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Muscle Cramping: Myth Busters

Practically everyone has experienced a muscle cramp in their life. Especially those very annoying and painful charley horses that you get in your calf or thigh at night. However, I know very little about them considering how frequent they are. To understand cramps better I looked to the research. What was surprising was how much is still unknown in something that is so common. Take a look below about what I found.

1. What is a cramp?

A true muscle cramp is a sudden and involuntary contraction of one or more muscles.

2. What are different types of cramps.

1. Arteriosclerosis: This results in poor blood supply to the lower legs. It is associated with impaired circulation and will stop with rest. Contact your physician or physical therapist in order to address this type of cramping.

2. Cramping as a side affect of medication: A common side effect of medication for high cholesterol (ex. Crestor, Zocor Lipitor) is muscle cramping. Contact your physician, they can modify your medication in order to reduce side affects.

3. Nerve compression in the spine: This can also cause cramp like pain in your low back to lower legs. Contact your physician or physical therapist in order to address this cramping.

4. Menstrual Cramps: During menstruation the uterus contracts to help expel its lining. Hormones (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more severe menstrual cramps.

5. Other Causes: Muscle cramps can also be the result of exercise, as well as metabolic (diabetes) and neurologic disorders. Exercise associated muscle cramps will be the main focus of this blog post.

3. What causes exercise associated muscle cramps.

Well, we don’t know for sure, but what we do know from the literature is that it occurs in active muscles. They most often occur in muscles that cross 2 joints, such as your calf, quads, hamstrings, and muscles in your feet. They range widely in severity, and the triggers are varied. Also “cures” work for some people and not for others.

In general muscle cramps are the result of over- excited nerves that supply the muscle. One theory proposes that during fatigue the nerves that supply the muscle remain over-active/excited and inhibitory pathways that stop the cramp are dulled. This results in sustained nerve activity and subsequent prolonged muscle contraction.

4. How can I get rid of my Muscle Cramps

There are multiple remedies, and unfortunately they help some people, some of the time.
Examples: stretching, staying hydrated, staying cool, salty drinks, sports drinks (replenish electrolytes), pickle juice, potassium (bananas), massage, quinine, mustard, analgesic pads, medications (ex. sedatives, anti-seizures, muscle relaxants) etc.

Why don’t common remedies work all the time?
With exercise there is a loss of the body’s electrolyte, salt, and water supply. However one study found that in order to replenish the amount of sodium lost with exercise you would need to drink 4-5 gallons of gatorade to see a noticeable difference.
For those who ascribe to bananas as their cramping solution, another study found that it would take at least 30 minutes after eating 2 bananas to see a noticeable (though small) difference in cramp reduction.

So what actually works?
1. Stretching: However, depending on severity it can take up to 30 minutes to break the cramp
2. Drinking Pickle Juice: And not for the reason you think!
Yes pickle juice is high in sodium, but as mentioned above you would need tons of pickle juice to see a noticeable difference. The hypothesis of why pickle juice is effective is that it contains molecules that activate pathway endings in your tongue, esophagus, or stomach. These molecules decrease the over activity of the nerve and muscle. A noticeable effect can be seen in as little as 90 + sec and can last at least 4+ hours after drinking 50ml of pickle juice. The molecules can also be found in cinnamon, capsaicin, and garlic.

If you have persistent cramping try the above suggestions, if cramping continues contact your physician or a trusted physical therapist to assess what are the causes of your cramp and how they can best be treated.

Minetto et al. Origin and Development of Muscle Cramps. Exercise and Sport Sciences Reviews 41:1; 2013.
Miller K, Burne J. Golgi tendon organ reflex inhibition following manually applied acute static stretching. J sports Sci. 2014; 32:1491-1497.

Miller et al. Electrolyte and plasma changes following injection of pickle juice. water, and a common carbohydrate-electrolyte solution. J Athl Train. 2009. 44: 454-461.

Miller et al. Reflex inhibition of electrically induced muscle cramps in hypo hydrated humans. Med Sci Sports Exerc. 2010: 42(5)953-61.

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