7 Tips to Prevent Stitches

Do you suffer from a sharp pain when running, swimming or exercising? We'll tell you what stitches are, their causes, and how to deal with them.

Reviewed and approved by el médico Diego Pereira.

Written by Josberth Johan Benitez Colmenares

Last update: 01 January, 2023

Stitches are a well-known ailment in many sporting activities. Experts refer to it as exercise-related transient abdominal pain (ETAP), although it goes by many names in popular terms. We’ll show you 7 tips to prevent stitches and some recommendations to deal with them once they appear.

This pain concentrated in the abdominal area is benign in nature, but seriously compromises the sports activities of athletes. Indeed, many of them have to slow down or even stop the activity altogether to get relief. Fortunately, there are some tips to prevent stitches and today we have compiled the most important ones along with suggestions to control them.

The best tips to prevent stitches

According to some estimates, up to 27% of athletes experience recurrent stitches. The most common area where it manifests is the right flank of the abdomen, although it can also develop in the left lumbar area, the central area, and the lower abdomen. The intensity of the pain is very variable, and can be concentrated in one area or spread throughout the entire area of the torso.

The exact causes of transient exercise-related abdominal pain aren’t known, although evidence suggests that it is more common in young athletes, in men, in people who are overweight or obese (symptoms are more severe), and in those with lower physical stamina. Among the possible candidates to explain the symptomatology are the following:

• Diaphragmatic ischemia: Due to the diversion of blood from the intestine to the muscles that produce movement.
• Visceral ligament stress: That is, the ligaments that connect the diaphragm to the abdominal organs (gastrophrenic, lienophrenic, and coronary ligaments).
• Muscle cramps: Many athletes experience stitches with muscle cramps, and some relate the two.
• Irritation of the parietal peritoneum: Due to the friction caused by movement with the visceral peritoneum. The first covers the abdominal wall and the pelvic cavity, the second covers the abdominal organs, and separates them from the previous one.
• Thoracic facet reference: Studies show that up to 47% of athletes experience stitches when the thoracic facets are palpitated between T8 and T12. This cause is more likely in particularly strenuous activities.

Other possible causes are gastrointestinal distension, compression of the celiac artery by the median arcuate ligament, and aggravation of the spinal nerves. All this demonstrates that it is a complex phenomenon, as well as it being very common. With these reflections in mind, here are the best tips to prevent stitches.

1. Improve your posture when training

There’s evidence that bad posture when training or exercising increases the chances of getting a stitch. For this reason, and as research has shown in this regard, leaning forward, stretching the affected site, breathing deeply, and pressing the area partially or totally can help to reduce pain.

Because of this, make sure that you improve your posture during training. Try to keep your back as straight as possible, and make adjustments according to the activity you’re doing (for example, if you run, you should lean slightly forward). Often, this is related to technique, which is perfected over time.

2. Reduce fluid intake and large meals

Some evidence suggests that fluid intake immediately before training (or at least a couple of hours before) can increase the chances of getting stitches. It’s believed that the fluid-filled intestine pulls on the visceral ligaments, causing pain. The same thing happens when you eat food just before training.

In this sense, avoid drinking large amounts of water and eating at least two hours before exercising. Plan the days you’re going to train, in order to ensure that your eating patterns don’t interfere with your performance. Drink plenty of water throughout the day, and eat healthily, but limit both before starting your exercise routine.

3. Train based on your physical resistance

A study published in Medicine and Science in Sports and Exercise in 2002 found that less physically fit athletes more frequently reported stitches during training.

This isn’t to say that high-performance athletes don’t experience it, just that they do so less frequently. Based on this, we recommend that you train according to your physical capacity, so that you don’t demand more than your body can give you.

4. Stretch before exercising

Warming up and stretching before exercising is an essential ritual to improve performance during training. Stretching helps muscles prepare for the intensity and effort they’ll soon be exposed to.

Many athletes only focus on stretching the large muscles, spending only a few seconds on those they think aren’t that important during training. Spend 10 minutes stretching all your muscles for optimal performance.

5. Exercise for the core

The core is an area that includes the abdominal, lower back, gluteal, and pelvic muscles. Researchers have found that exercises for this area help reduce the chances of developing flatus.

Then try to allocate your routine exclusively to train this area. This will help you strengthen your muscles, improve your posture, as well as your technique.

6. Try different breathing patterns

This is a useful technique both for preventing stitches and for dealing with it when it occurs. Controlling your breathing is very important in any exercise, and not all people need the same exercises.

Some people feel more comfortable with large puffs of air, while others prefer short, steady puffs. Alternate several methods until you find one that reduces your stitches.

7. Use a sports belt

If these tips to prevent stitches don’t have any effect, the best thing you can do is use a sports belt. Try to combine it with exercises for the core, as an excessive dependence on it can weaken the trunk muscles. Even so, it’s a practical and functional option when you experience discomfort in your workouts.

It’s worth seeking professional help to diagnose possible muscle or nerve abnormalities in your central area. There’s no one perfect way to prevent stitches, so you should alternate with several of these strategies until you find the one that is most effective for you. We can assure you that these are the most effective, as all of them have been confirmed by scientists as ways to prevent stitches.