A stitch is a commonly occurring cramp-like abdominal pain experienced during exercise.  Despite the regularity with which this condition is described by athletes, it remains uncertain as to what the exact cause of it is.  It has been suggested that it may be caused by trapping of air in the bowel during exercise or by the redistribution of blood flow away from the bowel to the exercising muscles during activity, reducing bowel blood flow.  Other theories suggest that a stitch may be caused by abdominal muscle spasm during exercise or even premenstrual pain.

Stitches may occur in any athlete but are more commonly seen where athletes exercise after a recent meal, exhibit thoracic spine stiffness or abdominal muscle tightness.  Dehydration also appears to be a risk factor in the development of stitches in athletes.

Generally, stitches don’t need any treatment and can be eliminated by simple measures such as adequate hydration and the avoidance of large meals in the 3-4 hours preceding exercise or training.