You settle into a run, find a comfortable rhythm, and then—there it is. A sharp twinge just below your ribs makes every step feel less comfortable. A side stitch is a common, usually short-lived pain that appears during exercise. Its exact cause is still debated, but slowing down, breathing steadily, and giving the pain time to settle can help.
The reassuring part: a stitch does not mean you have failed at exercise or need to abandon your workout. It is often a cue to adjust what you are doing, then ease back in when you feel ready.
What Does a Side Stitch Feel Like?
A side stitch—called exercise-related transient abdominal pain, or ETAP—usually feels like a localized ache, cramp, or stabbing pain around the lower edge of the rib cage or the side of the abdomen. It can occur on either side, though the right side is more common. A mild stitch may feel like a tug; a stronger one can make you want to stop and bend forward.
Running is a familiar setting for a stitch, but it is not the only one. Swimming, horseback riding, and other activities that move or jostle the torso can bring it on, too. It can happen to experienced athletes as well as beginners, so getting one is not a verdict on your fitness.
Why Does Exercise Cause That Sharp Pain?
Here is the intriguing part: scientists do not yet have a single, proven explanation. You may have heard that a stitch is simply a cramp in the diaphragm, the muscle that helps you breathe. The diaphragm is one proposed piece of the puzzle, but calling every stitch a diaphragm cramp is more certain than the evidence allows.
Researchers have explored several possibilities, including strain on the tissues supporting the abdominal organs, digestive discomfort, and irritation of the parietal peritoneum—a sensitive lining inside the abdominal wall. A research review found that irritation of this lining explains many features of a stitch, while emphasizing that more investigation is needed. That uncertainty is worth remembering when a remedy promises to “fix the cause” for everyone.
There are, however, useful clues about when stitches tend to show up. Activities with repeated torso movement are a common setting. Some people notice a stitch after eating or drinking shortly before exercise, particularly after consuming a large amount. Those patterns can help you experiment with your routine without assuming that any one habit is the culprit.
If stitches keep interrupting the same workout, note when you ate and drank, what you had, and when the pain began; a simple pattern may be more useful than a one-size-fits-all rule.
What to Do When a Stitch Strikes
You do not have to try to outrun the pain. Start by easing your pace; if it is sharp, switch to a walk or stop for a moment. Breathe in comfortably, then let your exhale become slow and unforced. You can also try gentle pressure with your fingers over the sore spot or lean slightly forward if that feels relieving. These are commonly used approaches, although no technique works reliably for everyone.
Give the discomfort a chance to fade before you pick up speed. When it does, return gradually rather than jumping straight back into a sprint. If the pain flares again, it is fine to keep walking or end the session. Changing the plan for one workout is a sensible response to what your body is telling you—not a setback.
How to Make Side Stitches Less Likely
Prevention is less about finding a magic breathing pattern and more about making a few comfortable adjustments. Try one change at a time so you can tell what, if anything, helps you.
- Leave space after a large meal. If you often develop a stitch after eating, try finishing substantial meals about two hours before exercise. A small snack may sit differently from a full meal, so pay attention to your own response rather than exercising hungry by default. Research reviews commonly suggest avoiding large amounts of food and drink close to activity, but individual tolerance varies.
- Drink regularly instead of catching up all at once. Stay hydrated across the day, then avoid gulping a large volume immediately before you move. If a sweet drink seems to precede your stitches, try water instead for an ordinary workout. For more context on everyday hydration, see A Healthy Living’s guide to when electrolyte drinks are useful.
- Begin gently. Walk, jog easily, or move at a relaxed pace for several minutes before increasing your effort. A warm-up cannot guarantee a stitch-free session, but it gives you time to settle into your breathing and movement. If you want a simple starting point, this balanced 30-minute workout opens with five minutes of easy movement.
- Notice your posture. If you tend to hunch as you tire, try relaxing your shoulders and letting your torso feel comfortably upright. Improving posture and building core strength have been proposed as prevention strategies, though neither is a guaranteed cure.
A pause is not the end of your progress; it can be the moment you find a kinder rhythm.
Is It Really a Side Stitch?
A typical stitch appears during activity, stays in a fairly specific spot, and eases when you slow down or rest. Still, not every pain near the ribs or abdomen is exercise-related transient abdominal pain. If the pain is new or unusual for you, repeatedly limits your activity, or does not improve after you stop, speak with a healthcare professional rather than repeatedly pushing through it. A sports medicine clinician can help sort out whether something else needs attention.
Seek urgent medical help if abdominal pain is accompanied by chest pain, shortness of breath, dizziness, or other concerning symptoms. Sudden, severe abdominal pain also deserves prompt attention. Those signs should not be brushed off as “just a stitch.” Mayo Clinic’s abdominal pain guidance outlines when to seek emergency care.
Keep Moving, at a Pace That Works for You
A side stitch can be startling, especially when you were enjoying yourself moments earlier. But a brief walk, a few steady breaths, and a gradual restart may be all you need to make the rest of your outing more comfortable. If stitches recur, small experiments with meal timing, drinks, and your warm-up can help you learn what works for you.
There is no prize for ignoring pain. The aim is to build a relationship with movement that you can return to—whether today’s workout turns into a run, a walk, or something in between.
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