Soreness after working your muscles too hard is not uncommon, and the abdominal muscles are no exception. The abdominal muscles shorten and contract more than other muscles, which can easily lead to side stitches -- a painful cramping sensation usually felt on the sides of the upper abdomen. Most abdominal pain that results from doing situps is temporary, but can last for several days if you have overexerted the muscles. Consult a doctor if the pain does not start to dissipate after three days or is accompanied by other symptoms, such as blood in the stool or fever.
Side Stitches
Side stitches -- technically referred to as exercise related transient abdominal pain, or ETAP -- are characterized by a sharp, stabbing pain under the rib cage in severe cases and a pulling, grabbing or dull ache in milder cases. Stitches usually appear on the right side of the body, but can also appear on the left side or on both sides simultaneously.
Causes
The exact cause of stitches is unclear, but they are believed to be caused by the weight of the organs pulling on the diaphragm -- the powerful muscle under the lungs that helps control your breathing. The organs are connected to the diaphragm by connective tissue, and activity that jars the organs -- along with movement of the diaphragm during breathing -- creates pressure on the diaphragm. This causes the diaphragm and the nearby muscles to contract, creating a painful muscle cramp. Running, situps and horseback riding are common activities that lead to side stitches, according to fitness expert Stew Smith at Military.com
Prevention
To avoid stitches, stretch your muscles gently before and after doing situps. Avoid eating too much too soon before performing your situps because a full stomach only adds to the pressure on the diaphragm. Improper breathing can contribute to stitches, so focus on even, deep breathing while you are engaged in the activity. Warming up your body before doing situps can stimulate blood flow and warm the muscles, which can help prevent cramping. Drink small sips of water before doing your situps to ensure you are properly hydrated. Avoid drinking too much water, because it can increase the pressure on the diaphragm.
Treatment
If you start to feel pain under the rib cage during situps, slow your pace or stop altogether. Rest for a moment and gently stretch your abdominal muscles by gently twisting side to side or bending backward at the waist. To help get rid of the pain, grab the affected muscles and gently squeeze or massage them. Focus on taking deep, slow breaths, pushing your abdomen out while you are inhaling and relaxing it when exhaling. The soreness should go away after several minutes. If it lingers longer, you may have simply overexerted the muscles. If this is the case, the pain should go away after one or two days of rest. If the pain does not start to dissipate after three days, consult a doctor.
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