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side stitch

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PostPosted: Wed Dec 03, 2003 11:59 am GMT +0000    Post subject: side stitch Reply with quote

Hi there...I know side stitches are most common in running but my friend has had one for a couple of months now. It hurts constantly (although very mild soreness) and is only exacerbated by hard running. I can find a million articles on how to prevent them and what to do during one but nothing on when the pain continues despite long periods of rest from running. He's had the whole workup for cardiac, liver, infectious disease, hernia, and is seeing a GI specialist. Every test came back negative. Could you provide some info on chronic side stitches or a resource? I know it involves stretching of the ligaments that hold the liver to the diaphragm. Could it just be a problem there?
Thank you for any help you can offer.
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The Bike Doc

Joined: 08 May 2003
Posts: 1371
Location: Corpus Christi and Warda, Texas

PostPosted: Wed Dec 03, 2003 3:16 pm GMT +0000    Post subject: Reply with quote


This is a tough one. On review of my Sports Medicine texts, explanations much like what you have described, are offered: " may be due to muscle spasm of the diaphragm or trapping of gas in the hepatic or splenic (right or left side) of the colon. " (Clinical Sports Medicine by Peter Brukner and Karim Khan). There is only one published reference that I could find on a PubMed search:

This article describes possible inappropriate fluid intake as a cause. Taking a sport drink (Exceed in this study) helped eliminate the "stitch".

It is good that your boy friend has undergone an appropriate medical evaluation to look for other etiologies (causes). He may want to consider an evaluation by an Osteopathic Physician (a D.O.) who does Sports Medicine and manipulations. One of my texts sites that a possible cause can be malalignment of the spine and/or ribs and manipulation may be in order if there are not other clear medical causes of the "stitch".

If there is no malalignment, then stretching exercises done daily and routinely before work outs may help alieviate the stitch if it is due to intercostal (ribs) muscle spasms. A physical therapist as well as an Osteopathic Physician who does manipulative therapy can be a good resources to learn propper stretching techniques. Bob Anderson's book "Stretching" is another invaluable resource.


Paul K. Nolan, MD
AKA: The Bike Doc
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