You’re working up a good sweat and finally hitting your stride when suddenly, out of nowhere – WHAM. Something sucker punches you just below the ribcage. Whether you call it a side stitch, side ache, or cramp, nothing shuts you down quite like the effects of this painful spasm of the diaphragm muscle. While common among novice runners, side stitches can slow even the most advanced athletes down to a crawl.

So far there’s no one definitive cause of side stitch. Popular theories for its effects include participation in an activity that is too strenuous for one’s level of conditioning, exercising too soon after eating, improper breathing techniques, trapped gas in the large intestine, dehydration, and the strain placed on the diaphragm by ligaments that attach it to the liver. Regardless of what actually causes side stitches, you can help prevent or lessen their symptoms by following these simple tips:

Lighten Your Load

Chances are greater you’re going to feel that stab of pain at your side if you scarf down a heavy meal shortly before your workout. So be sure to go with a light meal, and wait at least one to two hours before going full throttle. Spicy, greasy and fatty foods that slow down the digestive process should be avoided. Instead, fuel your body with easier to digest, carbohydrate-rich foods such as bread and pasta to lessen the chance of getting of side stitches.

Drink Wisely

Sports drinks low in sugar are fine, but your best bet is still good old H2O when it comes to hydrating. Sugary, carbonated drinks have been shown to contribute to side stitches, and should be eliminated as a source of hydration. Attention should also be paid to the amount you drink. Don’t guzzle down a bucketful of liquid pre-workout; pace yourself and drink only 8 to 12 ounces of fluid 30 minutes before getting started.

Side stitches 2

Warm Up

Going full speed right out of the gate is a recipe for side aches. Just like your car’s engine on a cold morning, it’s best to gradually warm up before putting it into high gear. Give your body a good stretch before getting started. A few minutes spent warming up will help to loosen tight muscles, which may contract and cause cramps.

Take a Deep Breath

The most effective way to prevent a side stitch is to take longer, deeper breaths through your mouth when exercising. Deep breathing from the stomach will allow you to take in more air, and ensure that the muscles in your side and chest are receiving the amount of oxygen they need to work properly.

Know When to Say When

Unless you’re neck-and-neck with your bitter rival heading toward the finish the line, don’t try to run through a side stitch. Once that jolt slams your body, slow it down, or take a knee and rest until the pain subsides.

Quick Fixes

If the pain continues to linger after shutting down your activity, a few simple stretches may help alleviate the discomfort. First try bending forward at the waist to stretch the diaphragm. You can also stand tall and raise your right arm overhead and lean to the left. Hold for 15 seconds, and then repeat stretch on the opposite side. Gently massaging the affected area can also provide some relief.