Stop Side Stitch While Running: Causes, Prevention & Fast Relief

You’re cruising through your run, feeling strong, breathing steadily. Then suddenly—a sharp, stabbing pain strikes just below your ribs. You slow down, press your hand against your side, and wonder if you should stop completely. Welcome to the dreaded side stitch while running, one of the most common and frustrating experiences.

If you’ve experienced this sharp, localized pain during a run, you’re far from alone. Approximately 70 percent of runners experience side stitches in a given year.

Despite being so widespread, this painful phenomenon remains surprisingly mysterious, with researchers still debating its exact cause.

The good news? While we may not fully understand why side stitches happen exactly, we know how to stop them quickly and prevent them from occurring in the first place.

This comprehensive guide with strategies, practical techniques, and real solutions to help you run stitch-free.

What Exactly Is a Side Stitch?

A side stitch—officially called Exercise-Related Transient Abdominal Pain (ETAP)—is a sharp, localized pain. It occurs during physical activity, most commonly while running.

The pain typically appears on one side of the abdomen. It is usually just below the ribs, though it can occur anywhere in the abdominal region.

How It Feels

The intensity and character of the pain of side stitch while running varies significantly between individuals and situations. Research by Morton and Callister describes the pain as sharp or stabbing when severe, and cramping, aching, or pulling when less intense.

Most runners experience side stitches on the right side, though left-sided stitches occur as well.

The pain can range from a mild, nagging discomfort to an intense, performance-limiting cramp that forces you to stop running completely.

The Good News

Side stitches are annoying and painful, but they’re completely benign. No runner has ever suffered serious harm from a side stitch.

The pain is fleeting—it disappears when you slow down or stop running, and causes no lasting damage or injury.

What Causes Side Stitch While Running?

Despite decades of research, the exact cause of side stitch while running remains debated among scientists and medical professionals.

However, several compelling theories have emerged from recent studies, each supported by different evidence.

Theory #1: The Parietal Peritoneum Irritation

The most widely accepted explanation suggests that side stitch while running result from irritation of the parietal peritoneum, a thin membrane lining the abdominal and pelvic cavities.

This membrane connects to the phrenic nerve, which transmits pain sensations.

How this works:

Running creates repetitive movement of the abdominal wall, which may increase friction between the parietal peritoneum and the organs it surrounds.

Additionally, running might decrease the fluids that normally lubricate around the peritoneum, causing even more friction and resulting in sharp, localized pain.

The movement patterns specific to running creates tension and aggravation in this sensitive tissue.

This theory explains why activities involving considerable torso movement—like running, horse riding, and swimming—trigger stitches more frequently than cycling or other lower-impact activities.

Theory #2: The Visceral Ligament Stress

Research published in Medicine & Science in Sports & Exercise investigated side stitches by having runners consume different types of fluids before running bouts.

Their observations supported the notion that stitch arises when the fluid-engorged gut tugs on visceral ligaments.

The mechanism:

Your abdominal organs—particularly the liver and spleen—are suspended by ligaments attached to the diaphragm. During running, these organs bounce up and down with each stride. When your stomach is full of food or liquid, the increased weight creates additional downward pull on these ligaments.

When you exhale, your diaphragm moves upward while the weighted organs pull downward, creating opposing forces that strain the ligaments.

Repeated thousands of times during a run, this strain manifests as the sharp pain we recognize as a side stitch.

This explains why the right side is most commonly affected—the liver, located in the upper right abdomen, is the largest and heaviest abdominal organ.

Theory #3: Diaphragm Spasm and Muscle Fatigue

Sports medicine physicians often describe side stitches as a spasm of the diaphragm, the dome-shaped muscle extending across the bottom of your rib cage that plays a crucial role in breathing.

Why this happens:

Just like your leg muscles, your diaphragm can fatigue and cramp when stressed.

During running, you breathe faster and deeper to provide adequate oxygen to working muscles. This increased respiratory demand places significant stress on the diaphragm.

Shallow breathing particularly contributes to this problem. When you take short, shallow breaths, the diaphragm remains in a consistently high position and never lowers enough to fully relax. The connective ligaments attached to organs like the liver can’t relax either, and the accumulated stress results in spasm.

Theory #4: Spinal Stress and Alignment

An intriguing but less common explanation suggests side stitches may relate to increased stress on the spinal column.

Both the vertical impact and rotational components of running place considerable stress on the spine, particularly in the thoracic region.

According to some physical therapists, this increased spinal stress can manifest as sharp, localized pain in the side—what we perceive as a side stitch.

What Research Tells Us

A comprehensive 2005 epidemiological study surveyed 965 participants across six different sports. The research found that ETAP appears to be a single, consistent condition rather than a variety of different pains.

The study concluded that ETAP seems to be exacerbated in the postprandial state (after eating) and is perhaps most common in activities involving repetitive torso movement, especially when the torso is extended.

Interestingly, one study comparing triathletes found that side aches were far more common during running segments than cycling portions, despite similar cardiovascular intensity. This supports theories emphasizing the role of impact and vertical movement.

Who Gets Side Stitches Most Often?

Side stitches don’t discriminate—they affect runners of all fitness levels and body types. However, certain groups experience them more frequently.

Age and Experience Matter

Research reveals that 77 percent of runners under age 20 experience side stitches. While only 40 percent of runners over 40 report the same issue.

The severity also tends to decrease with age, though the exact reason remains unclear.

Experienced runners report fewer side stitches than novice runners, though fitness level doesn’t provide complete protection. Even well-trained athletes experience occasional side stitch while running, particularly when they deviate from their normal eating or hydration patterns before runs.

Stress and Anxiety Connection

Psychological stress and anxiety may correlate with increased side stitch while running frequency.

Higher levels of anxiety and stress were associated with higher levels of reported side stitches, even among experienced runners.

While this doesn’t prove causation, the association suggests that mental state may influence vulnerability to this physical phenomenon—perhaps through altered breathing patterns or increased muscle tension.

Gender Considerations

The research on gender differences remains inconclusive.

Some studies suggest side stitches may be slightly more common in female athletes, particularly in cross-country runners, soccer players, and swimmers.

However, other research reveals no significant gender differences in ETAP occurrence.

Immediate Relief: How to Quickly Stop a Side Stitch While Running

When a side stitch strikes mid-run, you need quick relief.

These techniques have been tested by researchers and proven effective by countless runners. Try them individually or in combination to find what works best for you.

Technique #1: Forceful Exhalation (My Go-To Method)

This is the technique that consistently works for me: Forcefully breathe out through your nose using your abdominal muscles, pushing the diaphragm down.

This resembles the breathing pattern in Kapalbhati pranayama from yoga.

How to do it:

1. Stop running or slow to a walk
2. Place your hand on your abdomen
3. Take a deep breath in through your nose
4. Forcefully exhale through your nose, contracting your abdominal muscles
5. Repeat 5-10 times until the stitch subsides

Why it works: This technique forces your diaphragm through its full range of motion, potentially breaking the spasm and relieving ligament stress.

Technique #2: Pursed-Lip Breathing with Increased Lung Volume

Research found that breathing through pursed lips with increased lung volume alleviated stitch within seconds.

How to do it:

1. Take a deep breath to expand your lungs fully
2. Exhale slowly through pursed lips (as if blowing out birthday candles)
3. Place your hand over the painful area and press firmly while exhaling
4. Repeat several times

This technique combines deep breathing with increased abdominal pressure, addressing multiple potential causes simultaneously.

Technique #3: Slow Down and Change Breathing Pattern

Often, simply adjusting your pace and breathing rhythm provides relief without completely stopping.

How to do it:

1. Reduce your running pace by 30-60 seconds per km
2. Focus on your breathing pattern
3. If you typically exhale when your left foot strikes, try switching to exhale when your right foot lands
4. Breathe deeply into your belly rather than taking shallow chest breaths

Why it works: Changing your breathing pattern alters the timing of diaphragm movement relative to organ movement, potentially relieving the repetitive strain causing the stitch.

Read : 3:2 Breathing Pattern : Prevent Side Stitches While Running

Technique #4: The Fist Technique (Surprisingly Effective)

This is an unconventional method without clear scientific backing, but many runners—including myself—report success with it.

How to do it:

1. Make tight fists with both hands
2. Tuck your thumbs inside your fingers (thumb between index and middle fingers)
3. Maintain the fists while continuing to run or walk
4. Focus on your breathing

I can’t explain why this works, but I’ve experienced relief using this technique multiple times. Perhaps it creates a subtle shift in posture or breathing mechanics.

Technique #5: Stretch and Reach

Physical stretching can relieve the muscular tension contributing to side stitch pain.

How to do it:

1. Slow to a walk
2. Raise both arms overhead
3. Lean away from the side that hurts (if your right side aches, lean left)
4. Hold the stretch for 10-15 seconds while breathing deeply
5. Return to upright and repeat as needed

Alternative: Reach your arm on the affected side up and over your head, creating a side bend that stretches the intercostal muscles and potentially relieves tension.

Technique #6: Apply Pressure and Massage

Direct pressure on the painful area sometimes provides immediate relief.

How to do it:

1. Place your fingers firmly on the location of the stitch
2. Gently massage or press the area while walking
3. Breathe deeply and slowly
4. Continue for 30-60 seconds

Some runners report that applying pressure while bending forward slightly enhances the effect.

Technique #7: Tighten Your Belt or Waistband

Research found that tightening a belt around the waist alleviated stitch within seconds for some runners.

How to do it:

1. If wearing a running belt or adjustable waistband, tighten it moderately
2. The compression should be firm but not restrictive
3. Maintain the tightness while continuing to run or walk

Theory: External abdominal compression may stabilize organ movement or provide proprioceptive feedback that reduces pain perception.

What Doesn’t Work

Researchers found that attempting to relax abdominal muscles or increasing the impact of foot strike had little effect on side stitch relief.

Long-Term Prevention Strategies to Avoid Side Stitch While Running

While quick relief techniques help during runs, prevention strategies allow you to avoid side stitches altogether. Here are few approaches to address the various potential causes.

Prevention Strategy #1: Master Proper Breathing Technique

Shallow breathing is one of the most significant risk factors for side stitches.

When you breathe shallowly, using only a small portion of your lung capacity, your diaphragm remains in a consistently elevated position and cannot fully relax.

Deep belly breathing technique:

1. Practice while lying on your back or sitting down with a hand on your stomach
2. Breathe deeply so your hand rises (not just your chest)
3. Focus on expanding your abdomen with each inhale
4. This should become automatic during easy runs with practice

Read : Build Strength with Yoga: Essential Routines for Runners

During running:

• Maintain rhythmic breathing patterns (like 3:2 ratio—inhale for three steps, exhale for two)
• Breathe deeply enough that you can feel your belly expand
• Avoid rapid, shallow chest breathing, especially at the start of runs

Recent research suggests that breathing with a faster rhythm—such as inhaling for two steps and exhaling for one—may increase breath depth and reduce side stitch while running.

Prevention Strategy #2: Maintain Excellent Running Posture

Proper posture is perhaps the most important long-term prevention factor, though it’s often overlooked.

Key posture elements:

• Run tall with your head up and shoulders back
• Avoid hunching forward, especially when fatigued
• Keep your core engaged but not rigidly tight
• Maintain a slight forward lean from your ankles, not your waist
• Let your arms swing naturally at your sides

Poor posture restricts diaphragm movement and increases stress on abdominal ligaments. When you hunch forward, you compress your abdomen and limit breathing efficiency.

Prevention Strategy #3: Always Warm Up Properly

Jumping into hard efforts without adequate warm-up stresses your respiratory system and increases side stitch risk.

Effective warm-up protocol:

• Start with 5-10 minutes of brisk walking
• Gradually transition to easy jogging
• Slowly increase pace over 10-15 minutes before reaching target intensity
• Include dynamic stretches focusing on torso rotation and side bending

This gradual progression allows your diaphragm and respiratory muscles to adapt to increased demands, reducing spasm risk.

Read : Pre-Run Yoga Flows: Dynamic Warm-Up Every Runner Needs

Prevention Strategy #4: Time Your Meals Strategically

ETAP is most common in the postprandial state and correlates with food and fluid intake before exercise.

General guidelines:

• Eat substantial meals 2-3 hours before running
• For pre-run snacks, stick to easily digestible options 45-60 minutes beforehand
• Avoid high-fat and high-fiber foods immediately before runs
• Keep pre-run portions moderate rather than eating to fullness

However, individual tolerance varies significantly. Some runners can eat immediately before running without issues, while others need longer digestion time. Experiment to find your personal threshold.

Important note: Don’t skip hydration out of fear of side stitch while running. Dehydration causes far more serious problems than side stitches ever will.

Read : Balanced Diet(Indian food) for Athletes : For Peak Performance

Prevention Strategy #5: Choose the Right Fluids

Not all fluids cause side stitch while running. Research on fluid composition reveals important differences.

Isotonic fluids cause side stitches to the smallest degree, while both plain water and hypertonic solutions (water with high carbohydrate concentrations) provoke side stitches more frequently.

Isotonic solutions contain a balanced ratio of water, electrolytes, and carbohydrates that matches your body’s natural fluid composition, making them easier to absorb and less likely to slosh around in your stomach.

Practical application:

• Use sports drinks with proper electrolyte balance before and during runs
• Avoid drinking large volumes of plain water immediately before running
• Sip fluids regularly rather than gulping large amounts
• Consider your gut’s tolerance—it can be trained to handle more fluid over time

Prevention Strategy #6: Strengthen Your Core

A strong core supports better posture and more efficient breathing mechanics, both of which reduce side stitch frequency.

Effective core exercises:

• Planks (front, side, and rotating variations)
• Dead bugs and bird dogs
• Russian twists
• Mountain climbers
• Pilates and yoga practices

Aim for 10-15 minutes of core work three times weekly. This investment pays dividends not just in fewer instances of side stitch while running, but also in improved efficiency and injury prevention.

Read : Why You Can’t Ignore These 8 Essential Lower Body Strength Moves?

Prevention Strategy #7: Build Consistency in Training

Research and anecdotal evidence both suggest that consistent training reduces side stitch frequency.

Elite athletes and highly consistent runners report fewer stitches than those with sporadic training patterns.

Why consistency matters:

• Your respiratory muscles adapt to regular training demands
• Your digestive system becomes more efficient at processing pre-run nutrition
• Neuromuscular patterns become more efficient and less prone to disruption
• Overall stress response improves with regular exercise

I’ve noticed in my own running that side stitches occur most frequently when I’m returning from a break or significantly increasing intensity after easier periods. Maintaining regular training volume seems protective.

Read : Setting and Smashing Your Running Goals – Complete Runner’s Guide(2026)

Prevention Strategy #8: Avoid Running Downhill When Prone to Stitches

Downhill running increases the forces exerted on your entire body with each foot plant. It exacerbates the tugging on visceral ligaments.

If you’re particularly prone to side stitches, novice runners should consider walking down steep hills until breathing techniques are mastered and fitness improves.

Read : Hill Running Training: Climb Up & Down Mountains Like A Beast

Prevention Strategy #9: Consider Wearing Support

Some runners find that wearing a snug belt, compression garment, or even a supportive waistband reduces side stitch while running. The external support may stabilize organ movement and reduce ligament strain.

Experiment with this cautiously—compression that’s too tight can restrict breathing and create its own problems.

Prevention Strategy #10: Manage Pre-Race Anxiety

Given the research linking stress and anxiety to side stitch while running, managing psychological state before important runs or races may help.

Stress management techniques:

• Practice controlled breathing exercises before racing
• Develop pre-race routines that calm nerves
• Use visualization to mentally rehearse successful performances
• Consider mindfulness or meditation practices

Special Considerations and Advanced Tips

Cold Weather Running

Some runners report increased side stitch frequency in cold weather. Breathing frigid air may contribute to respiratory muscle stress.

Cold weather strategies:

• Wear a buff, neck warmer, or face mask to pre-warm inhaled air
• Breathe through your nose when possible (though this isn’t always realistic during hard efforts)
• Extend your warm-up in cold conditions

I’ll admit there’s no solid scientific evidence supporting these strategies, but they’re low-risk interventions worth trying if you notice cold-weather correlations.

The Foot-Strike Breathing Connection

You may have heard that consistently exhaling on the same foot strike contributes to side stitches. The theory suggests that if you always exhale when your right foot lands (causing your diaphragm to rise while your right-side organs move downward), the repetitive stress accumulates.

The solution: Vary your breathing pattern so you’re not always exhaling on the same foot. Using odd-numbered breathing ratios (like 3:2 or 5:2) naturally alternates which foot you exhale on.

Some runners consciously practice this alternation, while others find it happens naturally with proper breathing depth.

Understanding Your Personal Triggers

Side stitch patterns are highly individual. Keep a training log noting when side stitch while running occur and the circumstances:

• What did you eat and when?
• What fluids did you consume?
• What was your workout intensity?
• How was your warm-up?
• What was your stress level?
• Were you running uphill or downhill?

Patterns often emerge that reveal your specific triggers, allowing you to develop personalized prevention strategies.

Quick Reference: Relief & Prevention from Side Stitch While Running

Immediate Relief Techniques (Try These During a Run)

1. Forceful exhalation through nose using abdominal muscles
2. Pursed-lip breathing with deep lung expansion
3. Slow down and change breathing pattern (switch exhale foot)
4. Make fists with thumbs tucked inside
5. Stretch overhead and lean away from painful side
6. Apply pressure and massage the affected area
7. Tighten waistband or belt moderately
8. Stop completely if needed—there’s no shame in walking until it passes

Long-Term Prevention Strategies

I’ll be honest—side stitches have frustrated me countless times over my running journey. That sharp pain striking unexpectedly during an otherwise great run can be incredibly annoying.

But I’ve learned that understanding the phenomenon and having reliable relief techniques transforms it from a run-ending crisis to a manageable inconvenience.

The beauty of side stitch while running being so common is that millions of runners have experimented with relief and prevention strategies. What works varies between individuals, which is why this guide provides multiple options.

Try different techniques, keep track of what works for you, and don’t be discouraged when stitches occur—they happen to everyone, even elite athletes.

Now get out there and run—stitch-free whenever possible, but prepared when they happen anyway.