In the second of a new series of features on Sportsister we ask our expert panel to answer your sporting questions. This week Nicki de Leon, a sports injury physiotherapist, looks at stitches.
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Q: I am plagued by stitch and although I have taught myself to ‘run through it’ I would love to find a way to prevent it coming on – any advice?
A: Most runners have experienced a sharp twinge of pain just below the ribs, usually on the right hand side. Also known as exercise related transient abdominal pain (ETAP), a stitch is thought to be caused by stretching of the ligaments that extend from the diaphragm to the internal organs, particularly the liver.
The liver is one of the largest organs and is attached to the diaphragm by two ligaments on the right hand side, hence most people experience a side stitch on the right. The jolting motion of running whilst breathing in and out stretches these ligaments, as the diaphragm is also moving up and down as you breath.
Runners tend to fall into a rhythm whereby they time their inhalations and exhalations with their feet hitting the ground. People whose right foot strikes the ground as they exhale are more likely to suffer from this problem as the diaphragm is moving up as the organs are moving down.
One way to prevent a stitch would be to try and time your breathing so that you exhale as your left foot strikes the ground. The organs on the left hand side are smaller and will not place as much strain on your diaphragm and its ligaments.
The other main way to avoid a stitch is to make sure you are not shallow breathing as this causes the diaphragm to remain high, placing continuous strain on the ligaments. Concentrate on breathing down to the bottom of your lungs causing your rib cage to expand slightly as you inhale.You could practice this initially lying down in the quiet of your own home.
Another breathing method if a stitch does come on is to breathe out through pursed lips as if you are blowing out candles. Once the stitch has gone, return to breathing normally again.
As a full stomach can also lead to a stitch by placing increased strain on the diaphragmatic ligaments, try not to eat for at least an hour before running and only a light meal within 3 hours of a run. Drinking fluids is still important to avoid dehydration, but sipping gradually prior to and during a run is better than gulping down large quantities.
Nicki de Leon, Sportsister
The Women’s Sports Magazine
Nicki de Leon is a sports injury physiotherapist with over ten years experience treating elite sportsmen and women and professional dancers. She was the official physio of the British Paralympic swimming team for over three years and attended the Paralympic Games in Athens 2004.
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