Why Running Causes Side Pain: What it is and How to Run Pain-Free
Morgan Medeiros MSc
September 15, 2017

Running Causes Side PainFAQ: I want to start running, but I always get a stitch in my side! What gives?

If you’re one of the millions of aspirational runners who is demoralized by side stitches, your frustration is totally understandable: that sharp, stabbing sensational just below your rib cage makes running almost intolerable, even for seasoned runners who might be otherwise adept at gutting out pain.

So what are side stitches, exactly, and how can you beat the burn, once and for all?

What are side stitches, and why do they happen?

Interestingly, there’s no firm consensus on what a side stitch actually is. Most experts agree that the pain associated with a side stitch is caused by a spasm in the diaphragm, which is trigger by intense aerobic activity.

For the unfamiliar, the diaphragm is located directly below the rib cage (the site of side stitches). The diaphragm is a dome-shaped muscle that plays an important role in breathing. More specifically, the diaphragm plays an important role in breathing and inhalation, servings as the means through which chest cavity volume is increased.

While there are a number of theories on how and why a side stitch might strike, most agree on one thing: the spasming of the diaphragm tends to occur when it’s put under stress, just as a leg muscle might cramp in a high-exertion exercise, or a bicep might cramp under too much weight. Just like any other muscle, the diaphragm likely cramps when the exertional load is too much to bare.

Side stitches can strike at any point, either at the beginning or end of exercise, and tend to strike novice exercisers more often than seasoned exercisers. They also tend to strike after high-intensity sprints, a nod to the fact that any muscle will-eventually- become fatigued.

How can I prevent a side stitch?

Side stitches tend to affect certain exercisers more than others: beginners tend to get them more than experienced exercisers (although even seasoned exercisers can get them if they’ve increased their pace, or if they’re new to running or cardiovascular exercise altogether), and tend to affect overweight individuals more than lean individuals.

However, regardless of your fitness level and tendency to cramp, there are a number of things you can do to help prevent side stitches.

#1. Warm up.

Don’t hit the ground sprinting, so to speak. Spend a few minutes warming up at an easy pace to slowly increase blood flow to working muscles.

#2. Watch your pace.

Don’t run at the pace you think you should be running at- run at the pace you’re capable of running at.

#3. Tone your core.

A weak core may help strengthen weak diaphragm muscles that aren’t capable of shoring up to high-intensity activity, and can help keep your core strong and straight during a run.

#4. Eat Intelligently.

Don’t eat foods high in fat or fiber before you run- both are difficult for the body to break down, which can make GI upset more likely during high intensity cardio. Save foods high in fat and fiber for later in the day.

#5. Breathe!

Ragged, uneven, labored breathing fails to deliver adequate oxygen to working muscle, resulting in spasms and cramps. If your breathing is labored because you’re a beginner, try reducing your pace until you can breathe more evenly, and slowly increase your pace as you’re able to breath easier.


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