What’s that painful feeling in your ribs?

woman running with stitchSometimes when you’re running along a sharp pain can develop and often causes you to stop exercising (good excuse to tell your trainer that you can no longer keep running). This is known as a ‘stitch’ which is a sharp pain felt in your side just under your ribs. Although it is not clear what the cause of a stitch is, it is thought that breathing has a lot to do with it.

The diaphragm and intercostal muscles (located between the ribs) are involved in the breathing process and can become tight and not function properly if there is a lack of oxygen. So the sharp pain you are feeling in between your ribs are perhaps a result of inadequate oxygen delivery to the muscles that are involved in breathing.

So how do we treat a stitch? Most of the time, stitches occur on the right side of the body. When the side stitch is on the right side, try to exhale when you’re left foot lands. Also try and drop the intensity slightly and hopefully it will settle after a few minutes. Another recommendation is breathing through pursed lips is to ease the pain, but stopping your exercise activity is sometimes the only solution. If you stop exercise the pain will usually stop in a few minutes with no harm done.

Now that we have treated them, how do we prevent them?

Here are some ways:

  • Improve fitness
  • Strengthen the diaphragm by using exercises such as those that aid respiratory rehabilitation
  • Strengthen core muscles (abdominalslower 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
  • Run on soft surfaces
  • Deep breathing with full exhalation
  • Slow the pace of the exercise.

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