Muscle Cramps 101

We’ve all heard of “The Wall” that long distance runners hit when they’ve pushed themselves to the limits of their strength and conditioning. It’s hard to explain if you’ve never experienced it. Years ago I was sailing along through a marathon in Las Vegas, actually enjoying myself, when almost exactly at the 20 mile mark I thought someone had shot me in the calf. I actually looked down to see if there was a bullet hole with blood squirting out of it. Within a few yards, bam, I got hit in the other leg. Then bam, bam, I was hit in the biceps of both arms. The final bam was in my side; I was one giant cramp. I had promised myself I would run the whole race and never stop. I’m proud to report that I kept that promise, but I want you to know that it was truly ugly. I was a pitiful sight.

Well, many may think that anyone who pushes themselves to the brink like that deserves what they get. Maybe so, but have you ever had to jump out of bed or a chair with a disabling cramp in the arch of your foot, or a charley horse in your thigh when you were doing absolutely nothing? What’s with that? What is a cramp and what causes it?

Muscles have the ability to contract and relax voluntarily, in most cases to move a joint or body part. When a muscle contracts involuntarily it’s called a muscle spasm, cramp or charley horse. Mild cramps are fairly common, but they can be so powerful that they are actually visible, painful, and can even cause a loss of function.

There are a number of reasons for cramps and charley horses. The most obvious culprits are overexertion, muscle fatigue, and injury. However, probably the major cause is a deficiency in minerals and electrolytes such as calcium, magnesium, potassium, and phosphorous. The Mayo Clinic estimates that 78% of those experiencing cramps are deficient in magnesium. Magnesium has demonstrated the ability to balance calcium levels, decrease pain and inflammation, relax blood vessels, and decrease blood pressure.

Other major charley horse causes are circulatory problems such as peripheral artery disease, dehydration, hormone imbalances, and diseases like MS. Cramps are more common during pregnancy as the mother has to share all her vitamins and minerals with a demanding hitchhiker. There are also a number of medications that contribute to the cramp curse, namely diuretics, steroids, statins which are prescribed for cholesterol control, anti-osteoporosis drugs, and birth control pills.

So, what is the best way to deal with the cramp nuisance? As with most problems, prevention is better than treatment of a problem. Most muscle problems can be prevented by proper conditioning, warm-up, and stretching of the muscles and tendons. A great emphasis should be placed on a nutrient dense diet which supplies all the building blocks for healthy muscles, with plenty of electrolyte rich hydration, before and during physical exertion. Once a muscle spasm or charley horse strikes, re-hydrate, massage, and stretch the cramping muscle. If it does not subside it may be necessary to slow or stop the exertion, and apply heat or cold. Night cramps can often be prevented or treated by consuming a liquid that contains quinine. If cramps become more than just an occasional nuisance, medical examination for a more serious cause may be advisable.

Now a word about the dreaded side ache, or what is sometimes referred to as a “stitch.” A bad one can be disabling. The real cause is still shrouded in mystery even to experts. It can affect either side of the lower abdomen and is often associated with the pre-exertion meal, particularly if it includes something that is re-constituted and sugary. One interesting and almost counter-intuitive factoid is that they actually become less common with advancing age. Once a side ache hits, you can try to run through it, but it often helps to slow down, breathe deep, and massage the side of discomfort.