Do anti-cramp remedies work?

You’ve seen them, possibly tried them. While there’s a variety of supplements and strategies that athletes use to avoid the onset of exercise induced muscle cramping (EAMC), no strategy has been shown to be consistently effective.

Pickle juice, mustard, vinegar and capsaicin shots have all been used in an attempt to prevent or alleviate cramps. All of these have some type of strong, bitter, or spicy taste and their components can activate TRP receptors (pain or taste sensors) in the mouth and gut; which, in turn stimulate the central nervous system (CNS). These TRP-stimulating components are typically found in commercially available “shots” (e.g. combo of vinegar, lime juice, cinnamon, ginger, capsaicin) marketed to help or prevent EAMC. These products and their unpleasant taste are suggested to activate the TRP-related oropharyngeal reflex via the CNS; that would, in theory, override a sustained muscle contraction/cramp.

But what does the research say? Pickle juice (containing sodium and acetic acid), arguably the most popular, has been shown to be effective for reducing the duration of cramps by 37% when consumed immediately after the onset of cramping (induced in a lab setting by electrical stimulation). For example, one study that used an electrically-stimulated cramp design found that 1mL pickle juice ingested immediately at the onset of cramping reduced the duration of cramping. Because this wasn’t an exercise study, these findings can’t be directly translated to “real world” EAMC scenarios. Furthermore, ingestion of small volumes of pickle juice does not appear to affect plasma electrolyte concentrations, plasma osmolality, or plasma volume.

Commercially available shots have been touted to provide a longer lasting effect against cramping due to the proposed TRP-induced mechanism. However, there is little research to support these claims so far; and, interestingly, the mouth requires a local pH of <6 in order for capsaicin to activate the TRP channel. Oral pH is likely going to differ between individuals and we don’t have a good way to know the pH in our mouth when we are exercising!

One limitation when attempting this type of research is getting people to cramp on demand. Electrically-induced cramping is a different process than what is likely happening physiologically during EAMC. While there is emerging evidence to support the use of these products, more research in a field based setting (e.g. race, or training) is needed to determine whether foods with a spicy/intense taste can actually disrupt spontaneous cramping, the optimal dose, and most effective combination of compounds.

PMID: 28192854; 31696455; 28573374

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