Cramping, Why do you have to be such a pain?

Here our Physiotherapist John takes a look at cramping and why it happens.

We have all experienced the dreaded muscle cramp. That unexpected shooting pain that can wake us during our sleep,  stops us in our tracks during footwork in a class or ends our hard training session just when you’re ready to dig deep and make some gains.

I myself, have been at the mercy of these unwanted side effects during my career in athletics.

But who is to blame?

Is it my lack of fitness, something I ate/didn’t eat, or have I been drinking enough water? If you’re like me and find yourself asking the same questions, read below and hopefully you can pinpoint the problem.

Firstly we need acknowledge that muscle cramps have been poorly researched and studied amongst the literature. This is because of the untimely nature and unpredictability of cramps. But what are muscle cramps: Technically, muscle cramps are a sudden, involuntary (unwanted) painful contraction of a muscle or part of a muscle. They can last a few seconds to minutes and often are associated by a visible knot in the muscle.

There are two main theories however which try to explain the phenomena:

The nervous system Vs the Muscle.

Before we go on, understand how our muscles and nervous system work together. In the most basic expiation, muscles work by contracting and relaxing to move a body part but the driving force for this is the nervous system. These guys send little electrical impulses from the brain to every muscle in the body and determine how fast, how hard and how long a muscles need to contract. Now think of a muscle like a bag of liquid with a perfect mix of water, protein and other chemicals like sodium and calcium to name a few. If this perfect balance is disrupted for any reason, such as exercising, not eating/drinking the right foods or not having enough time to replenish these values, we are in for a fun ride!

The nervous system:

When muscles are over worked there is an imbalance between impulses from muscle spindles and inhibitory impulses from Golgi tendon organs. Or in ordinary terms, muscles tend to cramp specifically when they are overworked and fatigued do to electrical misfiring! What backs this theory up is that stopping the activity/exercise and stretching the muscle is a universally accepted method to combat the cramp. What stretching does is evokes afferent activity from the Golgi tendon organs (part of the muscle responsible for telling it to relax) and causes the cramp to dissipate.

The Muscle:

The oldest theory when we look a muscle cramps. This theory speculates that a disturbance in the fluid balance in the muscle can cause the muscle to cramp. Simply put, if you lose a lot of sodium and don’t replace it (sweating a lot) it can cause fluid shifts in the body that in turn cause muscle cramps. This is based on observational data, anecdote and expert opinion. In other words, it lacks concrete proof!

Other factors to consider: 

When we look back at the earliest research into cramping, it brings us to the 1900s where coal miners worked in hot humid conditions. These miners were sweating a lot and drinking a large volume of water at the same time. This was seen again in the mid 1900s and early 20th century with construction workers, foundary workers and military personnel. Again working in hot conditions with high sweat loss and drinking large volumes of water. The theory branched off into two sub sections:

1. Lack of Salt: Maintaining a normal fluid level but depleting salt levels by having a low salt diet and sweating profusely either by exercise in hot climates/conditions researches were able to educe cramps among themselves. By eating bacon and replenishing the salt in their bodies their sense of weakness and cramps returned in under 15min!
2. Hyponatremia: this is a condition seen commonly at marathons or towards the end of an endurance race. When a person’s blood sodium level falls lower than it should and they have been drinking too much water.

Other theories/causes less likely:
• Inadequate blood supply. Narrowing of the arteries that deliver blood to your legs (arteriosclerosis of the extremities) can produce cramp-like pain in your legs and feet while you’re exercising. These cramps usually go away soon after you stop exercising.
• Nerve compression. Compression of nerves in your spine (lumbar stenosis) also can produce cramp-like pain in your legs. The pain usually worsens the longer you walk.
• Mineral depletion. Too little potassium, calcium or magnesium in your diet can contribute to leg cramps. Diuretics — medications often prescribed for high blood pressure — also can deplete these minerals

So how do I help prevent muscle cramps:

1. Drink Fluids! Be sure to drink plenty of water but of you are sweating a lot or exercising in hot conditions remember to drink an electrolyte drink such as a Lucozade sport or similar to keep that balance.
2. Stretch your Muscles! Let’s evoke that afferent activity from the Golgi tendon organs! Get those muscles to relax!
3. Train smarter! As fatigue is most likely related to cramping. Be sure to train smarter. Train at a volume that is appropriate for your fitness level. Be sure to taper into events such as marathons or iron mans. And fuel the body prior to or post exercise to replenish those levels in the muscles.

In Closing:

Don’t get caught up in one theory or another, it can be a combination of both musculature and neurological fatigue. More research is currently being carried out but we simply don’t have enough concrete evidence to pin point one cause. As with most things, cramping is likely multifactorial, a result of a combination of things. The important stuff is below! If you think you are well hydrated, stretching regularly and still suffer from muscles cramps when you walk, exercise or during the night when you sleep pop into one of the studios and ask to see a physiotherapist. There can be other reasons behind this and we are all happy to help you get rid of those nasty cramps!

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