Side Stitch

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Introduction

Side stitch is an acute, localized, pain on the upper side of the abdomen that occurs after exercise.

It is also called Exercise Induced Abdominal Pain (E.I.A.P.). [1]

Causes

  • High Intensity Exercise
  • Low level of fitness
  • Running[2]
  • Stress on Diaphragmatic ligaments
  • Rib fracture (10th/ 11th/12th)
  • Most common causes are diaphragmatic ischemia and spasm.[1]

Signs And Symptoms

  • Post-exercise pain on the upper right quadrant of abdomen. The pain is mostly laterally oriented.
  • Pain stops after the cessation of exercise.
  • Pain is sharp/stabbing in severe cases.[1]
  • This pain is more consistent and can also present in activities that are not in high respiratory demand

Physiotherapy management

  • Proper warm-up before exercise
  • focus on core- strengthening
  • Slow down – try to change your foot strike and breathing to match one another. For example, if the stitch is on the right, exhale when the left foot hits the ground and vice versa
  • Purse your lips while breathing
  • Tighten your abdominal muscles as if you were bracing for impact
  • Place your hand on top of your head and bend forward
  • Try to avoid consuming large meals or drinking in excess before exercises.[3]
  • When participating in a long run or high endurance workouts, drink small sips of water throughout to keep yourself hydrated.
  • Work on taking deep breaths from your belly as opposed to breathing from the chest. You diaphragm will learn to contract and relax through a full range of motion, preventing spasm or extra strain when exercising.

Evidence Based

Increased vertical displacement of the body and reduced angle of the neck, trunk and hips may be important factors affecting the incidence of stitch. Therefore, by modifying these factors in people with stitch, would reduce the incidence of a stitch.

[4]

References

  1. 1.0 1.1 1.2 Eichner ER. Stitch in the side: causes, workup, and solutions. Current sports medicine reports. 2006 Nov 1;5(6):289-92.
  2. Morton DP, Aune T. Runner’s stitch and the thoracic spine. British journal of sports medicine. 2004 Apr 1;38(2):240-.
  3. PLUNKETT B, HOPKINS W. Investigation of the side pain" stitch" induced by running after fluid ingestion. Medicine & Science in Sports & Exercise. 1999 Aug;31(8):1169-75.
  4. SAFARI BM, KHOSHRAFTAR YN, HAKAK DE. COMPARISON OF VERTICAL DISPLACEMENT OF THE BODY AND BODY ANGLES DURING RUNNING IN THE PEOPLE WITH SIDE STITCH AND HEALTHY PEOPLE.