Does Exercise Take Your Breath Away? Stitches Explained

Most of us have experienced the sharp pain in our chests, abdomens or necks at some stage during vigorous cardio exercise. These are stitches.

A STITCH that literally floors you, slows your pace and makes it extremely difficult to breathe. For some of us this may have occurred on the odd occasion but for others it is a problem that presents itself frequently when we exercise and negatively affects our performance.breath-away

The cause of stitches may very likely be a tight diaphragm muscle and tight myofascial connective tissue around the diaphragm, rib cage or abdomen. The diaphragm is an umbrella shaped muscle that sits above the abdomen and below the chest cavity.

When we breathe correctly the diaphragm drops down on an in – breath to make more space in the chest cavity for the lungs to expand, the belly will rise as the abdominal contents move slightly forward to make space for the expanding lungs. This is commonly known as BELLY BREATHING. Unfortunately most of us do not breathe properly and hence the diaphragm does not get to move through its full range and can potentially become tight and develop trigger points (areas of localized muscle spasm).

In exercise when we are flexed (bent forward) for example cycling, the diaphragm is under less stretch so a stitch is usually not felt, but when we run our bodies are in an extended (straight up)position which creates a greater tension on the diaphragm, especially when running downhill.

The solution to this is to have your breathing and musculoskeletal system assessed and corrected if necessary by a physiotherapist with experience in this . The diaphragm can be released with massage, spinal mobilisations and breathing as appropriate. I have seen patients who have battled with a ‘stitch’ for months or even years who have improved considerably after a few treatments and are now able to exercise in comfort and thus improve their performance.


  • Palastagna N, Field D, Soames R. Anatomy and Human Movement. Butterworth Heinemann, 2006.
  • Myers T. Anatomy Trains. Churchill Livingstone, 2001.
  • Martarelli D, Coccioni M, Scuri S, Pompei P. Diaphragmatic breathing reduces exercise induced oxidative stress.Evidence Based Complimentary and Alternative Medicine, 2011.


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Cheryl Stacey BSc (Physio) SPT

Cheryl qualified from Wits in 1993 and worked for a variety on practices locally and abroad to gain a vast scope of practice. She opened her own practice in 1999 seeing orthopaedic and sports patients as well as 6 years spent treating post- operative spinal patients.

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