What a rough and painful finish it was, the end of my first elite heat of a Spartan Sprint race. In fact, I had to walk through the finish line because of a side stitch.
Before this race, I’d experience the side stitch sometimes during my training sessions when I would overreach. But I never thought that this could get more extreme to the extent of me gassing out and walking part of the race.
So what is a side stitch? Unless you’re superhuman, you’ve probably experienced that extremely sharp abdominal pain on one side of your lower abdominal regions. This usually comes out of thin air and might ruin a training session or even a race, as it did my first elite heat.
I consulted more senior coaches and personal trainers in the fitness industry on the best ways to prevent side stitches, but none of them had a silver bullet to also completely fix them mid-run.
Except for one coach, who simply said: ‘suck it up and complete your race, even if you need to clench your teeth to make that happen‘. Sounds harsh, yet it’s actually very close to the fix. Is that it, you might ask, just suffer through?
Yes and no, it’s rather simple: the first part of the solution is to force the pain to go away and keep running. This might sound counter intuitive since forcing it might be the cause of the side stitch in the first place, right? Hold up, there is a second part to the solution but let’s first go over why side stitches happen in the first place – this will help us put all the puzzle pieces together.
Why do we get side stitches?
Side cramps can happen for variety of reasons such as: shallow breathing, imbalances caused by bad posture, diaphragm issues, food and liquids slushing and irritating the gut, internal organ hypoxia, and others. The last one is of the main causes of side stitches in healthy overachieving athletes.
During intense exercise the liver and spleen tend to increase in size and so there’s internal pressure to squeeze more blood cells carrying the oxygen. Think of it as your body going into intense panic mode that it’s never been in before. This requires more oxygen to be circulated in the system, thus some hypoxia might occur causing the pain.
To put it simply, the majority of all bodily cramps are caused by the body being pushed where it has not been pushed before. Overreaching, hyperventilation powered disaster mode.
How can we prevent side stitches and say the last goodbyes?
My own mistake during that Sprint race was acquiring momentum in order to keep up with other elites. This resulted in a, for me, unnaturally fast pace, which I never experienced nor trained in before. I pushed my body to cash out in the first mile, having to force it to make the remaining 2-3 miles.
Now that we know the main causes of these cramps it is much easier to adjust and improve our running game. What I did in my routine was:
- No liquids nor food at least 40 mins before the race. I’m used to drinking an abnormal amount of liquids throughout the day. It would always slush in my gut creating discomfort both during training and in races. My simple solution was to add some electrolyte tabs in the water 40mins before a high-intensity session or race. Thirst issues resolved instantly.
- Practicing deep, gut based breathing to strengthen diaphragm and lungs. Proper breathing techniques can and will be a game changer once implemented in your routine. All too often I see people shallow breathing/panting with their chest rather than using full lung capacity to fill it to the very bottom parts using diaphragm. Now what will happen if a person does not use diaphragm in day to day scenarios and forces it during the race? They will bomb and underperform at best.There are multiple different ways to improve this. We previously mentioned SEALFIT commander Mark Divine’s box breathing exercises. Moreover paying attention to your breathing at all times or using one of the elevation training masks will force you to breathe deeper so you’re better prepared for action.
- Add at least a day a week of high intensity running. No need to go overboard with this. But even a single run a week can make all the difference. This will not only increase your VO2Max, but directly prepare your body and mind (you will need to push so much more) for the stress and intensity of the race.
- Fixing posture issues. This varies on your body composition and lifestyle, however almost everyone has some spinal imbalances. Two primary types of issues affect absolutely everyone to some extent: lordosis (prevalent in hunched over, desk-bound office workers, ladies wearing heels, and trying to bend their bottoms upwards, runners who lean forward etc.) and scoliosis (an abnormal twisting of the spine in a sideways fashion – imagine carrying a bucket or a sandbag in on of your arms or on a single shoulder. Your spine and rest of the body will compress sideways on one of the sides). I find that the latter and most prominent irregularity is one of the biggest causes of side cramping. Taking care of this is a long process, however recognising where you lose form is always a good start.
These are just some strategies to prepare your body and prevent the stitches. But what if you still get them? It’s time to unveil a simple trick and second part of the previously mentioned solution.
How can we eliminate side stitches mid-race?
You run through a mossy trail and that sharp pain starts to creep in. The best thing to do is to start working on it right away. And you don’t need to stop. Lowering the intensity will help of course, but the answer here is breathing.
What you will need to do is to focus on every exhale you make. You need to match the exhale with the foot strike of whichever side you have a stitch on. Meaning if you have a stitch on your right side, try exhaling with every right leg strike you make. It’s that simple. The cramping will stop just within a minute.
Why this works?
First of all it takes your mind off the discomfort. This is similar to the breathing practice in yoga where you direct your breathe to the part of the body where the discomfort or pain lies. This relaxes and completely dissipates the pain. Second of all, breathing deeply forces your diaphragm to relax and so the pressure from the internal organs is released, which relieves the previously discussed hypoxia.
Try this one out next time you get one of those sharp stitches out of the blue. It works wonders.