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Coping with Cramp

17 Jan 2018
Robert Brandham
Muscle cramps occur for a variety of reasons – and when they do, they are not pleasant. An exercise-induced muscle cramp is when one, or a group of, muscles suddenly and involuntarily contract. This can happen both during and after exercise. There are many theories why cramps occur, including dehydration, electrolyte imbalance, muscle fatigue, heat and hyperexcitability of muscle nerves.

Research has shown that neither hydration nor electrolyte levels vary between those who cramp and non-crampers in endurance events. Therefore it is less likely that dehydration alone causes cramping, but it can’t be ruled out as part of the trigger process for increasing susceptibility. Dehydration and electrolyte depletion can increase the rate of muscle fatigue, leading to cramping developing more rapidly during exercise.

Temperature is also unlikely to be a driving factor as cramping can also occur in cooler weather, however heat can exacerbate muscle fatigue too.

The theory with the most scientific support is around alterations to the nerves controlling the muscles due to neuromuscular fatigue. As the muscle overloads, there is an imbalance in the nerve signals from the central nervous system (a go signal) and the inhibitory sensory signals coming back from the muscle (a stop signal). This leads to a cramp and explains why many people report they can feel their muscles fatiguing and sense a cramp was imminent.

When a muscle contracts in a shortened position, there is a depression of the inhibitory stop signals. This is why cramps frequently occur when a muscle is shortened and why stretching can be effective in reducing intensity. Holding a sustained stretch helps restore the balance between the conflicting signals.

Why some people are more susceptible to cramping than others is harder to explain. It is not always a reflection of poor fitness and conditioning. A past history heightens risk, as does higher intensity levels and longer duration of activity.

Males generally seem to be more susceptible, possibly due to their higher proportion of fast-twitch fibres which are more fatigable. Women also have a tendency to burn more fat than carbohydrates compared to men, which is a better muscle fuel.

Managing cramps

There’s no easy-fix to prevent cramps, but these approaches can help:

Stretching: Holding a sustained stretch is the most effective way to treat cramp. It is also important to stretch before and during sustained activity as a prevention method.

Stay hydrated: Despite the lack of evidence for the hydration/electrolyte theory, athletes still need to stay hydrated to prevent heat-related illness. A general rule is an athlete should consume enough fluid to prevent a two per cent loss of body weight, this can be recorded by weighing before and after activity. For those brave enough, drinking small amounts of pickle juice is thought to reduce cramping intensity as it has a high concentration of salt and acetic acid that can provide immediate relief when a cramp strikes.

Train smartly: As fatigue appears to be a major contributing factor to cramps, proper conditioning helps. Plyometric exercises, such as jump training to force muscles to exert maximum force in a short interval, can help build resistance to cramps. Addressing any muscle imbalances and areas of weakness also limits their progression to fatigue.

Electrical stimulation: There is some evidence to support using electrical stimulation to induce a cramp in the affected muscle groups in the days or weeks prior to competition as a method of rebalancing the electrical signals within the muscles.

Kinesio taping and compression garments: Both have risen in popularity in recent years. There is limited evidence to support their use to prevent cramps, however, they can help reduce muscle vibrations at ground impact to delay onset of muscle fatigue.

Massage: The pressure alters neural signals and may reduce potential for cramping. However massage can reduce the excitability of a muscle, so it would potentially be unwise to perform this prior to a match as it may negatively affect performance. This is a more common post-exercise solution. Massaging when cramping can help reduce pain.

At the Australian Open there is a high incidence of cramping for a few reasons – it is the 1st major tournament after the off season and there is wide variation in the preparation of the players. Many have come from the northern hemisphere winter to our summer and may have not acclimatised to the conditions. There have been instances where players have gone into full body cramping and been unable to continue in a match and had to be transported from the courts in wheelchairs. There was even a time when a player had to be sedated when returning to the locker room due to the persistence of the cramps.

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