Exercise-related transient abdominal pain” Opps, I’ve got a running stitch

31 Jul

For those of you who enjoy a bit of science while suffering should read  MORTON, D. P., and R. CALLISTER. Characteristics and Etiology of exercise-related transient abdominal pain. Med. Sci. Sports Exerc., Vol. 32, No. 2, pp. 432-438. Is as good a place as any to begin to get up to date with what causes the stitch. Obviously you need to clarify what you are talking about . Its that sharp abdominal pain that some people get while being active. Not an aspect of needle work. (BTW ETP=  exercise-related transient abdominal pain)

This study issued a questionnaire to different types of sports people and asked them about the stitch ETAP appears to be most prevalent in activities that involve repetitive torso movement, whether ” vertical translation or longitudinal rotation”. Its normally  a local pain  mostly experienced in lumbar regions of the abdomen. Some  unlikely people also also experience “shoulder tip pain” (STP) too, famously known as the  diaphragmatic-referral  site, suggesting a miffed diaphragm

Note. No one has actually done anything in this report. They havent got runers, held them down and cut them open, or ultra sounded them, or poked them with sharp sticks. All they did was to ask some people if they have had it.  Thats not being a scientist, that being a pollster and a gossip

Conclusions:   This gives “perspective” to suggested etiologies of ETAP, which include diaphragmatic ischemia and stress on the visceral ligaments, and suggest we should be looking at other causes  such as cramp of the “musculature and irritation of the parietal peritoneum” ( who knew)

Interesting to note that the condition that is mostly associated with runners, is suffered through all sports. Its merely that runners whine more.

And the cure, after all this science?…. “factors that provoke and techniques that relieve ETAP, are not well understood” ( All that money, all those surveys, for this. Fu@%ers)

Several causes “theories”  make the rounds in gyms ;ischemia of the diaphragm and   stress on the visceral ligaments  have gained the most credibility. Im surprised my theory about irritated pixies hasn’t got more coverage. “Further examination of the characteristics of ETAP and the stimuli that provoke it may be beneficial for evaluating the integrity of these and other theories”. Oh, and guess what, more studies, funded by the tax payer is some secret roundabout sort of way, is needed. Oh yeh!

With my Therapist and Crossfit hat on, it was interesting to note that rotational movement through the torso played a part.  A lot of what we try and achieve  at Crossfit is to maintain a solid “core” which acts as an anchor for the limb to swirl about. We train you to use your legs to Deadlift, while keeping your  torso “locked down” Clinically we have noticed a tendency among aerobic athletes, when they come to us, to be unable to initiate a leg movement without a body movement. ( If they swing a leg it begins from the lower back, not the hip. load is lifted from the back, not the hip) in short, if every time you move you have to wiggle your core.

Thats a lot of additional movement for a biological box with lots of other stuff to do

4 thoughts on “Exercise-related transient abdominal pain” Opps, I’ve got a running stitch

  1. Another explanation put forth by some researchers is that a side stitch can be caused by the stretching of the ligaments that connect the diaphragm to the internal organs, particularly the liver. The jerking motion of running with the combination of breathing in and out, raising and lowering the diaphragm, stretches these ligaments. Unfortunately, breathing is also an important part of running and we need keep doing it!

    Most runners breath with a steady rhythm and tend to exhale every two or four steps. Surprisingly, most runners exhale when the left foot hits the ground, but some runners exhale when the right foot hits the ground, or this might start to happen when we get fatigued. When this occurs, research shows that runners who exhaling as the right foot hits the gourd seem more prone to get side stitches.
    Exhaling when the right foot hits the ground causes greater forces on the liver (which is on the right side just below the rib cage). So as the liver is dropping down the diaphragm raises for the exhalation. It is believed this repeated stretching leads to spasms in the diaphragm. BOOM!! There is your side stitch.

    Try it out and let me know how you go?

  2. Thats whats the confusing thing is . It “sort of” works as an explanation if it was a running only thing, But with swimming, the body isnt upright.

    But theres lots of interesting advice, like, “you didnt warm up enough”… So you are 5 miles into a race and get the stitch , and it because you didnt warm up…presumably, by doing another 5 miles before the 5 miles you need to do. One site mentions a lump of hard poo ( inside you, presumably, unless someone bunged it at you). Very confusing. But, try it. It could work. The only problem is, because we dont know what causes it, we dont know how to stop it. If you breath on the other foot, the other way round, you probably wont get a stitch. Unless that provokes it, the reverse wont protect you ( if that makes any sense)

    personally I found having sex with someone beautiful cures it. ( lets face it, it makes any experiment more fun!)

  3. Hey Stretch- I ran to football yesterday (only a mile and a half) and monitored breathing. I definitely exhale when my left foot hits. Never (touch wood) had a stitch so maybe there is something in that!

  4. I heard about the left foot versus right foot thing when I found I was getting a lot of stitches, and when I thought about it I noticed my right foot was generally hitting the ground when I exhaled. I’ve consciously been correcting that and I haven’t had a stitch since….
    Not sure if it’s the different foot or that I’m focusing more on my breathing, but either way, I’ll keep doing it!

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