What is actually happening when I get a stitch?

Stitch, cramp, side pain, call it what you want but however you refer to it, it isn’t a fun thing to experience. Described as “sharp or stabbing when severe, and cramping, aching or pulling when less intense” getting a stitch is not an enjoyable byproduct of exercise. Studies have started to be conducted over the last decade or so to try and determine what actually causes it and the answers might surprise you.

A lot of the studies would feed volunteers with carbonated, high sugar soft drinks and then put them on a treadmill. This method would be successful at starting a stitch and then tests could be done to determine what was happening. This makes sense, drink pop before a run and you’re normally asking for trouble! A common theory for a stitch is an abdominal muscle spasm, another one being a respiratory muscle spasm (diaphragm). Electrodes used to monitor muscle activity during a stitch ruled both of these theories out. Too much jostling of the ligaments that support the internal organs is another thought, however the occurrence of stitches during non-jostling activities like swimming argues against this theory.

Unfortunately there is still no definitive answer. Bet you’re really happy you read this now?!?! However more recent studies have offered some revealing hints. During occurrences of a stitch there have been compressed nerves in certain parts of the thoracic spine. The thoracic spine is the area which houses the rib cage. This would suggest a nerve component, and in a 2010 study a link was discovered between the degree of spinal curvature and their susceptibility to stitches. The greater the curvature, the more severe the pain of the stitch. A greater curvature can create more potential spots for nerves to get ‘pinched’ by the spine.

The actual pain is argued to be from irritation to the “parietal peritoneum” the outer layer of the membrane that lines the abdominal cavity. Hence why we will feel the pain in varying locations in the abdomen. So with this knowledge how can we prevent the occurrence of a stitch with activity?

Avoid pop before exercise, probably something we were all aware of already. Other foods may be triggers for some people and not others as the sugar content is a factor but pop is pretty universal. Keep the spine mobile! Spinal mobility exercises before are as important as dynamic muscle stretches for example. If all this fails, the clearest correlation found is with age, the younger you are, the more likely you are to get a stitch, so time may cure you. Less frequent and intense stitches are one of the few things we can look forward to with getting older!!