We can’t talk about how to stop muscle cramps unless we know what they are and what causes them.
Muscle cramps can stop a training session or other physical activity dead in its tracks–but what causes them and how can we stop them?
Get-Fit Guy is hosted by Kevin Don. A transcript is available at Simplecast.
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Welcome back to Get-Fit Guy. Coach Kevin Don here and this week past week I received an email from an avid listener asking me about how to stop muscle cramps. As a curveball, she gets migraines, so she avoids sweeteners, fermented foods, and bananas and doesn't take sugar so she can’t have sports drinks. Did I have any advice about “natural” electrolytes?
We can’t talk about how to stop muscle cramps unless we know what they are and what causes them.
According to the dictionary, a cramp is a sudden, involuntary, spasmodic contraction of a muscle or a group of muscles. I don’t think anyone who has ever had a cramp would argue with that definition.
So what causes them? Well, this is the interesting part, because I think if we were to ask the general population, we would hear about electrolyte imbalances—no doubt because we have been exposed to a sports drink industry with lots of advertising dollars to sponsor trending athletes and teams. But actually, in spite of many studies being conducted on exercise-induced muscle cramps, scientists aren't sure exactly what causes them! There are, however, two main theories.
The first, is, indeed the “dehydration/electrolyte theory.” This theory is probably the oldest, most well-established theory and came about from a salt deprivation study conducted in the 1930s by Robert McCance, a British physiologist. He was interested in what would happen if we depleted salt but not fluid from study participants. Aside from removing salt from their diets, they also drank a lot of water and took hot baths to accelerate salt loss. What they found was that when salt depletion hit, participants suffered from a loss of taste, fatigue, cardio respiratory distress upon exertion, and muscle cramps. These symptoms were alleviated within fifteen minutes of salt consumption.
Another contributor to this theory is evidence around the effects of hyponatremia (low blood salt) caused by overconsumption of water during exercise, which affects sodium levels. There are also many cases of both diagnosed and undiagnosed cystic fibrosis sufferers. Cystic fibrosis causes increased salt loss during exercise via very salty sweating and sufferers therefore tend to have a high incidence of cramping.
Seems pretty compelling to me, but what about when we have cramp in cold weather or in the absence of an abundance of sweating, which is just as common as cramp in hot and sweaty conditions?
Well, thats where the second theory on cramp causation comes in, the neuromuscular theory. This is a more recent idea on the root cause of cramp and is basically that muscle overload and neuromuscular fatigue are the culprits. Fatigue causes the excitatory impulses from muscle spindles and inhibitory impulses from what is called the Golgi tendon organ to get out of balance. Essentially, there is an electrical misfire or short circuit in the muscle. This theory is pretty easily tested in a laboratory setting because you can attach electrodes and literally see what is going on at an electrical level within the muscle when it cramps. That means there are a lot more studies on this than on the dehydration theory.
One learning from the studies is that stopping movement and applying stretching to the muscle is effective at stopping the cramp. Think about when you see an athlete collapse with a cramp on the field of play. Immediately, a teammate rushes over and applies pressure in the opposing direction to the cramp. The athlete isn’t shouting “quick, bring me a salt tablet!” No, they are calling for a teammate to stretch the muscle out. This stretching in the opposing direction applies tension to the muscle, signaling the Golgi tendon organ (which is responsible for telling the muscle to relax) and the cramp dissipates.
EMG studies have also shown a high level of excitation (increasing cramp potential) in muscles as they become more fatigued. This lends support to the theory that fatigue is causing an electrical neuro-muscular excitation issue, leading to cramping.
Another idea is that both theories are correct and that, rather than there being a cause of cramp, there are different causes of different TYPES of cramp. In this case, multiple interventions may be needed to address the cause.
So what would that look like? Well, firstly we can:
It’s definitely worth looking at your sodium intake because it’s a cheap and easy way to potentially address cramps with little downside. I don’t think you need to buy expensive sports drinks—I personally just add some salt to my water bottle pre-training with a splash of lemon juice for flavor. I also have some electrolyte drops, which are basically super-concentrated seawater. Even in hospital, they don't give patients sports drinks when they present with low-level dehydration—they get a mix of orange and apple juices. As a rule of thumb, human sweat has about 900-1500mg of sodium per litre. So, if you really wanted to work this out, you’d weigh yourself before and after training and consume the same amount of water back, with 900-1500mg of sodium in it.
Because the evidence is strong that muscle fatigue causes cramping, learning to cope with the demands of a sport will be good thinking. Therefore, training your muscles up by progressively overloading them to let them adapt is a great idea. So is specificity. Irrespective of what your local gym might tell you, their general classes won’t prepare you for a specific outcome. Running a marathon? Training your running will help prepare your muscles for that type of exertion. Loading up on carbs will also help because low glycogen results in premature fatiguing. Anyone on the ketogenic or carnivore diet, don’t email me.
Use warm-ups to prepare your muscles for what will occur. Remember, warm-ups should be both general AND specific. A general warm-up will be full body and to raises the heart rate and specific will be looking at the demands of the training or competitive scenario about to follow.
Massage can help a lot with muscle relaxation, but I wouldn’t do that pre-event, only post-event.
If you have a training question, are looking for individual training program design, or just want to say hi, head over to the Get-Fit Guy Facebook page or send me an email at getfitguy@quickanddirtytips.com