They're unpleasant and usually harmless and yet side stitches can be a major nuisance during a training session – be it swimming, running or a group fitness course.
Here's what you can do to prevent them.
Out into the fresh air and off on a jog, you've got to work off the calories from the meal you just ate.
But it doesn't take long before you're waylaid by side stitches, transient abdominal pain that most recreational athletes have experienced at one time or another.
"They hurt, but as a rule are completely harmless," says Dr Ulrich R. Foelsch, a specialist in internal medicine.
They're by no means a sign of a serious illness, but rather a kind of indisposition.
"They could possibly have been avoided if a sizeable meal hadn't immediately preceded the workout," says Ingo Froboese, head of the Centre for Health Through Sport and Exercise at the German Sport University (DSHS) in Cologne. Side stitches generally occur during physical strain and primarily affect endurance athletes – mainly runners, but sometimes swimmers and cyclists, too.
"Well conditioned athletes get them less often than unconditioned people do," Froboese says.
Side stitches can occur on either side of your abdomen and sometimes on both. It's unclear what triggers them.
Although several theories exist,"none have been scientifically proven," notes Foelsch.
One theory, he says, is that reduced blood flow to the spleen is to blame. Studies have shown that the spleen, along with the liver, is supplied with less blood during physical exertion.
This theory is supported by the fact that side stitches tend to strike during physical exertion after a heavy meal. The gastrointestinal tract requires blood for digestion, the muscles need blood too, and a deficiency results.
"So you shouldn't exercise on a full stomach," Foelsch advises.
The diaphragm is another possible cause, according to Froboese.
One of the main muscles involved in breathing, it lies below the lungs between the abdominal and chest cavities.
You breathe faster and deeper during physical exertion, putting stress on the diaphragm when it's deficient in oxygen-rich blood.
The reason the cause of side stitches remains a mystery is that they often go away as quickly as they arise.
"They're already gone before they can be medically examined," points out Foelsch.
Posture could also play a role. If you start jogging tensed up and hunched instead of being upright, you may be more likely to get side stitches.
Being overweight is thought to be possible risk factor as well.
Whatever the kind of exercise you engage in,"it's important not to overdo it, but rather to adapt your training regimen to your abilities," Froboese says.
This also means warming up well and increasing the level of exertion gradually, not abruptly.
The severity of side stitches varies. If they're mild, you needn't stop your workout.
"You can if you want, but it's sufficient to breathe more consciously and evenly into your abdomen, and to slow down," Froboese says.
If the pain is sharp, he advises taking a break to focus on breathing.
"Take four steps while consciously inhaling, then take another four steps while consciously exhaling."
Continue doing this until the pain subsides.
There's no one remedy for everyone," according to Foelsch, so you have to figure out what works best for you.
To prevent the puzzling pain from occurring in the first place, he says it's important to talk as little as possible during your workout because talking can throw your breathing out of rhythm and cause muscular tension, possibly leading to side stitches. – dpa
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