Muscle cramps are a common event-ruiner for many of us; between 40 and 95% of athletes are affected by cramp at some point depending on which survey you read. 

So we asked our friends at Precision Hydration to tell us a bit more about why we might be cramping up and to share some tips on how to avoid them…

So, just why do you cramp up during exercise?

Despite the fact that they’ve been widely studied, no-one really knows the full story on why athletes suffer with cramp just yet. 

There are two main theories on what causes athletes to cramp…

Theory #1 ‘Dehydration/Electrolyte Depletion Theory’

This theory is probably the oldest and it speculates that, if you lose a lot of water and sodium through sweating and don’t replace it, this can cause fluid shifts in the body that in turn trigger the cramps. 

The theory is based on plenty of case studies, observational data, anecdote and expert opinion – what scientists call ‘level 4 and 5 evidence’. 

Much of the early evidence behind this theory actually came from looking at the problem of cramp during sweaty work in difficult conditions rather than athletes cramping up during sport. 

Between the 1920s and 1950s there were numerous documented cases of minersconstruction workersstokers, foundry workers and military personnel all suffering muscle cramps in hot conditions. 

These cramps were usually associated with high sweat losses and sometimes with the consumption of large quantities of water at the same time.

The researchers conducting these studies tended to come to the pretty universal consensus that providing workers with adequate amounts of salt alongside the water they were drinking was quite effective in treating or preventing many cases of cramp.

There are also a number of case studies, observations and anecdotal reports from athletes whose cramping problems seem to be directly related to times when fluid and sodium balance are significantly disrupted due to heavy sweating.

In 1996, Dr Michael Bergeron documented a case study of a tennis player who often suffered with cramps during tournaments. The player had a high sweat rate and was deemed unlikely to be replacing his sodium losses through his normal diet. 

He was prescribed an increased salt intake and “was ultimately able to eliminate heat cramps during competition and training by increasing his daily dietary intake of sodium.”

Although there’s a decent amount of circumstantial weight behind the Dehydration / Electrolyte Depletion theory, it lacks the more “concrete proof” of data from large-scale, Randomised Controlled Trials necessary for it to be widely accepted as anything approaching ‘fact’.

Theory #2: The ‘Neuromuscular Theory’

This theory is more recent and proposes that muscles tend to cramp specifically when they’re overworked and fatigued due to electrical misfiring.

This theory is much better suited to being tested in a lab, where researchers can ‘excite’ muscles with electrical stimuli and provoke muscle cramps to measure what’s happening at an electrical level, and so there’s arguably more robust data to support it than is the case for the Dehydration/Electrolyte Depletion model. 

It’s probably also fair to say that, in certain circles at least, this theory is gaining widespread popularity. One big factor that does appear to support the neuromuscular theory is that stopping and stretching affected muscles is often an effective method for fixing cramp when it occurs. 

This stretching puts the muscle under tension, invoking afferent activity from the Golgi Tendon Organs, the part of the muscle responsible for telling it to relax, causing the cramp to dissipate.

At this point it’s important to steer your thinking away from this being a binary, ‘either/or’ argument between two competing ideas, even though this is how the topic of muscle cramp is commonly presented in both the scientific and mass media. 

As no-one definitively knows what’s going on with muscle cramps yet, focussing on a polarised argument between two incomplete theories is a lot less productive than looking at the bigger picture and considering the merits of both theories and the actionable advice they have to offer.

One thing that makes muscle cramp so difficult to understand is that it’s an unpredictable phenomenon that’s hard to study. This is one reason why evidence for both of the major theories is not as robust as it could be.

Cramps happen from time to time, not all of the time, so zeroing in on causative factors and cures can be tricky. 

The bottom line appears to be that muscle cramps are likely to have multiple causes including, but not limited to, dehydration andneuromuscular fatigue. 

As a result, it’s likely that multiple interventions are likely to be needed to try to eliminate these different types of cramp. 

So, how can you avoid or alleviate muscle cramp? 

Well, it’s safe to say that there’s no ‘magic bullet’ available at the moment and it doesn’t look like there will be one coming along anytime soon, despite some of the claims made by some sports nutrition products on the market.

But, there are a few things you might want to try if you’re a regular cramper and want to try to get on top of the issue… 

1) Try consuming additional sodium

Try this before and during exercise that tends to result in muscle cramps. It’s worth looking at your sodium intake in relation to your sweat output. This is a cheap and simple exercise and has little downside to it. 

It’s certainly a good idea if your cramps tend to occur during or after periods of heavy sweating, in hot weather, late on during longer sessions, or if you generally eat a low sodium diet.

One note of caution here. 

If you do take on additional sodium, especially in the form of electrolyte drinks, make sure they’re strong enough to make a real difference. Despite the claims they make on their labels, most sports drinks are extremely light on electrolytes, containing only about 200 to 500 milligrams sodium per litre. 

But the average athlete loses about 950 milligrams of sodium per litre of sweat, and saltier sweaters can lose as much as 2,000 milligrams per litre of sweat. 

So, it’s a good idea to look for supplements containing upwards of 1,000 milligrams of sodium per litre if you’re looking to see if sodium supplementation can help with your cramping.

If you’re consuming salt separately to your fluids, aim for a similar ratio of sodium to fluids and bear in mind that table salt is actually only 39% sodium – the other 61% is chloride – so you need about 3 grams of salt to give you around 1,170 milligrams of sodium.

Take in the extra sodium in the hours immediately before and during activities that normally result in muscle cramps and see how you get on. 

You’ll know pretty quickly if this is effective or not, and can fine tune your dosage to balance cramp prevention with keeping your stomach happy over time.

If you want to give Precision Hydration’s supplements a try in your training, just ask your Spokes coach for your exclusive 15% off Members discount code and use that on electrolyte drinks that match how you sweat at going forwards.

2) Try to avoid fatigue

Because it seems highly likely that fatigue is also a factor in many instances of cramping, finding ways to minimise it is also logical. 

As obvious as this might sound, try to train specifically for events that tend to result in cramps, with the right mix of volume and intensity to prepare your muscles for what’s going to be asked of them.

Taper into events so that you’re fresh and well rested when you start.

Make sure that you’re adequately fuelled for the event, with plenty of carbohydrates on board before you start and that you refuel adequately to avoid becoming glycogen depleted, which can contribute to premature fatigue.

Finally, it’s important to pace yourself appropriately based on fitness levels and environmental conditions to avoid prematurely overloading your muscles.

3) Other things to try

Other strategies for overcoming problems with cramp that are far from proven, but that either make intuitive sense, or have been used successfully by athletes include sports massage and stretching of the affected muscles, acupuncture, thorough warm ups before cramp-inducing activities and mental relaxation techniques.

Although none of these tactics are likely to offer a complete solution on their own, they are generally accessible, inexpensive and may even benefit performance in other ways, 

so there would seem to be little downside to giving them a try.

I hope this overview of the major theories on what causes Exercise Associated Muscle Cramp and some of the potential avenues to explore for solutions to the problem have left you feeling better equipped to help you combat your issues with cramp!

To get some personalised hydration advice, take PH’s free online Sweat Test. And, if you want to give Precision Hydration’s supplements a try in your training, just ask your Spokes coach for your exclusive 15% off Members discount code and use that on electrolyte drinks that match how you sweat at going forwards.

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Andy Blow founded Precision Hydration to help athletes solve their hydration issues. Hehas a degree in Sport and Exercise Science and was once the Team Sports Scientist for Benetton and Renault F1 teams. He also has a few top 10 Ironman/70.3 finishes and an Xterra World Age Group title to his name.

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