Ever been cruising through a run when — bam — a sharp pain stabs your side? That’s the dreaded side stitch. It’s one of the most common annoyances for runners, cyclists, and athletes of all levels. While experts still don’t fully agree on the exact cause, research offers several clues — and even better, proven ways to prevent it.

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What’s That Pain in Your Side?

Side stitch. Stomach cramp. Side ache.
Whatever you call it, that sharp stab in your side mid-run can ruin your runner’s high.

This common discomfort has a scientific name: Exercise-related transient abdominal pain (ETAP). While experts haven’t nailed down the exact cause, they have some solid theories — and proven strategies to keep it from stopping you in your tracks.

What Is a Side Stitch?

A side stitch often strikes during activities where your upper body stays upright for long periods — think running, jogging, cycling, hiking, or playing soccer.

It’s been around for centuries. The first recorded mention dates back to ancient Roman philosopher Pliny the Elder. Yet, despite centuries of complaints, researchers still don’t fully agree on why it happens.

Up to 70% of runners experience it each year, and it’s more common on the right side.

What Causes a Side Stitch?

The truth: we don’t know for sure. But here are the leading theories:

• Posture problems: A 2010 study suggested that a stiff spine or poor posture could contribute.
• Nerve irritation: A 2022 review points to your right foot striking the ground while you exhale, irritating the phrenic nerve and possibly the lining of your abdomen (especially the lower right side).
• Diaphragm blood flow: Running increases blood flow around the diaphragm, which might trigger pain.
• Pre-run eating or drinking: Anecdotal reports suggest that loading up on food or drinks right before running can raise your risk.

How to Stop a Side Stitch Mid-Run

If that pain hits, try:

1. Slow down – Ease your pace until the pain subsides, then gradually speed back up.
2. Stretch it out – Raise your arms overhead, lean away from the pain, and take deep breaths.
3. Apply pressure – Press your palm into the painful spot while breathing deeply.

How to Prevent Side Stitches

Your best defense is prevention. Try these tips:

• Breathe mindfully: A 2022 review found that slower breathing during exercise can make workouts feel easier and reduce stress. While not proven for stitches, it may help by affecting diaphragm blood flow.
• Avoid big meals before running: Wait at least two hours after eating or drinking large amounts.
• Improve posture: Good posture supports better breathing and running form. A 2014 study suggests stronger core muscles may help prevent stitches.
• Stay hydrated: Proper hydration supports overall performance and may lower stitch risk.
• Build gradually: Start slow and increase speed over time instead of sprinting right away.

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When to See a Doctor

Most side stitches are harmless, but see a healthcare provider if you experience:

• Pain under the breastbone with shortness of breath (possible heart or lung issue)
• Persistent pain after exercise
• Severe or debilitating stomach pain

Takeaway

Side stitches are common and usually harmless. While their exact cause is unclear, experts think breathing patterns, posture, and nerve irritation may play a role.

By improving your form, watching your pre-run meals, and practicing controlled breathing, you can reduce your risk. If the pain persists, consider getting help from a physical therapist or trainer.