Article by Cynthia Xu, Accredited Practising Dietitian
It’s that last 500m until the finishing line and your sides are burning with pain. Or maybe you’ve only just started to exercise again and the stitch in your side is making you question why you ever bothered to try and get fit again. Many new to exercise and many seasoned athletes would have experienced one or both of cramps or stitches. There is a lot of folklore surrounding the topic and the internet forums are filled with effective and non-effective strategies for dealing with them.
Stitches vs cramps
The two words are often used interchangeably but stitches occur in the upper body (mostly the abdominals), and cramps usually occur in the lower body (calves, hamstrings and quadriceps). Anyone who’s ever had a stitch know the pain to be localized and frequently triggered by repetitive movements, such as in running or swimming.
When I speak of cramps, I am referring to exercise associated muscle cramps, not cramps arising from other medical conditions. The contraction is painful, involuntary and only takes a split second to set in, but can last for minutes.
…. and can last from seconds to minutes.
What are the causes of cramps?
The frustrating news is that no one can pin point any single cause or mechanism by which they occur. Many possible theories have included: sodium depletion during exercise, dehydration, use of creatine and mineral depletion. In truth, the evidence surrounding all of them is divided equally for and against.
What about stitches?
The explanations for what causes stitches are just as blurry and grey. The previous idea was that blood supply to the diaphragm is reduced, but that theory has since lost favour. The newest suggestions are to do with irritation of the linings of your abdomen by the abdominal contents, either due to jolting motions or due to the stomach being too full.
So what to do?
Many scientists have suggested that it is more likely to be a combination of factors contributing to cramps and stitches, rather than an isolated cause. So it seems that are the following may be pertinent precautions for those of all fitness levels to avoid cramps and stitches.
- Exercise accordingly to your fitness level, rather than being over ambitious and cranking up the intensity.
- Drink plenty of fluids to avoid dehydration. During exercise, aim for regular mouthfuls, rather than big guzzles. This allows the fluid to empty from the stomach without that sloshing discomfort.
- For extended exercise sessions, in particular if you sweat abundantly, drink sports drinks to replenish your electrolyte stores and rehydrate you.
- Have an adequate warm-up to ensure adequate blood supply to the muscle.
- Don’t eat substantial amounts of food 2 – 3 hours before exercise to allow the food to adequately empty from the stomach.
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