There's nothing worse than running along, enjoying a gift of a beautiful day, when suddenly a cramp (“side stitch”) develops in your abdomen. Ouch! Whether you like it or not, you're practically forced to walk because choosing to continue only makes the cramp more intense. Why Does It Happen?
A cramp is nothing more than a spasm of your diaphragm muscle and can develop for a couple of reasons: irregular breathing, shallow breathing, and meal timing are the most common. Of those, I'm going to focus on shallow breathing because in my experience, that is the hardest to fix and identify on your own.
Many runners get stitches on their right side because the liver is located on your right side. It's a fairly heavy organ (in comparison to the stomach which is on your left side) that is attached via fascia and ligaments to the diaphragm. Furthermore, runners usually unconsciously time their breath to coincide with landing on their dominant foot- so the right side becomes the “chosen” side.
How does shallow breathing cause a stitch?
If you breathe correctly, your diaphragm contracts and presses downward as you inhale. If you are breathing in a shallow manner (into your chest rather than your belly), then your diaphragm is not contracting as much as it should. It is staying “up”.
Remember, everything in the body is connected. Your liver is connected via ligamentous tissue to your diaphragm. When you are mid-stride and then crash to the ground, your organs are falling downward, too. If you are breathing incorrectly, your liver basically pulls on your diaphragm which has remained tight and 'raised'.
After a short while your diaphragm gets really annoyed with all of that pulling from the ligaments/fascia connected to your liver. It starts spasming. You cramp up. This is why you'll often experience worse cramping on downhills – there is more pulling on your diaphragm due to increased jostling and impact forces.
Eating too close to run time or eating the wrong type of food are the other common causes of cramping.
It can be stopped, though.
Assuming you've eaten 3+ hours prior to running and you've stayed clear of fatty or excessively fibrous foods, you should be ok. Simply eat lightly if you plan on running in the next few hours. Most people learn this the hard way and never make this mistake again.
I used to avoid drinking much before a run, but now I know that your stomach will empty any liquid within a few minutes. Food takes much longer to empty. Go ahead and drink, but give yourself about 5-10 minutes to allow your stomach time to empty.
The root of the problem is usually your breathing technique. I could do a whole post on this at some point, but you MUST learn to breathe correctly. We've been told to “suck it in”, we want to appear thinner, we're overstressed, and so we start chest breathing instead of belly breathing.
Think of a little boy who's run around with his shirt off. What's his belly doing as he tries to catch his breath? That thing is protruding like crazy, huh? He's breathing perfectly! Someday someone will tell him to 'suck in his gut' and he'll become self-conscious and unknowingly change his breathing strategy to accommodate our society's aesthetic ideal. Or not... but you get my point ;-)
So the next time you're out for a run and a cramp strikes, now you know why.
So what do you do? Well, clearly you're going to have to invest some time in learning how to breathe correctly. Start by practicing the crocodile breath exercise. It's really important you start your breathing awareness education by doing this- rather than just trying to “think” about it. This drill develops awareness by FEEL. And that's how you learn- by feel, not words or thoughts.
If you're out on the run and a cramp threatens, slow your pace so that you can better focus on your breathing. Send the breath low. Feel your low back and sides expand. Gradually raise your pace as you continue to focus on that breath. Enjoy the rest of your day!
Have you overcome side stitches or cramps in the past? How? Leave a comment below!