Experiencing a stitch while running can range from being annoying to severely hindering. The sudden sharp or cramp-like pain lasting from a few seconds to several minutes has the potential to disrupt numerous running sessions. What exactly is a runner's stitch, what triggers it, and how can you prevent it? Discover the answers to these questions below!
What does the term "runner’s stitch" refer to?
Runner’s stitch, also known as 'exercise-related transient abdominal pain (ETAP),' is a frequently encountered condition among individuals participating in various sports activities. This issue has been documented as far back as the times of Shakespeare and Pliny the Elder. It is typically characterized as a 'localized pain that is most commonly felt in the lateral areas of the mid-abdomen along the costal border, although it can manifest in any part of the abdomen...the pain is usually sharp or stabbing in severe cases and cramping, aching, or pulling when less intense.
Who is prone to experiencing a runner’s stitch?
Anyone participating in intense physical activities can experience a stitch, with runners being the most affected group (75%), followed by horse-riders (62%), and then by those doing aerobics (52%). Activities like swimming or cycling have significantly lower rates at 15% and 8% respectively.
Age also plays a role, as 77% of active individuals under twenty have reported experiencing a stitch, compared to only 40% of those over forty.
One's fitness level can impact the likelihood of a runner’s stitch, although elite athletes tend to experience it less frequently than those who are less well-conditioned.
Factors like body type and posture seem to have minimal influence on the occurrence of a stitch. However, individuals with increased spinal curves (scoliosis/kyphosis) may experience more severe pain episodes.
Consuming food or drinks before exercising can also contribute to stitch-like symptoms, especially if the intake is high in sugar or salt.
What is the reason behind a runner experiencing a stitch?
This is an interesting query. Various causes have been studied to understand the occurrence of a stitch, with many commonly mentioned reasons lacking substantial evidence. Initially, it was believed that a stitch could be due to inadequate blood flow to the diaphragm, mechanical strain on the ligaments supporting the abdominal organs, digestive issues, or muscle cramps, but none of these explanations seem to be accurate.
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There are three potential factors that could clarify why individuals experience a stitch:
Neurogenic pain – The sensation commonly known as a stitch might be caused by mechanical factors in the torso sending pain signals along the intercostal nerve, leading to similar pain in the upper abdomen. The repetitive rotational and compressive forces during running can irritate the intercostal nerve, potentially causing a stitch.
Irritation of the Parietal Peritoneum – The parietal peritoneum, a tough connective tissue surrounding abdominal organs and forming the underside of the diaphragm, can cause pain akin to a stitch when irritated. This pain, felt in various abdominal areas, worsens with movement and improves with rest, characteristics typical of a runner's stitch. Younger individuals, with a relatively larger peritoneal surface, might be more prone to experiencing a runner's stitch. Moreover, irritation of the peritoneum could explain why stitches are more likely after eating or drinking, as abdominal distension from food consumption may lead to friction. Sugary or salty beverages can affect peritoneal fluid due to osmotic changes in the blood, further supporting peritoneal irritation as a source of pain.
Lack of core stability – Research indicates that individuals experiencing a runner's stitch often have weaker core muscles. Inadequate core strength can increase the mobility of abdominal organs during exercise, potentially irritating the peritoneum. This factor might also contribute to the severity of stitches in less physically fit individuals.
What can be done to prevent a runner’s stitch?
According to the information provided, the literature indicates several strategies that may help decrease the chances of experiencing a stitch while running.
Avoid consuming large amounts of food or beverages shortly before exercising, especially sugary or salty drinks. It is recommended to have small, regular fluid intake during the activity instead of large quantities.
Enhance your core stability – Strengthening your core muscles to reduce the impact on the intercostal nerve and minimize abdominal organ movement during exercise could reduce the frequency and intensity of the pain.
Enhance your spinal mobility and function – Improving the spine's ability to move correctly and maintaining proper posture has been proven to lower the occurrence of stitches.
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