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Muscle Cramps: Causes and Treatments - December 17, 2014

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Muscle Cramps Causes and Treatment

By Hannah Jefferson, PT, DPT

If you are human, you likely have had a muscle cramp or “Charley horse” at one time in your life. Patients are often concerned about muscle cramps and why they occur.

I’ve often described muscle cramps as overuse, or just exercising a specific muscle too much. There actually is a little more to it.  When surrounding and associated muscles are weak, other muscles have to make up for that weakness and are helping these weaker muscles too much. This is what causes the cramp.

The definition of muscle cramp is a “sudden and involuntary contraction of one or more of your muscles. Can be painful and make it temporarily impossible to use the affected muscle.”

Muscle cramps are rarely serious and will typically disappear on their own.

The cause of muscle cramps is unknown and theories remain anecdotal and observed instead of sound experimental evidence.  Muscle cramps often occur in single, multi-joint muscles (calf, quadriceps, hamstrings) when they contract in an already shortened state.

COMMONLY DISCUSSED CAUSES FOR MUSCLE CRAMPING:

  • Muscle overuse/overload
  • Extreme fatigue
  • Dehydration
  • Muscle strain
  • Electrolyte imbalance
  • Neuromuscular causes
  • Exercise in hot/humid environments
  • Large sweat losses

TREATMENT AND PREVENTION OF MUSCLE CRAMPS

Most of the treatments and preventions listed in the table below are anecdotal and have only been observed to sometimes help decrease muscle cramps.  Only the shaded cells have been studied and found to be effective.  You should talk to your doctor before making any extreme dietary changes.

TREATMENT

PREVENTION

Moderate static stretching of affected muscle Proper fluid intake
Fluid replacement by mouth Electrolyte balance
Occasionally, intravenous fluid replacement Neuromuscular retraining
Ice/heat Decreasing exercise intensity
Body position Body position
TENS (Transcutaneous Electrical Nerve Stimulation) Night ankle dorsiflexion splints
Massage 1.8 L per hour of fluids
Compression garments 1 L of water/fluids 1 hour before competition
Physical exercise Balanced diet
Weight loss Plyometric exercise
Completely anecdotal treatments:

  • Ingesting mustard
  • Drinking pickle juice
  • Drinking sports drinks
  • Adding salt/sodium to drinks

 WHEN TO SEE A DOCTOR:

  • Cause severe discomfort
  • Are associated with leg swelling, redness or skin changes
  • Are associated with muscle weakness
  • Happen frequently
  • Don’t improve
  • Aren’t associated with obvious cause, such as strenuous exercise

COULD BE RELATED TO A MEDICAL CONDITION:

  • Inadequate blood supply (normally go away after you stop exercising.)
  • Nerve compression
  • Mineral depletion (not enough potassium, calcium, magnesium

References:

Behringer, M., Moser, M., McCourt, M., Montag, J., Mester, J.  “A promising approach to effectively reduce cramp susceptibility in human muscles: a randomized, controlled clinical trial.”  PLoS One.  2014; 9(4): e94910.

Miller, K.C., Stone, M.S., Huxel ,K.C., Edwards, J.E.  “Exercise-associated muscle cramps: causes, treatment, and prevention.  Sports Health.  2010; 2(4): 279-283.

 



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