Gary Moller: [DipPhEd PGDipRehab PGDipSportMed(Otago)FCE Certified, Kordel's and Nutra-Life Certified Natural Health Consultant]. ICL Laboratories registered Hair Tissue Mineral Analysis and Medical Nutrition Consultant.

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Thursday, January 25, 2007

How do I overcome the "stitch" when running?

ia
"Hi Gary
I have decided Im going to do my first half marathon this year in October - I have an average fitness level playing netball twice weekly, swimming once a week and biking 11km each way to work at least 3 times a week.
I have dutifully set my alarm clock 20 minutes earlier than the norm and have pre-set out a kilometre circuit I can run from my door (using my cars km clicker).
After 3 weeks of training I am up to a comfortable 2km run in around 8 - 10 minutes but havent been able to bust past this distance due to stitch pains under my rib cage, right hand side.
Ive researched extensively into "the stitch" and have tried the thumb pressure for a few minutes technique, relaxing my gut, walking for a bit til it subsides and I run on an empty stomach (no food or water) in the morning (around 6.20am).
I know this is beginners stuff and I REALLY want to overcome my 2km brick wall so I can have a go at the Akld Round the Bays in March."
"Frances"
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Gary Moller comments:
The stitch as described here by Frances is most likely caused by either jostling stress on the ligaments that support the stomach, poorly conditioned transverse abdominals or from spasm of the diaphragm muscle. Because she is suffering stitch early in the morning before eating or drinking, it is reasonable to initially preclude the stomach ligament theory and to concentrate on the diaphragm. We will deal with the transverse abdominal muscles possibility in another posting if the following recommendations do not work.

The diaphragm is a broad, thin muscle that inflates and deflates the lower lobes of the lungs. It naturally works hard when running. Because of its broad expanse blood supply to it can easily become inadequate during exercise and it only takes a few of its fibres to cramp up to cause disabling pain.

Although Frances is quite fit relative to most women, she is still a novice when it comes to running. This kind of cramp is most common in beginner runners who breathe quite hard despite the relatively slow pace. As endurance training continues it becomes less of an issue because breathing becomes less intense and the proliferation of capillaries in the diaphragm means a much better blood supply to the areas that were prone to cramping.

It is possible that Frances might be low in magnesium (most people are) and a course of maganesium over three months would be interesting to trial and highly recommended.

Here is what I advise Frances to do in training:
  • Commence her morning runs with five minutes of power walking before breaking out into a steady trot. This will give time for her circulation to wake up and be fully pumping before revving the engine.
  • Run steady on the flat sections of her running course, power walk up and down hills.
  • Power walk 2-3 minutes at the slightest hint of the stitch coming on.
  • Do one long run/walk per week of from 2-3 hours right away, such as on a Sunday morning. The idea is to get the time on the feet right away even if it is 90% walking to start with. This could even be a weekly hike with a light back pack through the Hunua or Waitakere Ranges (Frances is in Auckland) with all of the running during the week.

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