A side stitch can stop a runner in his tracks. Conventional wisdom is that spasm from over-exertion in the diaphragm causes a sidestitch. Conventional advice is to stop and breathe slowly-- which is rather obvious, since the pain forces the runner to stop running, and the spasm subsides in a few minutes.  Conventional prevention includes not drinking before a run (not true) and not eating (true...and consistent with new findings below).

However, a new study linked kyphotic posture (round shoulder aka rounded back) with side stitches. This observation agrees with the experience of CPEPs (Certified Posture Exercise Professionals) when people report changes in running, singing or just taking a deep breathe with the 5 Breathes StrongPosture^TM exercise.

My conjecture re: the mechanism of Posture affecting Side Stitches- Forward head posture and upper cross syndrome both compress the torso anteriorly, limiting diaphragm excursion (in other words, diaphragmatic range of motion). Running makes the diaphragm contract and relax more frequently, but when the range of motion is limited individual fibers must work harder, setting the stage for hypoxia and cramping. Eating before a run would aggravate this by putting the food in the stomach which would further compresses the abdomen.

A solution: Strengthen posture with 5 Breaths and the other Alignment protocols ( along with mechanical therapy to unlock tight kinetic links) to promote fuller motion and allows previously unused fibers to participate, distributing the workload.

Other theories offered by the authors: Poor running form can affect thoracic spine nerves running to the abdomen. Another is that hunching increases friction on the peritoneum, a membrane that surrounds the abdominal cavity. Both of these would also be impacted by StrongPosture^TM exercise and therapy.

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1. Influence of posture and body type on the experience of exercise-related transient abdominal pain, Morton DP, Callister R. Journal of Science, Medicine and Sport. 2010 Sep;13(5):485-8.
2. Improving running posture may help relieve stitches, A. O'Conner, NY Times, February 28, 2011