What causes a side stitch and how to avoid it?

Surprisingly, the origin of this universal pain is still not well understood.

Shoes on, stopwatch started, jogging starts well. But after a few minutes, sudden pain is felt in the abdomen: it's a side stitch, which sometimes forces you to stop running. Surprisingly, this phenomenon is still not well understood. But the specialists agree on at least one point: having a side stitch from time to time is not a sign of an underlying disease. What exactly do we know about this phenomenon? How do avoid having it? Le Figaro interviewed two specialists.

Unknown mechanisms

"There is no precise definition of a side stitch - but everyone knows how to recognize it," says Dr. Burel, sports doctor at the Rouen Sports Health Center. This pain, which is often accompanied by difficulty breathing, generally disappears within minutes of stopping the effort. It does not cause any complications. The only possible risk: confusing it with a real problem (appendicitis, peritonitis, myocardial infarction, etc.). “In reality, these pains are very different, reassures Dr. Burel. During a cardiovascular problem, for example, the pain does not go away in a few minutes. And other symptoms than pain are added to it, such as a general malaise.

What is this pain due to? "No study has ever been able to answer this question," says the doctor. However, there are several hypotheses. "Some say that the side stitch is the consequence of a cramp or a lack of blood supply from the diaphragm," says Dr. Mathieu Saubade, head of the clinic specializing in sports medicine at the Center Hospitalier Universitaire Vaudois, in Lausanne. Except that side stitches generally appear quickly, without the effort necessarily being sustained. However, a cramp or a lack of blood supply is unlikely in these conditions. Unconvincing, therefore.

“The most commonly accepted hypothesis is that of a slight irritation of the peritoneum, the membrane that surrounds the organs of the abdomen”.

"Some specialists have also suggested that it could be a mechanical stress on the level of the visceral ligaments, these structures which support the abdominal organs", he continues. This would explain why horse-riding enthusiasts are also prone to side stitches: this sport causes vertical pendulum movements of the trunk, which could strain the ligaments.

But the most common hypothesis in the medical community is that of a slight irritation of the peritoneum, the membrane that surrounds the organs of the abdomen. It is composed of two layers which, during physical effort, would be in friction, which could cause a small painful inflammation. For now, this theory is still waiting to be confirmed.

Adapt your breathing

So how do you avoid the side stitch? First, you have to learn to breathe properly. “By breathing poorly, we initiate bad movements of the diaphragm, which could increase the friction of the layers of the peritoneum,” says Dr. Saubade. This explains why children are more concerned. "Their breathing is often anarchic during physical exertion," says Dr. Burel. Conversely, experienced athletes manage their breathing correctly and are therefore spared from side stitches.

“It is important to exhale deeply, to be sure to reject all the carbon dioxide,” the doctor further recommends, adding that all beginners must learn to synchronize their stride and their breathing and find the breathing rhythm that suits them. “You have to start slowly and focus on your breathing. And above all, you have to make an effort adapted to your physical conditions, ”he adds. Finally, it is advisable not to eat too much before the sports session.

If the pain occurs despite everything, you have to focus on your breathing. Leaning your chest forward can also help. Stretching the muscles on the side of the pain, or pressing on the area also sometimes alleviates the symptom. “But often, slowing down or stopping can be enough,” concludes Dr. Burel. And if you decide to leave, you have to do it gradually.