It is reasonable to question why muscle cramps appear in people that are not exercising at all, and if some at-rest muscle cramping has some of the same causes of exercise related cramping. Are all non-exercise cramps related to low serum levels of electrolytes? Are all of these traceable though blood testing? We don't currently know the answer to this question.
Looking at literature and combining research with coaching and racing experience, below are some of my conclusions specifically related to preventing inner thigh cramps.
? Hydration and electrolytes: Maintaining adequate (no excess in either category) levels of hydration and electrolyte balance won't hurt the athlete and are essential to good performance—even though science is showing that serum levels on both do not differ between athletes that cramp and those that do not, pre-and post-racing. I have not found any testing done at the actual time of cramping. Are those that cramp mid-race low on hydration and electrolyte status at the time of cramping, only to recover by the end of the event? Or where they not low on either at the moment of cramping? We don't know.
? Endurance and intensity: Training must include adequate endurance volume and intensities that will be experienced on race day. Athletes must have both components in training as one without the other seems to be related to cramping. This does not mean that race-day duration and intensity must be done together in a single workout prior to race day.
? Rest: Go into key races adequately rested. Accumulated fatigue seems to be related to cramping.
? Strengthen the adductor muscle group (adductor magnus, adductor longus, adductor brevious, pectineus, gracillis, psoas major, iliacus, gluteus maximus – lower fibers): Many triathletes and cyclists train by themselves and in a linear fashion. In other words, leg muscles have been training in a motion where the hip, knee and ankle are aligned in a single plane of motion. Race day brings an assortment of movements made up of dodging and weaving among other competitors or over obstacles (mountain bike). These motions are not typically seen during training, and they certainly are not seen at the same intensities as those on race day. Strength training the adductor muscle group, in addition to other hip extension muscles, seems to eliminate cramping for some athletes. At minimum, even if no strength training is done, high-intensity efforts and motions can be trained in lower-priority and perhaps shorter races.
? Stretching: If stretching is found to relieve cramps, perhaps a regular stretching program can help prevent them. This includes a focus on adductor muscles.
? Massage: A certified sports massage therapist can relieve muscle tension and help work knots out of muscle bellies. There is some research that finds massage (depending on the type and frequency) can improve markers for good health. Many athletes know a massage simply makes them feel better. Perhaps more research will prove the significance of the effects of massage for recovery, injury prevention and perhaps cramp prevention.
? Acupuncture: This practice rooted in Taoist tradition dates back over 8,000 years. The practice is thought to promote healing, improve circulation, decrease inflammation, relieve muscle spasms, and increase healthy T-cell counts. Some athletes have eliminated cramps, including muscle cramps in thighs, with this technique.
? Temper race-day stress: High levels of stress are known to stimulate the release of hormones in the body such as cortisol. Stress hormones are thought to affect metabolic processes and deplete energy stores. At least one study correlated very high performance expectations on race day with cramping. Learning to control race-day stress so that it remains a stimulant to performance rather than a hindrance is important. This stress reduction includes complete confidence in preparation.
Perhaps only half of the items on the list are key to certain individuals. If triathletes and cyclists accomplished all eight items listed in the prevention category, would cramping be completely eliminated?
We don't know.
Maybe future research can examine a range of other aspects of training and recovery that may affect the likelihood of cramping—in addition to blood markers before and after long endurance events.
Search for your next triathlon.
- Acufinder Learning & Resource Center; How Does Acupuncture Work?
- Biel, A., Trail Guide to the Body, Books of Discovery, Boulder, CO, 2005, pp 298-299.
- Mayo Clinic; Causes of Muscle Cramps
- MedicineNet; What are the Types and Causes of Muscle Cramps?
- Schwellnus, M.P. "Aetiology of skeletal muscle 'cramps' during exercise: a novel hypothesis," J Sports Sci. 1997 Jun;15(3):277-85.
- Schwellnus, M.P. "Cause of exercise associated muscle cramps (EAMC)–altered neuromuscular control, dehydration or electrolyte depletion?" Br. J. Sports Med., 2009 Jun;43(6):401-8. Epub 2008 Nov 3.
- Schwellnus, M.P., et al, "Increased running speed and previous cramps rather than dehydration or serum sodium changes predict exercise-associated muscle cramping: a prospective cohort study in 210 Ironman triathletes." Br J Sports Med. 2011 Jun;45(8):650-6. Epub 2010 Dec 9.
- Schwellnus, M.P., et al, "Factors associated with a self-reported history of exercise-associated muscle cramps in ironman triathletes: a case-control study," Clin J Sport Med. 2011, May;21(3):204-10.
- Rapaport M.H., et al, "A preliminary study of the effects of repeated massage on hypothalamic-pituitary-adrenal and immune function in healthy individuals: a study of mechanisms of action and dosage," J Altern Complement Med. 2012 Aug;18(8):789-97. Epub 2012 Jul 9.