Stitches, breathing, and racing

I had a similar problem. Still not sure what causes it.

My junior high school XC season was plagued with side stitches. I ran a so-so 17:14 as a PR without a side-stitch. The next meet was an abysmal one and I ran 17:44 with a side stitch for nearly two miles.

This Senior year I eliminated dairy products from my diet on the day of a race. I woke up, ate a waffle and English muffin with a glass of Gatorade, compared to the usual breakfast of English muffin, cereal w/ milk and OJ. (That's right, you heard me, glass of blue Gatorade.)

I would spend the hours leading up to the race drinking sips of Gatorade, and might even consume 1.5 bottles of the stuff before the gun went off.

Eliminating gassy dairy products and staying hydrates with a surplus of electrolytes seemed to do the trick for me. (Knock on wood of course.) The only race I've felt a side stitch coming on was in a meet where I neglected to sip on Gatorade throughout the day

Thanks for the reply, t94bell. How long have you been stitch free? I do avoid dairy for between 12-24 hrs before a big race, so I don't think that's the issue. The main area of discomfort is center/right, just below the ribcage. I've heard the ribcage can rub the abs or diaphragm? However, if this was the case, why would I only experience the stitch in longer races and not 5ks, intervals, or tempo runs? I really want to correct this problem, because otherwise my training is going well and I find pushing myself at longer distances is quite enjoyable.

To be honest, I've only been stitch free this past senior-year XC season. Junior year was alright because of the shorter distances, but a few 3200M runs were plagued with cramps.

You might want to check your form. My arms tended to rotate like train wheels and perhaps this motion lifted my diaphragm up creating the rubbing of the diaphragm and ribs. This has since been fixed, and might've cured the side stitch.

If you're form is good, the only knowledge I can give you is to stack up on electrolytes. Like I said before, I steadily drink Gatorade before a race. This keeps me hydrated, and the sports drink gives me electrolytes. If you really want to be bold, you can try pickle juice, which has an insane number of electrolytes and has been known to be a good remedy for cramps/stitches.

If this advice doesn't work, I'm afraid I can't give you much more advice. I recommend electrolytes though. Good luck.

Thanks again.

You don't need a huge pasta dinner the night before a 1/2

Have 2 slices of toast or crumpets (if you have them over there) 3-4 hrs before a race

Skip the coffee have tea instead if you want a hot drink- no cereals

Good luck I used to get stitches a lot in morning races and they are hard to get rid off. I bet you do a lot of your hard training at night like I did and are not used to pushing it in the morning

You are on the right track with the water, I used to think I should have less but that made it worse. Get plenty in especially when you wake on the race morning

I started doing core work and stopped getting cramps. Of course, there were plenty of other changes in my life that could have caused the cramps to go away, like going to bed earlier, longer tempos, getting a girlfriend, upping my mileage, etc. But I would say core work is worth a try!

i always run like this...

right foot - breathe in
left foot - breathe in
right foot - breathe in

left foot - breathe out
right foot - breathe out
left foot - breathe out

repeat until you're done running.

i read about this somewhere and i remember it going a little something like this...there's a muscle that attaches your right lung to your diaphragm and if you breathe at the wrong time it causes the muscle to expand while your right foot is planted and thus causes the stitch...

breathing like i mention above makes you breathe with this muscle's movement/contraction and lets you avoid the stitch.

i always breathe in this pattern and never get stitches...well, i will get them if i screw up and break the pattern.

just my experience and flawed memory.

Stitches are caused by hypoxia in the diaphragm. It's a muscle, it gets tired. Typically, you will experience stitches if:

You are not properly aerobically warmed up

You are in poor aerobic condition, aka out of shape

You have aberrant breathing rhythms

Good luck

Thanks for all the suggestions. Just a quick update. The spot where the stitch started is still tender to the touch. This seems to suggest a muscular issue maybe? But if so, I'm not sure why it would only come on during long races.

ugh. that doesnt sound like a normal stitch. hope someone reads this and has an idea.

True. I wish I had a knowledgeable doc, but mine is a quack. Probably should search for a new one, but instead I come to message boards...

I have had the exact same problem for the last 2 years, anything over 5k race for me and on tempos sometimes. I have still ran some pretty good long races and only had 1 race where it hurt so bad i had to stop but it would be nice to just run and not worry about cramping up. I've gone to doctors and they don't have any ideas since it does not really hurt unless i am running hard otherwise it feels tender sometimes.

I do massage the area and use electronic stimulator pads on the area along with making sure I am staying hydrated getting enough vitamins a which does seem to help a little.

either of you try the breathing thing i and another poster mentioned? although your stories are more intense than mine for sure, the breathing pattern eliminated any stitches.

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Camalot wrote:

I know this topic has been covered before, but I figured maybe some new posters have some insight or old posters have new ideas. At the very least, it's probably a more worth while topic than half of what's on here.

Anyway, I'm a former HS and college runner who has recently moved up to running longer races. I'm really enjoying it. Unfortunately, I've been hit with a moderate to severe side stitch in every race I've run over 10k (3, all this fall). I almost never had side stitches before. I would get the lactic acid feeling in my stomach, but this is different. It's more of a tightness and discomfort that leads to being able to breath properly.

Here's my latest example. I ran my first half marathon this weekend. I hydrated a lot the day before, ate a large pasta dinner the night before, and drank more water and a cup of coffee the morning of. The race was at 9am. I did a gentle warm-up, and a few relaxed strides. The pace was very easy the first few miles. The the leaders surged and I went with them. My legs felt great and I wasn't breathing hard. However, within a mile I had a side stitch that made breathing difficult. I forcefully exhaled for a while, which helped some but not much. I was able to gut it out, but ran 4-5 minutes slower than my workouts had suggested. I also felt quite strong, except the stitch which led to a lack of oxygen.

It's two days later, and my abs are sore. Mostly in the center/right under the ribs where the cramp came on, but somewhat all over. I didn't notice this feeling in a single training session, though I did in my last race.

Sorry this is so long, but any ideas on how to overcome this problem would be greatly appreciated!

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Camalot wrote:

Thanks for all the suggestions. Just a quick update. The spot where the stitch started is still tender to the touch. This seems to suggest a muscular issue maybe? But if so, I'm not sure why it would only come on during long races.

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Your story sounds the same exact as mine - I haven't found anything to completely eliminate them, however I suspect that I experiencing an electrolyte defficiency. I ususally consume some clif-shots about an hour before the race, which has helped me in my past races. Before doing that, I would stitch up every single race, but now it happens about 1 in 5.

Side-stitches are sometimes caused by the coupling between stride rate and breathing rate. So if foot strike happens when you exhale, you might cause the diaphragm to start cramping. So changing your breathing rate and/or your stride rate will usually fix the problem.

Another thing you might want to investigate is if you're a "shallow breather." A lot of athletes don't use the diaphragm enough when training, and then when racing the diaphragm is called up to do a lot more work and cramps up. Learn to breathe from your "belly" not your chest, fix lying down and just pushing your abdomen in and out, but progressing to practice that kind of breathing when you're out running.

I do plan to eat less and make sure I've consumed enough electrolytes before my next race. And breathing is going to be a focus this winter before I run a spring marathon. I do think I'm a shallow breather. At the start of my last race I felt like I was hardly breathing because the pace felt so easy. I kind of thought this was a good thing, but I'm thinking now that I should maybe force myself to take deeper breaths even if I don't need more oxygen. When I used to race in HS and college, I'd get breathing really heavily. That doesn't seem to happen anymore. I figured it was the longer distance and again that it was a good thing, but maybe not. Thanks for the suggestions. It's nice to see serious answers on this board.