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Pain Under Right Side of Ribs When Running

author image Henry Halse
Henry Halse is a Philadelphia-based personal trainer, speaker, and writer. He's trained a wide variety of people, from couch potatoes to professional athletes, and helped them realize their own strength, determination and self-confidence. Henry has also written for various fitness and lifestyle publications, including Women’s Health, AskMen and Prevention.
Pain Under Right Side of Ribs When Running
Side stitches can slow your run down to a halt. Photo Credit grinvalds/iStock/Getty Images

When you're running, nothing can take you out of the zone faster than a side stitch. The stabbing pain, which is almost universally in the same spot on the right side of your abdomen, can be debilitating. With every breath, you feel it more and more and, sometimes, it can slow you down to a walk until the pain goes away. In some cases, you might feel pain in your shoulder as well.

Causes of Side Stitches

Many runners will feel this pain to some degree now and then. Some runners suffer through it, while others stop to take a break and wait for the pain to dissipate. The strange thing about this pain is that it's almost always in the same spot on the right side of the abdomen, a few inches from the navel.

Read More: Side Pain After Exercising

You might find that side stitches only really happen after you eat a big meal or drink too much water. That's because the most likely cause for these cramps is an irritation of the lining of your abdomen. The up-and-down movement of your organs when you run is probably the cause of side stitches. In fact, the only other sport where side stitches are very common is horseback riding.

The Peritoneum

There is a tissue, called the peritoneum, that wraps around your organs. It separates the organs in your torso from the muscles surrounding them, so that they can move independently of each other. The outermost layer is always rubbing against the ab muscles.

The point of the peritoneum is to reduce friction from your organs against the muscles of your abdomen. When you run, your body moves up and down, and your organs rub up against the front and back of your torso. Without an added layer of tissue to reduce friction from this up and down motion, there would be a lot of irritation to your organs and muscles.

However, even with this added layer of protection, there is still a great deal of irritation when you eat a big meal or drink too much water because your stomach and intestines have to expand to accommodate everything that you've ingested. When they expand they press against the peritoneum, squeezing it between the ab muscles and organs.

Read More: Pain on the Right Side After Eating

Your peritoneum is very sensitive to pain. Interestingly enough, when you feel pain in your peritoneum — even when you're not running — it has the same characteristics as a side stitch. It feels like a stabbing or cramping type of pain, and sometimes you even feel it in your shoulder.

Preventing a Side Stitch

If you're sick of having your side cramp up during runs, the best thing that you can do is avoid having a large meal or drinking fluids excessively before your run. Two hours before the start of your run, try to cut almost everything out except for sips of water. If you can prevent the expansion of your stomach and digestive system, there will be less pressure in your abdomen. This pressure makes the up-and-down motion of running even more painful.

Work on your posture to avoid future cramps.
Work on your posture to avoid future cramps. Photo Credit Eyecandy Images/Eyecandy Images/Getty Images

Improving Your Form

You can also work on improving your running form. If you slouch while running, it can put extra pressure on your abdomen and make side stitches worse. Slouching brings your ribcage down, which puts pressure on the front of your abdomen and the organs in that area. It can also pinch nerves in the front of your abdomen which can make the side stitch worse. Focus on running more upright and sticking your chest out to prevent side stitches.

Strengthen Your Ab Muscles

Strengthening your transverse abdominis muscle with exercises such as planks can also help prevent side stitches. A 2014 study in the Journal of Science and Medicine in Sport showed that having a stronger transverse abdominis, which is one of the four main ab muscles, makes you less likely to get a side stitch while running.

Because a side stitch is caused by an up-and-down motion of your organs, it makes sense that strengthening your ab muscles would prevent more pain. Strong ab muscles can hold your organs in place by squeezing around them.

Mid-Run Solutions

If the pain in your side is too much to bear mid-run, the only thing you can really do is slow down to a walk. Once you slow down, you'll stop the up-and-down jarring motion that causes the side stitch. The pain should slowly dissipate and then you can keep running.

Other techniques such as breath control and stretching might seem like they're helping the pain; however, the real cause of your relief is the break you take from running to stretch or work on breathing drills.

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