Hello,
I have been dealing with a side stitch type pain on my right side for close to a year now. It began late spring of 2022 during some hard 20 min type efforts. Prior to this I never had any side stitch type pain/cramps and have trained with hard intervals for 6-8 years. When I first experienced these issues I was in the middle of a 25 minute interval on a local MTB climb and pacing myself well. My max heart rate is mid 190’s and I find I can push hard for this length if I keep it below 180. About mid interval I was hit with what I would describe as a strong side stitch. I slowed down to a recovery level and it went away. I then continued the ride at an easy pace to save myself for another push later in the week.
Fast forward a few days and I try the same effort again and 5 minutes into the interval same results, moderately painful side stitch. I always warm up for 15-20 minutes. I took the rest of the ride easy and did not think anything of it. however the next day I had mild/pain irritation deep in my lower rib cage on the right side.
Fast forward again after resting for a few weeks this pain will not go away so I go see my primary care doctor. He pushes and prys on that area and thinks he can feel some muscle swelling or a small tear. He prescribes rest and for 2 months I ride 6-10 hours a week but limit it to very easy zone 2 type riding. I try and push hard after 2 months of rest and it came right back. Side stitch as soon as my heart rate stays in the 170 range for a few minutes. This is now late summer 2022 and I go see my doctor again. He recommends longer rest as this type of issue can take a long time to heal. I have taken his advice and stayed active but kept it easy for months and months.
Today I am still feeling irritation/pain in this area and my doctor has ordered a CT scan but does not seem optimistic it will show anything. It sounds like an ultrasound by a medical professional that really knows this muscle/skeletal structure of this area is what I need. What needs to happen is to be able to pinpoint the issue between rib cage and diaphragm as I think it’s a diaphragm injury/issue.
Anyone ever dealt with anything like this or heard about anything like this?
Thanks!
Proper imaging is overdue. Anything else is speculation.
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Above and see a proper doctor. One that specializes in sports medicine. They will get you back riding again.
Sharp pain on the inside of your ribcage (don’t really think it’s the ribs that hurt) when you try to take more than maybe 1/2 a breath? Just trying to clarify the symptom for everybody. If that is what you’re experiencing, I’ve had them from time to time my whole life. Seems very random, often not during exertion, usually just regular walking or sitting type activity.
Interested in if anyone has any info.
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I’d agree that it’s time for imaging. I did come across this brief mention of a side cramp in a recent Huberman podcast. Not sure if it helps.
Link to the youtube version is How To Build Endurance In Your Brain & Body | Huberman Lab Podcast #23 - YouTube
Time stamp is 01:32:10 Eliminating the “Side Cramp” With Physiological Sighs
Good luck.
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Side stitches are one of my weak points. I had my first really bad one during lockdown doing a virtual 5K going out WAY too hard (6:30-6:45/mi when I usually ran 7:15-7:30/mi for 5K). That searing pain in the ribs and barely being able to get a breath is horrible. Nowadays, I get it during some workouts and some Zwift races, but am usually able to work through it. I never saw a doctor about them, but it wouldn’t shock me if part of it is posture-related, for me at least. When I go too hard and forget to focus on posture and quality breathing is when I’m in for a bad time. Actually, I can feel the spot that gets mad is mad right now after doing my 30/15 outdoor intervals in a more aero position. Maybe some core strengthening would be a good idea to help fight this.
I always successfully eliminate my side stitches with the physiological sighs recommended by Huberman. I just did that some days ago after a long time with no side stitches.
I’d agree with everyone else that asking a medical pro is the proper thing to do. But, I will give a personal anecdote. A few years ago I had a string of failed 20 minute FTP tests due to pain in my side. I realized I had recently been drinking Powerade on my rides. The blue kind in powdered form (a local grocery store I liked sold this instead of gatorade powder).
I stopped using the powerade powder and the stitch in my side during hard efforts also stopped. I still don’t really know what exactly was going on, but something in that drink mix did me dirty.
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This happens to me on significantly hard efforts well above my normal training. It feels like my right lung just stops working entirely. Very hard to get a breath in and I slow way down as a result. I’ve thought maybe it’s just my body’s way of telling me I’m going too hard for my current level of fitness, and to slow down. Will take the advice in this thread of hydration and breathing technique but definitely open to any other advice.
Lol, I was just rereading this thread, and thinking “What could it be? It’s not ribs, are the lungs muscle? I think the diaphragm is a muscle you’re supposed to exercise to take deep breaths. Why have I never googled this?” Here’s what I found in 2 seconds, after having these stabbing pains from time to time my whole life.
Side Stitch: Symptoms, Causes, and Treatment
…" When you get a side stitch, it’s commonly because your diaphragm is spasming. The diaphragm is the muscle responsible for respiration (breathing). It’s located right under your rib cage.
The Diaphragm: Anatomy and Function
Side stitches are often experienced by athletes. There are three underlying causes for side stitches, including:2
- Diaphragm muscle cramp (diaphragmatic ischemia)
- Stress on stomach ligaments (peritoneal ligaments)
- Irritation of the muscles lining the abdomen and pelvic cavity (parietal peritoneum)
Side stitches may happen when activity causes changes in blood flow or irritation in parts of the body like the diaphragm or the abdomen. Any person can get a stitch doing many physical activities, but runners and swimmers may be more likely to experience side stitches. One report estimates some 70% of runners may experience this type of pain.3 People participating in team sports and cyclists can also experience side stitches.
Other causes
Other reasons side stitches may develop include:2
- Swollen spleen
- Rib fracture
- Muscle strain
…"