UT Health Austin Sports Medicine Timeout

What causes a side stitch when you workout?

Let’s talk about that infamous stitch you get in your side, you know, the nasty cramp that occurs just under your ribs, typically during an intense cardio session or a core workout. It’s characterized by sharp, localized pain that is often described as a stabbing feeling in your side. It can be so annoyingly painful that it can slow down a good workout even when you felt like you were on a roll. Most of us have experienced it at some point during exercise and whether or not it stops you in your tracks or you push through it, it’s something we’d rather avoid altogether. So, what causes this intrusive side cramp, what can you do to get rid of it, and are there in fact ways to completely prevent it?

Today, experts refer to this nagging abdominal pain as “exercise-related transient abdominal pain,” or ETAP. Sounds pretty fancy; however, there is not a definitive explanation for the exact cause of a side cramp, but there are several theories as well as some suggestions on what you can do to ease and avoid it.

One of the most important factors in whether or not you develop ETAP during your activity is the timing of your pre-workout meal and what you choose to eat. One study suggests that it’s important to give your body enough time to digest, about 2-3 hours, before engaging in demanding physical activity. Having food in your stomach means that your body requires more blood to be directed towards the stomach to do the work to digest your food. This results in blood being directed away from the diaphragm, which is needed during exercise, thus causing a cramp in the area. Several other studies and tests suggest that consuming foods or beverages high in concentrated sugars, such as reconstituted fruit juices, can also trigger a side stitch during exercise.

Another theory put forth by researchers suggests that ETAP is caused by the stretching of the ligaments that extend from the diaphragm to the internal organs. The jarring motion of running continuously in addition to breathing in and out stretches these ligaments and prevents them from having enough time to relax. When this happens, the diaphragm becomes stressed and a spasm, the stitch you feel, is more likely to occur. Unfortunately, there is little you can do to avoid this during exercise; however, stretching your sides beforehand by raising your arms and leaning to one side and then the other may help.

So, what can you do to prevent and alleviate the pain of a side stitch?

  • Time your pre-workout meal to allow enough time to digest before your exercise
  • Avoid beverages and foods that are high in processed sugars
  • Stretch your sides by raising your right arm straight up and then leaning towards the left, hold for 30 seconds and then repeat on the opposite side
  • When a stitch does occur, slow your pace and breathe deeply until the pain subsides
  • You can also massage or press on the area affected by pain or bend forward to stretch the diaphragm to ease pain
  • Increasing abdominal strength with core workouts may also help build up abdominal ligaments, preventing side stitches

If you are experiencing pain regularly or think you may have a more serious condition, please make an appointment with your primary care provider.

For more information about UT Health Austin’s Musculoskeletal Institute or to make an appointment to see a specialist, call 1-833-UT-CARES (1-833-882-2737) or visit here.

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