Muscle cramps in sport

… and what’s the deal with the 🥒 cucumber?

Today we want to talk about muscle cramps in sport in an interview with Physio Restart . Anneke has been coaching teams with great passion for years. The topic of cramps on the pitch comes up from time to time.

Physio Restart: An anecdote that is actually used: drink the leftover juice from gherkins when muscle cramps occur as a result of sport. This reduces the duration of the cramps by a few seconds. (Miller et al. 2010) But is this the solution to the problem? No. Basically not, because firstly: the juice really doesn’t taste good, … does it? And secondly: the cause has not been solved.

Interviewer: Interesting, introductory anecdote. Anneke, what exactly are muscle cramps?

Physio Restart: Maybe you know the situation: 81st minute of the game, the score is 1:0 in your favor, but the opponent is hungry, you are exhausted and no more player changes are possible. In other words: pull through and carry on. Suddenly your left calf cramps, followed shortly afterwards by your right calf. Running on is virtually impossible.

This cramp is an involuntary or unintentional muscle spasm . (Of course you didn’t want to get this very painful cramp in the middle of the field during this game, right?)

In principle, our brain communicates with our muscles via the nerves. This requires certain electrolytes (ions), including magnesium. This is why people are quick to say that a muscle cramp occurs because there is a lack of magnesium. But in fact this is not the answer to the problem and often not the cause.

Muscle cramps can be caused by:

1. disturbances in the electrolyte balance (e.g. loss of sweat at high temperatures)

2. dehydration (not drinking enough)

3. insufficient warm-up or lack of routine stretching

4. altered neuromuscular activation/fatigue (e.g. last minutes of the game)

If we take a closer look at the literature behind it, we can quite quickly (and many years ago!) critically question the claims made in points 1 and 2.

1) Even at cool temperatures (10-12°C), almost 20% suffered from exercise-induced muscle cramps. (Maughan 1986) Marathon runners were tested.

2. despite sufficient water intake (in relation to sweat loss), almost 70% of the test subjects had cramps. (Jung et al. 2005) However, this study population was very small.

Supplement to point 1+2: Many of these claims are based on case studies, which are not good sources.

Interviewer: Too bad. So not: take magnesium, done. Okay. And point 4… Neuromusku… what? And now the whole thing again in German…

Physio Restart: Laughs.

Sorry. “Neuro” means “concerning the nerve”, “muscular” of course the “muscle”. In other words: neuromuscular = the control or communication between nerves and muscles, which, as mentioned above, trigger muscle contraction and relaxation. Experts are increasingly in agreement that this is often the problem with cramps. It is simply fatigue during intensive exercise, but not a lack of any particular ion.

Interviewer: Ok, that was actually not difficult to understand. Good, and now that I know all this… What do I do the next time I have a cramp?

Physio Restart: There’s a lot you can do for yourself and your teammates. But not just on the pitch!

Try to drink enough before the game. Before the game means at least 1 hour, as the water needs time to be absorbed and processed by the body. Apparently it takes up to 13 minutes….

Drink the right amount before and during activity. 1 liter of nutrient-rich water or an isotonic drink. Remember: not all water is nutrient-rich. It should contain sufficient potassium, calcium and magnesium, as well as many other elements . According to the FSVO, tap water here in Switzerland is of good quality. Mineral water should contain <100mg potassium, >70mg magnesium and >300mg calcium . In comparison, as a woman I need about 4000mg potassium, 500mg magnesium and 1000mg calcium . (BLV) So I also have to get it from my food.

Avoid ingesting magnesium directly before the game. Your gastrointestinal tract can cause you problems during this time.

Warm up. Warm up sufficiently and properly before the game. Maybe you have a joint warm-up routine from the physio?

Avoid tight clothing. Excessive compression, for example due to shoes that are laced too tightly, can disrupt optimal blood circulation.

If you do suffer a cramp, avoid stretching abruptly at all costs. What many people do: quickly lie on their back, raise their legs in the air, put their toes up and stretch. However, this can actually lead to strains. Instead, stand in a stepping position and stretch yourself. Otherwise, do it carefully and slowly. Ask your physio to help you massage the cramped muscle lengthwise.

Stay warm. If you are sitting on the bench as a substitute, try to keep warm. Not just by wearing clothes, but by using the Blackroll, skipping rope, jogging on the sidelines. It’s not advisable to dance around a bit just before taking the field. Laughs.

Have yourself replaced if it happens several times in quick succession. This indicates fatigue, which can subsequently lead to an injury. Neuromuscular fatigue!

Birthday party the night before? Alcohol promotes muscle cramps.

Hot and cold showers after the game and as a general preventative measure.

Interviewer: Take Home Message as always with Physio Restart? Except that I shouldn’t celebrate my 30th right before an important match or only with iso drinks……

Physio Restart: Laughs. All I can say is:

“Don’t believe everything you read and hear. Look at information with a critical eye. You can also judge this text. Nevertheless, I hope I have been able to give you a few tips: work on the cause of the problem, because prevention is the best cure, even for muscle cramps.”

Book your appointment for physiotherapy, massage or group courses: here.

References:

1.Jung A, Bishop P, Al-Nawwas A, Dale R. Influence of hydration and electrolyte supplementation on incidence and time to onset of exercise-associated muscle cramps. J Athl . 2005;40:71-75

2.Maughan R. The effect of osmolality and carbohydrate content on the rate of gastric emptying of liquids in man. J Physiol. 1995;486:523-531

3,Bye A, Kan A. Cramps following exercise. Aust Paediatr J. 1988;24:258-259

4.Schwellnus MP. Skeletal muscle cramps during exercise. Phys Sportsmed. 1999 Nov;27(12):109-15.

5.Miller, K. C., Stone, M. S., Huxel, K. C., & Edwards, J. E. (2010). Exercise-associated muscle cramps: causes, treatment, and prevention. Sports health, 2(4), 279-283.

6.Schwellnus M, Derman E, Noakes T. Aetiology of skeletal muscle “cramps” during exercise: a novel hypothesis. J Sports Sci. 1997;15:277-285