Reviewed By: Pramod Kerkar, MD, FFARCSI

Have you ever experienced a side cramp or a pain in your side while running, horse riding, swimming, or exercising? Side Cramp, also known as Side stitch or Side ache is an intense stabbing pain experienced under the lower edge of the ribcage, which usually occurs during exercising or running.

What is a Side Cramp or Side Stitch?

What is a Side Cramp or Side Stitch?

As mentioned earlier side cramps or side stitch are severe stabbing pain occurring under the lower edge of the ribcage, which feels like an abdominal pain occurring mainly during exercising. That is the reason, it is technically referred as ETAP or Exercise related transient abdominal pain. Mostly the pain is caused on the right side of the body; though side cramps may also occur in the other side of an individual. The pain can be benign and may not require a medical investigation in case the pain occurs only while exercising and is absent during the resting hours in a healthy person. There are various causes for the side cramps; however, it feels like the pain is caused by the visceral organs like stomach or liver pulling downwards on the diaphragm. We will talk about the major causes of these side cramps or side stitch in the following section.

What Causes Side Cramps or Side Stitch?

There are many theories that tell about the causes of side cramps or side stitch. So here, let us take a look on the causes for side cramps.

The contraction of liver or the spleen may cause the side pain; which squeeze extra oxygen carrying RBCs in to the blood circulation. There are evidences that the spleen size changes with exercise and may be associated with pain that may be severe and may be relieved only by rest.

  • Imbalances in the thoracic spine also may lead to side cramps or side stitch.
  • Diaphragmatic ischemia can be a cause of side cramp.
  • Strain on the visceral ligaments by a fluid-engorged gut can lead to side pain.
  • Shallow breathing also causes side cramps.
  • Imbalances of the electrolytes like calcium, sodium and potassium in the blood also cause side cramps.

What Happens During Exercise Which Causes Side Cramps or Side Stitch?

During the time of your inhalation, the diaphragm goes downward and contracts; while when your exhalation process is going on, the diaphragm rises upward and relaxes. Now, considering the same thing while exercising, especially running; you are bouncing up and down while in turn breathing in and breathing out. It usually happens that most of us exhale while one feet strike on the ground during running. However, when the foot strike the ground the internal organs goes down. So, here while the organs are going down the diaphragm is rising up. This actually puts a lot of strain on the ligaments connected to the diaphragm as well on the various connected organs like the stomach or liver. This can cause pain or the side cramps or side stitch.

How is Side Cramps or Side Stitch Treated?

Below are some ways you can treat your side cramps or side stitch caused due to exercise or the pain caused by stretching of the visceral ligaments which occurs while exercising.

  • Stretching may relieve the pain of a stitch.
  • The pace of exercising may be reduced until pain reduces.
  • The area where pain or the side cramp occurs must be pressed or massaged.
  • Bending forward to stretch the diaphragm may ease the side cramps.
  • Inhale fully by raising both hands above the head. This would expand the abdominal and thoracic cavities. Then, exhale completely by tightening the core muscles until the side cramp subsides.
  • Massage the area gently where you are experiencing pain. This definitely helps in increasing the blood flow to the area and aids in reducing pain.
  • Try making a grunting sound while exhaling; which possible forces the diaphragm out and helps in relieving the side cramp or side stitch.

“The poke and blow” technique can work well in relieving the side cramps. This is the technique where you have to push your fingers on your stomach just below the ribs on the right side and also make sure you purse your lips tightly and blow out as hard as you can. This relives the pressure on the diaphragm and helps in reducing the side pain.

In case you are having the side cramp, stop exercising or running completely and take some rest till the pain subsides.

What Are The Preventive Measures For Side Cramps or Side Stitch?

In this section, we will get to know about some of the preventive measures for protecting safe from the side cramps or side stitch.

Learn To Breathe Deeper: It is necessary to learn how to breathe deeper with your diaphragm, which can be one of the best defence mechanism against cramps. Breathing at a faster rate can increase the depth of your breath.

Work on The Abdominal Muscles: Strong abdominal muscles help you in limiting the jarring on the visceral organs. This can limit the strain on the ligaments that are connected to the diaphragm. Thus, working on the abdominal muscles or the abs can help you prevent the side cramps or side stitch.

Do Not Completely Fill Up Your Stomach: Make sure you are not completely filling up your stomach. A full stomach can cause side pain in some people while exercising. It is also necessary that you wait for at least one or two hour after eating your meal and only then go for exercises. Also keep a note that though it is important to keep self hydrated, but should not be over hydrated while exercising. This can lead you to have a real severe side cramp or side stitch.

Stretch Properly: Stretching aids you in preventing from side stitch or side cramps. So, it is important to stretch properly before exercising or running. However, make sure an improper stretch can also cause side cramp.

Practice Fast Running: Fast running actually helps in strengthening the muscles of diaphragm and abdominal muscles. You can try to run fast at least two times in a week. This practice of fast running can help in preventing the side cramps.

Work On The Core Strengthening: It is recommended to perform 10 minutes of core strengthening exercises; three times in a week. Planks, donkey kicks etc are some of the best core-strengthening exercises you can go for. Stronger core helps in strengthening the weak diaphragm muscles and prevent them from cramps or side stitch.

Conclusion:

Pain or problem can encounter anytime in life and that is pretty normal. It is important to know the preventive measures and keep self ready to face the harsh circumstances. As we came across some of the causes for side cramps or side stitch along with the treatments and preventive measures; next time when you feel like experiencing a side cramp or go for intense exercises, it can be a good idea to take a note on the tips mentioned.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 31, 2018

This article does not provide medical advice. See disclaimer

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