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Fighting Cramp


Muscle cramp is inherent in sport. But what can be done to minimise the risk? And how do you get rid of it? 2PEAK has the answers.


What plagued Lance Armstrong at the end of the Stage Royal in this year's Tour de France, has been experienced by most endurance athletes at one time or another: towards the end of a long, hard ride, muscles get out of control and contract, when they shouldn't. The cramp spectrum ranges from slight fluttering of the muscle, to a very painful complete blockage. Cramp is a widely known problem. Tests on 2,600 endurance athletes showed that 2/3rds of triathlon and marathon competitors get cramp. Mot common according to this study is cramp in the calves. For racing cyclists the main muscles also cramp often – the thigh muscles and ham strings behind the thigh. Not so common but still present in cyclists, is cramp in the feet, hands and arms.

What causes cramp? There is a plethora of theories, which cause controversy between sports experts and doctors. The most common theory has been a lack of electrolyte as a result of loss of fluid. This is being overtaken by the fatigue theory, propagated by the SA professor Dr. Martin Schwellnuss in 1997. The core of the fatigue theory is a malfunction of tired nerve cells, through which the muscle is controlled. A post-study last year published in the USA, divides cramp into two categories – Fatigue cramp and Heat cramp.

Pickle juice, the cure!

New studies have found, that when it comes to treating muscle cramps, you have to treat the nerve not the muscle. It’s believed that cramps occur when the nerves are destabilized. In other words, cramps are the expression of destabilized, over excited nerves and are caused when motor neurons in the spinal cord fire excessively. Rumors have been heard, that athletes drinking pickle juice or a special mixture of mustard and warm water were able to get rid of their cramps. Taking these rumors as a base, scientists have looked deeper into the topic and came up with the idea that both substances had an activating effect on TRP (Transient Receptor Potential) channels in the mouth. The conclusion was made that the stimulation of the sensory nerves in the mouth, esophagus and stomach trigger a response from the nervous system and calm down the motor neurons in the spinal cord. But now what does that mean for us, when we want to avoid having cramps during our next training or race? Seems pretty simple and cheap! We’ll just pack some pickle slices for along the way and once we feel cramps are coming, we’ll suck on them a little. And there you go, we’re cured☺ !!! Obviously there’s also other solutions, with the same “pickle juice idea” behind them. If you’re interested, go check out the product of HotShot for example

Salt is vital

So how do you know what the cause of your particular cramp is? Heat cramp can attack several muscles at the same time. It usually gives some warning before the main attack. The title is somewhat misleading, as it isn't the heat but massive sweating which triggers this type of cramp. Do you have very salty perspiration? Do you get a salty crust on your clothing, not only after a long marathon but after training? Then you should increase your salt intake in phases of large loss of sweat. If you get a pre-warning of cramp, immediate intake of concentrated salt solution (3g salt – that's three knife ends worth - to ½ litre of carbo-hydrate drink) will help. (Int. Journal Sport Nutrition 6 1996) It is also possible to drink too much. If you only drink water in large quantity you thin the salt concentration in the body. This has to be kept pretty constant within narrow boundaries, however. There have been marathon runners, who have died as a result of excessive water consumption.

Apart from common salt, containing vital sodium, magnesium is also important for avoiding cramp. But 2PEAK diet expert Benoit Nave advises against concentrated intake of magnesium, "Under stress and during competition especially, magnesium products cause a strain to the stomach and should be completely avoided.” Roman Gruber, therapist for vital substances agrees. He recommends filling the body's electrolyte store before the start in the same way as the carbohydrate store, because, Gruber says "Many athletes don't react well to electrolytic drinks and prefer to drink pure water in competition, although they know that a lack of minerals can result.” His tip is, "Two handfuls of nuts a day cover the magnesium intake.” During a race Gruber, who advises the Milram team, recommends 2g (two knife ends' worth) of salt to a litre of drink. An alternative could be salt capsules, which should be washed down with water. The energy bar manufacturers have also started to mix more salt into their products – check on the sodium (Na) value on the packing.

Sometimes muscle pain is mistaken for cramp, according to Roman Gruber, "Women especially get a lack of iron and then the body is unable to manufacture its own L-Carnitine.” In this case experts recommend daily intake of 5gm L-Carnitine on competition days and 2gm on training days. Any type of extra intake and competition fuel in general must be tried out in training! Each of us reacts differently. Don't experiment in competition!

Tired muscles go haywire

Although old and often quoted, the electrolyte loss theory is inconsistent. For instance, a musician can get cramp in his fingers although he hasn't lost much sweat. By deliberate movements, muscles can be made to cramp quickly. But also in long endurance competitions with large loss of fluid, the electrolyte theory is shaky. In tests on racing cyclists, runners and triathletes in long competitions, it was found that there was no difference in fluid loss between athletes who got cramp and those who didn't!

Schwellnuss' fatigue theory, provides another conclusive explanation for cramp. It rests on the experimental observation that nerve activity changes during fatigue. We will need to get into neurophysiology a little bit to understand why. Muscle activity is controlled by two sensors, which are built into the musculature. The first is the muscle spindle of which there are several running parallel to the muscle fibres. Then there is the so-called Golgi tendon organ which is at the junction of muscle and tendon and measures the power which the muscle applies to the tendon. The nerves of the muscle spindle activate the working muscle – they make it contract. The Golgi organ is there to prevent over tension and if required send a relaxing feedback so the muscle doesn't get strained. When muscles are tired, the balance of these two sensors is lost. The spindles get over active and send out too many signals - the Golgi organs send out too little feedback. The uncontrolled over-stimulus causes the cramp.

But it isn't only muscle fatigue which upsets the balance between the activating and safety feedback signals. This mechanism is less effective, if the muscle is tightened when already in a shortened state (reasons for the shortening – see below). As the tendon is looser, the Golgi organ senses no tension and sends no feedback. The most affected muscles are the ones which run via two joints, as these can be brought into a shorter position than muscles with only one working joint. Examples of muscles running via two joints are: the especially cramp happy calf muscle (bends the knee and stretches the ankle) or the rear long part of the biceps femoris, attached to the prominent tendon at the outer edge of the hollow behind the knee (stretches the hip and bends the knee). If you tighten the biceps femoris in a shortened position (flat on your stomach – knees bent – heels touching the bottom) you can quickly cause a cramp, although the muscle wasn't tired before. The duping of the Golgi organ is enough to trigger the cramp.

Local cramp can be cured mechanically, by stretching the affected muscle. By stretching, the Golgi organ is back in the loop and receives tension information, sends a feedback signal and relaxes the muscle. You may not need to dismount to stretch the muscle. But you need to do a proper slow motion stretch because the muscle spindle would react to a quick motion and in a reflex tightens the muscle again. You may know this from the doctor's reflex test. A tap with the hammer on the knee tendon causes the thigh muscle to contract and the lower leg to swing forwards.

Once the cramp is resolved, you should carry on at a lower intensity at first. If it was in a thigh muscle problem, try only to use the muscle between the 12 and 2 o'clock position and slowly increase the extent. If it was the calf muscle, don't ankle the pedal round but keep the ankle low at first.

Other Causes of Cramp

Although these theses sound mechanically straightforward, biological systems are very complicated. So it's no surprise to find that there are other causes for cramp, than these simple theories would have it. Your diet plays an important role in this. Diet expert Benoit Nave sees as one cause of symmetrically occurring cramp, excessive consumption of dairy products. Nave explains, "This puts a strain on the liver and the venous blood system, affecting the return transport of blood from the muscle.” For local one sided cramp, Nave often finds blocked foot or hip joints to have been the cause and has been able to cure this with osteopathic treatment.

Sometimes it is little things, which can cause cramp. Racing cyclist Ronald Andraczek, from Dresden found by trial and error the cause of his cramp, which hit him mainly during competition: he had been taking an energy gel with caffeine and when he switched to a gel with no caffeine, the cramp disappeared. You can find reference to this effect in medical literature but there is no definite proof of any connection.

Lack of carbohydrate is also critical. When the glycogen storage in the muscles is empty, the risk of cramp increases. In a lab test in which the volunteers were given carbohydrate rich electrolytic drinks, it was at least possible to delay the onset of cramp considerably. Those leisure cyclists who think, that going without food or drink somehow makes their training more efficient, shouldn't be surprised when they get cramp.

Steps for Preventing Cramp

The first step to avoid cramp under stress is appropriate training. Overload will probably lead sooner or later to cramp. Unusually long or unusually hard training afflicts the musculature. The exact mechanism of fatigue isn't known but we know from observation, that even a few single loads can set the scene for cramp later. So: if you already get your muscles into the red area at the beginning of a marathon (and haven't practiced this) the probability increases, that you will get cramp when the muscles are tired, later in the event. In very hard conditions – for instance in time trialling, where maximum effort and a less familiar position combine unfavourably, cramp can occur in a very short time – in some cases after only 20 minutes.

Our advice: Train specifically, stretch after training, take a balanced diet and replace fluid and salt when at high output. Then you will have done a lot towards beating cramp. If you still get cramp, then you know that you have been to your bodily limit.


Cramp Precautionary Tips

+ train specifically for your event
+ stretch your musculature after training
+ eat a couple of handfuls of nuts daily

In Training and Competition

+ carbohydrate-rich drink with a gm of salt per ¾ litre.

If you get Cramp

+ stretch affected muscle
+ if cramp affects several muscles take salt

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