Why does the stitch usually hit under my right rib and not the left?

The right side houses the heavy liver, increasing downward tug on the diaphragm’s right ligaments when you run.

Will strengthening my core really stop stitches?

Yes—studies show a 50 % drop in stitch episodes after six weeks of oblique and transverse-abdominis exercises.

Is it okay to keep running through a mild stitch?

You can jog lightly while performing deep exhalations, but sprinting through pain prolongs the cramp and may alter your gait.

Do electrolyte drinks prevent stitches?

Hydration helps overall performance but has little impact on diaphragm cramps; focus on breathing technique instead.

Can children get side stitches while playing sports?

Yes, kids have proportionally larger livers, making them prone to the same ligament traction seen in adults.

Does smoking increase my risk of stitches?

Smokers often have reduced lung capacity and must breathe faster, which fatigues the diaphragm and raises stitch risk.

Should I use ibuprofen before a race to avoid stitches?

Pre-medicating is not recommended; it masks pain without addressing the underlying muscle fatigue and can irritate the stomach.

How long should I wait to run after a small snack?

A light 200-calorie snack usually clears the stomach in about 45 minutes—safe for most runners to start training.

Why do I get side stitches when running?

What exactly is happening inside your body when a side stitch strikes?

A side stitch is most often a spasm of the diaphragm—the large muscle under your lungs that drives breathing. As you run, the diaphragm moves up and down up to 30,000 times an hour, tugging on the ligaments that connect it to the liver, stomach, and abdominal wall. When that workload outpaces blood flow and oxygen delivery, the muscle cramps and you feel the classic stabbing pain just below the ribs.

Diaphragm strain from rapid breathing is the main culpritStudies using ultrasound show reduced diaphragmatic excursion when runners develop a stitch, suggesting fatigue of the muscle itself.
Ligament tug intensifies with each foot strikeWith every heel strike, abdominal organs pull down on the diaphragm via the falciform ligament, magnifying stress on the muscle fibers.
Shallow chest breathing cuts blood flow by up to 30 %Less diaphragmatic movement means less oxygen delivery, increasing the chance of cramp.
Expert insight on the pain mechanism“Think of it as a supply-and-demand problem: the diaphragm demands oxygen that the body can’t deliver fast enough when breathing is shallow,” says Sina Hartung, MMSC-BMI.
Side stitches affect about 70% of runners every yearSports-medicine surveys show roughly seven in ten recreational and competitive runners experience exercise-related transient abdominal pain (ETAP) at least once annually. (NCBI)
Average stitch pain is rated 5.6 / 10 before runners ease upA 2015 field study reported a mean pain score of 5.6 out of 10 among athletes with a stitch—intense enough to make many slow down or stop until the discomfort eases. (SELF)

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When should side-stitch pain send you to a doctor?

Most stitches disappear within minutes of slowing down. Persistent, spreading, or systemic pain can signal something more serious such as gallstones, pleurisy, or even a small lung collapse. Recognizing warning signs helps you decide when to seek care.

Pain lasting longer than 30 minutes after stopping exerciseContinuous pain may indicate gallbladder disease or liver inflammation rather than a simple muscle cramp.
Fever, nausea, or vomiting alongside the stitchThese systemic symptoms raise concern for infection or gastrointestinal pathology and warrant prompt evaluation.
Breathlessness or chest pressure accompanying the stitchCould signal an asthma flare or, rarely, a pneumothorax—especially if you have underlying lung disease.
Quote from the clinical team“If a ‘side stitch’ wakes you from sleep or comes on when you’re not exercising, get medical attention—true stitches only occur with movement,” notes the team at Eureka Health.
Most runners feel a stitch at least once, but persistent episodes need evaluationAbout 70 % of runners report a side stitch each year, and while the pain usually fades soon after slowing down, stitches that linger or recur frequently should be discussed with a clinician to exclude gastrointestinal or diaphragmatic causes. (Healthline)
Pain radiating to the back or striking at rest suggests deeper organ or lung issuesIf a supposed stitch spreads to your back or appears when you’re not exercising, experts note it could stem from gallbladder, liver, diaphragm, or even lower-lung problems—situations that warrant a prompt medical exam. (RunnersWorld)

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How posture, meals, and training level set you up for side stitches

Your running mechanics and pre-run habits can make the diaphragm’s job harder. Small adjustments in timing of meals, core strength, and body alignment significantly lower stitch frequency.

Eating large meals within 60 minutes of running increases risk by 2-3×A full stomach pushes upward on the diaphragm, reducing its range of motion.
Poor rotational core strength means the diaphragm compensatesWeak obliques offload stabilization to the diaphragm, increasing fatigue.
Slouching narrows the rib cageForward-rolled shoulders decrease lung expansion and force shallow breathing patterns.
Expert comment on mechanics“Think of your torso as a spring—if alignment is off, force distribution is uneven and the weakest link (your diaphragm) cramps,” explains Sina Hartung, MMSC-BMI.
Side stitches affect up to 70% of runners in a given yearSurveys cited by SELF report that roughly seven in ten runners experienced exercise-related abdominal pain during the previous 12 months, highlighting how widespread the problem is. (SELF)
Younger athletes experience stitches nearly twice as often as those over 40GoodRx notes that 77% of people under 20 report side stitches versus only 40% of athletes older than 40, indicating that training age and conditioning influence risk. (GoodRx)

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Practical ways to prevent and relieve a side stitch during your run

Simple techniques during training and in the middle of a run can stop a stitch within seconds and prevent it next time.

Slow your pace and exhale as the foot on the painful side strikesCoordinating a deep exhale with that foot strike reduces organ tug and relaxes the diaphragm almost immediately.
Press fingers into the painful spot while bending forwardCompression shortens the stressed ligament and often relieves pain within 6–10 breaths.
Schedule meals 2–3 hours before runningRunners who adopted this timing in a small study cut stitch episodes by 54 %.
Train the diaphragm with pursed-lip breathing drillsTwo sets of 10 deep diaphragmatic breaths, twice daily, strengthened the muscle in a 4-week pilot trial.
Clinical perspective on rapid relief“Most stitches resolve in under a minute if you slow down and breathe from the belly—not the chest,” advises the team at Eureka Health.
Roughly 70 % of runners battle at least one stitch each yearSurveys cited by Healthline put the yearly incidence of exercise-related transient abdominal pain at about seven in ten runners, highlighting the value of proactive breathing and fueling habits. (Healthline)
Skipping a dynamic warm-up is a leading but overlooked triggerThe Running Week names going straight into pace without 5–10 minutes of mobility work as a common reason stitches strike, right alongside heavy pre-run meals and sugary drinks. (RunningWeek)

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Can tests or medications ever be needed for recurrent side stitches?

Occasional stitches rarely need work-up, but frequent or atypical pain deserves investigation. Lab work rules out liver, gallbladder, and inflammatory problems; imaging looks for structural issues.

Liver panel and amylase check for organ involvementElevated ALT, AST, or amylase could point to hepatic or pancreatic disease masquerading as a stitch.
Abdominal ultrasound visualizes gallstones or liver lesionsUltrasound is non-invasive and identifies 95 % of symptomatic gallstones.
Spirometry may uncover exercise-induced bronchospasmAsthma can cause diaphragmatic fatigue; an FEV1 drop of ≥10 % after exercise supports the diagnosis.
Medication is rarely first-lineNSAIDs can dull pain but do not address the cramp’s cause; prescription bronchodilators help only if asthma is confirmed.
Expert note on when to escalate“If you log more than one stitch per 10 runs despite lifestyle changes, ask for blood work and imaging,” says Sina Hartung, MMSC-BMI.
History and physical exam usually sufficeSports medicine guidance notes that side stitches are typically diagnosed clinically; blood tests or imaging are “rarely needed” unless other abdominal conditions are suspected. (SportsMedToday)
Pain that persists at rest or radiates warrants deeper work-upExperts recommend medical evaluation when stitch-like pain occurs outside exercise, spreads to other areas, or shows abnormalities on exam—signs that further testing may be necessary. (RunnersWorld)

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How Eureka’s AI doctor guides you after a painful run

Eureka’s AI doctor lets you log the exact moment the stitch hit, your pace, and pre-run meal, then analyzes patterns to suggest evidence-based fixes.

Automated symptom triage flags red-flag patternsThe app prompts urgent care if you report pain at rest, fever, or shortness of breath.
Tailored breathing and core-strength routines in the appExercises adjust to your current mileage and are updated weekly based on feedback.
Direct ordering of basic labs when indicatedWith one tap, Eureka can request a liver panel; a physician from our team reviews and signs the order within 24 hours.
Quote about the AI workflow“Runners appreciate that they can describe the pain in their own words and get a personalized plan in under a minute,” says the team at Eureka Health.

Runners using Eureka’s AI doctor to stay stitch-free: what to expect

Users track episodes, follow breathing drills, and receive reminders to space meals and runs. According to in-app surveys, runners who used Eureka for at least one month cut stitch frequency by 63 % and rated the feature 4.7 out of 5 stars.

Private and secure data handlingAll logs are encrypted; only you and the reviewing clinician can view your information.
Continuous adjustment keeps advice relevantThe plan evolves with your training volume and race goals.
Success statistic underscores effectivenessAmong half-marathon trainees, 81 % reported completing their event without a stitch after using Eureka for eight weeks.
Final expert reassurance“Consistent tracking turns a mysterious pain into a solvable pattern,” notes Sina Hartung, MMSC-BMI.

Why do I get side stitches when running?

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Key Takeaways

What exactly is happening inside your body when a side stitch strikes?

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Become your owndoctor 🩺

When should side-stitch pain send you to a doctor?

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How posture, meals, and training level set you up for side stitches

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Practical ways to prevent and relieve a side stitch during your run

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Can tests or medications ever be needed for recurrent side stitches?

Sources

How Eureka’s AI doctor guides you after a painful run

Runners using Eureka’s AI doctor to stay stitch-free: what to expect

Frequently Asked Questions

Why does the stitch usually hit under my right rib and not the left?

Will strengthening my core really stop stitches?

Is it okay to keep running through a mild stitch?

Do electrolyte drinks prevent stitches?

Can children get side stitches while playing sports?

Does smoking increase my risk of stitches?

Should I use ibuprofen before a race to avoid stitches?

How long should I wait to run after a small snack?

References