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How to Avoid and Treat Side Stitches

Apr 15, 2019

An ETAP or an Exercise-related transient abdominal pain is often known as a side stitch or even a cramp or an ache. ETAP often affects 1 in 5 runners or even athletes like basketball, soccer or even cyclists and can be extremely debilitating.

Side Stitches

A side stitch feels like a sharp localized pain found in the middle abdomen. When the pain is severe it can feel like a sharp stabbing pain, after subsiding the pain often feels like an aching cramping or pulling. Adolescent are the most common to fall victim to these side pains. As an athlete becomes more fit, this type of pain will decrease as the athlete becomes stronger.

Causes of ETPA

The most common reason for side stitches is called diaphragmatic ischemia. This pain is more consistent and can present in activities that are not in high respiratory demand. A second cause of side stitch can be a result of a strain or stress on the ligaments that attach the diaphragm to the abdominal lining. This stitch is often seen in swimmers and can be resolved by wearing a supportive belt.

A third cause of a side stitches is exertional peritonitis which is inflammation or irritation of the outer lining of the organs. The tissue can become sensitive to movement which can often intensify the sharp and stabbing pain.

Preventative Measures


  • Try to avoid consuming large meals or drinking in excess before exercises.
  • When participating in a long run or high endurance workouts, drink small sips of water throughout to keep yourself hydrated.
  • Work on taking deep breaths from your belly as opposed to breathing from the chest.You diaphragm will learn to contract and relax through a full range of motion, preventing spasm or extra strain when exercising.

In the event a side stitch occurs try these techniques:

    • Slow it down – try to change your foot strike and breathing to match one another. For example, if the stitch is on the right, exhale when the left foot hits the ground and vice versa
    • Purse your lips while breathing
    • Tighten your abdominal muscles as if you were bracing for impact
    • Begin pushing inwards and then outwards to the area in pain
    • Place your hand on top of your head and bend forward


If you would like to learn more about side stitches and other techniques to use to avoid this type of pain, contact our team of Atlanta chiropractors at (404) 889-8828 for a consultation today!


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