No, not the stitches or sutures your doctor used to close your wounds. You have probably experienced it at some point of your life while running. The stitches referred to here are the pains you get in your abdomen that come on during exercise.

What are stitches?

The medical term for this condition is actually called “exercise-related transient abdominal pain” or ETAP. As the name implies, it occurs in the setting of exercise. The type of pain has been described in many ways, from sharp and stabbing pain to cramping and pulling pain. It usually occurs in the upper part of the abdomen (below the ribs) and is often well-localised to a specific area. It goes way when the exercise is stopped.

What causes stitches?

The specific cause is unclear!

How to stop stitches?

Stopping the exercise is the most effective way to stop stitches. Other methods that have been shown to work in small research studies are the following:

• Modified exhalation through pursed lips after deep inhalation
• Wearing a tightened abdominal belt
• Contraction of abdominal muscles by leaning forward while running
• Pushing on the site of pain

How to prevent stitches?

• Avoid food and fluid intake at least two hours prior to exercise
• Hydration during exercise with small and frequent amounts of plain water
  • Fruit juices should be avoided before and during the exercise
• Physical conditioning and more specifically, improved core stability, may help prevent stitches

When to see a doctor?

Please see a doctor if you have severe abdominal pain, persistent abdominal pain even after exercise is stopped or other symptoms such as vomiting, diarrhoea and bloody stools.

References:

• Morton DP, Callister R. Characteristics and etiology of exercise-related transient abdominal pain. Med Sci Sports Exerc. 2000;32(2):432. doi:10.1097/00005768-200002000-00022. PMID: 10694128.
• Morton DP, Aragón-Vargas LF, Callister R. Effect of ingested fluid composition on exercise-related transient abdominal pain. Int J Sport Nutr Exerc Metab. 2004;14(2):197. doi:10.1123/ijsnem.14.2.197. PMID: 15118193.
• Plunkett BT, Hopkins WG. Investigation of the side pain “stitch” induced by running after fluid ingestion. Med Sci Sports Exerc. 1999;31(8):1169. doi:10.1097/00005768-199908000-00004. PMID: 10449020.
• Sullivan SN. Exercise-associated symptoms in triathletes. Phys Sportsmed. 1987;15:105.
• Morton DP, Richards D, Callister R. Epidemiology of exercise-related transient abdominal pain at the Sydney City to Surf community run. J Sci Med Sport. 2005;8(2):152. doi:10.1016/j.jsams.2005.04.008. PMID: 16075775.
• Sinclair JD. Stitch: the side pain of athletes. N Z Med J. 1951;50(280):607.