Side Cramps / Side Stitches

Good day All

I get terrible side cramps / side stitches during hard training sessions and outdoor rides; to the point that it interferes badly with my breathing resulting in sessions not being completed as they should be.

  1. What causes these?
  2. How does one get rid of them when they do occur?
  3. How does one mentally cope with them when they don’t go away and lingers for a long time?

Thank you in advance.


I train before big meals, and try and limit my fluid intake to a bottle per 2 hr’s of riding. So doubt that it is related to a “full stomach”.

Thank you, was worth a shot.

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I can’t speak for the side cramps/stitches but for nearly every rider in nearly every riding condition you are underhydrating at one bottle per 2 hours and should consider drinking significantly more - 2-3x as much (work your way up to it if you aren’t comfortable just making a sudden switch)

Cramps in the side can be from spasms of the large intestine which can be made worse if you have a lot of air in the colon. The distention and subsequent increase in pressure when it spasms/contracts can lead to acute pain. That’s likely why some individuals link these pain to oral intake.

Not sure of easy fixes but could try something like Gas-X tabs if feeling bloated. Keeping your bowels working and moving regularly may help, especially before exercise.

I’m wondering if it is not related to a muscle imbalance around the hip joint, or possibly breathing technique?

I’ve had instances of stitches during hard efforts on and off over the last few years. After a few weekends in a row of them this season I did some research and one of the things that resonated with me was a potential link between breathing rate and side stitches. I made a conscious effort to breath at a more controlled rate instead of letting my body run away with itself and the issue has not re-occured since. YMMV.

I’ve not experienced this while cycling, but 2 years ago I used to do short 2 miles runs first thing in the morning 2-3 times per week. I would have to completely stop running and walk because my side would hurt so bad, and I was only doing a 9 minute per mile pace.

This didn’t feel like the side stitch that you get from breathing to me, it felt much much worse than any side stitch I had ever encountered. It also didn’t happen every time I ran. I ended up asking my doctor about it and his first question to me was about how hydrated I was.

I literally would wake up first thing and go out the door and start the run, completely dehydrated. Not sure about other people, but when I wake up in the morning, I am incredibly dehydrated.

I never tested the theory, because I ended up just quitting on running all together and focusing on cycling. But I have learned that hydration levels can effect so many things, I would not be surprised if it were the answer to my issue.

Wonder if anyone else has had these issues?

Lately I’ve been getting side stitches on moderate outdoor rides after harder efforts, but I never seem to get them on the trainer. It’s always on my right side. Sometimes they’ll go away if I ride slow for a while, or hop off the bike for a few minutes and relax or stretch.

I’ve been trying to keep up on hydration but that doesn’t always help.

Any ideas? Thanks!

From what I been able to gether, it’s a matter the muscles are not up to the task as with cramping elsewhere on my body. I believe there’s a short discussion on recent Science of Sports podcast on breathing better (or the podcast before, to lazy to look), Mine comes on after hammerfest or extended rides mostly during the drive home or in the shower after a longish trainer ride (simulated long climbs).

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Perhaps you are moving/leaning slightly different outdoors and putting stress on a muscle that you aren’t using indoors.

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