Caring for you as we would for ourselves

Can stitch be avoided?


What is stitch?

The problem of stitch is frequently encountered both in beginner sportsmen and women and in accomplished athletes. It is generally seen in runners, but is also very common in cyclists, swimmers and even equestrians. A sudden, acute pain, often described as like being stabbed with a knife, stitch may be felt in different areas of the abdomen and is most often located in the left or right side, but can even affect the shoulders or collar bone. Stitch impacts performance and is one of the most frequent complaints in sportsmen and women.

What causes stitch?

The exact cause of stitch is not fully understood. One of the oldest theories is that stitch is the result of mechanical stress on the visceral ligaments which support the liver and the stomach via their attachments to the diaphragm. This stress interferes with how the diaphragm works, meaning it receives less oxygen and thereby affecting our breathing as a whole. 

Another hypothesis, which seems more plausible according to the most recent studies, is possible irritation of the parietal peritoneum, the membrane that lines the abdomen and helps to support the internal organs. 

When engaging in physical activity, the pain can often be caused by starting or stopping too abruptly or quickly. Stitch may also be due to poor posture, poor breathing technique, overly weak abdominal muscles, or eating a large meal before playing sport.

Can stitch be prevented and treated?

There are a number of strategies for preventing and/or curing stitch, based on sometimes highly empirical scientific evidence. The most common are as follows:


Preventing stitch:

1) Avoid drinking/eating much for at least 2 to 4 hours prior to physical exertion 

2) Avoid hypertonic drinks (orange juice, for example) prior to exertion

3) Warm up properly prior to physical exertion and start off gently, increasing your pace gradually

4) Perform regular exercises to strengthen the deep muscles of the trunk (core strength)

5) Control your breathing. It is easier to oxygenate your body by breathing in and out mainly through the mouth. Finding the right rhythm is individual to you and comes with time and through training.


Curing stitch:

1) Slow the pace of your activity or even stop completely for a moment to allow the stitch to pass

2) Breathe deeply and calmly

3) Press your hand on the area where it hurts and then release the pressure, breathing out as you do so. Breathe deeply

4) Stretch by bending the top half of your body to one side

5) Bend forwards with your hands on your knees.


The good news is that the best way to prevent stitch is through running! The better your endurance, the less likely you are to suffer stitch, because running trains your diaphragm and respiratory muscles.

Should I have a check-up?

If you get stitch occasionally when you exercise and the pain is temporary, then there is no need for concern. Make sure, though, that you don’t mistake chest pain and difficulty breathing for stitch. If in any doubt, or if you frequently get recurrent stitch even after stopping for a few moments, please speak to your doctor.