Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Stitch

Runners who have not warmed up properly sometimes feel a sharp pain in the upper part of the abdomen a few minutes after they have started to run. It may be located on the right or the left and is more frequent when sporting activity is undertaken immediately after a meal. The pain may be made worse by deep expiration and relieved by deep inspiration.

The real causes of stitch are unknown, although some studies indicate that a purely mechanical effort may trigger it. The connective tissue that anchors the abdominal organs bears a much greater load just after a meal, and physical activity at this time could cause strain and minor internal bleeding. Other suggested causes are an insufficient supply of oxygen to the diaphragm, or pain arising from the internal abdominal organs, such as the spleen and the liver, as the blood flow is redistributed.

Treatment

– avoid training and competition for a few hours after main meals;

– run bent forward, or stop so that the stitch has time to disappear before training is resumed;

– squeeze a hard object such as a stone, in the hands. Most athletes feel that this makes the stitch pains subside, but the mechanism of this phenomenon is unknown.

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