Cramps - Causes and Treatments
From children running around the school playground to triathletes, almost everyone has experienced a frustrating cramp or stitch at some point when exercising. Despite being so common, little research has been done to investigate their causes leading to a lot of myths which can make it difficult to know how to deal with it them.
What is a cramp?
Cramps during physical activity are referred to as Exercise Associated Muscle Cramps (EAMC) to distinguish them from other cramps that may occur at rest, in pregnancy or due to a medical condition. An EAMC is a sudden, tight and intense pain in the muscle groups being used when exercising, for example in the foot during swimming. They can vary in length, from a few seconds to several minutes, and in intensity, from a slight pain to debilitating excruciating pain.
What causes a cramp?
Myth: Dehydration
The belief that dehydration causes EAMC is mainly due to anecdotal clinical observations whereas recent studies have shown that there is no difference in the hydration status of athletes experiencing EAMC and not experiencing EAMC. There is also no possible physiological mechanism to link EAMC with dehydration.
Myth: Abnormal levels of sodium, potassium, magnesium and calcium in the blood due to losses in sweat
Very little potassium, magnesium and calcium are lost in sweat during exercise so there is no evidence to support this. Some athletes do lose large amounts of sodium in their sweat but again, studies have shown there is no correlation between serum (blood) sodium levels of athletes and experiencing EAMC.
Myth: use of creatine
Due to reports that creatine supplementation can increase muscle strength and has other benefits, it has become a common nutritional supplement. There are anecdotal reports that, when training in hot environments, creatinine supplementation causes EAMC (the hypothesis behind this being that cells become ‘full’ due to creatine and fluid which can disrupt the cell membrane structure). However, research carried out with footballers training in 40⁰ heat found no relationship between EAMC and creatine.
Fact: fatigued muscles
A muscle in a shortened position, because it is tired or hasn’t been stretched properly is more likely to be abnormally stimulated, causing involuntary forced contraction which doesn’t relax until the cramping is over. As a result, there have also been links between increased running speed and EAMC especially when an individual is doing prolonged exercise at a much higher intensity than they are used to.
How can I avoid cramp?
Allow adequate rest and recovery for muscles after hard training
Wear loose clothes as tight clothes are more likely to restrict blood flow to muscles and cause cramp
Ensure adequate carbohydrate intake before exercise (and during exercise when training exceptionally hard). Carbohydrates help prevent premature muscle fatigue. Good sources include rice, potatoes and pasta.
Increase strength and fitness at a gradual steady rate. Stronger muscles are also more resilient to fatigue and therefore less likely to cramp
Treating a cramp
Stop exercising and stretch the cramped muscle. This increases tension in the muscle which decreases muscle contraction so it can relax and recover. Massaging the area and applying ice can also relieve the discomfort.
