Lets talk about cramps

Published: 12 Jul 2018

Lets talk about cramps

Almost everyone has had a cramp once in their lifetime. Cramps can occur when asleep, during sport or sometimes you may have to stop during an activity as a result of a cramp.  Two out of three athletes have experienced a cramp during sport. Usually a cramp can be felt in the calf muscle when running and in foot muscles when swimming. About 2% of the population has nightly cramps on a weekly basis in the calf and foot muscles. Cramps are common in most age groups but seem to occur more often as one gets older. Of the elderly population about 30% to 50% can get nightly cramps. Cramps can happen during the day as well and can happen in the legs, hands, arms and even the abdomen. Cramping is a very common problem and it is important to know what to do to prevent one or know what to do when you’re having one.

What Causes a Cramp?

Cramps are an involuntary contraction of a muscle or muscle groups. The muscle contracts hard and does not want to relax.

Muscles tend to cramp more easily when they are fatigued, overtrained or untrained. Too much intense stretching could also lead to a cramp. Dehydration (simply not enough water in the body) is a possible cause of a cramp, especially when the water and salt (sodium) losses are great. Sodium plays an important role during muscle contraction and a shortage can lead to an uncontrolled contraction. A cramp is often linked to losses of potassium, calcium and magnesium due to sweating a lot. But at present this is still a theory due to a lack of evidence.

Extreme temperatures do not appear to be a direct cause of exercise associated muscle cramping (EAMC) but they do increase the risk. At present science believes that the primary cause of EAMC is altered neuromuscular (involvement of both the nerve and the muscle) function secondary to extreme fatigue in the exercised muscle.

  • Other causes of cramp could also be:
    • Having poor circulation (atherosclerosis)
    • Too much build-up of lactic acid in the muscle.
    • Repetitive movements. For example: writing, typing, playing an instrument or video games for prolonged periods at a time. Simultaneous contraction of muscle groups without rest is the underlying cause.
    • Shortage of minerals. For example: dietary deficiencies, certain diseases and certain medications (cholesterol pills or diuretics). Too much alcohol and caffeine can also lead to cramps. Both substances causes dehydration.
    • Pregnancy. A specific cause is unknown but decreased circulation, being too low on magnesium levels and muscles that fatigue quicker most likely play a role.
    • Neurological disorders. MS, ALS, Restless legs syndrome or neuropathies can also cause cramps.

How Can I Prevent a Cramp?

  • Rest
    • Have enough rest after an intense training session. A well-rested muscle has less chance of cramping up.
  • Fitness Level
    • The fitter you are the less chance you have of getting a cramp. Work out a well-balanced program with your physiotherapist, exercise physiologist or personal trainer. Have a specific program for the event/sport or goal you are training for and be well trained and conditioned.
    • A well-balanced training program should have a good build up and the program should also have resting moments in it. It’s simple, a rested muscle has less of a chance of cramping up then a tired one.
  • Hydration
    • Stay well hydrated before, during and after a training session – if your urine has a light colour this is a good indicator of good hydration.
    • The average intake is about 2-2.5 litres of water per day.  This can increase to up to 10 litres with heavy long distance exercise in warm conditions. The decrease in weight after exercise is mainly due to loss of water. In the ideal circumstances you drink enough to stay within 1% of your body weight.
    • Fluid is lost quite easily.  In some circumstances it may be suitable to have a sport drink as they contain potassium to retain wate,r to prevent an involuntary contraction of the muscle. Sports drinks replenish lost fluid but can also replenish sodium and minerals. When sodium losses are great, think of long distance running/cycling, you would have to make sure your intake is about 0.25-0.7 grams of sodium per hour. A 500ml bottle of sports drink contains roughly 0.2 grams of sodium. If the losses of sodium or electrolytes are abnormal there are powders or other drinks available to replenish those losses but it would be highly recommended to consult a sports dietician.  If you would like to know more about sports drinks our blog written by Susan Williams, Dietitian has some great advice.
    • Also make sure you consume enough carbohydrates before, during and after exercise to avoid premature muscle fatigue.

7 Tips for Treating a Cramp

  • Stretching definitely helps reducing the painful muscle contraction and relaxes the affected muscle.
  • Stretch gently to start with and while you are stretching increase the intensity gradually, but make sure it is always pain free. Your stretch can last roughly 30 to 60 seconds and you can repeat the stretching up to 5 times.
  • Stretch before and after exercise.  Ensure you do a proper warm-up after stretching.
  • For specific stretches please consult a physiotherapist to make sure you stretch the right area.
  • With more severe cramps ice can help to reduce the contraction of the muscle and reduce the pain.
  • Resting and drinking are other measures that can be taken to recuperate from a cramp as quickly as possible.
  • When stretching the calf muscle whilst having a cramp, ensure the knee is straight and push the toes toward the knee cap.

There are a whole range of causes for getting a cramp and therefore it is not always easy to pinpoint the exact cause of a cramp. Most of the time a cramp is temporary and can be treated using the above methods mentioned.  I would recommend consulting with a general practitioner for a review if a proper diet, training and stretching are not helping or when the cramp is severe and are very frequent or when the cramps are not related to extreme exertion.

Michiel van Straten