The stitch can be a bitch

Just about every runner has had one of these painful little demons that strike in the upper part of the abdomen, smack dab at the base of the ribs. It’s the dreaded side stitch or side sticker. Regardless of what you call it, when one stabs you in the rib cage, it can short circuit your race or run in an instant.

Typically, the side stitch feels like someone is sticking a needle into your ribs. It isn’t pleasant, but fortunately its shelf life is brief and causes no lasting damage. Side stitches seem like they come out of nowhere and almost always strike when you’re pushing yourself hard during a tough run or race. They fade nearly as quickly as they come on. All you have to do is slow down, stop and/or walk for a minute or two and they disappear.

The side stitch is especially common among beginners who are still adapting to the demands of running and may have weak abdominals. But even elite runners get stitches. One-time world-class marathoner Don Kardong, who was fourth in the ’76 Olympic Marathon, was plagued by stitches throughout his career and could never quite figure out how to prevent them.

What causes stitches is a spasm of the diaphragm, the muscle that controls your breathing. When you’re running too fast or too hard, the diaphragm is deprived of oxygen which results in the spasm. Another cause is when you breathe exceptionally hard, it forces the diaphragm downward and the ligaments that connect the diaphragm are stretched. Result: Pain.

Whatever the exact cause, if your breathing too hard while running, the diaphragm can often bark back with the distinctive stabbing pain. Sometimes in a race you’ll be pushing hard to catch another runner and the strain of doing so can cause a stitch.

Stitching can also occur when racing downhill because the jarring motion tightens the abdominal muscles. Or, if you are running too soon after eating, your heavy stomach may literally be tugging at the ligaments connected to the diaphragm. Sometimes drinking very cold water during a race can also cause stitches.

If you’re hit with a stitch, the best remedy is slow down or stop. Don’t panic it will pass quickly.

But if you’re in a race and can’t afford to slow down, concentrate on getting your breathing under control by belly breathing. That is, force your belly out when you breathe in and relaxing it as you breathe out. Take deep breaths when you inhale and exhale forcibly. Remain calm.

Usually this works within a minute or so, but if the pain is just too much to endure and you’re forced to stop, bend over and raise your knee on the side of the stitch while pressing your fingers deep into the painful area and tightening your stomach muscles. Or just walk for a for few seconds while belly breathing.

If you’re susceptible to side stitches, practice belly breathing on training runs so you’ll be prepared for the next stitch.

To prevent stitches from nailing you, try doing abdominal work after every run. Do bent-knee sit-ups to strengthen the abdominal muscles. Or crunches.

Also make sure you don’t eat too closely to a run or a race.

If you get a stitch, just relax. Use belly breathing, slow down and stick your fingers into the painful area. Exhale deeply three or four time. It will go away just as soon as the diaphragm relaxes again.