Problem with cramp

[Blackviper8]

Hi all,

I was hoping to ask you for some advice. I am a 26 year old male who does quite a lot of sport, football at least twice a week and currently in traning for the Microsoft challenge so running and cycling also. Now the summer has arrived I will also be getting my windsurfing kit back out.

The problem I am finding is that I seem to cramp up really easily. Tues for example I played footy on a very wet and muddy pitch, got to 60 mins and the cramp just hit the back of my calf in the left leg. Now admitely I had been doing a lot of running and tackling but within my self I felt fine, wasn't particularly struggling for breath or anything like that, certainly could have finished the game but for the cramp. This is not the 1st time that the cramp has hit my legs (I sometimes get it in my feet at night). Since the game on Tues the back of my leg is v sore and is actually quite painful, this is not something I have ever experienced before when cramp has hit, is this normal or is it likely that I have perhaps damaged the leg in someway?

What I am basically getting at is that I am reasonably fit, but for some reason I keep getting cramp, and now I seem to have sustained an injury from it. Please could you offer some advice as to perhaps what I have done and perhaps what I can do to avoid in the future. I have got 3 days of events in mid-june, for the Microsoft challenge, that I am currently meant to be training for so one this is now hampering my training and two ovviously I don't want it to ocurr during the event.

All advice greatly appreciated.

Thanks in advance
BV

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[sdkashif]

The could be the possiblity of exertion compartment syndrome.

[wutti]

hi another reason might be magnesium and camcium deficiency. espacially if the cramp happends at night and after or at the end of training sessions or matches. try to rehydrate properly with water or fluid containing enough electrolytes.
good luck

[arthyyy]

Its Good To Consult A Dietician Who 'll Help U With The Amount Of Fluid U Shd Take Prior To Game... During And After The Game... About Ur Diet And Other Stuff....

[ilona]

I think you have a Calcium & Magnesium deficiency. It is easy to find out: get a blood test. Wish you well!!!

[physio.smith]

I did some research into Exercise Induced Muscle Cramps (EIMC) for an MSc paper, here is a brief summary of what I found...I hope it helps. It is not meant to be definitive by any means!

Serum electrolyte and dehydration related theories postulate that systemic disturbances of fluid and electrolyte imbalances would lead to gramps. Fact is that chronic disorders, causing sodium and calcium depletion are not commonly associated with cramps. Systemic abnormalities would lead to generalised muscle cramping (Maughan, 1986; Schwellnus et al., 1997), before these cramps occur the athlete would be likely to suffer muscle fasiculation, dizziness, disorientation and stomach cramps.

Muscle fatigue, due to glycogen depletion within the muscles and liver, cause a relative deficit of ATP and thus a resultant inability of crossbridges to detach, causing contractures (McArdle et al., 2001). However as the body has the ability to produce ATP from a number of reserves athletes are likely to be unable to continue competing well before contractions occur and these contractions (or cramps) are likely to affect more than 1 muscle group.


EIMC are of sudden onset, often with no warning. What is more likely to cause them is an abnormality in the alpha motor neurone activity. This may be centred around fatigue, leading to a reduced control of the excitatory effects on muscle spindle afferent activity and inhibition of the golgi tendon (GT) afferent activity. Contractions occurring in muscles held in a shortened position causes a reduced tension in the tendons, thus the golgi tendon activity is reduced and cramping is likely to occur (eg. contraction of the calf whilst foot held in plantarflexed position - as in kicking a ball). When the ground is rough, muddy, up or down hill muscle activity is increased further and the risk of cramping increases.

Passive stretching results in immediate relief as the stretching increases the GT activity and thus reciprocal inhibition, causing the muscle to relax.


What this all means to you....
If you are not suffering from shortness of breath, dizziness, muscle weakness (at rest) and any other general systemic problems then it is most likely that it is a localised muscular problem.
Seeing a physiotherapist for a neuromusculoskeletal assessment would be a good start...to assess peripheral control, assess muscle imbalances, biomechanics etc.
Often trigger points maybe a factor, these can be treated with accupressure, accupuncture, soft tissue massage, stretching.
A specific program of exercises addressing muscle imbalances, muscle conditioning, flexibility, posture / body awareness (pilates, Alexander Technique, yoga, swiss ball...may be helpful) and task specific activities would all be of use...as well as looking at your training patterns and nutrition (to aid recovery post exercise).

Personnally having played rugby for over 12 years I found that I started to suffer from calf cramping at the beginning of the season. What was causing it for me was poor cool down, lack of good stretching habits and my boots. I ran with antipronation trainers but never thought to look at my boots...no insole support. Also studs too long when the ground was hard etc... Changing my boots, adding support for my feet, and better training habits...as well as some soft tissue work resolved the problems I was having.

Good luck...don't forget to give yourself time to recover in your training program.

[Canuck Physio]

Hi all,

I was hoping to ask you for some advice. I am a 26 year old male who does quite a lot of sport, football at least twice a week and currently in traning for the Microsoft challenge so running and cycling also. Now the summer has arrived I will also be getting my windsurfing kit back out.

The problem I am finding is that I seem to cramp up really easily. Tues for example I played footy on a very wet and muddy pitch, got to 60 mins and the cramp just hit the back of my calf in the left leg. Now admitely I had been doing a lot of running and tackling but within my self I felt fine, wasn't particularly struggling for breath or anything like that, certainly could have finished the game but for the cramp. This is not the 1st time that the cramp has hit my legs (I sometimes get it in my feet at night). Since the game on Tues the back of my leg is v sore and is actually quite painful, this is not something I have ever experienced before when cramp has hit, is this normal or is it likely that I have perhaps damaged the leg in someway?

What I am basically getting at is that I am reasonably fit, but for some reason I keep getting cramp, and now I seem to have sustained an injury from it. Please could you offer some advice as to perhaps what I have done and perhaps what I can do to avoid in the future. I have got 3 days of events in mid-june, for the Microsoft challenge, that I am currently meant to be training for so one this is now hampering my training and two ovviously I don't want it to ocurr during the event.

All advice greatly appreciated.

Thanks in advance
BV

Considering you are an athlete, do you take creatine?

Creatine supplement sales exceeded 400 million dollars in 2004. Over 200 studies have shown that creatine supplementation enhances athletic performance. Despite an abundance of research that shows the effectiveness and safety of this supplement, some fallacies still exist. One of these is an unfounded concern about muscle cramps and dehydration.

Although, a number of published studies have refuted these claims directly, a position statement by the American College of Sports Medicine (ACSM) in 2001 advised individuals who are over weight and exercising intensely in hot environments, to avoid creatine supplementation.

However, recent reports now suggest the exact opposite. That is, creatine may enhance performance in hot and or humid conditions by maintaining hematocrit, aiding thermoregulation and reducing exercising heart rate and sweat rate. Creatine may also positively influence plasma volume during the onset of dehydration.

Creatine supplementation in the heat does not promote any additional risk to healthy people. The ACSM should get with the latest research and report the facts to the public.

Ref: Br J Sports Med. Jan 2008.

Additionally, augmenting creatine supplementation with a carb source is research proven to enhance performance in a variety of athletes.

What I am getting from the below post (MSc research) is that electrolyte balance, and nutrition are a key factor here as well

[physio.smith]

I have not read the latest research on creatine supplimentation. Basically what I found in the literature that I read was that EIMC, specifically those in the calf, where the muscle spans 2 joints are likely to cramp more due to lack of reciprocal inhibition & increased excitation of alpha motor neurones.

Generally that the problem of cramping in calf muscles was localised to the muscle, rather than systemic..electrolyte / dehydration problems etc...

Thus treating with STM, stretches, accupressure and re-eduction of muscle control was more likely to improve things.

[Canuck Physio]

Quote: "Muscle fatigue, due to glycogen depletion within the muscles and liver, cause a relative deficit of ATP and thus a resultant inability of crossbridges to detach, causing contractures (McArdle et al., 2001)."

If this were true, then it would make sense that Creatine, which acts as an ATP energy substrate in cells would offset the relative deficity of ATP. This would indicate that in fact cellular substrate manipulation could indeed influence muscle contracture/cramps. The study cited appears to support this statement.

However, although certain food or nutritional materials are quite obviously necessary (K+/Na+ for example vital for muscle contraction), it is likely that the effects of this are augmented by appropriate muscle work, as you mentioned.

I think it is important even as physiotherapists to understand how cellular mechanisms influence physical presentation of symptoms. Hypokalemia/hyperkalemia, as an example

[Canuck Physio]

To blackviper,

please update on your progress, I think the advice regarding diet and muscle tissue is sound and reasonable. Considering you have been active, is this activity greater than usual? Local massage may induce lymph drainage of waste materials and re-balance lactic acid buffering systems. I believe H+ and acidic environments influence cramping:

As mentioned previously:

Glucose + 2 ATP + 2 NAD+ + 4 ADP + 2 P ====>
2 Pyruvate + 2 NADH + 4 ATP + 2 H+ + 2 H2O

If insufficient enzymes present, Pyruvate is converted to Lactate

Pyruvate + NADH + H+ ====> Lactate + NAD+ + 2 H+

H+ buffering by increasing cellular muscle carnosine levels is now being shown to improve sporting performance.

Regards