Is pain cramping your style?

If you ever have experienced this sudden intense pain, you will agree getting cramp can become extremely frustrating

We see a lot of our patients coming in regarding cramping especially in the calves (which is one of the most common places) and it makes no difference whether it be our ultramarathon runners, elite triathletes, the recreational fitness fanatic, our desk jockeys, musicians or our mums to be. It can affect everyone.




What it is not proven - Debunking the Myths
Muscle cramping mythology is said to be linked to having low electrolyte concentration after exercise, becoming dehydrated or exposed to extreme weather conditions, such as hot and humid environments, but these 'theories' which are widely promulgated are only said to be anecdotal clinical observations which have never been proven. 

What is proven 
Accumulating evidence suggest it is has a neuromuscular basis.  Firstly it is associated with how the muscle is contracted through nerve stimulation.  Secondly, it is associated with how sensory receptors (muscle spindles and Golgi Tendon Organ (GTO) play a key role in controlling the muscles length and state of relaxation (muscle tone) after exercise.  For example when sensory receptors are exposed to such things as faulty posture, shortened muscles, intense exercise, and exercise to fatigue; it results in ramping up these sensory receptors to increase muscle activity, this provokes a neural response similar to a contraction and causes cramp.

What attributes to cramping
High Intensity exercise
Exercising for a long duration
Performing high mechanical loads, such as Hill running
Conditions causing premature fatigue due to going too hard too fast or being unfit
Poor stretching habits and/or flexibility
Two-joint muscles such as your calves and hammies. The most commonly affected is the calves
A genetic predispostion for cramping in your family history

Prevention
Muscle stretching - this is your first port of call.  Slow passive stretching is the most common and effective therapy for relieving acute muscle cramps as this ideally acts on a certain sensory receptor called the GTO which works to inhibit cramp.

Useful strategies
To lessen the affects of cramping here are some useful strategies to implement.
1. Have a good warm up, followed by a well-controlled exercise session (avoid going too hard too soon), a good cool down with stretches and adequate rest.
2. How's your fitness? Are you fit enough to perform the activity and are you giving your body enough time to adapt to your training programme?
3. Commence regular stretching - the team at Top Notch Massage and Health can show you the right stretching relaxation technique that you can perform at home during your next massage session.

Other strategies such as incorporating plyometrics or eccentric muscle training, maintaining adequate carbohydrate reserves during competition still remain speculative.  


References:
Bently. S. (1996). Exercise-Induced muscle cramp. Journal of Sports Medicine, 21(6), 409-420.
Hoffman, M.D., & Stuempfle, K.J. (2015). Muscle cramping. Journal of Sports Medicine. Unpublished.
Schwellnus. M. P. (2008). Cause of exercise associated muscle cramps (EAMC) - Altered neuromuscular control, dehydration or electrolyte depletion? British Journal of Sports Medicine, 43, 401-408. doi:10.1136/bjsm.2008.050401

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