Side stitch

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For other uses, see Traditional Chinese bookbinding.

When exercising, a side stitch (also called a side cramp, a side sticker or, more commonly in proper English, simply a 'stitch') is an intense stabbing pain under the lower edge of the ribcage. It is also referred to as exercise related transient abdominal pain (ETAP). This pain is caused by the internal organs (like the liver and stomach) pulling downwards on the diaphragm. It is therefore more likely to occur in sports involving up and down actions - like running, jumping and horse riding.

There are more theories regarding ETAP than merely stretching of the visceral ligaments due to repeated vertical translation and jolting. Other theories include:

Diaphragmatic Ischemia
Imbalances of the thoracic spine
Irritation of the parietal peritoneum

The reasons for these theories include, in particular, the prevalence of ETAP during swimming.

Most of the time, side stitches occur on the right side of the body. This is due to the largest organ in the abdominal cavity, the liver, being on that side. Certain athletes also report a pain in the tip of their shoulder blade. This is believed to be because this is a referred site of pain for the diaphragm via the phrenic nerve.

1 Preventing a side stitch
2 Curing a side stitch
3 References
4 External links

[edit] Preventing a side stitch

Improve fitness
Strengthen the diaphragm by using exercises such as those that aid respiratory rehabilitation^[1]
Strengthen core muscles (abdominals, lower back, obliques)
Limit consumption of food and drink two to three hours before exercising (in particular, drinks of high carbohydrate content and osmolarity (reconstituted fruit juices))
Drink water beforehand to prevent muscle cramps
Warm up properly (Stretch before running for a long period of time)
Gradually increase exercise intensity when running
Exhale when the left foot hits the ground, and inhale when the right foot hits the ground^[2]
Run on soft surfaces

[edit] Curing a side stitch

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Pain induced by the stretching of the visceral ligaments is relieved by; removing or minimizing the applied force by slowing or stopping the exercise and lying down until the pain subsides. Alternative cures are listed and exist in much the same context as the cure for hiccups;

Stop exercising. With the digits, push into the abdomen on the right side, and up under the rib cage. At the same time, forcefully let out a deep exhale while holding the lips closely together.
Try belly breathing; inhale while pushing out the stomach, and on the exhale, relax the stomach muscles.^[3]
While running, exhale when your foot strikes on the opposite side that the side stitch is located. For example, a side stitch on the right, exhale hard when your left foot strikes the ground.
Reduce the frequency of breathing (e.g. in jogging, inhale for four steps and exhale for four steps)
Lie down on the back and lift the knee on the side with the stitch up to the chest.

These alternatives work by implementing the aforementioned function in combination with a coordinated task to occupy the sufferers mind. Results are achieved in much the same way as the old American Indian technique in which one must find a round stone and spit under it.