Side stitching - causes and countermeasures

Side stitching - causes and countermeasures

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Side stitching: what helps?

Everyone knows this: when running or running fast, while jogging, the right and / or left side of the body suddenly hurts and stings under the costal arch: this is how side stitching feels. This phenomenon is also known as side stitches. Mostly untrained people are affected, although experienced athletes can of course get this pain.

Unfortunately, there is still no precise scientific explanation for this complaint. However, there are obvious indications and some theories related to them. Since the side stitch disappears relatively quickly, it is rather difficult to investigate the causes.

The diaphragm

The diaphragm is the most important respiratory muscle for us humans. This muscle tendon plate is located between the chest and abdomen and has the shape of a dome. When you breathe in, the diaphragm contracts, which increases the volume of the chest. It relaxes when you exhale. The diaphragm is breathable, which means that its position changes depending on the intensity of the breath.

Since this muscle is so important to our breathing, many scientists now agree that the diaphragm bears a large part of the blame for the side stitch.

Different theories

Various theories exist for the emergence of side stitches.

  1. breathing
    One says, for example, that the sudden complaints arise due to "wrong breathing". Everyone probably knows this statement from his childhood: “That goes away again. You just breathed wrong ”. During exercise, our diaphragm, which is the most important respiratory muscle and is really used to breathing, is said to be overloaded - but this is often considered a myth. What speaks in favor of the diaphragm as the cause is the statement that the exhalation phase is shorter during physical exertion and therefore this respiratory muscle is not adequately supplied with oxygen. This theory is pretty obvious. Because it also helps a deep inhalation and exhalation to drive out side stinging.
  2. Meals before exercise
    In general, large meals before exercise are not healthy. The body primarily has to supply the muscles with blood during exercise. Accordingly, the digestive organs are in second place. After a sumptuous meal, just before exercise, the opposite is the case. The body has to supply the gastrointestinal tract. This means that the diaphragm is not supplied with sufficient blood, so-called stretching pains develop in the spleen and / or liver, which are then perceived as side stitches. On the other hand, it is also discussed that after a sumptuous meal, the higher blood flow back to the spleen and liver can cause stretching pain there. Both organs have sensitive organ capsules.
  3. Irregular breathing rhythm during sport
    Beginners when it comes to jogging are particularly affected by the unpleasant side stitch. This could be caused by an irregular breathing rhythm. The athletes only focus on breathing in and out after a certain number of steps. In doing so, they cramp, which can cause the stitches in the side.
  4. Posture
    Furthermore, an incorrect posture is suspected as a trigger for side stitches. A bent upper body, drooping shoulders, a rounded back or a hollow back are said to be responsible for the pain. Poor posture creates pressure on the abdomen and on the nerves between the ribs. As the organs are very sensitive, they could react with pain as the pressure increases.
  5. Flatulence
    A completely different approach is the gas bubble theory. This means that flatulence, i.e. air in the intestine, stresses it, expands it and then triggers side stitches during physical activity.
  6. Inadequately trained abdominal muscles
    Another theory is that of insufficiently trained abdominal muscles. If the abdominal muscles are not properly trained, they may cramp during exercise. The diaphragm is thereby restricted in its movement, which can possibly cause side stinging.

Tips to prevent side stabs

Here are some tips to prevent the painful side stitch.
For beginners the following applies: Slowly increase the pace, do not start at the highest speed, give the body time to get used to the new load. Do not stick to any breathing guidelines, but find your own breathing rhythm. Deep breathing in and out, i.e. the right breathing technique, is important.

A small snack, for example a banana, is allowed before sport. However, a large meal should be at least two to three hours ago. Drinking too much directly before sport is also unsuitable. Take a little water with you on a long run and drink a few sips from time to time.

Good posture is important for every sport. So also when running or jogging.
Well-trained core muscles are recommended and warming up before exercising should not be forgotten.

Tips to get rid of the side sting

When side stitches occur, a pause is important, such as slow walking, deep breathing in and out. Change your posture. Raise your arms as you inhale and lean forward as you exhale. What is also easier is when the hand is pressed on the painful area. Through regular training, the side stitches will lose themselves over time.

When to the doctor

As a rule, side stitches are something completely harmless and also go away on their own quite quickly. However, if this lasts longer despite a break in training and causes very uncomfortable pain, a doctor should be consulted. The abdominal cavity is then examined for gallstones or appendicitis, for example. Indigestion can also cause such pain. Antispasmodic drugs may be given.

Help from naturopathy

If someone breathes properly, does not eat meals before exercising and also pays attention to their posture and still suffers from side stitches, there could be a magnesium deficiency. In this case, a suitable magnesium preparation is recommended to those affected. For example, the Schüßler Salt No. 7, Magnesium phosphoricum, is also helpful. This is drunk as so-called "hot seven". For this, 10 tablets are boiled with boiled water (approx. 250 milliliters), the whole thing is stirred with a plastic spoon and drunk in sips. Ideally, half an hour before exercising.

If the symptoms cannot be remedied, the Schüßler Salt No. 19 Cuprum arsenicosum D6 (two tablets) can be added to the hot seven. So-called Amara herbs such as ginger root, gentian root and peppercorn can help with digestive problems that lead to the side stitches. These are available in the form of drops or as a powder and are best taken just before physical activity. It is also helpful to cream the abdominal area up to the costal arches with a high-quality magnesium oil, which is available in the pharmacy. The best time to do this is just before sport. (sw)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Susanne Waschke, Dr. med. Andreas Schilling


  • Christoph Raschka, Stephanie Ruf: Sport and Nutrition, Thieme Verlag, 4th edition, 2018
  • Internists on the net: side stitches - where does it come from ?, BDI
  • Willibald Pschyrembel: Pschyrembel Clinical Dictionary, De Gruyter Verlag, 261st edition, 2004

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