Why Do I Get a Side Stitch When I Run?

This article is brought to you by the neighbor kids who practically live at our house. I was asking what I should write about next—and they unanimously agreed. I should answer the question: “Why do I get a side stitch when I run?”

Indeed, I was giving a talk to a business class at the University of Tennessee, Knoxville, last week about turning my passion into my career. I asked the kids if they ran and NO ONE raised their hand. NO ONE. I asked why. The answers were in the vein of: it hurt, it’s hard, and “I get a side cramp.”

side-stich — Side stitches can stop you in your tracks.

So, clearly, we need to get to the bottom of side stitches during running if we want this beautiful sport of ours to live on into the next generations.

Related: How to Start Our Kids Running

I don’t get side stitches when I run anymore but I do remember my side hurting repeatedly when I ran as a kid. I would take off running only to get an intense pain under my rib cage. Most of the time, the running was spontaneous, and not prepared for by a proper warm-up or nutrition.

I would stop, stick my fingers into my side, put my arms over my head, and lean over from side to side. The side cramp would usually go away—and off I would go. But for some people, the pain under their ribs is so intense it keeps them from running.

Turns out, though, not being used to running and not properly fueling or hydrating for a run can cause side stitches. A little education on proper running hygiene (what to eat, drink, and how to warm up) can go a long way.

In this article, I got with Dr. Nicole Lombardo from the Hospital for Special Surgery in New York to discuss what causes side stitches and how to get rid of them. Even if you have outgrown side stitches, this information could become useful if your child wants to start running.

Specifically, in this article, I will answer:

What is a side stitch?
What causes a side stitch while running?
Can you run with a side stitch pain?
How can you prevent a side cramp while running?
And, what to do to stop a side stitch pain when you are running.

So, let’s get going!

What is a side stitch?

A side stitch, also known as a side cramp or muscle stitch, is an uncomfortable cramping sensation in the abdominal or rib cage area—commonly on the right side, says Dr. Lombardo. If your side has hurt while running, then you most likely experienced a side stitch

Most people experience a side stitch while starting to run or when starting a workout. It usually goes away after a short period of time, but sometimes it can linger.

The medical term for a side stitch is exercise-related transient abdominal pain or ETAP.

side-stitch-pain — Pin these tips for how to get rid of side stitches for later!

What causes a side stitch while running?

The exact cause of a side stitch while running is actually not known—though doctors do have some ideas.

The most common theory is that a side stitch pain comes from a spasm in the ligaments between and diaphragm and other internal organs, triggered by the repetitive impact of running and rapid, hard breathing.

What does a side stitch feel like?

If you are experiencing a sharp pain in your stomach while running, you want to ensure it’s not a more serious medical condition.

The signs and symptoms of a side stitch are:

A dull or sharp, localized pain in the mid to upper right side of your abdomen. It can be in other parts of your stomach, but this is the most common area for a side stitch.
The pain is consistent while running.
It begins when you are running (soon after starting) and dissipates soon after you stop running.
A side stitch feels like you need to stretch out your side or massage away the cramp to help it go away.
The pain is so intense that it will likely force you to slow or stop running.

What causes a side stitch pain when you are not exercising?

According to Dr. Lombardo, a side stitch is most often caused by:

a lack of a warmup
a sudden start to an exercise
a recent meal
sugary drinks
dehydration, or
an altered breathing pattern (such as shallow or quick short breaths).

Related: How to Warm-up for a Run

Should you run through a side stitch?

Running with a side stitch is not dangerous—though the pain in your side may be intense enough to stop you from running.

For many people, slowing down and taking slow deep breaths and a few overhead stretches will alleviate the side cramp. Other times, a side stitch pain may go away independently even if you keep running at the same pace.

Related: How to Breathe While You Run

Who is at risk for side stitches?

prevent-side-stitch — You can prevent side stitches with proper precautions like warming up and eating right.

According to Dr. Lombardo, people who are at risk for side stitches may include:

Those who skip a warm-up
Younger athletes
Newer runners
People who ate a heavy meal within two hours of running
Those who drank sugary drinks before exercise
Runners who are dehydrated
People with impaired breathing mechanics who take shallow breaths
Those with a weak core
People with certain vitamin and mineral deficiencies
Runners on certain medications

How can you prevent a side stitch while running?

To prevent a side stitch, Dr. Lombardo suggests to:

Warm up for 15 minutes with a light walk and jog before running
Eat simple and familiar foods 30 to 60 minutes before exercise
Stay hydrated throughout the day
Practice deep belly breathing (think of it as expanding your ribcage out like an umbrella)
Run tall with good posture
Hydrate and eat a small snack of about 200 calories of simple carbs for morning runs
Strengthen your core or wear a supportive belt while running.

Related: How to Become a Morning Runner

Does dehydration cause side stitches?

Yes, dehydration is a cause for side cramps. Drinking sugary fluids like fruit juice can also cause side stitches.

Related: Hydration Guide for Runners

When should you be worried about a side stitch?

If your side stitch continues long after you’ve stopped running, it is time to see a doctor. The side stitch may actually be something else and/or need medical attention.

How do you get rid of a side stitch while running?

How do I stop my side from hurting when I run? That’s likely what you want to know if you are reading this article!

There are steps you can take to stop a side stitch while running.

Stop or slow down. Try to slow down or stop what you’re doing.
Breathe slow and deep. Then take slow, deep breaths into your belly and rib cage.
Stretch it out. Do some side-bending or rotational stretches. This involves twisting your core from side to side.
If you have water, drink some water—but not too much if you intend of continuing your run.
Massage the area. You may also massage the area that hurts by pressing your side with your fingers.
Start slow. Resume running again gradually with a proper warm-up. If you jump right back into it, your side cramp is likely to return.

If you are getting them often and the above suggestions have not helped, contact your doctor or physical therapist to see if something else may be the cause, suggests Dr. Lombardo. For example, certain medications or lack of certain minerals may cause cramping, or impaired running or breathing mechanics.

If you want guidance with your running goals, including how to run without side stitches, check out my run coaching services. Also, be sure to check out my free training plans: