Some more info on stitches and proper breathing -I thought it might be better for the forum to post it seperately vs. in Palmtag’s Training Journal only, as others might find it usuful, too (check his journal for another post on the subject).
Learn Proper Breathing
Correct breathing is yoga breathing, or belly breathing, which involves breathing predominantly with the diaphragm, rather than with the chest muscles. With belly breathing, the chest hardly moves at all. Instead, the abdomen (stomach) appears to be doing all the work, for as you breathe in, the stomach goes up and when you exhale, the stomach retracts. Note that the term belly breathing is incorrect, albeit descriptive. The diaphragm, not the belly, is doing the work.
Proper breathing can prevent side stitches from developing. Side stitches occur only during exercises that are undertaken in the erect posture and that involve running or jolting or both (Sinclair 1951; Abrahams 1961; Rost, 1986). The pain of the stitch is usually felt on the right side of the abdomen, immediately below the rib margin. Frequently, the pain is also perceived in the right shoulder joint, where is feels as if an ice-pick were being drived into the joint. However, a recent study (Morton and Callister, 2000) found that a clear majority of athletes report that pain occurs most commonly in the middle abdominal areas, suggesting that multiple mechanisms may be causing the problem. The pain is exacerbated by downhill running and by fast, sustained running, as in short road races or time-trials. Other factors that predispose runners to developing side stitches are eating and drinking before exercise; lack of training; weakness of the abdominal muscles; cool weather; nervousness; and starting a race too fast (Rost, 1986). In addition, constitutional factors would seem to be involved, as only certain people are susceptible to stitches. Swimmers are often affected by the condition (Morton and Callister, 2000). Since vertical jolting of the ligaments does not occur in swimming, another mechanism is involved. Morton and Callister propose that irritation of the abdominal lining, the parietal peritoneum, most adequately describes all the clinical features of this condition.
If you have a side stitch, lie down immediately with the hips elevated; this helps differentiate the stitch from other conditions, including chest pain due to heart disease, as the pain of the stitch disappears very quickly on lying down. Indeed, this characteristic explains why so little is known about it. It is extremely difficult to study a phenomenon that disappears mysteriously the moment exercise stops. About 20% of athletes have residual discomfort on deep inspiration for two to three days after getting a side stitch (Abrahams, 1961).
For various complex anatomical reasons, the fact that side stitches cause discomfort in the shoulder joint suggests that the diaphragm is one cause of the pain, but it is likely that other factors may also contribute. The historical explanations for this condition (Sinclair 1951; Abrahams, 1961; Rost 1986) are based on the anatomical finding that a group of ligaments that support the stomach, the liver and the spleen are also attached to the diaphragm. Vertical jolting of those organs during running is believed to put strain on the diaphragm, which ultimately goes into spasm, causing the pain of the stitch. The tension is greatest at the insertion of the diaphragm into the rib margin, explaining why the discomfort is often felt under the rib margin. Rost (1986) suggests that the stitch can be prevented by avoiding food and water for 2 to 4 hours before exercise, by training the abdominal muscles with appropriate sit-ups and by learning how to breathe with the diaphragm. Forced exhalation is the most effective technique to break a stitch that is caused by a cramp of the diaphragm.
To learn how to belly breathe, lie on the floor and place one or more large books on your stomach. Concentrate on making the books rise when you breathe in and fall when you exhale. As it takes about two months to learn to do this while running fast, it is important to start practicing well before an important race.
A change in breathing pattern may help relieve the stitch. Within a short period of starting to run, breathing becomes synchronized with footfall. Thus, we automatically breathe in on one leg and out when landing either on the same leg or on the opposite leg. This phenomenon was first reported by Bramble and Carrier (1983). Of particular interest was their finding that most runners begin and end a respiratory cycle on the same foot, usually in a stride-to-breathing ratio of either 4:1 while jogging, or 2:1 while running fast. Runners then become habituated to breathing out on the same leg, day after day. This produces asymmetrical stresses on the body and could be a factor in both the stitch and certain running injuries.
(Lore of Running, T. Noakes)