Exercise Associated Muscle Cramping

Jeff Albertson
Jeff Albertson

Exercise Associated Muscle Cramping (EAMC) is a painful phenomenon familiar to many athletes. An abrupt spasm caused by hyperactivity of the neuromuscular junction (where the nerve and muscle connect), it can put one to the ground quicker than an Italian soccer player looking to draw a referee’s whistle.

EAMC can be tricky to differentiate from another phenomenon, Exertional Heat Cramps (EHC), as both are related to exercise. EAMC is associated with local muscle fatigue, while EHC is associated with dehydration and sodium loss. EHC is decidedly less common and typically occurs with profuse sweating or high temperatures.

Historically, muscle cramps were attributed almost exclusively to dehydration and electrolyte depletion; however, experts now agree that the majority of athletic cramps are not caused by these factors.

-Cramping risk is not correlated with blood electrolyte depletion during endurance events. In fact, when dehydrated, blood electrolyte levels are not depleted. They remain static or even rise slightly.

-Dehydration is a systemic phenomenon and therefore does not explain why just one muscle cramps.

-Interventions with no relation to electrolyte levels, such as stretching and brief rest, frequently alleviate cramping.

Muscles have sensory structures that help regulate tension. When fatigued, these receptors fail to work properly, resulting in an increased propensity to cramp. Anything that leads to muscle fatigue increases the risk of cramping: inadequate training, inefficient mechanics, and, yes, to a lesser degree, poor hydration.

The following guidelines can help prevent EAMC.
1) Train properly for athletic events to ensure adequate conditioning.

2) Consult with a coach to determine a training and recovery plan, including a pre-race taper and an optimal race pace.

3) Consult with a Sports Nutritionist to determine proper hydration strategies.

4) Get a foam roll. Muscle trigger points indicate heightened excitability. Regular self-massage techniques can lower levels of resting muscle tension.

5) Trigger point dry needling is a more aggressive, but highly effective, method of reducing local muscle tension.

6) Have your gait assessed. A video analysis can ensure proper form to avoid local overuse.

Treatment for EAMC is manageable by the individual athlete.

1) Heed early warning signs.

2) Stretch.

3) Trick the nervous system. Contracting muscles that oppose the cramping muscle can help alleviate a cramp.

4) Massage the muscle.

5) Ice sore muscles. In severe cases, perform multiple 10-minute ice sessions with the muscle on stretch. Walk in between.

6) Hydrate. If EHC is suspected, hydrate immediately with supplemental sodium.

See our blog at www.VASTAsports.com for links to research and more details including hydration strategies, a video demonstration of tricking the nervous system and important information regarding indications for medical attention.

As always, I invite the reader to email me directly with any thoughts on this subject, injury related questions or ideas and requests for future articles.

Jeff Albertson is a sports physical therapist and the Director of Physical Therapy at VASTA Performance Training and Physical Therapy. See VastaSports.com for information on services or for more tips on remaining injury free.

Jeff and his family live in Charlotte.