A stitch is a common term used to describe a sharp, stabbing pain usually felt just below the ribs during physical activity, especially running or vigorous exercise. Although it is a familiar experience for many, the exact cause of a stitch remains somewhat uncertain. Understanding what leads to this discomfort can help people manage or prevent it and enjoy their exercise more comfortably.

What Is a Stitch?

A stitch is medically known as exercise-related transient abdominal pain (ETAP). It typically presents as a sudden, sharp pain on one side of the abdomen, often just under the rib cage. The pain can be intense but usually subsides quickly when exercise stops or slows down. Stitches are most common in activities involving running, swimming or other movements with repetitive torso motion.

Why Do Stitches Occur?

Several theories explain why stitches happen, though no single cause is definitively proven. One widely accepted idea is that stitches arise due to irritation or strain of the diaphragm—the large muscle that helps with breathing, located just beneath the lungs and above the stomach.

During vigorous exercise, especially when breathing patterns are rapid and shallow, the diaphragm may experience stress or reduced blood flow. This can cause cramping or spasm, leading to the sharp pain known as a stitch.

Another theory suggests that ligaments connecting abdominal organs, like the liver and stomach, to the diaphragm are stretched or pulled during movement, causing discomfort.

Additionally, eating a large meal or drinking sugary or carbonated drinks too close to exercise can increase the risk of stitches. A full stomach may press against the diaphragm, making it more likely to cramp.

Who Is More Likely to Get a Stitch?

Stitches can affect anyone but are more common in people who are new to exercise or who increase their activity suddenly. They also tend to occur in those who have shallow or irregular breathing patterns during exercise. People who eat or drink heavily just before physical activity or participate in activities with lots of jarring or bouncing motions, such as running or horse riding, may be more prone to getting a stitch.

How Can You Prevent a Stitch?

To reduce the chances of developing a stitch, it is best to avoid large meals or sugary and fizzy drinks for at least one to two hours before exercising. Warming up properly and building exercise intensity gradually also helps. Focusing on deep, rhythmic breathing during activity rather than shallow, rapid breaths supports the diaphragm. Strengthening core muscles can improve posture and reduce strain on the diaphragm. Staying well hydrated is important but avoid drinking large amounts of fluids immediately before or during intense exercise.

What to Do If You Get a Stitch

If a stitch occurs, try slowing down or stopping exercise briefly. Deep, controlled breathing can help relax the diaphragm. Pressing gently on the painful area and bending forward slightly may provide relief. Once the pain eases, you can usually resume activity at a lower intensity.

When to See a Doctor

Stitches are generally harmless and resolve quickly. However, if you experience severe, persistent or worsening abdominal pain during or after exercise, it is important to seek medical advice. Other conditions such as gallbladder issues, muscle injuries or gastrointestinal problems may cause similar symptoms and require assessment.

Summary

A stitch is a sharp, temporary pain often caused by strain or irritation of the diaphragm during exercise. It is common in activities like running and can be triggered by eating or drinking too close to activity or shallow breathing. Understanding these causes helps prevent stitches and manage them effectively when they occur.

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