Treatment of Muscle Cramps

By Kristina E. Wodicka, D.C., L.M.T.

A question I am often asked, especially by weekend warriors and newcomers, is "Why do I get muscle cramps and how do I get rid of them?"

Leg cramps are involuntary, painful contractions of muscle. They usually take place in the hamstrings (below the buttocks) orgastrosoleus (below the knee) muscles, but may in other areas of the body as well. While many hypotheses have been put forth, a definite cause has not been established for leg cramps. However, the suggested etiologies give helpful insight into the prevention andtreatment of cramps.

HEAT CRAMPS

Dehydration is probably the most common cause of cramps in athletes. Sometimes these are referred to as "heat cramps". They occur as a result of prolonged, intense, or unaccustomed exercise where the athlete is not acclimatized. Such cramps may be seen in the weekend athlete, or during the first two to three weeks of competition for regular athletes. They are most often associated with a hot environment and are usually due to excessive sweating (i.e. fluid loss).Treatment includes the following:

Warm-Up

Performing the specific sporting activity at 10-15 percent of normal intensity is best. The goal here is to attain a heart rate of 20 bpm within the target heart rate (220 minus your age times the percentage of the desired workout; usually 60-80 percent.) A goodrule of thumb if you don't want to do the math is to make sure you can have a conversation with the person next to you and are not completely breathless. If you are going for a run or bike, use the first five to ten minutes as your warm-up, preferably on a flat surface.

Stretching

O.K. You know who you are! This is arguably the single most important aspect of cramp-prevention. Studies have shown that muscle-lengthening interferes with the development and course of cramps. Stretching before and after exercise, should be done by all athletes. If you have to choose before or after, your best bet is after. Follow the warm-up protocol, do your workout, cool down and develop a routine of stretches for the major muscle groups specific to your sport.

When stretching, adhere to the following: Do not bounce; simply hold the stretch. Relax while stretching (keep breathing), and do not stretch muscles to the point of pain.

Hydration

Drink one to two cups of water two hours before exercise. During the exercise, drink four to eight ounces of water at 10 to 15 minute intervals. This may have to be increased at higher exercise intensity or climate. Monitor fluid loss by weighing yourself, dry and nude, before and after exercise. For each pound of body weight lost, an equal amount of fluid should be consumed during the next couple of hours.

Nutrition

Proper dietary nutrition including supplements should be noted. Mineral imbalances are often the cause of muscle cramping. Minerals to consider are potassium, calcium, and magnesium. Potassium may be the most important. Decreased potassium levels may be the result of a diet high in salt and low in fresh fruits and vegetables and may eventually impair circulation, hasten fatigue and increase irritability of muscle tissue.

• Calcium 2000 mg/d
• Magnesium 4.5 mg/kg of body weight
• Sodium 300 mg/kg of body bicarbonate weight
• Potassium 3500 mg/d
• Vit. E 600 IU/d
• Ginkgo 650 mg/d
• Vit. C 3g/d

If muscle cramps and spasms persist, consult a professional practitioner such as a licensed massage therapist or a chiropractic physician. Adjusting, massage and manual trigger point therapy can be used to treat cramps directly, as in someone with low back spasm.

Musculoskeletal (M/S) problems, especially those related to gait and posture, can often lead to excessive stress on muscles, which may ultimately cause cramps or even injury. For this reason it is wise for any serious athlete to have a qualified physician perform a posture and gait analysis. If M/S problems are noted and are found to be the result of joint dysfunction, then adjusting may be helpful.

Most importantly - go out and have fun running!