Usain Bolt – a biomechanical perspective on a sprinters’ foot

That’s it, we won’t have the delight of seeing Usain Bolt competing ever again. And despite his disappointing result at the 2017 World Championships here in London he is still the man to beat with an incredible World Record set at 9.58secs. We at Vitality Physiotherapy wish him very well after his injury in the 4x100m.

In his television interview on the BBC a couple of years ago, Usain said that he was less hard working than his younger teammate, Yohan Blake (who incidentally thanked his physiotherapist when he won Silver in the 100m men’s final in 2012). Bolt, however attributes much of his success to his talent!

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Do you get a side stitch when you run?


There are more than a million downloads of the couch to 5K running app, running has become one of the most popular sports to kickstart in the summer. For both novice and experienced runners alike, most would have experienced a side stitch (exercise-related transient abdominal pain (ETAP)) at some point.

It is usually experienced just below the ribs, often affecting the right side. It usually results in a complete halt to running!


What are the causes of a side stitch?

  • Some biomechanists suggest that it is caused by the reduced blood supply to the diaphragm. The diaphragm is the main muscle we use to breathe.  This theory however has been largely disregarded as a possible reason for pain.
  • Other medical scientists have proposed that pain was due to the downward pulling of visceral ligaments (ligaments that connect your abdominal organs such as the spleen, liver and stomach). This mechanism couldn’t explain why swimmers could experience stitches because these ligaments are not pulled downwards during a swim.
  • A more plausible and recent theory is parietal peritoneum irritation. The parietal peritoneum is one of two membranes that lines the abdomen. This membrane has a good nerve supply. The other membrane is called the visceral peritoneum. Between these two layers, is a naturally occurring fluid, which helps to allow the two membranes to slide against each other
  • When the stomach is full, the two layers can rub against each other and can cause pain.
  • If we don’t drink enough water, our parched bodies can become dehydrated. This can compromise the amount of fluid lying between the two membranes causing friction. Which in turn can cause that sharp pain in your side!
  • Eating or drinking just before running causes the stomach to expand and distend. This too can cause a build-up of pressure against the membrane.
  • Other factors include poor fitness, insufficient warm-up, and abdominal or core muscle weakness

Top Tips to avoid a stitch:

  • Eat 1.5 to 2 hours before exercising, preferably carbohydrate richer and protein poorer meal.
  • Before you run, ensure that you have drank enough fluid. The more slowly you do this, the better.
  • Plan the progression of your running regime- by consulting your Physio, Personal trainer, or Running coach. Progressive gradual increases of no more than 10% of training volume a week are recommended to both keep injury-free and stitch-free.
  • Include Pilates and other core stability exercises specifically for running as part of your strength and conditioning routine.

Top Tips if you have a stitch:

  • Lower the intensity of your run.  Slowing down to about 50% of your current effort will ease the tension you feel.
  • Are you breathing through your mouth? Try nasal breathing instead! This will encourage breathing from your diaphragm and have loads of other health benefits too!
  • Breathe deeply in for 4 sec, hold for 5sec, and breathe out for 7 sec. Breathing control is a powerful tool to stop that stitch in its tracks!
  • Then, apply firm and gentle pressure on the painful area for a few seconds until the pain dissipates.
  • Raise your arm above your head and side bend away from the pain.


Characteristics and Etiology of Exercise-Related Transient Abdominal Pain,’ Medicine and Science in Sports and Exercise, Volume 32 (2), pp. 432-438, 2000

The Lore of Running, Tim Noakes, Publisher: Human Kinetics Publishers Date Published: 1991

Johnson. “Side Stitches: Cause and Cure”. Retrieved 9 September 2011.

Quinn, Elizabeth. “The Side Stitch”. Retrieved 4 November 2012

Sports Medicine 32(6): 2002. 261-269 The human spleen during physiological stress, Stewart & McKenzie

Vitality Physio featured in Women’s Fitness Magazine

Lead Physiotherapist, Janine Enoch talks to Amanda Khouv from Women’s Fitness Magazine in the Ultimate Runner’s Guide April 2012.

In this article, Janine recommends a few general principles to avoid running injuries but remember, always consult your GP or Physiotherapist if you suspect that you may have sustained an injury or are at risk of developing one.

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Shin Splints

Have you got a place for the Virgin London Marathon? Want to challenge Kenya’s Patrick Makau magnificent 2hrs 3min 38sec set at this year’s Berlin marathon, perhaps? Plagued by shin splints, and don’t know how to get rid of them? Well, look no further, Vitality Physiotherapy has the solution for you!

Shin Splints, is a global term often used to describe pain in the leg below the knee. It can occur on the front outer aspect of the leg (anterior shin splints), or on the inside of the leg (medial shin splints). They can affect novice athletes who do too much too soon, or experienced athletes who modify their exercise programme by increasing their mileage or gradient excessively.

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Achilles Tendon Pathology

The legendary warrior of Homer’s Iliad may have died from an arrow piercing his Achilles tendon, but Achilles injuries today have a good prognosis. Achilles tendinopathy is a common injury affecting athletes, particularly males between the ages of 30-50.

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ITB friction syndrome (runner’s knee)

ITB Friction syndrome is a very common complaint amongst elite and amateur runners alike. It is caused by the friction of the outside thigh muscle against the lateral aspect of the thigh bone (the lateral aspect of the end of the femur).

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