Abdominal Pain

Stitch Pain in the Stomach

As a gym junkie who loves to sweat it out jogging on the treadmill, one of my worst enemies is the stitch pain I occasionally get in my stomach and side. While sometimes the pain is bearable and I am able to continue exercising, other times the pain is so severe that I am wincing and forced to stop. I have decided to investigate the cause of the stitch pain to see if it can be avoided completely.


Stitch Pain in the Stomach and Side


Scientists refer to stitches as Exercise-Related Transient Abdominal Pain (ETAP). Stitch pain is usually felt in the stomach or on the right side just below the ribcage and is occasionally accompanied with a sharp stabbing pain in the shoulder. The pain felt can differ from mild cramping, aching, pulling or stabbing and usually disappears once exercise is ceased, however in some cases soreness can last for a few days.


Stitch pain in the stomach and side is most common during rigorous vertical exercise like running, fast walking and horse riding, although it can occur in any sort of activity.


What Have I Found Out?


Unfortunately after some research I have discovered that scientists still do not know what the exact causes of a stitch really are. Some believe that the pain is caused by a reduction in blood supply to the diaphragm or by internal organs such as the liver and stomach pulling downwards on the diaphragm.


What is the Thoracic Diaphragm?


The thoracic diaphragm is a large muscle that extends along the bottom of the ribcage between the chest and abdomen that the inner organs are connected to by several ligaments. The common association of shoulder pain supports the theory that the diaphragm is involved as it is connected to branches of the phrenic nerve that is found in the neck.




The theory regarding the downward pull on the diaphragm has been proved conflicting with stitch pain in the stomach or side occurring during swimming, where there is no downward drive on organs.


The theory of lack of blood supply to the diaphragm has also been disregarded as this muscle and limb muscles have to work harder during exercise and therefore it is improbable that insufficient blood is steered to the diaphragm.


A much more scientific theory involves two layers of membrane (parietal peritoneum) that line the inside wall of the abdomen and are divided by a lubricating fluid. If there is a reduction in this fluid or the stomach is bloated, friction may occur between the two layers and this is believed to be what causes the stitch pain in your stomach and side. The parietal peritoneum is attached to the phrenic nerve that I mentioned earlier, which would also explain the shoulder pain that some athletes suffer.


Possible Prevention


There are a few steps you can take to limit and control your chance of getting stitch pain in your stomach and side.


  • The main tip you should follow is to not eat too soon (two to three hours) before exercise, especially foods high in fibre or fat. The best type of food to choose for a pre-workout snack would be something high in carbohydrates, low in fat and protein.
  • Do not drink sodas or juice as the high sugar and carbonation bloats the stomach but do drink plenty of water as dehydration is thought to be a cause.
  • Strengthen your core muscles; this includes your abdomen and obliques.
  • Control your breathing and take full breaths.


A Stitch in Time


Hopefully the tips I have provided will help you. I know I plan on following these guides to avoid the wincing pain I have previously experienced. Let’s get moving!