Running brings many moments of joy, triumph, stress relief, and pride, but that’s not to say that it all come easy. Just about every runner experiences their fair share of recurring struggles and pains along the way. One of the most common struggles runners face is dealing with those dreaded side cramps, commonly referred to as a side stitch.

Although they may not indicate anything serious, side stitches can feel debilitating on the run. These dreaded side stitches often appear at the most inconvenient times – right when you’re settling into the groove or really working hard.

A side stitch is actually a spasm of the diaphragm, the muscle used by the body to breathe. This muscle can spasm just like any other muscle in your body, which may affect any of the surrounding tissues, ligaments and tendons.

These side stitch pains can range in severity from a dull ache in your lower side to a sharp, shooting pain. Some runners power through when the pain sets in, while others are forced to stop in their tracks. Either way, these side cramps are never welcomed when running.

What Causes a Side Stitch?

While side stitches are fairly common among runners, their cause is still somewhat up in the air. However, there are a couple of theories that may help determine the root of your side stitch pain.

One theory is that these side stitches are caused by what and when you eat before a run. Runners may experience side cramps if they eat right before a run or fuel with the wrong type of food.

What makes this theory frustrating is that every runner is different – so just because a fellow runner has found success eating 30 minutes before a run doesn’t mean that your body is going to respond in the same way. Creating a successful fuel strategy before a run involves quite a bit of trial and error, as well as experimentation along the way.

Related: Fueling Tips for a Successful Long Run

Another theory is that these side stitches are a result of irregular or improper breathing on the run. Many beginners experience side cramps in those early days of running, and this theory suggests that their side stitches occur because they have not yet regulated their breathing.

A lot of beginner runners push themselves to run too quickly when they are starting out, which can lead to fast, rapid breathing, and potentially cause a side cramp. This type of irregular breathing on the run could potentially cause the side stitch pain if your breathing is so sporadic that it causes a spasm in the diaphragm.

While both theories provide reasoning for the cause of the side stitch, they can often leave runners feeling confused and frustrated when trying to stop side stitches from occurring on the run.

How to Deal with a Side Stitch

Most runners have experienced side cramps on the run at least once your twice before. We all know the frustration of experiencing a pain that seemingly never goes away just when we’ve settled into our running groove.

Learning how to deal with side stitches while running is key to avoiding unnecessary walk breaks, shortened runs, and interruptions to your training.

Regardless of the cause, getting rid of a side stitch almost always involves slowing your pace. When you feel a side cramp coming on, slow down your pace and focus on your breathing. As you slow to a jog, adjust your breathing so the foot opposite to the side of pain strikes the ground when you exhale.

Focus on intentionally changing your breathing rhythm so you exhale only when the opposite foot hits the ground. You don’t have to exhale with every single step, but make sure that each time you exhale the opposite foot is striking the ground.

If this strategy does not help get rid of the side stitch, slow down to a walk. Focus on exhaling using the diaphragm muscles, located lower in your abdomen, rather than your chest. Consciously breathing while running or walking at a slower pace should be enough to gradually reduce the pain and eventually stop your side stitch altogether.

For many runners, though, understanding how to deal with a side stitch isn’t quite enough: we all want to know how to prevent them from occurring in the first place.

3 Ways to Prevent Side Stitches

Here’s where things start to sound promising – with a little trial and error, attention to your body and intentional strategizing, it is possible to potentially prevent side stitches from occurring on the run (or at least reduce their frequency).

There are a few strategies you can use to reduce the occurrence and even prevent a side stitch.

Adjust your fueling strategy.

Take note of the times in which side stitches occur on the run. Make a note of when you ate prior to your run and what types of food you consumed. Try to limit yourself to eating no later than 60 minutes before a run, and stick to foods that have a higher concentration of carbs.

Carb-heavy foods are usually easier to digest and provide quick energy on the run. Similarly, allowing your body to have a bit of a break between eating and running provides time to get the digestive process started and avoid and]y digestive-related causes of side cramps.

Keep in mind that each runner is different. If you notice that you experience side cramps every time you eat something 75 minutes before a run, your body might need more time to digest. Adjust your timing and fuel source until you find the strategy to which your body responds best.

Take things slow and steady.

If fueling doesn’t seem to be an issue, your side stitches might be caused by irregular breathing on the run. If this is the case, try slowing things down a bit and really focus on your breathing. Regulate your breathing so it is in sync with your run, slowing down your pace until your breathing feels more natural and less rapid.

Taking the time to slow things down for a week or two during training may help establish better breathing habits and provide your body with the time it needs to adjust to a more regular breathing pattern. Once things start to feel more natural, gradually return to your regular pace.

Implement a warm up routine.

Another strategy to try to prevent side stitches is to get in the habit of warming up before each run. These side cramps are usually caused by a spasm in the diaphragm, which is a muscle just like your calves, quads and glutes.

Taking the time to warm up your muscles before a run helps get the blood flowing and loosens things up a bit before the work begins. Loose, limber muscles are much less likely to spasm when activity increases than those that immediately switch from tight and inactive to active.

Ultimately, the key to preventing side stitches lies in your ability to listen to your body. Each runner is different, so while side stitches are very common, their causes are not always the same. Experiment with your training schedule, timing and routine to discover what leads to those pain-free runs.

More pain free running tips:

• How to Overcome the Most Common Causes of Running Pain
• 6 Habits of Runners to Prevent Injuries
• How to Start Running: 6 Steps for Beginner Runners
• The 5 Biggest Mistakes Runners Make – and How to Fix Them