Side Stitch

The stabbing pain in your side is known as a side stitch, side ache, side cramp, or exercise-related transient abdominal pain (ETAP). It’s considered exercise-related pain, but exercise doesn’t cause side stitches. Side stitch is caused by stress or pressure on the diaphragm muscle.

This article will explain the symptoms of side stitch, the causes of side stitch, and what treatment, including prevention, looks like. You’ll also learn when to see a healthcare provider. 

Symptoms of Side Stitch

You’ll know when you’re experiencing a side stitch. You may feel a stabbing pain near your rib cage or a sharp cramping feeling on both sides of your abdomen. While it can feel incredibly uncomfortable and limit what you’re able to do in the moment, side stitches are common and not typically a cause for concern.

Side stitch symptoms may include:

• Sharp or stabbing pain on one or both sides of the abdomen
• Pulling feeling under or near the rib cage
• Aching in the surrounding area
• Cramping sensation

Causes of Side Stitch

When you get a side stitch, it’s commonly because your diaphragm is spasming. The diaphragm is the muscle responsible for respiration (breathing). It’s located right under your rib cage.

Side stitches are often experienced by athletes. There are three underlying causes for side stitches, including:

• Diaphragm muscle cramp (diaphragmatic ischemia) 
• Stress on stomach ligaments (peritoneal ligaments)
• Irritation of the muscles lining the abdomen and pelvic cavity (parietal peritoneum)

According to research, runners and swimmers may be more likely to experience side stitches while exercising, but it also occurs in people participating in team sports and in cyclists. One report estimates some 70% of runners may experience this type of pain.

When to See a Healthcare Provider

You’ll know whether or not your side stitch is cause for concern by how long it lasts. Benign (harmless) side stitches are transient, meaning the pain does not last. So, if you stop or reduce the intensity of your physical activity, side stitches may resolve within minutes. Some cases of severe cramping can leave a lingering soreness in the area for a few days.

How to Treat Side Stitch

Treatment for side stitch can involve stopping a stitch when it’s already happening and doing your best to prevent side stitch in the first place.

How to stop a side stitch in its tracks:

• Slow down (i.e., if you’re running, start walking).
• Stop the activity.
• Bend over forward.
• Press your hand inward and upward on the stitch location.
• Contract or tighten your abdominal muscles.
• Breathe through pursed lips as if drinking from a straw.

If you’re still experiencing pain, you can try walking slowly with your arms raised above your head. This helps stretch the tight muscles. If this is uncomfortable, and you have a safe spot to rest for a moment, try lying down on your back with your hips elevated. This can help ease stress on the area and reduce pain within minutes.

How to Prevent Side Stitches

Sometimes a side stitch will just happen, and it’s nothing to worry about. Still, it can be annoying to stop an activity due to pain and discomfort. If you want to prevent side stitches from occurring in the first place, try the following tips:

• Plan your meals around your physical activity to give yourself enough time to digest the food. It’s recommended people avoid eating within two hours before physical activity. 
• Warm up before increasing intensity. For example, try stretching first for about five or 10 minutes.
• Remember to breathe. Sometimes we can hold our breath during physical activity. This creates stress on the diaphragm. Keep breathing. 
• Stay hydrated throughout the day rather than trying to compensate during physical activities. Too much water while working out can cause pressure on your diaphragm.
• While working out, try wearing a lightweight, wide belt that can be tightened as necessary.
• Practice belly breathing to strengthen the diaphragm muscle. 

Summary

Side stitches are rarely anything to worry about. Diaphragm cramping happens during physical activity. Treatment involves slowing down, locating the pain and pressing on it, and focusing on breathing. Preventing side stitches requires meal planning around physical activity, warming up properly, remembering to breathe, and staying hydrated. Wearing a specific belt while working out may also help reduce side stitches. 

A Word From Verywell

Getting a side stitch while working out or engaging in physical activity of any kind is a real pain. But it shouldn’t stop you from enjoying the benefits of moving your body in the ways you love. If the fear of experiencing a side stitch while exercising is holding you back, you may want to consider talking to your healthcare provider about your concerns and learn how to prevent them before you exercise.