Another Day of Adversity

I attempted to run ten kilometers yesterday and could only get to five kilometers before I succumbed to sheer exhaustion. It was a replay of what occurred on Sunday at my 10K race in Elizabethtown. I forgot to mention I had side-stitches during my last race. They subsided after five or six kilometers, but never totally left my side until after the race. Prior to this race I had not had to deal with side stitches. While I have had them when I was younger, this was the first time I had to contend with them this year.

excerpted from http://www.runnersrescue.com/Side_Stiches_Running.htm

Causes of Side Stitches

A "side stitch" is a sharp, intense pain under the lower edge of the ribcage caused by a muscle spasm of the diaphragm. Such pain can occur during vigorous exercise, such as running, and seems to occur more commonly in novice exercisers who have not yet established proper pacing and who tend to breathe more quickly and shallow. However, about 30% of all runners will experience stitches at some point. What exactly causes them? On inhalation, we take air into the lungs, pressing the diaphragm downward. When we exhale, the diaphragm moves up. If the body has some trapped air/gas below the diaphragm, if we've eaten too close to exercise, or if we start exercising too vigorously, the diaphragm may cramp, causing pain under the rib cage on the right side.

Treatment of Side Stitches

As with any muscle cramp, the best immediate treatment is to try to stretch the cramping muscle as much as possible. How do you get to the diaphragm on the inside of your body?, Try altering your breathing pattern. Take a deep breath in as quickly as you can, to force the diaphragm down. Hold the breath for a couple of seconds and then forcibly exhale through pursed lips to restrict the outward air flow. You may also find that bending forward can help you expel as much air as possible. I have actually found that stretching up as tall as I could, even to the point of extending arms up over head, then alternating crouch-tall and tightening/flexing the abs, helped as well.

You may even have to stop and walk briskly for a few seconds while concentrating on deep breathing. Continue running after the stitch goes away. If you get a cramp in the middle of a race, you might want to try mixing up your rhythmic breathing/ striding pattern. If you always exhale when your right foot strikes the ground, try exhaling with the left foot strike. The organs attached to the diaphragm on the left side of the body aren't quite as big as those on the right side, hence there is less strain on the diaphragm. Another technique that may work for some is peaceful visualization--if you are feeling stressed from the day or race, try imagining you are elsewhere, and take deep calming breaths as you run.

Excerpted from http://www.exclusivefitness.com.au

The pain of a stitch is caused by a spasm of the diaphragm muscle. The diaphragm is a dome shaped muscle that separates the lung (thoracic) cavity from the abdominal cavity. This diaphragm is the muscle that you control when you breathe. As you breathe in you are moving this muscle down thus creating a low pressure in the lungs, and atmospheric pressure doing what it does best it pushes air into the lungs, creating a breath. Opposite for breathing out, the diaphragm relaxes, and rises, and the lungs have air pressure higher than atmospheric therefore the air escapes through your mouth. Enough with the biology/physics lesson.

The rising and falling of the diaphragm almost always happens in a pattern with steps. Most people exhale when the left foot strikes the ground. As you inhale most peoples right foot strikes the ground causing the diaphragm to lower. Internal organs are attached to the diaphragm by ligaments. The liver falls with gravity as your diaphragm rises. The constant pulling on the diaphragm muscle and the ligaments that are attached to the internal organs causes the pain of a side stitch.

With all that out of the way we'll talk about ways to fix side stitches. The best way to stop the pain is to stop or lessen the activity that caused the side stitch originally. That being the least practical as exercise is really important to do another way is to alter your breathing pattern. If you are one of the people that exhale when the left strikes the ground exhale when the right strikes the ground. Another is to push your hand into your right side under the ribs inhale and then exhale through pursed lips a few times. One of these remedies should lessen the pain so you can continue. As a preventive measure, take deep, full breaths while you are running. Remember not to take shallow breaths, as the diaphragm is constantly raised which is stretching those ligaments.