What causes a side stitch and how to treat and prevent it

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A side stitch often feels like a cramping sensation but can also present as a dull pain.

Some people describe the feeling as a sharp, stabbing pain. It is more likely to happen during prolonged physical activity, such as swimming, running, or cycling.

A side stitch can happen to all types of exercisers and people of all levels of fitness, including well-trained individuals.

Research from 2014 suggests that side stitches are more prevalent in younger people.

Most people describe the pain as localized. Right side pain is also more common than left side pain.

There is no definitive cause of side stitches. However, there are some theories as to why side stitch pain develops during physical activity.

According to an article in Sports Medicine (Auckland, N.z.), specific individual physiological characteristics may play a part in why some people are more prone to side stitches than others.

Some studies suggest a link to a person’s sex. However, research in this area is conflicting and non-conclusive.

The article also suggests the following factors as possible causes of a side stitch:

Age

Evidence shows that younger individuals are more susceptible to side stitches.

However, researchers note that this might be because older people have lower activity levels.

Posture

Posture may also play a part.

Evidence suggests that people with poor postures, such as those with kyphosis, may be more susceptible to side stitches.

Exercise intensity

There is no consensus about whether exercise intensity can influence the development of side stitches.

Some research suggests that higher intensity workouts are more likely to cause side stitches, while other research shows the opposite.

Well-trained people may not have as many instances of side stitches as non-conditioned ones. However, athletes do still experience side stitches.

Eating and drinking

Eating before working out is a potential cause of side stitches. However, failure to reproduce the experience in laboratory settings means that the evidence is inconclusive.

There is also some evidence that ingestion of liquids with carbohydrates may increase a person’s chance of getting a side stitch.

Temperature

Anecdotally, insufficient warmups or working out in cold conditions may also provoke side stitch pain.

Muscle cramps

Some people associate side stitches with muscle cramps. However, there is little research to confirm any difference in muscular electrical activity while a person experiences a side stitch.

Potential risk factors for side stitches include:

• younger age
• eating or drinking before exercise
• performing high-intensity exercises
• not warming up
• poor fitness level
• exercising in cold weather

The basis for most side stitch treatments is anecdotal.

Some common strategies for treating side stitches include:

• deep breathing
• pulsating the affected area
• stretching the affected side
• bending forward

Briefly stopping the activity may also help get rid of side stitch pain.

The suggestions for preventing side stitches are similarly anecdotal because there is little research to support their efficacy.

People who wish to avoid side stitches during exercise should:

• avoid eating at least 2 hours before working out
• take in fluids throughout their workout but in small amounts
• avoid sugary drinks before and during exercise
• work on improving core strength
• improve their posture
• continue to exercise to improve their conditioning

A side stitch can quickly derail a person’s workout. It can start as a dull sensation and increase in severity.

Sometimes the pain can be so bad that a person doubles over and needs to stop exercising.

Side stitches are not life threatening, but they are annoying.

Unfortunately, there is little conclusive research about what causes them and how to treat and prevent them.

Most of the wisdom about treating and avoiding side stitches is anecdotal.