At mile 18 of the Shamrock Marathon last March, Scott Young's right calf began to cramp. The sharp pain came and went for the last 8 miles of the race. "The worst cramp nearly doubled me over just as I crossed the finish line, keeping me from finishing the race with my head up," says Young, 51, a social worker who lives in Virginia Beach, Va. Needless to say, Young's finish-line photo left something to be desired.
His experience is common to runners. Muscle cramps are disabling, involuntary spasms that often occur during exercise or competition, most often in the large muscles of the lower leg. Although, be aware: They can hit anywhere.
And once you've had these cramps, you never forget them. "Every time I go out for a long run now, the fear of cramping is always in the back of my mind," says Young.
Causes
Muscle cramps are one of the most common medical complaints from athletes during endurance events, especially marathons and triathlons, according to Martin P. Schwellnus, M.D., professor of sports medicine at the University of Cape Town, in South Africa. No one really knows for sure what causes them, and there is ongoing debate on the subject. The theories are varied and range from excessive heat, dehydration, and the loss of electrolytes, to muscle fatigue, insufficient training, and poor stretching habits. The newest theories focus on the interaction between nerves and muscles."What causes muscle cramps? Sweat and dehydration," says Rachel Miller, P.T., a physical therapist in Chevy Chase, Md. The theory she espouses goes like this: During a marathon or other endurance event, your muscles are working constantly, and thus your body temperature rises. To lower it, you begin to sweat, but this leads to a loss of body fluids and electrolytes, which means your blood volume decreases and your heart rate increases. All of this reduces the body's ability to dissipate heat, which accelerates fatigue and takes its toll on our muscles. Result: they cramp.
But other experts beg to differ. "In all of our studies, we have never found dehydration to be associated with cramping," says Dr. Schwellnus. A study of 1,300 marathon runners conducted by Dr. Schwellnus and Tim Noakes, M.D., medical director of Ironman South Africa, indicated a number of risk factors for muscle cramps including older age, longer history of running, higher body-mass index, shorter stretching time, irregular stretching habits, and a family history of cramping. Exercise-related conditions, such as hard racing, long-distance running, muscle fatigue, and hill running also contributed to their developing muscle cramps.
Prevention
Despite all the debate on causes, experts do agree on several steps you can take to reduce your cramping risk. Try these five strategies.1. Take time to stretch. And you should pay particular attention to the muscles that are most prone to cramping. Stretch those muscles gently but thoroughly.
2. Train appropriately for every event. This is especially important for marathoners. On race day, running much faster or farther than you've trained will simply overwhelm your muscles and make you susceptible to cramps.
3. Prepare your body for the elements. If you live in a dry climate, for example, don't decide to run a marathon in an extremely humid city, unless you give yourself ample time before the race to become accustomed to the steamy conditions. This can take up to a week or more.
4. Keep a sports drink handy. Though experts don't know for sure if dehydration causes cramping, it's still important to stay well hydrated when you run. And it may lessen the severity of any cramps you do develop. So, about an hour or two before you run or race (depending on your tolerance), top off your tank with 16 ounces of fluid. Then take in between 5 and 12 ounces of fluid every 15 to 20 minutes during the run. And make sure your fluid of choice contains electrolytes since these salts can help prevent cramps.
5. Hop to it. Try some leaping, hopping, or skipping drills otherwise known as plyometrics as part of your regular training. Such exercises can improve muscle-nerve coordination, strength, and help loosen tight muscles.
Treatment
Even if you follow all of the above precautions, cramps may still strike during a race. Then what?1. Stop running immediately and stretch the affected muscle. This helps relax the spasm. You may have to stop and stretch a number of times before the cramp abates.
2. Apply deep pressure at the site of the cramp to provide relief. Just use your fingers to press into the affected muscle and hold for 10 to 15 seconds.
3. Drink a fluid with electrolytes. Sports drinks that contain electrolytes can help resolve cramps as well as prevent them.
4. Slow down for awhile. To keep a cramp at bay you need to take the stress off your muscles, so back off a bit. Besides, when a cramp hits, you may not have a choice.