If you have ever had a stitch in the side while running you know how severe the pain can be.

In fact, it can double you over and stop you in your tracks. The proverbial "stitch" is common to athletes who have weak abdominal muscles. They often get air trapped under the diaphragm, which causes this painful crampy pain.

It is usually between the stomach and the ribs and can be as low as the hip and belly button. It may also be caused from eating too close to race time, where there is an accumulation of gas and the lower bowel has not been emptied adequately. In other athletes, it may be nervousness when entering an event, which causes stimulus to the colon resulting in spasm even when it is empty. This is known as spastic colon.

In most cases, when an athlete develops a stitch, it usually passes spontaneously in a few minutes, when they stop running. There is always a lesson to be learned from experience.

I can remember years ago at a run when my then, a young relative of mine, asked if he could run the distance. My first thought was of the extreme hot weather and high humidity conditions, but his persistence won out. When we arrived at the "Run" the running club was ready with a large number of award trophies, which was the first thing this young man saw. I had made certain to instruct him to start out slowly, and then run at a faster pace at the three-quarter mark.

As the run began, he surprised me by taking the lead. He held it for about 300 yards but then the more experienced and faster runners passed him.

His trouble began when he developed a "stitch" which happened when he had air caught under the diaphragm. He described the pain like being punched hard in the stomach. Therapy consists of belly-breathing. That means taking air into the abdomen and pushing it out with your belly muscles, exhaling against resistance. He was also instructed to do bent knee sit-ups to develop strong abdomen muscles.

Every run is a different experience and each one can be a teacher. It is always a learning experience and one should listen to his body.

Dr. Robert F. Weiss, a sports podiatrist, was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. Weiss is a veteran of 35 Marathon & has a practice in Darien; affiliated with Stamford Hospital and member of Stamford Health Medical Group-Foot & Ankle. For info visit his Web site at www.stamford

healthmedicalgroup.org, and find a Physician-Dr. Robert F. Weiss.