Is it possible to avoid cramping?

If you’ve ever experienced spontaneous muscle cramps during an event you know what a pain they can be. Despite trying seemingly every prevention strategy in the book, some athletes experience cramps more than others. There have been some possible risk factors for cramping that have emerged through research. In a study in 210 Ironman triathletes, the primary independent risk factors for exercise associated muscle cramping (EAMC) were a history of cramping and competing at a higher intensity than in training. Interestingly, dehydration and serum sodium changes did not predict EAMC. Another study evaluated 1300 marathon runners and concluded long distances (> 30 km), the presence of fatigue, and again running at a faster pace than their training paces were associated with cramping.

Even though athletes take a variety of electrolyte supplements, sometimes with the intention of preventing cramps, it’s unclear how electrolytes may influence EAMC. When electrolyte concentration is measured in plasma, it’s unlikely that the values reflect intra- and extracellular electrolyte concentrations in muscle and nerve cells local to the area of cramping; and, EAMC is most commonly experienced within the muscles being used. Cramping is also often associated with high rates of sweat loss during exercise in the heat, but it can also occur in cool environments with little sweat loss. These observations suggest that, while we can’t rule out the involvement of either sweat loss or electrolyte changes in EAMC, these factors don’t explain EAMC in general.

Ultimately, there’s no consensus on the exact cause of cramping so we can’t make clear cut recommendations for cramping prevention during training or racing.

For some people, it may be that hot temperatures, high sweat losses, and ingestion of large volumes of plain water can be risk factors for cramping and that the addition of salt to fluids might help.

Pickle juice and capsaicin shots might help some in certain situations but there’s no guarantee (more on this in an upcoming post). The best strategy against EAMC seems to be not over-racing at an intensity/pace/effort based on what we have prepared for in training, especially when environmental conditions make things more challenging.

PMID 31696455

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