Almost everyone knows side stitches from running, but that stabbing pain under the ribs can also strike mid-session while swimming. In the water it's especially annoying, because you can't simply stop and stand. The good news: the causes are usually clear, and there's plenty you can do about it.
What is a side stitch anyway?
A side stitch is a short, stabbing pain on the side of the abdomen or lower rib area, known medically as "exercise-related transient abdominal pain." The exact mechanisms aren't fully settled scientifically, discussed causes include irritation of the peritoneum, tension in the diaphragm, and stress on ligaments in the abdominal area. Important to know: side stitches are almost always harmless and disappear on their own after a short time.
The most common causes when swimming
- Too full a meal before training: A full stomach presses on the diaphragm and is one of the most common causes. Ideally, leave one to two hours between eating and swimming.
- Shallow, hurried breathing: During freestyle, people often breathe too short and too shallow. That leads to a tense diaphragm, a direct trigger for side stitches.
- Cold water: Jumping into cold open water can speed up your breathing and irritate the diaphragm, especially at the start of a session.
- Too fast a start without warming up: Going straight into a high pace without preparation overloads your breathing and core.
What you can do in the moment of a side stitch
If it catches you mid-swim, one thing helps most: ease off the pace and consciously deepen your breathing. Exhale deliberately slowly and fully, this relaxes the diaphragm. Many swimmers benefit from breathing to the opposite side for a few strokes or briefly switching to breaststroke to calm the rhythm. Don't force yourself through the pain at the same pace, that usually only makes it worse.
How to prevent side stitches
The most important lever is breathing. A calm, deep breathing rhythm instead of short, panting breaths noticeably relieves the diaphragm. Also warm up properly before intensive sessions instead of going full throttle right away, and time your last larger meal with enough of a gap before training. A trained core helps too: a stable midsection supports breathing and body position and makes you less prone overall.
When you should take a closer look
Side stitches are almost always harmless. However, if the pain occurs very frequently, is especially severe, appears independently of exertion, or lasts unusually long, that's a reason to have the cause checked by a doctor. This applies especially if pain in the chest or upper abdomen comes with other symptoms. This article does not replace medical advice.
Frequently asked questions about side stitches when swimming
Why do I get side stitches when swimming?
Common causes are too full a meal, shallow hurried breathing, cold water, and too fast a start without warming up.
What helps acutely against a side stitch in the water?
Ease off the pace and consciously exhale slowly and deeply to relax the diaphragm.
How can I prevent side stitches?
Breathe calmly and deeply, warm up properly, leave enough of a gap after your last meal, and strengthen your core.
Are side stitches dangerous?
Usually not. But with very severe, frequent, or persistent pain, you should have the cause checked by a doctor.
Enjoy your swim.
