Understanding Diaphragmatic Pain (Stitches) During Running and How to Prevent Them

Many runners have experienced the discomfort commonly known as stitches, or diaphragmatic pain, during a run. This pain manifests as sharp, stabbing sensations under the ribs and is a common occurrence among runners, even those who diligently maintain proper hydration and nutrition. While the cause of stitches can vary, there are several factors and solutions to help prevent this discomfort.

Common Causes of Stitches During Running

Stitches can be caused by several factors, but generally fall into a few main categories:

Running With a Full Belly: Eating a large meal before a run can fill your stomach, leaving no room for the diaphragm to move freely. This restriction can strain the diaphragm and lead to stitches. It is recommended to avoid eating for 3–4 hours before a run and to stay hydrated without overdrinking close to the start. Long Downhill Running: Descending on long downhill runs can cause the diaphragm to work harder, potentially leading to stitches. Running uphill can also impact the diaphragm, but the strain is lessened compared to downhill. Heel Striking: Running with forceful heel strikes can negatively impact the diaphragm. Practicing forefoot or midfoot striking can improve stride efficiency and reduce stress on the diaphragm. Lack of Fitness and Weak Core: Weak abdominal muscles and a lack of core strength can contribute to stitches. Strengthening the core is essential for proper running form, which can help in reducing the occurrence of stitches. Underlying Medical Conditions: Sometimes stitches can be a sign of an underlying medical condition that may require medical evaluation. If the pattern of stitches does not match the typical progression for an individual or if the pain is severe, it is important to see a medical professional.

How to Prevent Stitches During Running

(1)Proper Timing Before Running: Avoid eating a heavy meal within 3–4 hours before your run. Stay hydrated but avoid drinking large amounts within the last 1–2 hours before running.

(2) Strengthening Core Muscles: A strong core, particularly the transverse abdominis, helps in propulsion and can reduce the strain on the diaphragm. Practices such as planks, side bridges, and Russian twists can improve core strength. Additionally, exercises like body-weight squats and lunges can enhance overall stability and running efficiency.

(3) Proper Running Form: Heel striking should be minimized. Use forefoot or midfoot striking to reduce the impact on the diaphragm and improve overall running efficiency. Imagine squeezing your buttocks and hamstrings while running to encourage the use of the glutes and hamstrings, which can help in proper propulsion.

Conclusion

Stitches during running are a common issue that can be managed with proper training and awareness. By understanding the causes and implementing preventive measures, runners can significantly reduce the occurrence of this discomfort. If the issue persists or if you suspect an underlying medical condition, it is recommended to consult a healthcare professional.

Key Takeaways: Eat and drink appropriately before running. Strengthen core muscles. Improve running form (forefoot striking). Visit a healthcare professional if necessary.

For those looking to learn more about running techniques and physical fitness, further resources can be found in our running resources. Happy running!