I have recently been experimenting to get my nutrition right on the bike. I tried consuming 300cal/hour using bars/gels and coke. I did a brick 30min run and got a slight side ‘stitch’. So I figured it might be a GI issue. I then tried an Infinit blend (300cal/hour)and again got a slight side stitch. So I figured it might not be a GI issue at all. To test it out, I did the same ride with 430cal/hour of bars/gels/coke and a snickers bar for good measure. Stomach felt fine, but again I got a slight side stitch which seemed to ease as I ran up an incline in my brick run. So I’m thinking maybe the side stitch has nothing to do with GI but is perhaps caused by something else?
Can anyone shed any light on this ?
FYI - all three sesions were a 3 hour bike below Aet and a 30 min easy run.
I’m only a sample of 1 but my experience has been that a side stitch is a GI issue that is usually related to pacing. For me it doesn’t really matter what is in my stomach as much as it matters how much and how fast I’m going. I generally transition from bike to run with slightly more food (usually gatorade/carbo pro and maybe gels) in my stomach that I can run comfortably with. If I push the pace in the first mile or so I will get a stitch. About 9 out of 10 times I can back off the pace slightly and it will be gone in 5-10 minutes.
I have had the same experience when tinkering with taking in more calories on the run. It seems to be a balancing act between pace and volume of stomach contents.
it’s going out to hard on the transition from bike to run. you could eat nothing and experience this. just back it down, and allow yourself a little time to adjust to the run and then go. ease into it at whatever pace is appropriate to you. (doesn’t mean “go slow”, just means you’re going out too hard in the transition).
I think side stiches are one of the big mysteries out there ----there never seems to be a clear answer as what works for one might not work for someone else. Here’s what’s worked for me. I found that when in the aero position on the bike and going hard that my illiopsoaz (look it up—it’s behind your abs sort of) got really tight. I found that if I stretched out my psoaz it really helped. Also make sure you have enough electrolytes in your system.
My uderstanding is that it could be referred pain from your diaphragm muscle. You’re breathing hard, and have just changed position (aero to running), so the muscle is experiencing pain, just like a burning in your legs. It took a while for it to go away in my case, and the only thing that worked was training- keep doing those bricks!
When you breathe normally at walk around and resting pace, you sigh, yawn, over-exhale, even stop breathing for a second or two. You do this unconsciously and frequently, on the order of several times an hour.
When you run, your breathing tends to be very uniform and rythmic.
My solution to stop side stitches is to consciously do the same thing running. I particularly concentrate on periodically exhaling as much as I can. This works for me but I don’t know if that is because my theory is sound or the placebic effect is so powerful.
I agree with SpinDogg that they seem to be mysterious, hard to diagnose and very personal in their cause.
For me, extra liquid does seem to make it worse, so in that sense it’s a GI issue. I never get a stitch if I’m not drinking (for example, when I just do a shorter morning run). The balancing act is getting the hydration and calories I need and not too much to cause a stitch. Shorter races it’s easier to get away with less fluid, but on a long race it will come back to haunt you. So, depending the workout or race it’s helpful to ease up on the fluid as the bike portion ends and see if that helps.
And yes, they often will feel better running uphill.
I have seen this associated with drinking cold drinks, but it usually is more to do with a very hard effort.
My tip is when you experience a stitch is to try ‘belly breathing’. When you inhale you expand your abdomon, and contract it when you exhale. I do this for a few minutes and the stitch seems to resolve itself, without having to slow down considerably.
My two cents: I’ve been fighting this problem for years and have read up everything on them and tried everything!
I seem to get them from three major causes (in no particular order):
Going too fast before being properly warmed up. I used to assume 5 mins was enough to warm up - no way! Now I do 15-20 min to get properly warmed up and some stretching.
Too much food/fluid in my gut. Easy to regulate - just took me awhile to find my threshold.
Too concentrated a mixture in my gut. Don’t if it’s the 6% rule or what, but if I only took concentrated stuff like gels and gatorade together I’d get them. Now I use either gels and water, or just gatorade (and a bit of water), or Maltodextrin which is easy on the stomach.
Also found that when I do get them the biggest cure is slowing down (and changing food/liquid mixture as per 2 and 3 above). I can hold it off too by having my timing my breathing and footsteps (exhale when the “ok” side foot hits the ground - so stitch on the right side, exhale when left foot hits the ground).
I’ve recently started altering my running style a bit to lessen the up and down pounding on my body which might help, but the jury is still out on that one! Basically shooting for a shorter and quicker stride.
Good luck! This problem was so bad for me I almost quit the sport after I wound up walking 7.8k of a 8k run on the tail end of what was going to be my best tri performance ever. Very demoralizing. But once I worked through some of the issues it’s been so much better!
Yes and no. It is a GI issue in that it is related to what you eat… Sort of… Basically, a side stitch is caused (usually) by your organs (most often your liver, I guess because it is the largest) bumping into your diaphragm. This causes spasms/cramps in your diaphragm. However, in order for your diaphragm to go into spasm/cramp, there has to be another factor at play, which generally is you are short on electrolytes (same reason ANY muscle you have might cramp) or are not getting enough O2 to the area (shallow breathing). That’s at least how I interpreted that articles I’ve read, which has been born out in my own experience. This is why 1) massaging the area does help and 2) why sometimes your breathing rate/pattern/depth can be the biggest factor. Apparently, most people (again according to an article I will look for) breathe in rhythm with foostrike. This can also set up a rhythmic pounding that is really what causes the stitch.
Perhaps it is breathing out-of-phase that causes it then? I certainly am no expert, and I was just doing my best to interpret the articles, though I certainly could have gotten it wrong. And of course, whomever wrote the articles might have as well. Then again, perhaps if you think you are breathing in-coordination with your footstrike, you are actually not, as is often the case with sports and what we think we are doing. Malcolm Gladwell in his book Blink provides an interesting example with elite tennis players - all of whom believe they roll their wrist when they strike the ball. Slow-mo video shows they actually roll is after, but they all believe they roll it in time. But, the image of rolling your wrist as it hits the ball does seem to lead to proper technique. So perhaps your breathing experiments are similar. What you think about fixes the sidestitch, whether or not that is what you are actually doing. It’d be neat to test.
That’s what I’ve heard and read—breathing is somehow out of whack, whether it’s simply not breathing from the diaphragm enough or overall “tightening up” as some of us tend to do on the run (you know, your shoulders are up by your ears) that causes the breathing to be too shallow, or something along those lines.
A side stitch is not a GI issue. It is thought to be caused by stretching the ligament that holds the liver to the diaphragm or other organs to the diaphragm.
My understanding as well is that it’s a spasm of the diaphram. To get rid of them, I was taught (and it almost always works for me when I get them) is a few forced exhales.
Someone earlier alludes to it – take a deep breathe and then exhale slowly (i.e. forced) through clenched teeth. Tough to explain, easy to demonstrate. Yeah, it makes a funny sound, but it also contracts your entire mid section (aka ‘core’). Not sure why it works…maybe the core contraction is adding stability to the ligament or maybe it’s helping me find a breathing rhythm…I dunno, but it works well.