your stride isn’t smooth enough, and needs to be lengthened.

What if you have a stitch on the left side? I dunno — maybe it was something you et.

Hope this helps----

Good info YWalker. Only you’re blaming Enolancooper for what I said.

I thought it may be the pressure on the ligaments or not enough oxygen. You’ve read it’s the stretching of the ligaments and your explanation of the breathing vis a vis the stitch makes sense to me. Thanks. I’d like to know your source if you have it since I’ve read a lot of different theories, but never came across that.

I always found that it helped to grab a fistfull of my side where the stitch was coming from, squeeze, and push in.

Oops. That’s what I get for reading the posts backwards in the topic review. Sorry.

Here’s where I first saw the ligament stretching theory postulated. It seemed to make sense to me. When I just went to go look this up, though, I decided to do a search for the author referenced therein and found a bit more explanation in this link. This one refers more to spasming rather than stretching of the ligaments, though (this isn’t the original source, however.)

Anyhow, check out the second link. It looked like it was filled with all sorts of handy advice. I can vouch for the stuff they mentioned about shin splints.

Thanks for the link,YWalker. I know it is a cramp, and I was going to post that upon reflection I doubted it’s a stretching of the ligaments, as stretching is what is done to relieve cramps.

What you read in that link is similar to this Board: you have to take it with a grain of salt. It is not gospel, but what some people believe. For example, that bit about lactic acid causing burning pain was debunked by one of the physicians on board, Choosy Beggar. He did some research and found that lactic acid is only a minor constituent in a cascade of metabolic events that cause the pain.

I’m not convinced about the causes stated in that link. Cramps are sometimes caused by lack of oxygen. Their explanation about the liver, being such a large organ, is the reason why it occurs usually on the right side sounds good, but in some people it occurs on the left side. Other explanations are possible. As I suggested concerning the ligaments, they are longer on the right side.

That link presents no scientific evidence, but merely is a compilation of what other runners think. In my mind, the answer remains unknown.