January 13th, 2012

Health N' Sports: Running Report

Staff Report

Health N' Sports: Running Report
photo from whirlawaysports.com

Louisville Orthopaedic Clinic Shares Running Advice

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation. On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to editor@catholicsportsnet.com. 

Managing Side Stitching While Running

What it is:

The common “side stitch” is experienced at some time by up to 60% of competitive runners.  It is a localized sharp pain or cramping in the right or left upper quadrant under the rib cage.  Referred to in studies as exercise-related transient abdominal pain (ETAP), the most popular theory supported is that the repetitive jarring forces and considerable torso movement of running causes the internal organs (including the liver, colon, and stomach) to pull downwards, causing stress on the ligaments connecting these organs to the diaphragm. 

Often, the pain is right-sided due to the more dense organs on that side (like the liver). 

Opposing arguments contend that side aches are not related to the diaphragm but to painful friction of the lining of the abdomen (called the parietal peritoneum).  While research has indicated that gender and body weight are not correlated with the prevalence of side stitches, studies on ETAP have suggested its relation to the amount of food intake prior to running, which may cause gas in the colon to push up into the diaphragm. 


Avoid eating large meals up to 3 hours before a run, small snack one hour before a run

Drink water instead of fruit juice or other high carbohydrate beverages (try 10-12 ounces 30 minutes before your run and stay hydrated throughout by drinking on the road)

Warm up slowly, gradually building intensity

Belly breathe while you run, taking deep inhalations while pushing out the stomach and relaxing it as you breathe out

Strengthen core muscles-see a physical therapist or exercise professional to learn more

Run more regulary-training can decrease the incidence of ETAP

During your run:

Slow pace or briskly walk and concentrate on deep breathing, trying to grunt on the exhale (pursed-lip method)

Try to exhale as you land on the opposite side of the stitch

Reach overhead and lean to the opposite side of the stitch

If symptoms persist, try bending over, applying pressure with your hands for at least ten seconds on the area of pain (bending knee up on the side of the stitch at the same time may also help). If side pain is a regular occurance, you may also benefit from seeing a physical therapist to assess and treat imbalances of the thoratic spine and improve posture, as movement dysfunction of the spine or rib cage joints may be a mechanisim of ETAP. A gait analysis can be performed to evaluate excessive trunk movement or faulty gait patterns that may cause added strain and development of cramps. In addition, a physical therapist may also teach you breathing techniques to strengthen the diaphram, facilitating more effecient breathing patterns while you run. If pain is severe and persistent or becoming more frequent. see your MD for evaluation of a more serious gastrointestinal pathology.


Recent Articles