6 Surprising Fixes to Try the Next Time You Get a Side Stitch

Few things destroy a good run the way a side stitch can. This sharp pain near your ribcage is technically a spasm in your diaphragm, the muscle separating your chest from your abdomen. But it’s more familiar to runners as a pain in the freaking neck, er, side.

No one knows exactly why these spasms happen. It may have to do with changes in blood flow to your diaphragm, spleen, or liver, or the way your liver tugs on your diaphragm, says Brian Nwannunu, MD, a runner and orthopaedic surgeon at Texas Joint Institute. Or, it could have to do with eating too much and too close to a workout, which sends blood flow to your stomach to help you digest instead of where you need it to fuel your activity, according to the Cleveland Clinic.

Side stitches are also common when you’re working extra hard, so they could be due to “running faster than you have trained for, which is why it is so prevalent during races,” says Ryan Schultz, PT, DPT, a physical therapist at Orlando Health Rehabilitation and Sports Medicine Center.

Some older research suggests irritation to the outer membrane of the diaphragm, called the parietal peritoneum, may cause side stitches, and the jostling of your torso during running might increase friction in this area. This may also explain why horseback riding is likely to cause stitches, even though riders are typically not breathing as heavily as runners, Dr. Nwannunu says.

Even though stitches are still quite mysterious, they’re also really common. About 70 percent of runners report having a side stitch in the last year, and about 20 percent of runners will experience this pain—also called exercise-related transient abdominal pain or ETAP—in any given running event.

But no matter the cause, in the middle of an otherwise pleasant run, what you really want to know is how to make this annoying pain go away, especially when slowing down isn’t an option.

Here are a few more surprising tactics you can try.

Some runners find pushing on the site of the stitch brings some relief. “Pressing on the area that hurts—where you don’t have to necessarily slow down, you don’t have to stretch, you don’t have to stop your run—just that upward force can sometimes cause alleviation of that side stitch,” Dr. Nwannunu says.

Doing so “might conceivably support the abdominal organs or restrict their movement,” thereby reducing the friction in the parietal peritoneum, Schultz says.

If you feel like more pressure might help, contract your abs and bend forward, suggests Kenzie Johnston, MD, a sports medicine physician and associate professor at Duke University. “This motion can increase pressure in the abdomen, providing support and reducing excessive movement of abdominal organs, which can tug on ligaments and trigger stitches,” she says.

A number of stitch-busting tricks rely on changing your breathing. Dr. Johnston suggests pursing your lips for a few breaths, “which usually results in a slower, deeper breathing pattern and can help symptoms,” she says.

Some Redditors swear by an interesting approach: make sure you exhale while landing on a different foot each time.

“There is unlikely to be anything magical about exhaling while landing on a different foot,” Dr. Johnston says. That said, it is likely to make you breathe more mindfully, and slower, deeper breathing might help alleviate the stitch, she explains.

Other runners sync their exhales to the foot on the opposite side of the stitch, Dr. Nwannunu says. This naturally stretches your torso and decreases pressure on the diaphragm on the side where the pain is.

Another Reddit-favorite, this breathing style is also common in yoga and other meditative practices. There’s no evidence it will banish a side stitch, but “this approach could help if the exhaling is through pursed lips and slows and deepens the breathing pattern,” Dr. Johnston says.

While there aren’t many robust, recent studies on this or other methods to ease side stitches, deep breathing has been reported to help in older research.

Unfortunately for your chances at hitting that PR, the tried-and-true solution is taking your foot off the gas. “The most effective strategy for relieving ETAP remains to stop exercising, which is not always practical or desirable,” Schultz says.

But there’s still good news if you really don’t want to stop: trying one of the less evidence-backed ideas above probably won’t hurt. “The good thing about a side stitch is it will always go away, it is non-life-threatening, and it usually doesn’t affect your activities moving forward,” Dr. Nwannunu says. “You can try all or any of these tactics, and whatever you feel works for you can help.”

It’s also worth doing what you can to prevent the stitch in the first place. The number one rule there is fueling properly. Try to avoid eating or drinking large amounts in the two hours or so before a workout, Dr. Johnston says.

And try not to get discouraged by a stitch, either. Sticking with your running routine will pay off. “The frequency of side stitch occurrence has been shown to decrease with improved fitness level, so continued physical conditioning might be considered a prevention strategy,” Schultz says.