Cramp Crises Averted: Preventing and Managing Exercise-Associated Muscle Cramps

It’s the bane of athletes and fitness enthusiasts – muscle cramps. Does this sound familiar? You’re in the midst of an intense workout or competition. Then, without warning, you feel a muscle tighten and seize up in a painful cramp. Ouch! Some people liken these cramps to the feeling of being shot in the leg with a bee-bee gun. Not pleasant, right?

Despite how painful they are and how they make you want to say a few choice words, they’re common.  And they usually come on suddenly and stop you in your tracks. When one sidelines you, it can cripple your performance and cause brief, but significant, pain. But what causes these cramps, and more importantly, how can you prevent and manage them? Let’s explore the world of exercise-associated muscle cramps or EAMCs.

Understanding Exercise-Associated Muscle Cramps

EAMCs are involuntary, painful contractions of skeletal muscles. Unlike the cramps some people get at night that awaken them from their sleep, EAMCs occur during or shortly after exercise. The muscles most likely to be struck by a cramp during exercise are the calf muscles, hamstrings, and quadriceps. Less commonly, you can get a cramp in a foot and, even less commonly, an arm.

Although it seems like they last an eternity, it’s uncommon for one to stick around longer than several minutes. In some cases, it’s only a few seconds before the tightness starts to ease. Sometimes, they ease off, only to restart a few minutes later.

What Causes EAMCs?

They’re common and distressing but scientists still don’t know the exact cause. However, these factors seem to play a role:

  • Dehydration: When you exercise, you lose fluids and electrolytes through sweat. If you don’t replace the electrolytes you lose, dehydration can occur, increasing the risk of muscle cramps. Although dehydration is a factor, it’s not the full story. Dehydration alone does not appear to be the sole cause of exercise-associated muscle cramping.
  • Electrolyte imbalances: Sodium, potassium, and magnesium are three minerals that contribute strongly to muscle function. If you sweat and lose these electrolytes, you can trigger muscle cramps. When electrolytes get out of balance, especially sodium and chloride, it disrupts normal neuromuscular function.
  • Muscle fatigue: As muscles tire during prolonged or intense exercise, they become more susceptible to cramping. This is particularly true if you’re pushing yourself harder than usual or engaging in unfamiliar activities.
  • Poor conditioning: If you haven’t conditioned your muscles, they aren’t ready for the demands of exercise. So, they’re more prone to tightness and cramping.

How to Prevent Exercise-Associated Muscle Cramps

While EAMCs can be unpredictable, there are steps you can take to lower your risk of them:

  • Hydrate: Drink plenty of fluids before, during, and after exercise. Water may be sufficient for a workout of less than 60 minutes that doesn’t lead to a lot of sweating. If it is a long sweat session, keep an electrolyte-rich beverage, like a sports drink or coconut water with a pinch of salt, by your side for rehydration.
  • Maintain electrolyte balance: In addition to hydrating with sports drinks, you can support electrolyte balance by consuming foods rich in sodium, potassium, and magnesium. Bananas, avocados, spinach, and nuts are electrolyte-rich foods that help support healthy muscle function.
  • Gradually increase intensity: If you’re starting a new exercise program or ramping up your training, do so gradually ramp up the intensity and give your muscles time to adapt. Sudden increases in intensity or duration can heighten the risk of cramps.
  • Warm up and stretch: Before launching into your workout, warm up your muscles with light aerobic activity and dynamic stretching. This will warm up your muscles and boost your flexibility, making it less likely a muscle will cramp.
  • Listen to your body: If you feel a cramp coming on, stop and rest. Pushing through the pain can worsen the cramp and increase the risk of injury.

A 2019 study published in Sports Medicine identified risk factors that predispose to EAMCs. Based on their findings, you’re more likely to have muscle cramps during exercise if:

  • You do high-intensity workouts
  • You do a prolonged exercise
  • You have a history of muscle cramps with exercise
  • You get dehydrated

Managing Exercise-Associated Muscle Cramps

Despite your best prevention efforts, EAMCs can still occur. If you feel the steely grip of a cramp, try these techniques to shorten its duration.

  • Stretch the affected muscle: Gently stretching the cramped muscle can help it relax. For a calf cramp, stand with the affected leg slightly bent and the heel pressed into the ground. For a quadriceps cramp, hold onto a stable object and pull your foot towards your buttocks.
  • Massage the muscle: Use your fingers or a foam roller to gently massage the cramping muscle. Gentle massage will increase blood flow to the muscle and help reduce the spasm.
  • Apply heat: If you have one handy, apply a heating pad or warm compress to a cramping muscle to help it relax. You can also do this if a night cramp awakens you.
  • Stay hydrated and replenish electrolytes: Drink water or a sports drink to combat dehydration and restore electrolyte balance.

If your cramps are severe, frequent, or you have other symptoms like muscle weakness or swelling, talk to your doctor. Some medical conditions and medications, like diuretics, can make you more susceptible to EAMCs.

The Bottom Line

So now that you know more about them, set yourself up to keep those cramps at bay. The best approach is to hydrate before, during, and after a workout and switch to electrolyte-rich beverages if you’re exercising for longer than an hour. Don’t launch into a workout too fast either. Do a light warm and give your muscles a chance to gradually adapt to the stress of exercise. If you get a cramp despite these measures, stretch and massage the tight muscle until the pain lessens. With a proactive approach and a bit of self-care, you can conquer cramps and stay focused on your fitness goals.

References:

  • Schwellnus MP, Drew N, Collins M. Muscle Cramping in Athletes—Risk Factors, Clinical Assessment, and Management. Clinics in sports medicine. 2008;27(1):183-194. doi:https://doi.org/10.1016/j.csm.2007.09.006,
  • Miller KC. Rethinking the Cause of Exercise-Associated Muscle Cramping. Current sports medicine reports. 2015;14(5):353-354. doi:https://doi.org/10.1249/jsr.0000000000000183.
  • Exercise and Fluid Replacement. Medicine and science in sports and exercise. 2007;39(2):377-390. doi:https://doi.org/10.1249/mss.0b013e31802ca597
  • ‌Valentine V. The importance of salt in the athlete’s diet. Current sports medicine reports. 2007;6(4):237-240. doi:https://doi.org/10.1007/s11932-007-0038-3
  • ‌ Maughan RJ, Shirreffs SM. Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Med. 2019 Dec;49(Suppl 2):115-124. doi: 10.1007/s40279-019-01162-1. PMID: 31696455; PMCID: PMC6901412.
  • “Muscle Cramps – StatPearls – NCBI Bookshelf.” 04 Aug. 2023, https://www.ncbi.nlm.nih.gov/books/NBK499895/.

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