What Causes Side Stitches and How Do You Get Rid of Them?

Most people have felt a side stitch while exercising. It can force you to slow down or even stop your activity. In fact, roughly 70% of runners report dealing with this annoying pain in their side. Fortunately, a few simple tricks can help relieve side stitches.

Side stitches often occur during activities in which your torso remains straight while engaging in repetitive motion. That's why it often happens while running or even fast walking. With these forms of exercise, your body is straight, and your torso slightly rotates as you swing your arms. 

Activities that can bring on a side stitch include:

• Swimming

• Cycling

• Horseback riding

• Basketball

What is a side stitch?

A side stitch — or exercise-related transient abdominal pain (ETAP) — causes pain on either side of the abdomen. It's two times more likely to happen on the right side in adults, and more common on the left in younger athletes. The pain is often felt right below the ribs or to the side of the belly button. It’s often described in several ways:

• Sharp, stabbing pain

• Cramping

• Aching

• Pulling sensation

The pain is often short-lived and goes away when the activity is stopped or slowed down. Side stitches are also more likely when exercising after eating. 

Although more research is needed, gender doesn’t seem to affect the likelihood of getting side stitches. 

Side stitches do become less common and less severe with age. Experts say that 77% of those under age 20 reported side stitches. And only 40% over age 40 reported them. 

What causes side stitches?

Researchers have several theories about what causes side stitches, though the exact cause is unknown. 

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• Warming up before exercise can prevent side stitches. Try these warm-up exercises before running and other workouts.

• Deep breathing can help, too. Learn how to practice deep breathing while running.

• The perks of proper form: These research-backed tips can help you master proper running form — and reduce risk of injury.

For years, experts believed that side stitches were due to one of the following causes:

• Restricted blood flow to the diaphragm (the muscle that helps you breathe)

• Stress on your abdominal ligaments

• Muscle cramps

However, those theories have been mostly debunked, with researchers now saying the cause of side stitches is likely due to:

• Abdominal irritation: The parietal peritoneum is a thin layer of tissue that lines your abdominal wall and diaphragm. Experts believe that repetitive movement of your torso and organ fullness after eating can irritate this lining.

• Poor posture: This can further irritate structures in the abdomen. It might also compress or irritate nerves near the ribs, causing pain. 

• Shallow breathing: Changes in breathing while exercising might also play a role. Deep, rhythmic breathing helps the muscles and ligaments relax and function as they should. 

How to treat side stitches

There's a need for more research on the best way to treat a side stitch. But these simple tips may help:

• Slow down. Start by slowing down whatever activity you’re doing when you feel a side stitch. You may need to stop altogether and rest for a few minutes.

• Try deep breathing. In a study of 965 athletes, 40% said deep breathing through pursed lips helped reduce side stitch pain. The pain often went away within 1 or 2 minutes. To do pursed-lip breathing, inhale through your nose for a count of two, focusing on making your belly rise while keeping your chest still. Exhale through pursed lips for a count of four.

• Press your fingers on the affected side. In the same study of athletes, 31% said that the pain was relieved simply by pushing on the affected area. You can also press gently on the side stitch while leaning toward the affected side or bending forward.

• Stretch. In this study, 22% of the athletes said that stretching the affected area helped ease pain. To do so, lift the arm on the opposite side of the side stitch overhead. Gently lean into the side of the stitch. Hold for 15 to 30 seconds. You can also lean away from the affected side with the opposite arm in the air. Try both stretches to see what feels the best to you. Repeat as many times as needed for relief. 

• Bend forward. And 18% of the athletes reported that bending forward reduced side stitch pain. As mentioned, you can push gently into the affected area while bending forward.

• Contract the abdominal muscles. A small study found that contracting or tightening the abdominal muscles while bending forward helped alleviate side stitch pain.

Can you prevent side stitches?

Yes, there are several things you can do to help prevent a side stitch from happening in the first place. Try these things:

• Avoid eating or drinking right before exercise. Try to avoid eating a large meal at least 2 hours before exercise. You should also avoid drinking lots of fluids, especially sugary drinks. Instead, sip small amounts of water throughout the day to keep yourself hydrated.

• Add deep breathing to your routine. Focus on deep, rhythmic breathing while exercising. This will help keep the diaphragm and abdominal muscles relaxed and functioning properly. 

• Strengthen your core. A study found that runners with stronger trunk muscles were less likely to have side stitches. The transverse abdominis, a deep-core muscle that helps stabilize the spine, was particularly important. Try incorporating core-strengthening exercises into your workouts 2 to 3 times a week.

• Prioritize proper posture. A slouched posture may contribute to side stitches. Focus on keeping your trunk straight, your shoulders back, and your head in a neutral position. 

• Warm up before exercising. Athletes have reported that warming up before an activity resulted in fewer side stitches. Aim to warm up for 5 to 10 minutes before workouts. Do warm-up activities like light cardio (walking, stationary bike) or dynamic stretches (jumping jacks, lunges, arm circles). 

• Pace yourself. Gradually increase your exercise intensity and duration to allow your body to build up strength and endurance. If you run, start by running on flat surfaces before progressing to hills.

• Switch up your routine. Do different workouts to switch up your routine. Try cross-training to include different workouts –– such as strength training, Pilates, yoga, or cycling –– in your routine. Take breaks or slow down when you start to feel a side stitch.

When to get help with side stitches

Side stitches can be painful. But they aren't serious, and they usually go away with rest or other simple techniques. Side stitches can mimic other conditions, so talk to your primary care provider if you have the following:

• Sharp pain in your side that doesn’t go away with rest

• A side stitch that occurs every time you exercise

• Chest tightness, pain, or worsening shortness of breath

• Other symptoms, like fever, vomiting, and diarrhea

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Written by:

Kim Grundy, PT

Kim Grundy, PT, is a licensed physical therapist and an experienced writer and editor. She worked at an outpatient orthopedic facility, where she treated patients with chronic conditions and post-surgical athletes working towards recovery.

Edited by:

Lauren Savage, MA

Lauren Savage, MA, is a health editor at GoodRx, where she focuses on movement, exercise, and healthy aging. She aims to provide readers with the information they need to live healthier, more active lifestyles.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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