We all know the feeling.  You are running in a race, and all is going pretty well though you can feel that you are pushing it.  Suddenly the familiar cramp sets in.  Somewhere around your right ribcage starts to scream at you and you need to ease up.  A stitch. Dammit. But what is a stitch?

We tend to use the term all the time but it seems the stitch is in the realm of the hiccup in that it’s the kind of thing you get, but don’t really know why or how.  Running too fast is obviously a factor – I assumed it was something to do with oxygen starvation – your bodies way of slowing you down before you damage yourself.  Last weekend in Ballycotton I got a stitch about mile 3 and it took a couple of miles for it to clear fully.  I don’t think it really affected my performance, but with a renewed interest in the topic I decided to do a little research into the humble stitch..

The first thing I was amazed to find out about stitches, is that nobody agrees on what they are!!  I think this is stunning considering the wealth of medical knowledge about relatively obscure things.  I guess nobody ever died of a stitch so they haven’t invested a lot of time or money into agreeing on what it is.  Perhaps there is a phd in that for somebody studying sports medicine.

However, there are a fair few theories about what they may be.  As with all running questions, the first port of call is Tim Noake’s Lore of Running – supposedly the runners bible. An interesting book to dip into, but a crashingly boring one to read. He thinks it is the liver pushing against the ribcage.  Thanks Tim.

There’s another chap called Dr Gordon Quick ("Doctor Quick" sounds like a fictitious superhero to me!) who claims that it is caused by a muscle spasm of the diaphram.  He believes the following:

"Such pain can occur during vigorous exercise, such as running, and seems to occur more commonly in novice exercisers who have not yet established proper pacing and who tend to breathe more quickly and shallow. However, about 30% of all runners will experience stitches at some point. What exactly causes them? On inhalation, we take air into the lungs, pressing the diaphragm downward. When we exhale, the diaphragm moves up. If the body has some trapped air/gas below the diaphragm, if we’ve eaten too close to exercise, or if we start exercising too vigorously, the diaphragm may cramp, causing pain under the rib cage on the right side."

Okay, fair enough – either one makes sense – I’m starting to get bored of medical articles and to realise that I don’t really care how they are caused.  Now Mister Google, how do you get rid of one? 

Here are some tips to help clearing and avoiding stitches:

1. Avoid eating within one hour of running .. are you listening Mr. Tobin???

2. If you are running in a cold place, try warming up indoors or in a warmer environment – e.g. outside if we’re talking nenagh indoor track!

3. Take deep belly breaths.  If you lie down, place an object such as a book on your belly.  As you breath in, this should rise.  This is of course for practicing the technique at home – not recommended during a race!

4. Straighten the arm on the side of the stitch.  This is supposed to help – I’ve often seen runners do this during a race.

5. Strengthen the tummy and back muscles with situps, etc.  This helps support the diaphram.

6. Breath in each time the foot opposite the stitch strikes the ground – i.e. most stitches are in the right side, so breath in each time your left foot strikes the ground.  This is meant to be very effective.

7. Bending over or stretching upright can help – though that involves slowing down!!

So that’s it – all I could find in 5 minutes on stitches.  If you have any tips, please let me know by emailing me at mark@craughwellac.com.