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Muscle Cramps: Prevention and Treatment

The most common cause of muscle cramps during intense exercise is damage to the muscle fibers themselves. Doctors in South Africa studied triathletes and found that most of the time muscle cramps are not caused by dehydration, thyroid disease, mineral abnormalities (calcium, sodium, magnesium or potassium), blocked blood flow or nerve damage (Br J Sports Med, June, 2011;45(8):650-6 and Medicine & Science in Sports & Exercise, July, 2005;37(7):1081-1085). Athletes with cramps had normal electrolytes and did not lose more fluid during exercise than those who do not suffer cramps.

Researchers can measure overactive nerves with a test called electromyograph (EMG). EMGs done on exercise-induced cramped muscles one to five minutes after they started, but not after ten minutes, showed markedly elevated electrical activity of the nerves controlling the cramped muscles. Thus muscle cramps during long distance athletic events are most commonly caused by overactive nerves that cause muscle fibers to remain contracted due to exercise-induced damage to the muscle fibers themselves.

Other known causes of cramps, less common in athletes, include:
• Dehydration
• Low levels of minerals such as sodium, potassium or calcium
• Poor conditioning
• thyroid or muscle diseases
• Starting a new activity or increasing the intensity or duration of exercise

Cramps During Competition
Muscle cramps during endurance events can be prevented by slowing down when you feel excessive soreness or straining in one muscle group and keeping yourself going by working the opposite side muscles and letting up on the muscles on the strained side. If you are pedaling a bike, use the other leg as the primary driving force. If you are running, slow down, and put greater effort on the other leg. Of course, competitive athletes will not do this, and they pay for it by suffering muscle cramps.

If you cramp during a competition, try to relax the cramped side and concentrate on using the muscles on the opposite side as your principal driving force. If the cramp gets worse, you will need to slow down or stop. Gently stretch and massage the cramping muscle or just walk on the cramping leg or foot.

Treating Frequent Muscle Cramps
• Check to see if you are taking any drugs that cause cramps. Statin drugs taken to lower cholesterol are a common cause of muscle cramps.
• Exercise every day to improve your level of fitness.
• Warm up before you exercise.
• Most muscle cramps are not serious. If your muscle cramps are severe, frequent, constant or of concern, see your doctor. He may recommend that you get blood tests to see if you have low minerals (sodium, potassium, calcium), thyroid tests, tests for damaged muscles (CPK), and so forth (Sports Health, 2010 July; 2(4): 279–283).

Checked 1/21/17

March 2nd, 2014
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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