For as long as people have been running, we have been dealing with side stitches or cramps.
Side stitches have been thought to be due to the stress on your diaphragm during each foot strike.
During inhalation, your diaphragm moves downward, and during exhalation, your diaphragm moves upward. While the diaphragm is moving upward in exhalation, your internal organs are moving downward with gravity. This respective movement during foot strike can cause extra stress or spasm on the diaphragm muscle itself, causing you to feel a side cramp or side stitch.
If you are always exhaling on the same side of foot strike, then you have an increased risk of getting a cramp on that side. Maybe you have noticed that you always get side cramps on one particular side.
One thing that can help to prevent or reduce side stitches is to modify our breathing while running.
How to do this?
You probably noticed that you have a fairly even breathing pattern consisting of inhaling for 2 steps and exhaling for two steps. When you have an even breathing pattern, it causes you to always exhale on the same foot strike/the same foot landing. In order to reduce that stress on your diaphragm, we need to alter which side or foot strike you are exhaling on.
An easy way to change this up is to inhale for two steps and exhale for one step during faster running or during more easy running, inhale for three steps and exhale for two steps. Both of these breathing patterns will alternate which foot you are exhaling on which can reduce that tension and stress on the diaphragm, reducing side stitches.
Try it out:
First, start by making sure that you are using your diaphragm and not just your chest and rib muscles to breathe while running.
Follow the steps while lying on your back to relax your chest muscles while you have one hand on your chest and one hand on your stomach.
While breathing in you should notice that your abdomen/stomach will rise up towards the ceiling, and when you breathe out, it should flatten. Practice this while breathing in through your nose and out through your nose for a few repetitions.
Once you have confirmed that you are using your diaphragm for breathing, practice this in kneeling, and then in standing, and then walking before you attempt it during running. While running, practice the three steps during one inhalation, and then two steps during exhalation, and you should start to notice that you are exhaling on alternating legs. Try this on a few easy runs this week and you’ll start to notice your breathing becoming more controlled and relaxed.
Let me know how it goes!
Bud Coates has an in-depth book on modifying your running breath patterns, called Running on Air, which I would recommend if you would like more information on training with breathing patterns or inspiratory muscle training.