I want to take some time to talk about a problem that plagues most people who exercise regularly.  A cramp can seriously hinder your workout routine and can even wake you up in the middle of the night.  But what is a cramp?  What causes them? And can they be prevented?

The term “cramp” stems from the German/Norse root meaning –squeezing, pressing, or pinching uncomfortably.  “Exercise Associated Muscle Cramps” [EAMC] are defined as –spasmodic, painful, involuntary contraction of the skeletal muscle that occurs during or immediately after exercise. The term EAMC is used to differentiate between these and other types of cramps.  EAMC represents a wide range of both pain levels and duration.  They can last anywhere from seconds to as long as hours.  The general practice is to wait them out; however, if you are in an sport event or exercise class, you may not have the time.  Muscle cramps can feel like a slight stinging or can represent excruciating pain.  When severe, cramps may result in a bruise on the skin.  While cramps can occur in any muscle, there are factors that make them more likely.  Cramps usually occur in muscles that cross two joints.  The most common areas for cramps are the calves, hamstrings, quads, feet, hands, arms, and abdomen.

It seems perplexing that something so common and debilitating doesn’t have a definite cause; however, researchers have yet to identify one.  The problem is that without a cause, cramps are difficult to prevent.  Common theories behind cramps include dehydration, electrolyte depletion, poor conditioning, and fatigue.  In a 2004 study, a majority of these theories were discredited.  After conducting a review of the current research regarding EAMC, Martin Schwellnus of the University of Cape Town, posits that the altered neuromuscular control is the most plausible theory.  He concludes “Whilst it is clear that further evidence to support the “altered neuromuscular control” hypothesis is also required, research data are accumulating that support this as the principal pathophysiological mechanism for the etiology of exercise-associated muscle cramping (EAMC).”  Altered neuromuscular control is related to muscular fatigue and results in a disruption of muscular coordination and control.

Without getting bogged down in physiology, every muscle receives a signal to contract from an alpha motor neuron.  This neuron fires, stimulating the contraction; however, other fibers exist to prevent over-stretching of a muscle (muscle spindles) and a contraction that is too forceful (Golgi tendon organs).  When a muscle fatigues, the interplay between these contrasting organs is changed.  The alpha motor neuron fires as planned, yet the protective fibers (muscle spindles and Golgi tendon organs) receive less stimulation.  The result is a muscle that continues to contract, without any limiting factors; thus, “an involuntary contraction.”  Without a definite cause of EAMC, treatment patterns vary.

Cramps will naturally go away in due time; however, remedies to speed this process in the athletic population have been determined.  First, the athlete should stop activity immediately.  Fluids containing carbohydrates should be ingested.  The affected muscles should be passively stretched, and the joint should maintain an extended position. It is common for the pain to decrease in severity and subsequently flare up repeatedly before it fully subsides.

Here are a few factors that may lead to cramps.  Older age, longer history of running, higher BMI, shorter daily stretch routine, increased environmental temperature and humidity, and engaging in new activities are all considered risk factors.

Cramps have historically plagued athletes and the common exerciser alike.  I hope this information helps.

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