Good Luck to those participating in the Chevron City to Surf for Activ on Sunday 30th August.

This year the event includes a marathon, half marathon, 12km walk or run and 4km walk, run or wheelchair race. All the registration fees will be going to Activ to help those living with disability.

Many of the participants in the event will have suffered from what we call a stitch during their training, and will hope they do not develop one during the event.

We do not understand the mechanism of a stitch fully. The theory currently explaining a stitch, involves the idea that friction between the two linings on the abdominal cavity, the outer layer lying against the anterior abdominal wall and folding under the diaphragm and the inner layer wrapping around the abdominal organs results in the pain we know as a stitch. This mechanism explains why a full stomach is linked to more chance of a stitch occurring and when dehydrated there is less of the lubricating fluid between the two layers. The lining under the diaphragm is attached to the phrenic nerve, which explains why some people also have a shoulder tip pain with a stitch.

Usually we call a stitch the pain in the side brought on by activity. It ranges from a sharp or stabbing pain to mild cramping or aching and results in the athlete slowing down or stopping; they occur more often in runners and upright activity, but also occur in cyclists and swimmers. No-one knows why most occur on the right side.  Stitch frequency reduces with age, 77% of active individuals under 20 years experience stitches, but only 40% over 40 years and the incidence further reduces over time.

Evidence for avoiding a stitch suggest

  • Hydrate well in the 12 hours prior to exercise. In the 2 hours immediately before, drink small amounts so hydration is maintained, but the stomach is not bloated
  • Don't eat large volumes of food for at least 2 hours before exercise (perhaps longer if you are stitch-prone)
  • Avoid very sugary drinks such as fruit juices or soft drinks before or during your exercise. Sports drinks are about 6% sugar compared to 11% for juices and do not appear to have the negative effect. Sugary foods such as lollies may also be a trigger. It is thought th sugary drink reduces the rate the stomach empties, which may affect bloating. The concentrated fluids may also reduce the fluid in the space lining the membranes in the abdominal cavity.

Less evidence exists for:

  • Improving fitness
  • Strengthening core, especially the trunk muscles
  • Improving your posture, stretching before the event, especially the torso

Due to the more mechanical nature of the mechanism explaining a stitch, it is not surprising that there is currently no evidence for the role of supplements or medication in prevention of a stitch.

If you suffer from a stitch, to relieve it , the evidence suggests bending forward, deep breathing and pushing or stretching the affected area.



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