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Exercise-Induced Muscle Cramps: Causes and Prevention

Exercisers are often told that muscle cramps are caused by lack of salt (sodium) or low potassium. However, recent studies show that athletes in endurance events who suffer cramps usually have normal sodium and potassium levels. A review of the current literature from Buenos Aires, Argentina shows that doctors don't know very much about exercise-induced muscle cramps (Journal of the American Academy of Orthopaedic Surgeons, July 2007). The most common cause appears to be muscle damage. Athletes may be able to prevent cramps by slowing down when they feel the muscle pulling and tightening, and picking up the pace only when the muscle feels good again.

Cramps may occur as a side effect of drugs used for high cholesterol, high blood pressure or diabetes. Oral contraceptives, various other drugs or alcohol can also cause muscle cramps. If you suffer from recurrent muscle cramps that cannot be explained, check with your doctor. Possible causes include pinched nerves, Parkinson's disease, hypothyroidism, diabetes, narrowed arteries, low blood mineral levels, or metabolic diseases that cause muscle damage. However, most exercisers who experience exercise- associated muscle cramps do not suffer from disease and can usually prevent cramps by slowing down when their muscle start to feel tight. Athletes are usually not willing to do this during competition, so they will continue to suffer from occasional cramps and work them out as they occur.

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Dear Dr. Mirkin: Will orthotics from a podiatrist get rid of foot pain when I run?

People with high arches are at increased risk for foot pain and stress fractures of their bones of their feet because their feet are usually very poor shock absorbers. A report in Cochrane Database of Systematic Reviews (October 2007) shows that custom orthotics can help. When you run rapidly, your foot hits the ground with a force equal to about three times body weight. This force can break bones and damage muscles, nerves, and tendons. So most people land on the outside bottom of their feet and roll inward. This is called pronation which helps absorb some of the shock of the foot striking the ground. However, pronation can cause pain from stretched ligaments (plantar fasciitis), pulled tendons (tendinitis), or pinched nerves (neuromas). Some people are at high risk for injury because they have very stiff ankles that prevent their feet from rolling in normally. These people usually have normally- formed arches and only appear to have high arches.

Orthotics are special custom arch supports that help to absorb shock and prevent foot pain. To see if orthotics are likely to help you, ask your podiatrist to strap your foot with a special taping procedure called a low-dye strap. If this reduces the pain, you probably will benefit from custom orthotics. If orthotics do not cure your problem, pick another sport with limited foot impact such as cycling, swimming or rowing.

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Dear Dr. Mirkin: Are salty drinks better for exercisers than plain water?

A study from New Zealand shows that women who drank a salty solution before exercising in hot weather retained more fluid and were able to exercise longer in hot weather (Journal of Applied Physiology, August 2007). Almost two hours before exercising, trained female cyclists started to drink a salty solution and continued to take this solution six more times over an hour. They took no fluid during their endurance trial. The salty drink caused their bodies to retain extra fluid before exercising and helped them to exercise much longer and harder than when they took no pre-exercise salty drink. The female hormone, estrogen, causes salt retention, but their performances were not affected by taking birth control pills, a source of estrogen, or at specific times during their menstrual cycles.

Most people object to the taste of salty drinks, so it may be more practical to drink water or the beverage that tastes best to you, and eat salted foods such as peanuts, chips or crackers.

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Recipe of the Week

Try this delicious "Trail Mix Bars" variation
using mashed ripe bananas instead of apple butter (with thanks to reader Tom Fritz for this suggestion)

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 25th, 2013
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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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