Side Stitch

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  • #43249

    Over the three years I’ve been running seriously, I’ve worked through a number of ailments including ITBS and some ankle issues. It just took gradual progression and building strength in supporting muscles and tendons. One thing that has baffled me, though, is how to fight the side stitch cramping I sometimes experience. When I was younger, this always got in the way of running any distance and made me hate running, but now it only hits me in very specific circumstances: at the end of hard uphill climbs on the order of 1km vertical. This could be two miles into a run or 30 miles into a run, and the intensity can be Z2-3 or Z3-4, but at some point, usually around 1000 meters of climbing, it hits me, right when it’s time to turn the gas on to make up time on the downhill. Sometimes I can tough through it on the downhill by flexing my abs, but other times I just have to stop and walk for longer than I would like until the cramping passes. It’s always on the right side (my dominant side), at the base of my ribs. Sometimes massage, pressure, or timing my exhalations to the other foot can help, but mostly not. Raising my arms, stopping to do some burpees, etc do no good. It seems to have no connection to what I’ve been eating or my state of hydration, although I haven’t completely ruled out hydration. It happens with or without trekking poles.

    For background about me, about 25% of my mileage is on trails, 75% on the road, with most of that pushing a jogging stroller with a 40lb training partner in it. That’s done great things for my lats but probably alters how my upper body rotates as I run. I’ve had a 3d gait analysis at a specialty running lab (IHC TOSH in SLC), and the only areas for improvement they found were in increasing my stride length, correcting lordosis, and bringing my hands a bit farther down/back as I pump them–nothing that in my mind stood out as a possible strain on my mid torso muscles like crossing midline with my arms.

    Given how I’ve overcome other physical challenges in my running, I assume the solution is to get stronger, maybe focusing on core exercises like kayakers or something. However, I’ve had a hard time wrapping my head around exactly what the root of this problem is–the information I find online is all over the map and makes it sound like this very common problem is a scientific mystery, which is hard to believe.

    Anyone have insight they can offer or experiences of overcoming this?

Posted In: Injury & Rehab

  • Inactive
    Anonymous on #43251

    Side stitches are usually the result of a cramp in your diaphragm. Pursing your lips as you exhale can help during the time that you’re cramping, but for longer term improvement, start practicing taking full, diaphragmatic breaths to train the muscle. Start with doing it while lying down, and place a hand on your belly, then feel it rise as you inhale. When you exhale, fell how it also engages your deep abdominal muscles, especially at the end of your full exhale. Then start playing around with it during runs. Posture makes a difference too, so that could be inhibiting your diaphragm from being able to fully expand. Good luck!

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