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Don’t Cramp Your Style!

I’m normally in favor of writing my own blogs and passing on my experiences or views. However, this EXCELLENT article in the September edition of Peak Performance with regard to Cramping is worth sharing. Please read and ENJOY!!

When muscle-cramping strikes, it can scupper even the best-laid plans. Andrew Hamilton looks at commonly-used strategies to minimise cramping risk and explains how recent research provides a revolutionary new anti-cramping approach…

A muscle cramp occurs when a muscle, or even a few fibres of a muscle contract
involuntarily (ie without you consciously willing it). Muscle cramps can affect any skeletal muscles in the body, but are most common in muscles or muscle groups that span two joints. The most common sites in the body for muscle cramps include:
• The calf muscles of the lower leg (gastrocnemius);
• The hamstring muscles of the rear thigh (see figure 1);
• The quadriceps muscles of the frontal thigh.

However, in addition to these areas, cramps can also affect the hands, tummy muscles (abdominals), the muscles around the rib cage, and the feet and toes. Muscle cramps can last anywhere from a few seconds to (in severe cases) 15 minutes or longer. A muscle cramp in a particular location may also recur multiple times before it finally goes away.

What Causes Muscle Cramps?
Despite being a very common condition, the exact causes of cramps have remained something of a mystery. What we do know is that cramping occurs when the mechanisms
controlling the electrical stimulation of muscle fibres (contraction – motor unit firing) and subsequent deactivation (relaxation) become impaired in any way. Physiological factors that have been investigated as possible contributors to this impairment of electrical control are shown in box 1. However, most authorities agree that ‘true cramps’ – those we normally associate with vigorous exercise, fatigue and dehydration/electrolyte imbalances etc – are caused by hyper excitability of the nerves that stimulate the muscles, which also explains why much attention on preventing cramps has been focused at minimising this excitability through optimum nutrition and conditioning protocols.

Anyone can experience muscle cramps, regardless of age, gender or fitness level. But in otherwise healthy people, muscle cramps are most common in endurance athletes such as marathon runners and triathletes, and those who perform strenuous physical activities without previous experience or lacking base conditioning. In short, the fitter and better trained you are for your event, the lower the risk of muscle cramps. The obvious implication is that with improved fitness and conditioning, the risk of cramps can be significantly reduced. However, an important question to ask is what other strategies can reduce cramping risk and in particular, whether improved nutrition and hydration can help?

Reducing Muscle Cramping Risk
Strategies involving stretching and relaxing muscles are proven ways to reduce cramping risk and help treat cramping when it occurs. When it comes to improved nutritional strategies however, the scientific evidence about what actually reduces the risk of cramping has been far from clear-cut, mainly because there’s actually very little data from published studies.

Inadequate hydration and insufficient levels of the electrolyte minerals in musclesPoorly-trained muscles that are inflexible and/or insufficiently conditioned for the exercise being undertaken (muscle cramps are much more likely to occur in muscles that are unused to vigorous training).
Inadequate rest and recovery – we know that muscles are much more likely to cramp when fatigued.
Genetics – all other things being equal, some people are simply more prone to muscle cramping than others, which is thought to be down to genetic makeup.
Age – muscles in the elderly are more prone to cramping than in younger people.
Injury – the risk of cramps can also be increased by injury, where certain muscles may go into spasm in order to ‘brace’ and protect the injured area

To add to the confusion, the studies that have been conducted have often produced mixed results. For example, South African scientists studied 72 runners competing in an ultra-distance marathon and compared data from those who suffered exercise-induce cramps and those who didn’t(1). Although they found small variations in blood levels of post-exercise sodium and magnesium, they concluded that there were no clinically significant alterations in blood electrolyte concentrations and no alteration in hydration status in runners with ‘exercise associated muscle cramping’ (EAMC).

Despite the lack of unequivocal evidence however, most scientific authorities agree that any nutritional cramp-prevention strategy should aim to address three important areas:
1. Maintaining adequate hydration(2) – because all electrical signalling activity in the muscles takes place in an aqueous (water) environment and even small shortfalls in hydration levels could lead to impaired electrical signalling and an increased risk of cramping;
2.Ensuring adequate dietary intake of the electrolyte minerals(3); sodium and potassium because they’re involved in conducting electrical signals to/from muscles, and calcium and magnesium, which are essential for the contraction and relaxation of muscle fibres; 3.Replenishing energy in the form of carbohydrate – because even small drops in the level of stored muscle carbohydrate (glycogen – your body’s premium fuel for exercise) can lead to increased fatigue, which may in turn increase the risk of muscle cramps.

Stretching and Cramps
One thing that nearly everybody agrees upon is that a regular stretching program targeted at muscles prone to cramping can greatly reduce the incidence of exercise associated muscle cramps as well as stopping cramp once it’s started(4,5). Passive stretches held for 15-30 seconds at a time seem to be effective. The mechanism is unclear but a regular program of stretching is known to lengthen muscle fibres, favourably altering spinal neural reflex activity. Regular massage may also be beneficial as it promotes general muscle relaxation and helps accelerate the disposal of exercise metabolites from muscles cells.

General Strategies for Avoiding Muscle Cramps
Until very recently, there’s been no guaranteed method of avoiding cramps entirely. The new research on hot spice administration before exercise is extremely promising but cramp-prevention products based on this research are not yet widely available. With that in mind, here are some recommendations that may help to reduce your risk of muscle cramps during or after exercise:
1. Consuming spicy, peppery foods before exercise (even several hours before) may help reduce your risk of muscle cramps. Try experimenting with homemade recipes but remember that any foods you consume in the hour or two before exercise should be light (low fat) to allow them to empty from the tummy before exercise begins. Never experiment before a competition – only before a training session!
2. Build your training intensity gradually. We know that the central nervous system plays a significant role in the aetiology of muscle fatigue during exercise, and this almost certainly explains why unaccustomed fatigue greatly increases the risk of muscle cramps. 3. Related to point 2, ensure you ease up on your pre-race training. Make sure you arrive at the start line fully recovered.
4. If you suffer from recurrent cramps in one particular muscle group, it might be worth carrying out some strength training for the relevant muscles. Higher levels of strength can delay the onset of local muscle fatigue by lifting the ‘threshold’ at which fatigue is experienced
5. Stretch regularly, particularly the key muscle groups recruited in your sport. Runners in particular should perform regular static stretches for the hamstring and calf muscles (see figure 3). To maximise performance for an event however, these stretches should NOT be performed immediately beforehand.
6. Consume a carbohydrate-rich diet, drink plenty of fluid and ensure that you eat plenty of magnesium-rich foods in your dayto-day diet such as green leafy vegetables, whole grains, nuts and seeds, and pulses (beans, peas and lentils).Magnesium has been shown to reduce the risk of night-time cramps.
7. Use massage-therapy as an additional method of relaxing muscles, particularly after tough workouts. General strategies for avoiding muscle cramps Figure 3: Hamstring and calf stretches Hold each stretch for 30 seconds, repeating 3 times. Stretch at least twice per week but not before training or competition.

References 1. Br J Sports Med. 2004 Aug;38(4):488-92 2. Int J Sport Nutr Exerc Metab. 2005 Dec;15(6):641-52 3. Med Sci Sports Exerc. 2005 Jul;37(7):1081-5 4. J Sports Sci 1997 Jun;15(3):277-85 5. Clin Sports Med 2008 Jan;27(1):183-94, ix-x 6. Neurology April 6, 2015 vol. 84 no. 14 Supplement S17.003
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