Exercise-induced muscle cramp

... and what is the 🥒 cucumber all about?

Today we want to talk about muscle cramps in sports in an interview with Physio Restart. Anneke has been working with teams with great passion for years. Cramps is a topic from time to time.

Physio Restart: An anecdote that is actually used: drink prickle juice when it comes to exercise-induced muscle cramps. This reduces the duration of the cramps by a few seconds. (Miller et al. 2010) But is this the solution to the problem? No. Basically not because firstly: the juice really does not taste good, ... right? And secondly: the cause is not solved.

Interviewer: Interesting, introductory anecdote. Anneke, what exactly are muscle cramps?

Physio Restart: Maybe you know it: 81st minute of play, 1:0: for your team but the opponent is hungry, yourself exhausted, no player exchange possible. In other words: go through and carry on. Suddenly, the left calf cramps, the right one shortly after. Running - almost impossible.

This cramp is an involuntary or unintentional muscle tension. (Of course, you didn't want to get that very painful cramp during this game in the middle of the field, right?)

In principle, our brain communicates with our muscles via the nerves. For this purpose, certain electrolytes (ions) are needed: for example magnesium. That is why it is quickly said that a muscle cramp arises because we lack magnesium. But in fact, this is not the answer to the problem and often not the cause.

Causes of muscle cramps could be:

1. Disturbances in the electrolyte balance (e.g. loss of sweat at high temperatures)

2. Dehydration (drunk too little)

3. Inadequate warm up or too little stretching routines

4. Altered neuromuscular control / fatigue (last minutes of the game)

If you take a closer look behind the literature, we can quickly (and many years ago!) question those hypotheses that claims from points 1 and 2.

1. Even at cool temperature (10-12°C), almost 20% suffered from sport-induced muscle cramps. (Maughan 1986) Marathon runners were tested.

2. Despite sufficient water intake (in relation to sweat loss), almost 70% of the subjects had anyway cramps. (Jung et al. 2005) However, this study population was very small.

Supplemental to point 1+2: Many of these claims are based on case studies, which are not good sources.

Interviewer: What a pity. So not: take magnesium, done. OK. And point 4... Neuromuscu.. what? And now once again in English the whole thing...

Physio Restart: Laughs. Sorry. "Neuro" means "concerning the nerve", "muscular" of course the "muscle". In other words: neuromuscular = the control or communication between nerves and muscles, which, as mentioned above, trigger muscle stimulation as well as relaxation. And experts are increasingly in agreement that this is often the problem with cramps. Simply the fatigue during intensive load and not necessarily a lack of any ion.

Interviewer: Ok, that was actually not difficult to understand. Well, and now that I know all this... What do I do the next time I play if a cramp occurs?

Physio Restart: There is a lot you can do for yourself and your teammates. But not only on the pitch!

Try to drink enough before the game. Before the game means at least 1h, as the water takes time to be absorbed and processed by the body. Apparently it takes up to 13 minutes....

Drink the right thing before and during the activity. 1 liter of nutrient-rich water or an isotonic drink. Remember: not all water is nutrient-rich. Potassium, calcium and magnesium as well as many other elements should be sufficiently contained. According to the BLV, tap water here in Switzerland is of good quality. In the mineral water should be <100mg potassium, >70mg magnesium and >300mg calcium. As a woman, I need around 4000mg of potassium, 500mg of magnesium and 1000mg of calcium in comparison. (BLV) Therefore I also need to take it via nutrition.

Avoid magnesium intake right before the game. Your gastrointestinal tract can cause you problems during this time.

Warm up. Warm up sufficiently and properly before the game. Maybe you received a warm-up routine from the physio?

Avoid tight clothing. Too much compression, for example shoes laced too tightly, can disrupt optimal blood circulation.

If you still suffer a cramp, avoid an abrupt stretch. What many do: lie quickly on the back, legs in the air, pull the toes towards you and let yourself be stretched. However, this can actually lead to strains. Rather stand in a lunge and stretch yourself. Otherwise, let it be done carefully and slowly. Let the physio help you massage the cramping muscle in the longitudinal direction.

Stay warm. If you're sitting on the bench as a substitute, try to keep warm. Not only by clothing, but by using the blackroll, skipping rope, jogging at the edge. A bit of dancing just before switching to the field is not advisable. Laughs.

Let yourself be replaced if it often happens directly after each other. This indicates fatigue, which can lead to injury afterwards. Neuromuscular fatigue!

Birthday party the night before? Alcohol favors muscle cramps.

Cold-hot shower after the game and also generally as prevention.

Interviewer: Take Home Message as always with Physio Restart? Except that I shouldn't celebrate my 30th right before an important match or only with iso drinks......

Physio Restart: Laughs. I can only say:

"Don't believe everything you read and hear. Look at information with a critical eye. Also this text, you may judge. Nevertheless, I hope that I was able to give you a few tips along the way: work on the cause of the problem, because prevention is the best cure, even for muscle spasms."

Author:

Anneke Penny

Book appointment for Physiotherapy, Massage oder Group classes: here.

References:

1.Jung A, Bishop P, Al-Nawwas A, Dale R. Influence of hydration and electrolyte supplementation on incidence and time to onset of exercise-associated muscle cramps. J Athl . 2005;40:71-75

2.Maughan R. The effect of osmolality and carbohydrate content on the rate of gastric emptying of liquids in man. J Physiol. 1995;486:523-531

3.Bye A, Kan A. Cramps following exercise. Aust Paediatr J. 1988;24:258-259

4.Schwellnus MP. Skeletal muscle cramps during exercise. Phys Sportsmed. 1999 Nov;27(12):109-15.

5.Miller, K. C., Stone, M. S., Huxel, K. C., & Edwards, J. E. (2010). Exercise-associated muscle cramps: causes, treatment, and prevention. Sports health, 2(4), 279–283.

6.Schwellnus M, Derman E, Noakes T. Aetiology of skeletal muscle “cramps” during exercise: a novel hypothesis. J Sports Sci. 1997;15:277-285