Solutions for preventing stitch during a triathlon

" I was wondering if you have any advise on possible solutions to avoid getting the stitch off the bike. My daughter is 15, and this problem is occurring about every 3^rd race. Basically she can either not finish the race or  virtually crawls home , and this totally destroys the result and is causing much distress, and she can almost not breathe or move, with all that effort in training wasted. The stitch rarely occurs in a run on its own. Everything tried has failed. "
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Gary:
There are a number of possibilities.  I will only list the ones I think are most relevant to your daughter:

• Using a drink or gel that is upsetting the digestive tract.  Try plain water or a heavily diluted drink.
• Drinking too much while on the bike causing the stomach to stretch and slosh under the weight while running.  Try drinking less.
• Gulping water, consequently getting air into the intestines.  Try not to swallow air while sucking/gulping.
• Spasm of the diaphragm. During intense cycling, this breathing muscle works very, very hard and may go into spasm from the effort.
• Abdominal muscle spasm.  If, during intense cycling, she is pulling excessively with the arms, the transverse abdominals may be over-worked.  Running is an intense transverse abdominal workout.
• The solution to the previous two possibilities is to join a cycle club and get experience at bike racing with the pros. Race-hardening is the solution.

Please read the advice in this article here: http://blog.garymoller.com/2011/02/how-to-slash-your-times-in-coast-to.html  It is likely, as well, that there are significant nutrient deficiencies associated with a high carbohydrate athlete diet, complicated by the enormous nutrient demands of puberty.  A Hair Tissue Mineral Analysis would be appropriate as an investigative tool.

Please follow the link at the end of this article to read the draft section about "Stitch" from the new and improved E-Book "Running or Walking a Marathon" that will be released in a few months from now.  The information and advice is relevant.

Feedback about chronic stitch problems

"I emailed quite a number of weeks ago about chronic "stitch" as a beginner runner. I have followed your advice and have been taking 400mg of Magnesium and a decent multi-vitamin every day. Just thought I'd pop in a follow up email as you encouraged.

Ive managed to find my "running style" finally and although I wouldnt go so far to say I run crouched over, I have found that running in a more controlled manner by tightening my gut muscles and belly breathing has really helped - I find Im restricting the movement of my stomach muscles and keeping my wobbly bits from wobbling ;o)

After completing a Triathlon in early March, I found a few muscles I didnt know I had and was getting the stitch just wondering around the shopping centre and put the cause down to strained muscles. I am working on strengthening my core muscles starting with 50 sit ups a day and working up every week - I can take some motivation from Oprah who does 300 a day ;o)

Im very pleased to report that I managed 7.5km last night - probably doesnt sound like a lot, but considering I could only manage 0.5km around Christmas, Im really happy with my progress. The next step is to get fitted into running shoes after suffering from sore feet after the last few runs. Still aiming for a half marathon in October.

Thank you very much for your help and advice - I am really enjoying your website."



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Gary Moller comments:
I doubt it very much if Oprah is consistent with her 300 situps/day! It may be a case of her doing a Donna Awatere, if you get my drift. 30 situps done properly each day is just fine.

As is usually the case, there is never a single solution to conditions like cramp and this is why single factor solutions, like a quinnine prescription, seldom provide lasting relief.

A good place to start with understanding core exercises is to read these articles.

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.