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Side Stitches—what gives? Is it nutrition?
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Did my first half iron this morning. Had a decent swim (despite no wetsuit), super strong bike (nailed my target power at 261 AP/266 NP ~ 80%FTP at 2:18), but fell off the run. I started really strong coming off the bike. My first three miles were at my goal pace (7:00/pace) but it quickly deteriorated due to side stitches. I did a walk/run routine and hobbled in with a 1:49.

I can't get too caught up in it, it was my first race at this distance. But obviously not hitting my target pace leaves me ready to put in work and fix what I need to fix.

I used a concentrated bottle of an Infinit custom blend. One serving is 291 calories, so I had 2.5 servings in a bottle and used about 2. I also drank 2 32oz bottles of water while I was on the bike.

Did I over-bike? Did I take in too many calories? Was I just unrealistic?

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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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The most obvious thing would be that you pushed too hard. Maybe you got dehydrated? But more likely pushed too hard on one of the legs.

Ian
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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I've only had side stitches once and that was when I ran at a pace that was too hard for me. I slowed to a very slow jog, recovered and then ran at my regular pace without any problems.
Last edited by: Sanuk: Nov 13, 17 17:45
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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Have you trained the nutrition plan? 300 cal/hr at 0.8if? Did you have a sloshing gut?

I get side stitches like that when when I overeat /overdrink (for the intensity) and I can feel it just sloshing in there.
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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Side stiches while running are often the result of not enough flexibility in the abdominals.

My recommendation would be to do some simple stretches such as holding onto a high bar and lean into it so you really feel a stretch in your abs. You could also push off the floor with your upper body while keeping hips and legs on the floor to stretch the abs. Like yoga's cobra position.

Of course this needs to be done well before a race. During a race, I hear it helps to thrust your fingers/hand into the stitch in an acupressure sort of way to get the muscle to release.

Indoor Triathlete - I thought I was right, until I realized I was wrong.
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Re: Side Stitches—what gives? Is it nutrition? [IT] [ In reply to ]
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IT is correct here - I dealt with this for about 5 years from 2002-2006. Compounding the issue is you were aero for over 2 hours which put a strain on you abdominals/core/whatever which may be something that wasn’t really addressed in training.

Things that helped me once I figured out what was actually going on were: improved core/abdominal stability work, stretching, and while racing being conscious to really push me belly out 5-6 times towards the end of the ride.
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Re: Side Stitches—what gives? Is it nutrition? [IT] [ In reply to ]
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IT wrote:
Side stitches while running are often the result of not enough flexibility in the abdominal muscles.

This. It's not nutrition, but mechanics. When you breathe to one side, you are stretching and taxing the muscles on that side more than the other. For example, if you're right-handed, you'll typically breathe "in" when your right foot is striking (assuming you're working hard, such that your body is seeking rhythm and trying to compensate for the load demand) and breathe out on the left foot. So the answer becomes almost apparent; you're over-taxing the right side.

Try this. On your next hard run, try changing the in-breath to the other foot. That sounds simple, but you might actually stumble or stutter-step while trying to change. The point is, being able to change the in-breath to the alternate foot will often eliminate side stitches. For me (n=1), I try to change the in-breath side every mile in a (more than 5k) race.
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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Well they were pretty common in HS CC and people would get them on 2 mile offseason runs, and all the time in races(5k). So I'm guessing it isn't a nutrition issue, considering some sufferers were 15:xx runners.
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Re: Side Stitches—what gives? Is it nutrition? [pvolb] [ In reply to ]
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I have a hypothesis. A side stitch I more than one thing with more than one cause.
1 pain from sloshing food or water in the gut
2. Muscle cramps in the intercostals. Either caused by rapid breathing or awkward positions during high efforts.

For instance I can get a painful "stitch" during very short efforts in both my diaphragm and intercostals. I also get a "stitch" in long races when I drink too much.
So what we call a stitch is just a catch all term for pain in your side during exercise which covers more than one cause of pain with more than one treatment.
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Re: Side Stitches—what gives? Is it nutrition? [Kscycler] [ In reply to ]
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They also result from running too fast for their capabilities.
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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i think you just drank too much water at the end of the bike or the start of the run, overbiking or starting any endurance event too fast doesnt cause side stitches, that just causes you to barely be able to finish or bonk
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Re: Side Stitches—what gives? Is it nutrition? [Kscycler] [ In reply to ]
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Kscycler wrote:

Try this. On your next hard run, try changing the in-breath to the other foot. That sounds simple, but you might actually stumble or stutter-step while trying to change. The point is, being able to change the in-breath to the alternate foot will often eliminate side stitches. For me (n=1), I try to change the in-breath side every mile in a (more than 5k) race.

just a second vote for the 'change your breathing foot' strategy. i've used it for years and it definitely helps. (my long-run pattern, though, is 3-step breathing, so the side always changes. . .)

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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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I get them on occasion. I find they are related to both nutrition (high concentration of food/drink) as well as pushing a pace that’s too much for my current ability. Although I try to find how much pain I can tolerate and sit on it. As in my legs are okay, I’m breathing very hard, but my side just hurts and won’t release. I find that if I take a few large “sigh” breaths (inhale deeply, hold and try and force your diaphragm down and out) that helps a lot. If that doesn’t work, then reduce intensity until it subsided and slowly increase as tolerated. When pushing a hard effort you will often be breathing rapid but much mor shallow than at a normal easier pace, this causes the intercostals and abdominals to remain in a contracted state. By doing the large sigh breath you disrupt this pattern and cause everything to release and relax. Hope it helps you.
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Re: Side Stitches—what gives? Is it nutrition? [IT] [ In reply to ]
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IT I've dealt with stitches for years and I tend to find they come on after eating or drinking. I'm definitely not flexible so that's helpful advice, my question is do you know why the eating/drinking would trigger it? Within 5 minutes of eating/drinking on the run I tend to get side stitch and I have no idea why.

Phillip
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Re: Side Stitches—what gives? Is it nutrition? [iron_mike] [ In reply to ]
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iron_mike wrote:
Kscycler wrote:


Try this. On your next hard run, try changing the in-breath to the other foot. That sounds simple, but you might actually stumble or stutter-step while trying to change. The point is, being able to change the in-breath to the alternate foot will often eliminate side stitches. For me (n=1), I try to change the in-breath side every mile in a (more than 5k) race.


just a second vote for the 'change your breathing foot' strategy. i've used it for years and it definitely helps. (my long-run pattern, though, is 3-step breathing, so the side always changes. . .)
N=3.
This has been my solution since HS, and that was a long time ago. Never, in all that time, have I heard anyone else use the same idea. I think of it as "change the exhale foot". So if the stitch is on my right side, I change breathing such that I FINISH the exhale as the left foot strikes the ground.

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"If only he had used his genius for niceness, instead of Evil." M. Smart
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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yesterday was a little brutal and even though it was obviously hot on the run, you might have lost a lot of salt on the bike too. i resolved my side stitch/cramping with salt and water. still wasn't a great race for me though
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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Studies show that side stitches happen to inexperienced runners that are still learning to breathe in a rhythm that works with their cadence. That's why kids get them a lot and the issue fades with adults.

Here's a long article on it. http://www.fictionweek.com/...ingusa/sideache.html While it's a bit all over the place, you can see how it's something that you self-solve without even knowing it as you run more and change your stride and breathing pattern over time. Just like somebody on a balance beam is all over the place until they do it enough to relax, your breathing and stride are mismatched all over the place until you do it enough to sync them up better. Probably only a problem in modern cultures where we don't run anywhere near as much as we used to as kids and learning the long stuff as adults reveals our deficiencies. Just watch kids in videos shot in rural villages without cars and they run around with form like Olympians.

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Re: Side Stitches—what gives? Is it nutrition? [jaretj] [ In reply to ]
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jaretj wrote:
They also result from running too fast for their capabilities.

I tend to agree. Everyone is different, but I breathe every breath on opposite foot strike. maybe 3, maybe 5, just depends on the effort. I’ve found that mine are more prevalent when running off the bike than just running, so stretching may play a part. That could also be nutrition related, whether it’s too much or too little. I guess what I’m saying is experiment.

One thing I have found to help is diaphragmatic breathing. When I feel one coming I take extra long and deep breaths while slightly backing off the pace. Breathe in by expanding your belly and not your shoulders/chest, then exhale deeply trying to touch your belly button to your spine. I can usually do a few these while easing off the pace and keep the stitch at bay. Once better I’ll pick it back up and try to keep up the breathing every few minutes. YMMV

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Re: Side Stitches—what gives? Is it nutrition? [RangerGress] [ In reply to ]
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RangerGress wrote:
iron_mike wrote:
Kscycler wrote:


Try this. On your next hard run, try changing the in-breath to the other foot. That sounds simple, but you might actually stumble or stutter-step while trying to change. The point is, being able to change the in-breath to the alternate foot will often eliminate side stitches. For me (n=1), I try to change the in-breath side every mile in a (more than 5k) race.


just a second vote for the 'change your breathing foot' strategy. i've used it for years and it definitely helps. (my long-run pattern, though, is 3-step breathing, so the side always changes. . .)

N=3.
This has been my solution since HS, and that was a long time ago. Never, in all that time, have I heard anyone else use the same idea. I think of it as "change the exhale foot". So if the stitch is on my right side, I change breathing such that I FINISH the exhale as the left foot strikes the ground.

I am also in agreeance

Although sometimes I'll stitch from eating too much too soon before a run vs. just going too hard [or maybe a little of both], the solution is the same = breathe on the opposite footstrike

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Re: Side Stitches—what gives? Is it nutrition? [RandMart] [ In reply to ]
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RandMart wrote:
RangerGress wrote:
iron_mike wrote:
Kscycler wrote:


Try this. On your next hard run, try changing the in-breath to the other foot. That sounds simple, but you might actually stumble or stutter-step while trying to change. The point is, being able to change the in-breath to the alternate foot will often eliminate side stitches. For me (n=1), I try to change the in-breath side every mile in a (more than 5k) race.


just a second vote for the 'change your breathing foot' strategy. i've used it for years and it definitely helps. (my long-run pattern, though, is 3-step breathing, so the side always changes. . .)

N=3.
This has been my solution since HS, and that was a long time ago. Never, in all that time, have I heard anyone else use the same idea. I think of it as "change the exhale foot". So if the stitch is on my right side, I change breathing such that I FINISH the exhale as the left foot strikes the ground.


I am also in agreeance

Although sometimes I'll stitch from eating too much too soon before a run vs. just going too hard [or maybe a little of both], the solution is the same = breathe on the opposite footstrike
For >40yrs I thought my "change the exhale foot" technique was kinda loony and no one else did it. Not only was I hesitant to ever suggest it to anyone, but I found it was quite hard to even explain. I'm honestly astounded to hear someone else mention it.

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"If only he had used his genius for niceness, instead of Evil." M. Smart
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Re: Side Stitches—what gives? Is it nutrition? [Seyseys] [ In reply to ]
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Seyseys wrote:
IT I've dealt with stitches for years and I tend to find they come on after eating or drinking. I'm definitely not flexible so that's helpful advice, my question is do you know why the eating/drinking would trigger it? Within 5 minutes of eating/drinking on the run I tend to get side stitch and I have no idea why.

Phillip

Phillip, my hunch is that anything that would make the abdominals want to "scrunch" could bring on a stitch. Eating or drinking adds to the work being done in the abdominal area while running. Enough work to skip the scales and produce a stitch? Probably or obviously.

While running erect there are two forces battling it out. One force is remaining erect/back while the other force is crunching/forward the abs as we work harder. If we have a narrow range of core/abdominal strength/flexibility we are going to feel it.

More often than not we have plenty of "scrunching" during the day. We have little pulling of the abs/core back to offset.

My source for this recommendation was what Arthur Lydiard told me at a running camp in 1980. It's worked for me since.

Indoor Triathlete - I thought I was right, until I realized I was wrong.
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Re: Side Stitches—what gives? Is it nutrition? [Kscycler] [ In reply to ]
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Kscycler wrote:
IT wrote:
Side stitches while running are often the result of not enough flexibility in the abdominal muscles.

This. It's not nutrition, but mechanics. When you breathe to one side, you are stretching and taxing the muscles on that side more than the other. For example, if you're right-handed, you'll typically breathe "in" when your right foot is striking (assuming you're working hard, such that your body is seeking rhythm and trying to compensate for the load demand) and breathe out on the left foot. So the answer becomes almost apparent; you're over-taxing the right side.

Try this. On your next hard run, try changing the in-breath to the other foot. That sounds simple, but you might actually stumble or stutter-step while trying to change. The point is, being able to change the in-breath to the alternate foot will often eliminate side stitches. For me (n=1), I try to change the in-breath side every mile in a (more than 5k) race.

I suffered from side stitches too, in races from sprints all the way up to halfs and hard training runs. I though it was nutrition but for me it's not. This Technique worked perfect for me once I got the hang of it. I get a stich on my right side, I noticed that I exhale on this side most of the time. When I feel a stitch I inhale on the right foot strike and exhale with a left foot strike a few strides later. (Usually 3 for me). Work on this in training as it takes a bit to get used to. This stops the stich in It's tracks. I also raise my right hand above my head and also stretch out the side. Good luck. Stitches stink

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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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I am pretty prone to stitching also. I used to run on steps, ie in in out out, in in out out etc. In the end I learnt to disassociate my breathing from the stepping which was good as breathing and cadence dont necessarily need to be the same. Never the less, I find that too high breathing rate (from intensity over a period) will bring on a stitch for me. If I haven't been training or training intensity drops the threshold of when stitches come on also drops, but likewise with training I can also push that stitch threshold up high enough to not be a problem even for the kick at the end of a run. I also find this for swimming.
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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I've notice over the many years of running that I tend to NOT get side stitches if I eat a banana before the work out.
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Re: Side Stitches—what gives? Is it nutrition? [cloy] [ In reply to ]
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Cross-country coach here. It's unlikely to be related to what you're eating or drinking unless you're doing something wild.
Side stitches are muscles spasms of the diaphragm, not intercostals as previously mentioned.

Alleviate while running with any or all of: exaggerated upper body twisting (as though you were in a bucket brigade), "belly" breathing (long, deep breaths, extending your gut as though you were exaggerating the size of your stomach), pinch-massaging with your thumb and first two fingers.

When not running be sure to include core stretches in your routine. Also, regularly massage the area (more frequently while you're having the issue, and regularly after it's gone). Any roller is good, but the smaller diameter ones get into the area more deeply.

Good luck.
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