Investigating the Cause of Side Stitch Pain: Is it Lack of Hydration or Something Else?

Side stitch pain is a familiar and unwelcome companion to any runner or exercise enthusiast. The sudden and uncomfortable sensation in the side of the abdomen can be frustrating and can even cause a person to stop exercising altogether. It has long been thought that side stitch pain is caused by lack of hydration, but is this really the case? Scientists and medical professionals have recently begun to investigate the cause of side stitch pain, to determine if hydration or something else is to blame. Experts are researching factors such as breathing technique, diet, exercise type and intensity, and even anxiety to determine which could be the culprit behind side stitch pain. With an increase in previous research and growing curiosity among the medical community, the cause of side stitch pain is well on its way to being discovered.

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Most athletes have experienced the sharp, stabbing pain of a during a workout or race. Though this discomfort usually dissipates once the physical activity has ended, it can be an uncomfortable and sometimes debilitating issue that can interfere with one’s performance. For years, researchers were uncertain what caused side stitch pain, but new investigations into the phenomenon are bringing us closer to understanding the underlying mechanism behind this common experience.

Uncovering the Mystery of Side Stitch Pain

Side stitch pain, medically known as exercise-related transient abdominal pain (ETAP), can occur in any active person. It is typically described as a cramping sensation on either the right or left side of the diaphragm, though it can sometimes occur in other areas of the abdomen. The pain is typically sharp and often causes athletes to have to stop their activity until the discomfort subsides.

Examining the Link Between Hydration and Side Stitch Pain

For many years, athletes have incorrectly assumed side stitch pain is caused by inadequate hydration, leading them to consume more water during their activities. In recent years, however, studies have increasingly shown that there is no direct correlation between hydration levels and side stitch pain.

In fact, has only been linked to side stitches when levels are especially low. This suggests that hydration is not the sole cause of side stitch pain and that another factor may be at play.

Discovering the Underlying Causes of Side Stitch Pain

Recent medical studies have suggested that side stitch pain is caused by a combination of factors, including the repetitive motion of the body and incorrect breathing techniques. When athletes perform vigorous exercise, the motion of the body can create an imbalance in normal breathing patterns, resulting in the body not being able to take in enough oxygen. This can cause the diaphragm to become irritated and lead to side stitch pain.

In addition, improper breathing can also cause athletes to take in too much oxygen. This can lead to a build-up of in the body and lead to the discomfort of side stitch pain.

Exploring Alternative Explanations for Side Stitch Pain

Other studies have suggested that side stitch pain may be related to the food a person consumes before physical activity. Eating a high-carbohydrate meal can lead to a build-up of lactic acid in the body, which may cause discomfort in the abdomen. Eating fatty or greasy foods can also cause digestive issues, leading to side stitch pain.

In addition, muscle tension can also increase the risk of side stitch pain. Researchers have found that athletes who engage in activities where their muscles are tensed are more likely to experience side stitch pain than those who perform activities that involve relaxing their muscles.

Understanding the Connection Between Side Stitch Pain and Other Factors

Though the exact cause of side stitch pain is still unclear, medical and scientific research is bringing us closer to understanding this phenomenon. By examining the role of hydration, breathing, and food intake, as well as exploring other potential factors, researchers are learning more about the issue and how to potentially prevent it.

Ultimately, side stitch pain can be a frustrating issue for athletes, one that can impact the amount of enjoyment they take from their activity. By exploring the various possible causes, we can hopefully find better treatments and solutions for this uncomfortable problem.


Side stitch pain is a common issue for athletes that has long been a mystery for researchers. Recent studies, however, have suggested that the phenomenon is caused by a combination of factors, including hydration, breathing techniques, food intake, and muscle tension. By continuing to learn more about these causes, we may eventually be able to find better solutions and treatments for this common issue.


  • B, Sinniger V. Exercise-related transient abdominal pain (ETAP): A review. Gastroenterol Clin Biol. 2012;36(10):638-45.
  • McKeag DB. Side stitch: The cause and the cure. Athletic Therapy Today. 2001;6(3): 8-12.
  • Taunton JE, Ryan MB, Clement DB, et al. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2003;37(3):239-44.

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