# What causes a "stitch" (as in the the pain in the ribs you get while running)? **URL:** \ **Category:** Factual Questions\ **Created:** [January 28, 2013, 11:30pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666 "2013-01-28T23:30:46Z")\ **Posts on this page:** 18\ **Page:** 1
**Author:** ![Bisected8](https://avatars.discourse-cdn.com/v4/letter/b/a4c791/32.png) [@Bisected8](https://boards.straightdope.com/u/Bisected8)\ **Post date:** [January 28, 2013, 11:30pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/1 "2013-01-28T23:30:46Z")
I just realised I haven’t had one since I was a kid. Do you get less prone to them as you get old or have I just gotten fitter as I’ve grown up? ---
**Author:** ![solosam](https://avatars.discourse-cdn.com/v4/letter/s/9d8465/32.png) [@solosam](https://boards.straightdope.com/u/solosam)\ **Post date:** [January 29, 2013, 2:50pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/2 "2013-01-29T14:50:11Z")
I always thought it was a cramp caused my insufficient respiration. Some people disagree. Getting fitter may reduce it. My problem was, when I was unfit I got lots of cramps. As I got healthier, I ran faster and worked harder… so I still got cramps. In my case, I could avoid the cramps by slowing down, but then I wasn’t getting a good workout. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [January 29, 2013, 3:18pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/3 "2013-01-29T15:18:01Z")
Preventing a side stitch(hopefully)😉 Improve fitness Warm up thoroughly Start your workout at a slow pace Relaxed breathing Keep your core strong Dealing with a side stitch Try to [belly breathe](http://en.wikipedia.org/wiki/Diaphragmatic_breathing) and keep your breathing relaxed. Press into the site of the pain with the heel of your palm, sometimes trapped gas is the cause. Breathe out under pressure, tighten up the abdominal muscles and force the air out. Raise your arms If nothing else, stop and walk or reduce effort. If in competition, work through it, it won’t kill you, it just feels like it. ---
**Author:** ![Jake](https://avatars.discourse-cdn.com/v4/letter/j/f475e1/32.png) [@Jake](https://boards.straightdope.com/u/Jake)\ **Post date:** [January 29, 2013, 5:51pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/4 "2013-01-29T17:51:39Z")
When I was a kid we called it a “Side-Ache.” Usually after running. I haven’t had one since I grew up… ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [January 29, 2013, 9:09pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/5 "2013-01-29T21:09:48Z")
I think as grownups we don’t sprint as much. When I run now, it is a steady, deliberate exercise. When I was a kid, I just sprinted until I couldn’t breathe and I ached all over. So I think the reason side stitches are less common as we age is just because we don’t run like that anymore. ---
**Author:** ![Blake](https://avatars.discourse-cdn.com/v4/letter/b/a9a28c/32.png) [@Blake](https://boards.straightdope.com/u/Blake)\ **Post date:** [January 29, 2013, 9:17pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/6 "2013-01-29T21:17:32Z")
The last theory I heard, stitches were caused by the bouncing of running stretching the ligaments holding the organs, especially the liver, in place. As the ligaments stretch, it causes pain. As you become fitter, stitches become less common as the ligaments become thicker and tighter. Learning to breathe correctly also helps. If you breathe in as you fall and out as your rise you keep the abdominal cavity firmer, leaving less room for bounce. You don’t need to practice that, your body should learn to do it automatically. Strengthening the abdominal muscles also helps because it gives the organs less room o bounce around. To relieve a stitch, you need to reposition the organs to take the weight off. You can do that manually by relaxing the abdominal muscles and pressing inwards and upwards to physically force the organs back into position. You can also do it by constricting the abdominal cavity to force everything back into position: raise the arms, breathe out and contract the abdominal muscles. ---
**Author:** ![RadicalPi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/radicalpi/32/9806_2.png) [@RadicalPi](https://boards.straightdope.com/u/RadicalPi)\ **Post date:** [January 29, 2013, 9:18pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/7 "2013-01-29T21:18:08Z")
But what’s the cause? What happens physiologically that’s so painful? ---
**Author:** ![Blake](https://avatars.discourse-cdn.com/v4/letter/b/a9a28c/32.png) [@Blake](https://boards.straightdope.com/u/Blake)\ **Post date:** [January 29, 2013, 9:24pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/8 "2013-01-29T21:24:00Z")
> [@RadicalPi](#): > > But what’s the cause? What happens physiologically that’s so painful? Bend over and try to touch your toes. Now keep bending until your forehead touches the ground. Notice how it gets painful as the tendons and ligaments stretch? It’s that simple. Your body experiences any stretching past the usual state as pain. It’s a mechanism that prevents us from injuring ourselves through over-stretching. Physiologically, there are nerves embedded in/along the ligaments. As they are stretched they send signals to the brain that we interpret as pain. ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [January 29, 2013, 9:32pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/9 "2013-01-29T21:32:43Z")
[http://www.drmirkin.com/archive/6310.html](http://www.drmirkin.com/archive/6310.html) Dr. Mirkin repeated this more recently: [http://www.drmirkin.com/fitness/1611.html](http://www.drmirkin.com/fitness/1611.html) ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [January 30, 2013, 12:52am UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/10 "2013-01-30T00:52:45Z")
That explanation makes little sense to me. In particular it is not consistent with the fact that it happens primarily when one has gone a bit into the anaerobic zone. If it was bouncing and stretching of liver attachment ligaments I’d think it would happen even more on the very rhythmic long slow runs. I do not think there is a definitive answer but the explanation that makes the most sense to me is diaphragmatic ischemia - inadequate oxygenated blood flow to meet the demands of the diaphragm at that point in time. I have also heard speculation that irritation of the parietal peritoneum is the cause. ---
**Author:** ![Backwater\_Under\_Duck](https://avatars.discourse-cdn.com/v4/letter/b/ba8739/32.png) [@Backwater\_Under\_Duck](https://boards.straightdope.com/u/Backwater_Under_Duck)\ **Post date:** [January 30, 2013, 1:02am UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/11 "2013-01-30T01:02:41Z")
Back in junior high, we would go to the “_sock hop_” and do all the trendy dances. The “_Slide_”, the “_Bugaloo_” the “_Watusi_”, the “_Mashed Potato_”, the “_Jerk_”. Heh. The favorite, of course, was, dig it, “_THE TWIST_”!!! I _ALWAYS_ got a stitch in my side while twisting. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [January 30, 2013, 1:31am UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/12 "2013-01-30T01:31:45Z")
I do not know the answer to OP, but the bang-go-the-organs explanation for pain is valid in another case everyone is familiar with: Sometimes you step off a curb without realizing the curb was there, and the “thump” your body makes against your flat foot is surprisingly hard, and your guts get what feels like a good painful kick from your hips upwards. What happened is you did not have enough time to consciously prepare your muscles for the descent. Ironically, perhaps, had the curb been just a little bit higher (I forget the minimum height), there would have been enough time for your nervous system to signal your balance system that something weird was going on. Curb height is really a close match to the proprioception blind spot there. Your organs are being arrested from gravitational acceleration with no damping short of your shoes. It hurts. ---
**Author:** ![Princhester](https://avatars.discourse-cdn.com/v4/letter/p/3e96dc/32.png) [@Princhester](https://boards.straightdope.com/u/Princhester)\ **Post date:** [January 30, 2013, 4:12am UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/13 "2013-01-30T04:12:33Z")
> [@DSeid](#): > > That explanation makes little sense to me. In particular it is not consistent with the fact that it happens primarily when one has gone a bit into the anaerobic zone. If it was bouncing and stretching of liver attachment ligaments I’d think it would happen even more on the very rhythmic long slow runs. > > I do not think there is a definitive answer but the explanation that makes the most sense to me is diaphragmatic ischemia - inadequate oxygenated blood flow to meet the demands of the diaphragm at that point in time. I have also heard speculation that irritation of the parietal peritoneum is the cause. I agree. The ligamentous thing just has to be crap. You can get a stitch from laughing too hard, or from smooth anaerobic exercise. It doesn’t feel like any other sort of ligamentous pain I’ve experienced in the sense it has sharp onset and sudden cessation. ---
**Author:** ![Lunchy](https://avatars.discourse-cdn.com/v4/letter/l/848f3c/32.png) [@Lunchy](https://boards.straightdope.com/u/Lunchy)\ **Post date:** [January 30, 2013, 5:58am UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/14 "2013-01-30T05:58:47Z")
I do HiiT (High intensity interval Training) with a recumbent stationary bike, the ONLY thing that moves are my legs, and I still get the aforementioned stitches! ---
**Author:** ![Private\_Bin](https://avatars.discourse-cdn.com/v4/letter/p/c0e974/32.png) [@Private\_Bin](https://boards.straightdope.com/u/Private_Bin)\ **Post date:** [January 30, 2013, 12:27pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/15 "2013-01-30T12:27:07Z")
I haven’t had a stitch since I was a kid. If I sprint these days lack of energy stops me, rather than the stitch. Thanks for reminding me, **Bisected8** , I had forgotten about that and it’s brought back memories. ---
**Author:** ![Grrr](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/grrr/32/146_2.png) [@Grrr](https://boards.straightdope.com/u/Grrr)\ **Post date:** [January 30, 2013, 12:37pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/16 "2013-01-30T12:37:50Z")
On a side note: I just learned what “You had me in stitches” (As in laughing) actually means. ---
**Author:** ![Lunchy](https://avatars.discourse-cdn.com/v4/letter/l/848f3c/32.png) [@Lunchy](https://boards.straightdope.com/u/Lunchy)\ **Post date:** [January 30, 2013, 1:51pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/17 "2013-01-30T13:51:06Z")
> [@Shakes](#): > > On a side note: I just learned what “You had me in stitches” (As in laughing) actually means. “You had me in Shakes” just doesn’t have the same ring. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [January 30, 2013, 2:50pm UTC](https://boards.straightdope.com/t/what-causes-a-stitch-as-in-the-the-pain-in-the-ribs-you-get-while-running/648666/18 "2013-01-30T14:50:01Z")
“You had me at ‘Hello’” is something I wish I had heard just once.