Side stitch

A side stitch (also called a side ache, a side cramp, a side crampie, a side sticker or simply a stitch) is an intense stabbing pain under the lower edge of the ribcage that occurs while exercising. It is also referred to as exercise related transient abdominal pain (ETAP). Some people think that this abdominal pain may be caused by the internal organs (like the liver and stomach) pulling downwards on the diaphragm, but that theory is inconsistent with the fact that it frequently occurs in swimming,[1] which involves almost no downward force on these organs. If the pain is present only when exercising and is completely absent at rest, in an otherwise healthy person, it is benign and does not require investigation. There are a variety of published ways of alleviating the symptoms including adjusting at what point in your stride you inhale.[2]

Contents

Causes

There are other theories regarding side stitches than simple stretching of the visceral ligaments due to repeated vertical translation and jolting. Such theories include:

  1. The pain may be caused by contracting the liver or spleen, which squeeze extra oxygen-carrying red blood cells into the circulation. Although there does not appear to be much muscle in the capsule of the spleen, there is direct and indirect evidence that its size does change with exercise. (see ref** below) This autotransfusion, (which is much larger in some animals) increases exercise capacity but the associated pain may be severe, relieved only by rest. A plausible mechanism for the pain is that high internal pressure in the liver or spleen restricts blood flow, causing hypoxia.
  2. Diaphragmatic Ischemia
  3. Imbalances of the thoracic spine
  4. Irritation of the parietal peritoneum

The reasons for the variety of 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 may be because the largest organ in the abdominal cavity, the liver, is 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. When the side stitch is on the right side, published advice is to try to exhale when your left foot lands.[2]

Prevention

Treatment

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;

These alternatives work by implementing the aforementioned function in combination with a coordinated task to occupy the sufferer's mind.

See also

References

  1. ^ "965 athletes in six different sports (running, swimming, cycling, aerobics, basketball, and horse riding). Over the course of a year of training and competition, 75% of swimmers had trouble with stitches, 69% of runners were afflicted, 62% of horse riders had ETAP, 52% of aerobics participants suffered, 47% of basketball players did so, and 32% of cyclists were affected " Characteristics and Etiology of Exercise-Related Transient Abdominal Pain,' Medicine and Science in Sports and Exercise, Volume 32 (2), pp. 432-438, 2000
  2. ^ a b p 391 The Lore of Running, Tim Noakes, Publisher: Human Kinetics Publishers Date Published: 1991 ISBN 9780880114387 ISBN 088011438X
  3. ^ Johnson. "Side Stitches : Cause and Cure" (in English). http://www.makeithappen.com/wis/readings/sidest.html. Retrieved 9 September 2011. 
  4. ^ "Diaphragm Strengthening". http://calder.med.miami.edu/providers/PHYSICAL/resdia.html. Retrieved May2007. 
  5. ^ How to Prevent Side Stitch How Stuff Works. 24 Oct 2007.

External links