Why stitches occur and how to prevent them?
Stitch is really annoying! If you are running or performing any kind of cardio, this could be one of the problems you encounter on a regular basis. Here at Greek Goes Keto we love solving things and offering help 😉 Therefore, here’s an article that will give you all the info you need for prevention and overcoming the uncomfortable sensation of
So what is a stitch?
An unpleasant experience that most runners have experienced at one point, and which fortunately does not point to a problem but the only consequence is that it spoils the race or training, it is the sudden intense pain that appears in an undefined area. That is why gets a single name the stitch pain but others report it as liver pain, spleen pain, or diaphragm pain.
A side stitch is a fairly common problem among runners, especially long-distance runners. Although it is nothing but an occasional hassle, for some people it can cause more serious problems in training or racing.
As we know, if some condition or injury that has a bad impact on the performance of a runner appears frequently enough, it is likely that the athlete will not have top results. There are many scientific studies that help us understand this specific problem.
Stitches are characterised by sensitivity, tingling or severe pain in the abdominal area, just below the ribs. They are often localised in the left side, and sometimes appear accompanied by shoulder pain on the same side.
Several studies based on runners’ and athlete surveys that had a problem with such type of pain showed that eating a bigger meal or taking concentrated, sweetened fruit juices right before the activity increased the risk of pain. However, the confusing thing was that as the training process intensified, the pain was reduced.
Liver or spleen contractions
Pain can be caused by liver or spleen contractions that squeeze excess red blood cells which carry oxygen to the blood vessels. Although these organs have no muscles, there are direct and indirect indications that the size of these organs changes during the activity. Such auto-transfusion increases the capacity of the athlete, but the pain that can be very harsh and tedious is eliminated by just interrupting or reducing the intensity of the activity. It is likely that the pain is the result of pressure in the organs thereby reducing blood flow causing hypoxia.
The cause of abdominal pain is still a mystery. There are several theories, each of which has its support in the evidence. The traditional interpretation of the source of pain is in diaphragm ischemia.
The diaphragm is a muscle located between the chest and abdomen, which separates these two parts of the body. The most important role is in the breathing process by exerting pressure on the chest, resulting in the change of air from the lungs.
Ischemia is a condition in the body caused by a local breakthrough in the bloodstream, in which certain tissues or organs do not receive enough oxygen due to disturbed blood circulation in the blood vessels they serve.
This reason also explains why certain foods and liquids are causing stitches: if the food or liquid requires more blood to be digested, the diaphragm will stay without sufficient blood. Nonetheless, some studies have shown that diaphragm ischemia is not a cause of pain in physical activity.
Exercise-Related Transient Abdominal Pain research claims that the characteristics of ETAP are reasonably well understood but the mechanism responsible for the pain remains to be fully investigated. Further studies are required to determine the real cause.
A pattern of breathing
A breading pattern in people suffering from stitches was noticed in the dedicated scientific survey. Of the 28 runners that have relapsed during abdominal pain, several respiratory variables related to lung function and breathing were measured. At the halfway point, a stitch appeared, while the other half could continue to run without any pain. After running, the test was repeated on all runners. Although runners who experienced pain had reduced lung power during exhalation, the difference was negligible. Furthermore, it is actually concluded that there is no difference in the inhalation/exhalation strength – which primarily governs the diaphragm. Consequently, reduced blood flow to the diaphragm is not a causal factor of pain and is not manifested by reduced diaphragm strength.
Irritation of ligaments and abdominal pain
The other explanation of the stitches has a starting point on irritation of the membrane ligaments that connect the muscles, bones and organs within the abdomen. This could explain why taking food (any kind) just before the activity causes pain. Also, such an explanation would have the meaning of why stitches are common while running and rare when cycling. Interestingly, there are several phenomena that do not match this theory.
However, one theory has been confirmed, varying the concentration of sugar in the liquid that is consumed directly or during the activity affects the appearance of stitches. This was demonstrated in 20047 in the research of 40 runners with the history of experiencing stitches during the activity. The runners consumed liquids with a different percentage of sugar content (from fruit juices, isotonic, water), and then ran. The biggest occurrence of stitches was in runners that consumed the fruit juice with the largest share of sugar.
Irritation of the spine
Crucially, this theory also explains the pain that occurs in parallel to the shoulders at some runners. Both nerve, one of which goes to the diaphragm, and the other in the shoulder are from the same vertebrae. It can also explain why runners, horse riders and swimmers are a group of athletes with the highest incidence of stitches, while cyclists are not. Running and horse riding imply vertically thrusting of the vertebrae while swimming involves rotational movement. All this is a strain on the upper part of the spine. At the same time, cycling causes less strain and spine in the upper part of the spine.
Stitch preventive and self-help suggestions
Unfortunately, as mentioned above, the cause of the appearance of stitches is still not fully explored and proven. Like many things in the sport, the roots of these specific problems appear to be much more complex than a single factor. On the confident side, we gathered some valuable information obtained through scientific research.
It is advisable to always keep in mind what you eat and drink just before running. Take enough time between meals and activities, and avoid excessively sweetened beverages before and during the run.
Deep breathing, stretching the abdominal area, and gentle pressure on the abdominal muscles when the stitches appear can help relieve pain.
As a long-term solution, sports science experts recommend exercises for the upper part of the spine, and some recommend stretching and strengthening exercises of the abdominal area. Furthermore, stretching and enforcing the back muscles and muscles around the area of hips.
If you have chronic back pain, you should visit a doctor or physical therapist or perform research including an MR scan.
The more research carried out on this subject, the closer we are to a complete understanding of the influence of the surrounding organs, diaphragms, ligaments and abdominal membranes, as well as the vertebral spine.
If you experience problems with regular coaching and racing try to identify a possible reason for occurrence and apply self-help methods to make this harmless, but often very unpleasant pain disappear.
With the years, stitches will appear less and less
As we remember, stitches occurred more frequently when we were children. There is an empowering fact and a great thing to know about the stitches. The vast majority of professionally trained athletes experience fewer stitches after several years of continuous training and when they are not any longer in the teenage or young adolescent ages. This leads us to the conclusion that our body is available to evolve, adapt and protect itself when it’s properly trained.