Dear Sarah,

I have just started running (about 3- 4 weeks now), but I find that I am getting stitches in my right side.

Although I am determined to keep at it, the stitches get so bad I have to stop. How can I get rid of them?


Dear Genevieve,

Running is a great way to get in shape, burn lots of calories, make your heart healthy and increase bone density. Stitches are an absolute literal pain in the side and quite common when you first start running. A stitch is usually described as a sharp twinge just below the rib cage, usually on the right side of the body.

There are a few reasons why the 'stitch' occurs. It could be that you are running on a full stomach, have weak abdominal muscles, or are dehydrated, but often they are caused by stretching the ligaments that extend from the diaphragm to the internal organs, particularly the liver which is on your right side.

The diaphragm is the large, sheet-like muscle that separates the chest (thoracic) cavity, which holds your lungs and heart, from your abdominal cavity, which holds your stomach, intestines and liver. It is attached by ligaments.

The diaphragm is at work when you are breathing. When you inhale, the diaphragm contracts to make room for the lungs to expand, and when you exhale, the diaphragm relaxes and the lungs return to their un-stretched size.

Stitches occur when the diaphragm gets fatigued just like any other muscle. The diaphragm gets jarred by your running stride, particularly when you are not controlling your respiration rate. The ligaments, which extend from the diaphragm to the liver, often have us "in stitches".

Exhaling when the right foot hits the ground causes greater forces on the liver. Just as the liver is dropping down, the diaphragm raises for the exhalation which can lead to spasms or stitches.

Shallow breathing can also lead to stitches because the diaphragm is always slightly raised and never lowers far enough to allow the ligaments to relax. The diaphragm becomes stressed and a stitch is likely to occur.

Here are some great ways to help prevent stitches:

Control your breathing as you run: Using deep breathing, you will exercise your entire lung. Unless we are conscious of our breath we tend to only use the top two-thirds of the lungs.

Step one: Push your belly out and allow air to flow in slowly through your nose which is a fantastic controller and filter. When your belly is full to a comfortable point, begin to expand your chest to a comfortable point.

Step two: First deflate your chest, then push your belly inwards to completely empty the lungs. Having too much food in your stomach during a workout may also increase cramping by creating more force on the ligaments. Try eating something light such as fruit and be sure to chew thoroughly for optimal digestion.

Your core works very hard to keep your body in position while you are running. Abdominal and lower back exercises will help strengthen your torso and reduce those stitches.

Stopping a Side Stitch

To stop a side stitch when running, stop running and place your hand into the right side of your belly and push up, lifting the liver slightly while you count to 10. Inhale and exhale evenly as you push up.

Stretching may prevent or relieve a cramp. Raise your right arm straight up and lean toward the left. Hold for 30 seconds, release, then stretch the other side.

Slow down your pace and start your deep breathing as described above; this will bring the diaphragm back into rhythm.

If you continue to experience pain, see your doctor.

The more you improve your run and your respiration, the less likely you are to experience stitches. Be patient with yourself and your breath.

Sarah Brown is a very healthy woman. She is not only a fitness instructor at Goodlife where she teaches Body Pump, Body Flow and yoga but she is also a registered holistic nutritionist. If you have a question for Sarah, leave a comment below and she will try and help, but note that not all questions will be answered.