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Side Ache’s

June 3, 2010
If you have ever suffered a side ache (often called a “stitch”) while running, you know it can be one of the most bothersome of all temporary running maladies. In fact, it can hurt your running performance just about as much as a serious injury. A strong side ache will slow even the best runner to a survival crawl. But, because it is usually a temporary problem, many don’t take it seriously. However, if you “run through it,” if you keep on running hard while suffering from a bad side ache, you may suffer a painful “after effect” for days.

In the end, it doesn’t matter much to us runners whether the muscle is spasming or cramping or just hurting: what we care about getting it to stop hurting, quickly.

Most of the experts agree that the best solution is to slow down a little and get rid of the side ache as fast as you can. And – if you learn the techniques described below – you may not have to slow down very much, or for very long.

I could spend the next 12 paragraphs discussing what the thought causes of a side ache are, but honestly who cares? We just want to know how to fix it when it happens, right? Researchers in sports medicine have focused on two primary methods to quickly get rid of the right-sided type of side stitch. They have to do with breathing technique, posture and running style, or a combination of both.

Breathing Techniques

If the side stitch is caused by a muscle or ligament problem related to rapid breathing, then changes in our breathing methods can often help get rid of the side ache. Some researchers have found that shallow breathers have more problems with side pain than deep breathers. To find out whether you are a shallow breather or a deep breather, try this test. Lie down and put your hand on your stomach and then take in a typical breath. Your stomach will move inward as you take in air. But if you are a deep breather, as you complete the intake, your lungs will get so full of air it will force your stomach back out again. Shallow breathers don’t have this outward movement at the end of each breath. It could be that this in and out movement is more relaxing to the stomach muscles, thus avoiding the resulting pain. The next time you get a side stitch, try slowing down for a few steps and taking in some really deep breaths. This technique alone will often bring many runners some relief. Then, as you pick up speed again, remember to add a very deep breath every so often.

Other methods are also related to how and when we breathe during running. Some runners have reported relief from side stitches by focusing on somewhat forceful exhaling while running hard. They purse their lips and force the air out for several breaths, a if blowing out candles on a birthday cake. If this works for you it may again be related to consciously changing the rhythm of your breathing, which can change the way you are using your internal muscles and ligaments. This change helps relax the muscles or ligaments that are causing the pain. If you have a side stitch, try several different styles of breathing as you continue to run. Watch for any breathing method that, after a while, seems to relieve the pain. Some also suggest pushing in at the painful area at the same time you are trying the pursed lip breathing technique.

Posture and Running Style

Some writers have suggested that your posture and running style can be related to side aches. For example, if you tend to lean forward slightly while running, it could be putting too much pressure on your stomach muscles. This means you may be more likely to get a side ache when running up a long hill (requiring more of a forward lean). Therefore, to get rid of a side ache, try leaning forward even more for a few steps and then leaning backward for a few steps. If this helps, then remember to add this forward and backward leaning to your running every once in a while. It may also help to lean to the left and right once in a while. The idea is to break up your repetitive running habits that could be contributing to the problem. The same goes for varying the foot you land on in relationship to your breathing patterns. According to some writers, you should pay special attention to which foot you land on as you breath out. Just as changing your running posture might help get rid of a side ache, varying which foot you land on as you breath out might also help.

Combining Techniques

The real cause of side aches could be a combination of things that cause stress on our internal muscles and ligaments while running. The villain seems to be repetition: running is, after all, a rhythmic, repetitive activity. Therefore, the solution is to develop techniques to break up that stressful rhythm. Try working out your own solutions using a combination of the methods described in this article. For example, some runners report that it helps to change their posture while changing their breathing patterns. Here is the problem: for most runners, one foot will be come habitually related to inhaling or exhaling. When we run, we all tend to become either right-footed or left-footed. We develop a running rhythm with slight differences in which foot uses the most push-off during each series of strides. As part of that running rhythm, we may get into the habit of exhaling as the right foot hits the ground. Some believe the pain of a side stitch is related to those kinds of unconscious habits; that is, the running/breathing rhythm puts unnecessary stress on the same set of muscles or ligaments with each stride. The solution is therefore to vary your stride pattern. If you get a side stitch, try consciously focusing on exhaling when your left foot strikes the ground for a while and then switch so you exhale when the right foot hits the ground.

Also, pay attention to your eating and drinking habits. Wait for at least three hours after eating or drinking before running or eat something light and easy such as a banana with 4 ounces of water. But don’t get dehydrated; that can cause other problems, including muscle cramps.

In the end, you will probably have to work out your own techniques. Each runner should develop his or her own methods systematically, by trying out varying combinations of the following:

  • Strengthen the stomach muscles.
  • Avoid eating large meals or drinking large amounts of liquid before running.
  • Periodically take deeper breaths while running.
  • Periodically purse your lips and forcefully inhale and exhale.
  • Lean forward or back, left or right to change the pressure on your stomach muscles.
  • Change the foot you land on during exhalation.
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