When to See a Doctor About Side Stitch

Sometimes side stitch is mistaken for angina pectoris, a serious pain caused by lack of oxygen to the heart. See a doctor immediately if the pain you experience emanates from beneath the breastbone or in the neck or radiates down the left arm, is accompanied by shortness of breath, and is brought on by emotional tension and/or physical exertion. And since it truly is better to be safe than sorry in this situation, if you experience any pain during exercise that concerns you, stop and contact your doctor.

You're running along your usual path at a steady clip when suddenly you're gripped with a sharp pain in your side. With each breath, the pain becomes more intense, and you're forced to stop. Looks like you've been temporarily sidelined by side stitch.

No one is actually sure what causes side stitch. It is believed to be a cramp in the diaphragm, the large, flat, muscular membrane that separates the chest and abdominal organs and helps force air into and out of the lungs during breathing. Exactly why the diaphragm spasms, however, remains unclear. It could be the result of tugging on the diaphragm by the ligaments that attach the internal organs, such as the liver, to the muscle. The organs naturally bounce up and down on the elastic ligaments as we run or jump.

If you happen to be exhaling -- which requires the diaphragm to rise and tighten -- at the same time your foot lands during a stride, the liver ends up pulling downward at exactly the same time the diaphragm is highest and tightest in the torso. This tugging and strain could cause the diaphragm to spasm.

Another explanation maybe that exercising intensely decreases blood flow to the diaphragm, causing it to go into spasm. Also, raising the knees to run contracts the belly muscles, which increases pressure inside the belly and presses on the diaphragm from below.

Additionally, during exercise, air tends to get into the lungs more easily than it gets out, so the lungs fill with air and press on the diaphragm from above. The dual pressure may squeeze the diaphragm and briefly shut off its blood flow, resulting in cramping.

Another theory suggests that side-stitch pain results from gas trapped in the large intestine. Exercise tends to speed up intestinal contractions and push gas toward the colon, or the end of the large intestine. If the colon is blocked by a hardened stool, however, cramping can result.

Yet another school of thought holds that side stitch may be brought on by exercising too soon after eating. Additionally, in some people, side stitch may be related to an intolerance of wheat or dairy products. People with such an intolerance may develop side stitch if they exercise within 24 hours of eating wheat or dairy.

Until a definitive explanation and cure for side stitch are found, you can help prevent or halt it quickly using the following home remedies.

Belly breathe. Most episodes of side stitch come from shallow breathing during exercise. While you exercise, try to breathe deeply and slowly, expanding the belly as well as the upper chest.

Try the "grunt" exhale. Making a grunting sound as you exhale seems to help relieve side stitch, possibly because it forces the diaphragm out of its taught "exhale" position.

Slow down. Being out of condition and exercising too intensely causes you to breathe quickly -- and more shallowly. Build your intensity slowly over the course of several weeks.

Stop. Some people, particularly competitive runners, believe you should "run through" a side stitch. However, unless you're in a race, the best idea is to stop completely until the pain subsides.

Use the "one hour" rule. If you've eaten a meal, wait at least an hour before exercising, because a full stomach does appear to cause problems for some people during exercise.

Massage it. Gently rub the area with your hands. Massage relaxes the muscles and helps increase blood flow to the area.

Use the "poke and blow" technique. One way to relieve diaphragm pressure is to push your fingers deeply into your belly just below your ribs on the right side. At the same time, purse your lips tightly and blow out as hard as you can.

Practice running fast. One of the possible causes of side stitch is weak abdominal and diaphragm muscles. To increase endurance and strengthen the diaphragm, try running fast a couple of times a week or inserting a couple of intervals of fast running during your regular, more moderately paced jog.

For more information about side pain and how to combat it, try the following links:

Timothy Gower is a freelance writer and editor whose work has appeared in many publications, including Reader's Digest, Prevention, Men's Health, Better Homes and Gardens, The New York Times, and The Los Angeles Times. The author of four books, Gower is also a contributing editor for Health magazine.

Alice Lesch Kelly is a health writer based in Boston. Her work has been published in magazines such as Shape, Fit Pregnancy, Woman's Day, Reader's Digest, Eating Well, and Health. She is the co-author of three books on women's health.

Linnea Lundgren has more than 12 years experience researching, writing, and editing for newspapers and magazines. She is the author of four books, including Living Well With Allergies.

Michele Price Mann is a freelance writer who has written for such publications as Weight Watchers and Southern Living magazines. Formerly assistant health and fitness editor at Cooking Light magazine, her professional passion is learning and writing about health.

ABOUT THE CONSULTANTS:

Ivan Oransky, M.D., is the deputy editor of The Scientist. He is author or co-author of four books, including The Common Symptom Answer Guide, and has written for publications including the Boston Globe, The Lancet, and USA Today. He holds appointments as a clinical assistant professor of medicine and as adjunct professor of journalism at New York University.

David J. Hufford, Ph.D., is university professor and chair of the Medical Humanities Department at Pennsylvania State University's College of Medicine. He also is a professor in the departments of Neural and Behavioral Sciences and Family and Community Medicine. Dr. Hufford serves on the editorial boards of several journals, including Alternative Therapies in Health & Medicine and Explore.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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