Got A side stitch !!!? .. What is it ?!

What is a Side-Stitch !?

 

A side stitch (also called a side ache, a side cramp, a side crampie, a side sticker or simply a stitch) is an intense stabbing pain under the lower edge of the ribcage that occurs while exercising, most common if the exerciser is a beginner. It is also referred to as exercise related transient abdominal pain (ETAP). Some people think that this pain may be caused by the internal organs (like the liver and stomach) pulling downwards on the diaphragm, but that theory is inconsistent with the fact that it frequently occurs in swimming[1], which involves almost no downward force on these organs. If the pain is present only when exercising and is completely absent at rest, in an otherwise healthy person, it is benign and does not require investigation. There are a variety of published ways of alleviating the symptoms including adjusting at what point in your stride you inhale.[2]

Causes

There are other theories regarding side stitches than simple stretching of the visceral ligaments due to repeated vertical translation and jolting. Such theories include:

1. The pain may be caused by contraction of the liver or spleen, which squeeze extra oxygen-carrying red blood cells into the circulation. Although there does not appear to be much muscle in the capsule of the spleen, there is direct & indirect evidence that its size does change with exercise. (see ref**^{[clarification needed]} below) This autotransfusion, (which is much larger in some animals) increases exercise capacity but the associated pain may be severe, relieved only by rest. A plausible mechanism for the pain is that high internal pressure in the liver or spleen restricts blood flow, causing hypoxia.
2. Diaphragmatic Ischemia
3. Imbalances of the thoracic spine
4. Irritation of the parietal peritoneum

The reasons for the variety of theories include, in particular, the prevalence of ETAP during swimming.

Most of the time, side stitches occur on the right side of the body. This may be due to the fact that the largest organ in the abdominal cavity, the liver, is on that side. Certain athletes also report a pain in the tip of their shoulder blade. This is believed to be because this is a referred site of pain for the diaphragm via the phrenic nerve. When the side stitch is on the right side, published advice is to try to exhale when your left foot lands.^[2]

Preventing a side stitch

• Improve fitness
• Strengthen the diaphragm by using exercises such as those that aid respiratory rehabilitation^[3]
• Strengthen core muscles (abdominals, lower back, obliques)
• Limit consumption of food and drink two to three hours before exercising (in particular, drinks of high carbohydrate content and osmolarity (reconstituted fruit juices))
• Drink water beforehand to prevent muscle cramps
• Warm up properly
• Gradually increase exercise intensity when running
• Exhale when the left foot hits the ground, and inhale when the right foot hits the ground
• Run on soft surfaces

Curing a side stitch

Pain induced by the stretching of the visceral ligaments is relieved by removing or minimizing the applied force, by slowing or stopping the exercise and lying down until the pain subsides. Alternative cures are listed and exist in much the same context as the cure for hiccups;

• Stop exercising. With the digits, push into the abdomen on the right side, and up under the rib cage. At the same time, forcefully let out a deep exhale while holding the lips closely together.
• Try belly breathing; inhale while pushing out the stomach, and on the exhale, relax the stomach muscles.^[4]
• While running, exhale when your foot strikes on the opposite side that the side stitch is located. For example, a side stitch on the right, exhale hard when your left foot strikes the ground.
• Reduce the frequency of breathing (e.g. in jogging, inhale for four steps and exhale for three steps)
• Lie down on the back and lift the knee on the side with the stitch up to the chest.
• Do not breathe too hard, shallow breathing for a few minutes at the same time maintain oxygen input levels.
• Relax the mind and do not focus on the stitch itself.
• Put pressure on the affected area, not enough to hurt, but just enough so the pain subsides.
• Stretch the chest wall and back, whilst laying on your stomach and arching your back,

These alternatives work by implementing the aforementioned function in combination with a coordinated task to occupy the sufferer's mind.

References

1. ^ "965 athletes is six different sports (running, swimming, cycling, aerobics, basketball, and horse riding). Over the course of a year of training and competition, 75% of swimmers had trouble with stitches, 69% of runners were afflicted, 62% of horse riders had ETAP, 52% of aerobics participants suffered, 47% of basketball players did so, and 32% of cyclists were affected " Characteristics and Etiology of Exercise-Related Transient Abdominal Pain,' Medicine and Science in Sports and Exercise, Volume 32 (2), pp. 432-438, 2000
2. ^ ^{a b} p 391 The Lore of Running, Tim Noakes, Publisher: Human Kinetics Publishers Date Published: 1991 ISBN 9780880114387 ISBN 088011438X
3. ^ "Diaphragm Strengthening". http://calder.med.miami.edu/providers/PHYSICAL/resdia.html. Retrieved May2007. 
4. ^ How to Prevent Side Stitch How Stuff Works. 24 Oct 2007.

• 1) Sports Medicine 32(6): 2002. 261-269. The human spleen during physiological stress. Stewart & McKenzie
• 2) Clin Nucl Med. 1995 Oct;20(10):884-7. The effect of exercise on normal splenic volume measured with SPECT. Otto et al.
• 3) J Appl Physiol 74: 1024-1026,1993; Spleen emptying and venous hematocrit in humans during exercise. Laub et al.