What to Know About a Side Stitch

Medically Reviewed by Dany Paul Baby, MD on August 24, 2022
4 min read

When you’re running or exercising, you might sometimes get a sharp pain on the lower edge of your ribcage. This is a side stitch, also known as an exercise-related transient abdominal pain. Side stitches are very common and typically aren’t significant or harmful!

What is a side stitch? Side stitches can happen when you’re doing cardio, strength training, playing sports, or even walking up a long flight of stairs. This persistent, precise pain will feel like it’s right under your ribs or jabbing into your side.

If you’re physically active, you’ve likely had a side stitch before! There are a few different theories as to what side stitches actually are. For example:

  • One idea suggests that side stitches are simply diaphragm spasms.
  • Another school of thought states that when blood is diverted away from your diaphragm, which needs blood during exercise, it causes a cramp in the area, — a side stitch. 
  • One theory states that side stitches happen when the ligaments that connect your internal organs to your diaphragm are overstretched.
  • It’s believed that friction between your parietal and visceral peritoneum layers of tissue in your abdomen is what we know as a side stitch.

Side stitch symptoms are very straightforward: you’ll feel a sharp pain, cramping, pulling, or aching on one or both sides of your body in the area where your rib cage ends. Sometimes you’ll feel a familiar pain on the top of your shoulder. The pain is often so bad that you need to slow or stop what you’re doing. If you stop activity, your side stitch could linger for a minute or two. If it’s a particularly intense cramp, you might be sore for a few days.

As touched on above, there are a few possible side stitch causes. Eating too close to a workout can trigger a side stitch. If you don’t time your meals well and if you consume the wrong things too close to a workout, you’re more likely to get a side stitch. If you have food in your stomach, your body will naturally pump more blood to that area as part of the digestion process. This means less blood in the diaphragm and a higher chance of diaphragm cramping.

Another potential cause is the stretching of ligaments. When you’re running, for example, the jolting motion of nonstop movement combined with labored breathing puts a lot of strain on the ligaments between your diaphragm and some of your organs. This stress often causes spasms, which is the sharp stitch that you feel in your side.

It’s possible that having an imbalance of sodium, potassium, and calcium in your blood can make side stitches more likely.

Put simply, side stitches can be caused by any kind of exercise. They’re more likely to happen while you’re doing things that require you to rotate or move your torso, like swimming, jogging, sprinting, and similar activities.

When you get a stitch mid-workout, there are a few side stitch treatments you can test out, like:

  • Slowing down, no matter what you’re doing
  • Taking deep breaths
  • Pressing on or massaging the painful area
  • Stretching the diaphragm by bending forward
  • Flexing your stomach muscles
  • Grunting loudly as you breathe in and out

There are a number of tips and tricks you can try for side stitch prevention, including:

  • Not eating for 2–3 hours before you take part in physical activity
  • Avoiding foods and drinks that are high in concentrated sugars, like fruit juice, before you work out
  • Stretching your sides before you exercise by leaning to either side while raising your arms
  • Regulating your breathing
  • Warming up before you start exercising
  • Trying longer, lower-intensity workouts
  • Doing strength exercises to bolster your abdominal muscles and diaphragm
  • Paying attention to your posture
  • Increasing your endurance and aerobic fitness

One of the most important things you can do is to stay well hydrated. Whether you have a significant event coming up or if you’re constantly active, make sure you drink a lot of water in the 12 hours leading up to exercising. Once you’re a few hours away, scale back your drinking so that you remain hydrated but not bloated.

If you notice that you’re constantly getting side stitches during the same activity, try switching your routine up. If you get a lot of side cramps while you’re running, try adding biking or swimming into your exercise regimen.

It’s important to know the difference between side stitches and chest pains due to low oxygen, as the two are often mistaken for each other. Chest pains are different in that the pain will be under your breastbone, not your rib cage; you’ll have a hard time catching your breath; and you’ll have a painful sensation in your left arm. Chest pains can also happen as a result of physical activity.

Stop what you’re doing, and pay attention to your symptoms. If it feels different than a side stitch, you could have a more serious condition like a heart attack. Find medical help as soon as possible and consult with a healthcare provider to know what next steps you should take.