CRAMP – CRAMPING YOUR STYLE?

“I can’t hardly stand it
You’re troublin’ me
I can’t hardly stand
It just can’t be” – The Cramps

Muscle cramps are defined as involuntary, painful, spasmodic contractions of the skeletal muscle that usually last a few seconds or longer.

WHAT ARE THE SYMPTOMS OF CRAMP?

  • A sudden, sharp localised pain in the muscles of the leg, lasting from a few seconds to 15 minutes.
  • Most leg cramps occur in the calf muscles (gastrocnemius), hamstrings or quadriceps.
  • During a cramping episode, the affected muscles will become tight and painful and the feet and toes will be stiff.
  • After the cramps have passed, you may have pain and tenderness in your legs for several hours.
WHAT CAUSES CRAMP?

Cramp is often associated with muscle fatigue and shortened muscle contractions.

Cramp can be classified as exercise-associated muscle cramp (EAMC) and non-exercised associated muscle cramp (NEAMC).

Exercise-Associated Muscle Cramp (EAMC)

  • Over exercise and Injury
RISK FACTORS ASSOCIATE WITH EAMC:
  • High Intensity Running, Long Distance Running, Exhaustive Physical Efforts, Older age, Long history of running, Higher body mass index, Shorter daily stretching time and irregular stretching habits, Family history of cramping.
ELECTROLYTE-IMBALANCE-AND-DEHYDRATION THEORY

Electrolyte-imbalance-and-dehydration theory suggests that EAMC is related to the decreased concentration of serum electrolytes, particularly sodium and chloride, resulting from excessive sweating or overconsumption of water. Other electrolytes lost in sweat to a much lesser degree, namely calcium, magnesium, and potassium, have also been implicated as the cause of muscle cramping during or after exercise when purported deficiencies are suspected. The pathophysiological basis for hypothesis remains poorly defined.

THE ALTERED NEUROMUSCULAR THEORY

The current most supported theory to explain cramp is neurological. Just like muscles can become fatigued, so can nerves. In this state, the nerves can misfire, accidentally sending signals to muscles to contract.

Muscle fatigue from activity disrupts the normal functioning of peripheral muscle receptors, causing an increase in excitatory afferent activity within the muscle spindle, and a decrease in inhibitory afferent activity within the Golgi tendon organ. Both of which then lead to an increase in alpha motor neuron discharge to the muscle fibers, producing a localized muscle cramp.

Non-Exercised Associated Muscle Cramp (NEAMC)

Underlying medical issues can cause cramp, such as:

  • Parkinsons, Diabetes, Lumbar stenosis, Neurological deficit, Osteoarthritis, Peripheral neuropathy, Kidney Disease, Cardiovascular Disease, Peripheral Vascular Disease and Pregnancy.

Cramp can also be caused by:

  • An adverse effect of medication.
  • Certain disorders that cause symptoms similar to muscles cramps.
  • Idiopathic – which means there is no known cause!

There are two situations where leg cramps may be a sign of a more serious underlying health condition.

You should seek immediate medical help if:

  • The cramps last longer than 10 minutes and fail to improve, despite exercise.
  • Cramps develop after you come into contact with substances that could be toxic or infectious, for example, if you have a cut that is contaminated with soil, which can sometimes cause a bacterial infection, such as tetanus, or after being exposed to elements such as mercury or lead.
THE BEST WAY FORWARD

Cramps are a common, usually mild and brief ailment. For some people however they become too frequent or too significant to ignore.

To help manage and prevent cramp we advise that you try the following:

  • Stretching and self-massage of the affected muscle can provide first aid during an episode, or help to prevent in some cases.
  • Decrease exercise intensity if you’re experiencing cramps
  • Home-made electrolyte drinks
  • Increase intake of salt
  • Increase quinine intake
  • Drink coconut water
  • Take electrolytes such as magnesium, potassium, and calcium as these electrolytes cause the relaxation and contraction of muscles.

Overall there is low evidence on the impact of dietary change on reducing the frequency of cramping, however, in general you can achieve the recommended daily intake of magnesium and potassium amount through a colourful diet.

Some examples of potassium rich foods:

  • Melon
  • Avocados
  • Sweet potato
  • Bananas
  • Blackcurrants

Electrolyte sports drinks are often full of sugar. Try making your own following these simple thirst quenching recipes!

#1 Blackberry Blitz

Recipe by Dr Rupy Ajula:

  • 1/2 cup fresh or frozen blackberries
  • Small handful of Fresh Mint
  • 2 cups water
  • 1/8 tsp Celtic Sea Salt

Put all ingredients in a blender and pulse for about 30 seconds. Serve and drink immediately.

#2 Strawberry Lemonade
  • 1/2 cup fresh or frozen strawberries
  • 1/4 cup fresh lemon juice
  • 2 cups water (or raw coconut water)
  • 2 tbsp raw honey
  • 1/8 tsp Himalayan Pink Salt

Put all ingredients in a blender and pulse for about 30 seconds, or until strawberries are pureed. Serve and drink immediately.

#3 Lemon Limeade
  • 1/4 cup lime juice
  • 1/4 cup fresh lemon juice
  • 2 cups water (filtered or raw coconut water)
  • 2 tbsp raw honey
  • 1/8 tsp Himalayan Pink Salt

Put all ingredients in a blender and pulse for about 30 seconds. Serve and drink immediately.

Osteopaths are trained to identify and treat the cause of you pain. To find out more information on how we can help you please contact us on: 020 3770 4754

REFERENCES

Allen, R., Kirby, K. Nocturnal Leg Cramps. 2012. American Family Physician (86) 4.

Swash, M., Czesnik, M (2018) Muscular Cramp: Causes and Management.