Stomach/rib cramp stich feeling- strange...
Hello all,
So, over the last few weeks I've started to feel what I can best describe as a cramp/stitch thing only when I run. It has happened enough now that I'm a little concerned as I am typically not the type to get side stitches during running, and can't remember the last time I've had one (maybe H.S soccer???, over 15 years ago?) Anyways, here are the details of it:
- Happens on right side only, rib cage only. Feels directly like same spot each time.
- Has happened regardless of morning or afternoon that I am running
- Has happened regardless of intensity, but have noticed it happening at intensities of Z1-Z2 pace even.
- Feels almost like somebody is kind of grabbing on the inside of my body in that area, yanking and twisting at various pressures, mild to pretty damn painful and annoying.
- Has happened on outside runs as well as treadmill.
Other things I've noticed is that sometimes it dissipates while running, sometimes I have to stop and walk for about 2 min and then get going and it may go away. I thought maybe I was dehydrated on a few runs but even noticed it on a few runs where I was hydrated.well and carrying water. Only supplements I am taking right now is Hammer Strength recoverite and endurance aminos, gel and perpetuem for training purposes, and sometimes a whey protein shake during the day.
At this point I'm just a bit nervous as we approach IMLP as I've never really experienced this before in training or racing. It does not feel like a GI issue but rather somebody poking, prodding, grabbing from the inside out. It's happened probably about 8 times now over the last 4 weeks. I may very well just have a case of really bad side stitches or whatever and I'm over reacting and need to MAN UP..., but it's strange...I've also had a few runs that I have not experienced it and can't think of anything different from runs I have had it.
Lastly, I don't feel this at rest, and have not noticed it during biking or the few swims I have gotten in. I know I should probably see a doctor but am afraid that I am going to get little to no helpful advice.
Thoughts from anybody who has had this.
Comments
-do you warm up well-slowly.
-Once you increase the pace, maintain smooth/deep breathing
This may not be the case since it seems to happen at z1 and z2 only.
Here is what I found online:
WHAT CAUSES A SIDE STITCH?
Side stitches are a muscle spasm of the "diaphragm". The diaphragm is a dome shaped muscle that separates the chest cavity from the abdominal cavity. In essence, it provides a boundary between the organs of the abdomen and the chest cavity where the heart and lungs are located.
The diaphragm assists in breathing. When we inhale, taking air into the lungs, the diaphragm moves down. When we exhale, the diaphragm moves up. (This detail, it becomes important later.)
Spasms of the diaphragm occur because of the movement of the internal organs as they jounce up and down while running, thus pulling down and straining the diaphragm as it moves up while exhaling.
The liver in particular is usually the cause of this. It is attached to the diaphragm by two ligaments. The liver is the largest organ in the abdominal cavity and is situated in the upper right abdomen. Hence most people experience stitches on their right side, immediately below the ribs. A stomach full of food may cause this as well.
In addition, most runners are "footed". They begin and end a respiratory cycle on the same foot while running, usually in a stride to breathing ratio of 4:1 while jogging and 2:1 while running very fast. As the runner's breathing then becomes synchronized with his/her stride, exhalation consistently occurs on the same leg. If one repeatedly exhales (causing the diaphragm to move up) when the right foot hits the ground (forcing the organs on the right side of the body to move down), a side stitch may develop.
HOW CAN I PREVENT A SIDE STITCH?
The most effective way to prevent a side stitch is to avoid "shallow" breathing. Shallow breathing can be defined as taking in a small volume of air with each breath, using only a small portion of the total lung capacity. When this occurs while running, the diaphragm remains in a consistently high position and never lowers enough to allow the connective ligaments of the liver to relax. The diaphragm becomes stressed and a spasm or "stitch" results.
Instead, one should breathe "deeply", also known as "belly breathing" while running. This allows the diaphragm to fully lower and reduce the stress on it.
Thanks, this is helpful. I had done some reading up on this as well and thought similiarly. I think I need to take a step back and just be more in tuned w/ my run next time (which is later this afternoon) and be a bit more conscious about my breathing and steps and see if there is any improvement.
I probably have also not warmed up as good as I should have and typically start at faster pace than what is constituted as 'warm-up'.
Appreciate your thoughts on this.
-Sean
It's worse when I'm: 1. Swimming. 2. Have something in my stomach. 3. Am a little out of shape. I now know that I can run or swim out of it - it'll be painful for awhile but it will subside within 10-15 minutes.
Years ago I read about a technique where you exhale completely, pushing every last bit of air out of your lungs, before inhaling again. Do this for about 5 or so breaths. Works like a charm. The cramp may return but I can always release it using this technique. Also, I altered my breathing pattern on the swim. I used to hold my breath until right before I was ready to take one, exhale quickly, then suck in air. Changing to a steady exhale of air underwater dramatically improved the symptoms. You didn't mention this being a problem on the swim, but the moral of the story is, steady is best, controlled exhalation is best.
And to be safe, you might want to add in some core work to strengthen your abdominals to ward off core fatigue when you run. Good luck!
ditto on what folks have said - I usually only get stitches when my breathing is off (most commonly when I run with a friend and end up talking too much - because then I'm not breathing as deeply as I should). So, I definitely echo the sentiment on making sure you're breathing with your gut and not shallow breathing in your chest. Also, I've been told that a few FULL quick exhales followed by some deep breaths helps.
This is all helpful... I think being about 6 weeks away from game day, every little issue and pain now seems to have mentally extrapolated itself into bigger concerns.
This info really helps and again, i've noticed it only running so far. I've experienced this many years ago from my soccer days, but think it may be popping up again as I think my breathing has been a bit off.
My core trainig has definetly gone down the toilet in the last few months due to time and other and do realize I need to do more of it.
Sadly (and here is my confession), I have a background in exercise science and actually oversee a pretty large personal training department (been in the industry for over 10 years). So sadly, taking care of others w/ teaching and training sometimes means putting myself second. I know much of the info that has been provided but it is super helpful to hear from others who have experienced similiarly. Ha...i think I've become the client, which is great.
@Suzanne- thanks- I have not heard or read about that technique but will try it next time. Great advice!
Thanks again everybody. I am actually leading a group run for our fitness members in about an hour so will be more aware of everything recommended and posted back. Today is about 4.5 miles of some steady state and fartlek speed intervals so it should be a good test to see if that stitch comes back or not.
Fingers crossed!
So I led a small group that I normally do on Tuesday afternoons for a a 40 min run (roughly 4.7 miles). Today was a fartlek day so after about a 10 min easy pace warm-up into our park where we run we all took turns of being the "leader" and calling out 2 distances (i.e. tree to bush, can to sign, etc..) where the speed effort took place. Effort times ranged from about 15 sec to about 1 min pending each effort. About 10 total within 20 minutes as we each did 2 (5 of us) and ran a steady easy pace to recover. After our efforts in the park as we were heading back myself and a few others picked up the pace and were probably Z3-Z4 for about another 12 minutes coming back to the building (work)
NO cramps or stitches today. I was hydrated well, nutrition was good and didn't have any food in the gut. I was aware of breathing but didn't feel like I had to alter much or really think about it too much after 20 minutes and no sign of a stitch coming. Everything else was pretty much status quo w/ my form, etc...
It was also more on the hot, humid side here in lovely Jersey City, NJ, but again, was prepared by being hydrated and carrying my handheld water.
I'll continue to be aware of my breathing and other and appreciate everybody's advice.
I have also done the exhale where you push all the air out and it seems to work well for me too. My last HIM I got a stich during the first mils and I think it was b/c I took a sip of my infinit too early. One lady yelled, "try some coke". I did and it was gone in a mere minute. Obviously we don't carry coke on our training runs, but if your in a race and get desperate, I say give it a try.
Glad you had a good run Sean. Hopefully you've nipped it in the bud!!
Thank you Jessica, Suzanne and Becky for the great advice to Sean that I will also be using!
This is very timely for me as I just had a side stitch issue in a race. The race was a trail run and my footing and breathing pattern were way off most of the run because of this. I'm guessing that and dehydration both played a part in this. I have only had two side stitchs that I can remember since elementry school sports, but both were so severe that that forced me to walk at points during races.