Clément Golliet: “The Stitch During Exertion”

Written by: Clement Golliet


***Clement Golliet is the newly appointed Director of ACE Fitness and is overseeing the fitness component of all ACE Tennis High Performance programs, is the Head Trainer at Toronto Tennis City and ACE Burlington, and offers private and group fitness sessions for ACE and OTA players as required. Clement’s mandate is to help build the new ACE Fitness brand and to offer leading edge training for tennis players in Ontario.

Clement has a Bachelors of Kinesiology from the University of Quebec at Montreal (UQAM) and possesses various certifications in the areas of private training, spinning, T-Rx, performance, and reconditioning. A former high level basketball player and bodybuilder, Clement also has his French Federation Level 3 in kayaking. Before coming to Toronto to work with ACE Fitness, Clement was a personal trainer, fitness, strength, and conditioning coach at Sporting Club Sanctuaire in Montreal for tennis, basketball, and track running. Clement also has professional training in Clinical rehabilitation and experience as a sports teacher in Switzerland.

If you have any questions for Clement, he can be reached here.***


The sore point sometimes felt in the abdomen during exertion is called a side stitch. It is also sometimes referred to as ETAP (exercise related transient abdominal pain). Its origins are various and it can create a discomfort which can become a stabbing pain either on the left or right side of the ribcage or in the middle of the stomach. In some instances the side stitch is not only caused by the reaction of the body during exertion, but also by the way people invest in their sport.

The practice of sport mobilizes an important percentage of muscle mass and a substantial increase of the energetic cost for which the body needs an increase of the respiratory flow (oxygen intake) entailing an incremented transport of oxygen and nutriments through the bloodstream.

One of the first causes of the side stitch is the increase of oxygen intake. This requires more work from the diaphragm (the diaphragm is located below the lungs and it is the major muscle of respiration. It is a large, dome-shaped muscle that contracts rhythmically and continually). As not every muscle is ready for exertion, a sharp increase of work for a long period of time can provoke diaphragm cramps. The pain can be felt in the middle of the thorax or towards the clavicle.

Another cause can be found in the increase of the blood flow (bloodstream) which supplies oxygen and nutrients to the muscle during exertion. When the supply concerns muscles from the lower body (legs), the bloodstream brings the blood to the heart through the liver (right) and spleen (left). If the blood flow to the organs is too sudden and brutal, it can create pains in the left or right side of the ribcage.

The last cause relates to blood circulatory conflict during digestion when exercising. In that case, most of the bloodstream goes to the muscles to bring nutrients and oxygen, thus neglecting to mobilize the blood necessary for the digestion. The lack of blood (ischemia) to the digestive tract causes pain in the region of the stomach. But pain can also occur in different spots on the thorax at the same time.

However, the pain quickly fades away after stopping or slowing down the exercise. If the pain is still present during resting, it can be assumed that there are other causes to the pain, such as a cardio-vascular or pulmonary problem, or an inflammation of the intercostal nerve.

To help stop the pain, it is recommended to alleviate the intensity of the exercise and press the fingers on the ribs where the pain is, and massage the sore point.

It is recommended as well to wait 3 hours before exercising after eating a substantial meal. It is important to start exertion gradually and do your warm-up carefully.

To conclude, in the longer term, a well-designed program with appropriate load will help you to better perform and avoid side stitches as those who are not in shape physically are more likely to suffer from this nagging abdominal pain than those who train on a regular basis.

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