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3rd May
written by John

Runners at one point or another get the dreaded side stitches. The sharp pain is normally below the rib cage on the right side of the belly. A side stitch is common in distance runners and usually they need to slow down or even stop to eliminate the pain.
In the past there was no real cause for this uncomfortable cramp. Recently though, researches believe the side stitch is caused by the stretching of ligaments from the diaphragm to the liver. Most runners usually breathe out every three to four steps depending on their running gait and speed. Runners who exhale when their right foot strikes the ground are more apt to receive side stitches.

If you receive a stitch while you are running, stop immediately and place your hand on the right side of the stomach and push up and move the liver slightly. Make sure you breathe in and out evenly while you are pushing up. Do this until the pain is gone and you feel comfortable to run.
Here are a few tips to help you prevent side stitches.

1. To prevent a side cramp, take deep breaths evenly while running and try to breathe out when your left foot hits the ground.
2. Eat a light meal three or four hours before you run. This will help with having nothing in your stomach and decreasing the chances of a stitch.
3. Stretching the core is also important. Raise your right arm up and lean toward the left side for 15 to 20 seconds. Then stretch the other side doing the same exercise.
4. Make sure you hydrate well before the race. Take in your last drink about an hour before you run. Making sure you hydrate before you run will help prevent cramps.
5. Warm up properly before you run. Make sure you jog lightly for a mile before you run a tempo run or a race.

To learn more you can go to breathing exercises for runners or go to my forum and I will address them personally.

If you have any questions or topics you would like for me to talk about Email them. Until next time, have a Great Run. Sign up for my newsletter for more tips.


  1. Delia

    Thanks for the information john, could you tell us anything about pain in the shins when running?

  2. 05/05/2008

    Shin splints are inflammation of the eriostium of the tibia. It’s the sheath surrounding the bone. Rest and ice help with the problem. Also strengthen the shin is important. Place cans of soup in a sock. Hang your leg over a couch. Place the sock on the toes and flex the toes lifting the sock up and down. I hope this helps.

  3. Jessica

    Thanks for the article on the side stitch. I was about to stop running for month thinking it was possibly a pulled muscle. How long do they typically last? Thanks

  4. 09/05/2008

    Usually side stitches are temporary. They may last a run or a couple of days. If they last more than a week yo may want to check with a physician.


  5. Erika

    Thanks for the information, but it seems like that I only get my stitches while im doing fairly good in a race, or when I might get nervous in a race. Is this normal?
    Thanks again

  6. 10/01/2010

    Hi Erika,
    Being nervous does tense you up. I normally think about my race and get the nerves out a week before. I go through the same emotions I would on race day except I do it a week before.

  7. ma

    Son only gets them in xc races, when he is at race pace…eats lunch 3 hours before, light, no fat…will try your tips. Do you recommend deep breaths while running? Is going out too fast a cause? Thanks.

  8. 29/10/2010

    yes going out to fast can do this. He can slow the pace at the begging or have a more intense warmup before he races. Good Luck to him.

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