Side Stitches:
Cause and Cure
By Gabe Mirkin,
M.D.
It took years for
the medical community to finally learn what causes a side
stitch. Suddenly a runner develops pain in the right upper
part of the belly, just underneath the ribs in the front.
With each step the pain worsens. Doctors proposed all sorts
of explanations for side stitch and most were nonsense.
A side stitch is not caused by gas in the colon because it
is not relived by passing gas. It is not caused by a liver
swollen with blood during running, because the liver has a
very distensible capsule and does not enlarge much during
exercise. It is not caused by cramps in the belly muscles
because the belly muscles are not held rigidly when you have
a side stitch, and it does not hurt when you push on the
belly muscles. Lack of oxygen to the diaphragm doesn't cause
them because blood flow to the diaphragm is not shut off by
running. They are not caused by trapped gas in the lungs
because gas does not get trapped in the lungs during
exercise.
The first reasonable explanation and successful treatment
came from Dr. Tim Noakes. Thick fibrous bands called
ligaments extend downward from your diaphragm to hold your
liver in place. When you run, your liver drops at the exact
time that your diaphragm goes up, stretching the ligaments
and causing pain.
Humans have a fixed pattern of breathing when they run. They
have a two to one breathing ratio, breathing once for each
two strides. Most people breathe out when the right foot
strikes the ground. When you breathe out, your diaphragm
goes up, and at the same time, the force of your foot strike
causes your liver to go down. This stretches the ligaments
that attach the liver to your diaphragm, causing pain. So
the cause of a side stitch during hard running is a
stretching of the ligaments that hold the liver to the
diaphragm and the cure is to relieve the stretching of the
ligaments.
When you get a side stitch, stop running and press your hand
deep into your liver to raise it up against your diaphragm.
At the same time, purse your lips and blow out against the
tightly held lips as hard as you can. Pushing the liver up
stops stretching the ligaments. Breathing out hard empties
your lungs. Usually the pain is relieved immediately and you
can resume running as soon as the pain disappears. Dr. Gabe Mirkin
has been a radio talk show host for 25 years and practicing
physician for more than 40 years; he is board certified in
four specialties, including sports medicine. Read or listen
to hundreds of his fitness and health reports -- and the
Good Food Book -- at
www.DrMirkin.com | 
Fast track weight loss with 