25 questions about cramp
1. What is cramp?
Usually not all fibres in your muscles are active at the same time. While
part of the fibres contracts the rest "takes a rest". The "working" and "resting"
alternates at high frequency. This way a muscle can continue performing over
a longer period of time.
Cramp is a sudden, involuntary contraction of all muscle fibres of a muscle,
mostly during or after intensive training.
2. How does cramp develop?
Muscle cramps occur when sinews that make the muscles contract, respond
wrongly and send too many signals to contract. Sometimes a muscle cramp
occurs without obvious cause but most of the times, the cause can easily be
found.
3. What is the cause of cramp?
The phenomenon of cramp is still not entirely clear. Possible causes are:
*Disturbed supply of blood with a shortage of oxygen in the muscle as a
result by, for example, wearing too tight stockings.
* Low glucose (sugar) levels in the muscle.
* Salt shortage because of a low-salt diet.
* Loss of water (extreme sweating), which could lead to a disturbed balance
of electrolytes.
* Overloading (exhaustion) by e.g. insufficient conditional training.
* Tiredness.
4. Where could I get cramps?
In principle you can get cramps in every muscle. There are certain "favourite"
muscles though. Most common is cramp in calf, foot, shinbone muscles and
hands. With gymnasts cramps occasionally occur in the toes. Cramps can occur
in other muscles as well, for example in the jaw and even in the sphincter
muscle of the eye.
5. How do I recognize a cramp?
The muscle will feel hard and tense and is rather painful. Moving is
difficult and no swellings or bruises are visible.
6. Can I do something about
cramp?
First you should check if it really is cramp. Sometimes a whiplash in the
calf could look like a cramp. If in this case you start stretching the
muscle you only increase the damage.
7. If it really is cramp, what next?
With cramp it is important to break the occurred reflex so that the muscle
fibres will return to their normal pattern of contracting and relaxing. This
can be done best by trying to stretch the affected muscle. Because
stretching is hard on "toe cramp" one could switch to "rubbing and squeezing"
of the area to break the reflex.
8. How should I stretch?
Stretching is done by elongating the muscle. For example: if you are having
a cramp in your calf muscle you could try moving your foot upwards. On cramp
in your foot you can move your toes upwards.
9. Could I just give a good pull?
No, in no case. Stretching muscles should always be done carefully and
without "bouncing". With quick movements comes the risk of muscle rupture in
the end.
10. I am not that lithe that I can reach, legs stretched, all the way to my
toes.
In that case you can pass a towel under the ball of your foot (legs
stretched). Take both ends with your hands. Pull the towel with your arms,
carefully, so as to lift your toes. You could also ask someone to assist you.
11. Does massage help against cramp?
Yes. When the worst cramp is gone, massage could help increase blood flow
and further restore peace in the muscle. If the cramp is caused by heat and
dehydration one should not do massage.
12. How do I do massage?
Self-massage is difficult. More convenient is when someone else, with calm
strokes, massages the muscle. One starts at the "furthest" point of the
muscle and works his way to the centre. To let the hands go smoothly across
the skin, massage oil is needed. This way, one can massage for 5 to 10
minutes.
13. Do (warmth) rubbing oils work?
No. The warmth medicine only get to the skin and will not reach the muscle.
It could even work in opposition because the blood that is needed for the
muscle will be transported to the skin. It is true on the other hand that it
will feel better and provide some diversion.
14. What else could I do
against cramp?
It could help to warm the muscles by means of warm clothing (leg warmers), a
hot pack or a visit to the sauna. If the cramp is caused by heat and
dehydration all this is of course not an option.
15. What is a hot pack?
A hot pack is the counterpart of the cold pack. It is a plastic bag with
liquid. After having put this in the microwave or in hot water it can be put
to the muscle where it will share its heat.
16. Could I return to my activity right again?
It is advisable to quit the exercising activity because the risk of the
cramp reoccurring is definitely there.
17. Are there any risk factors?
I named a few in the causes part. Another well-known risk factor is too low
a water temperature for swimmers. In their case, too stiff or flippers that
do not fit properly could also cause cramp.
18. What should I do if I get cramp while in the water?
In any case, do not panic. Best thing to do is to try and swim ashore or to
stretch the muscle while floating on your back. Never take on longer
swimming routes without assistance or buddy.
19. What about minerals and supplements?
Anyone thoughtful about his diet will not suffer from mineral shortages. It
could happen though that the balance is temporarily disturbed by exhaustion,
dehydration or heat. Regularly complementing the body fluids, sugar and salt
in endurance performance is wise, from this point of view.
20. Is there any good in calcium and magnesium?
If you are suffering from cramps very often you can, in consult with your
physician, choose to complement your diet. The physician will take a blood
sample for research and look for shortages.
The methods and need for this are subject of an ongoing discussion these
days.
21. If dehydration is the cause, how much water should I be drinking?
Two litres a day at least and also before and after an endurance
performance. Preventing thirst is the point. If you are feeling thirsty it
is too late already and you can no longer "drink in". Loss of performance is
immanent and the risk of cramps is increasing.
22. I am a creatine-user, does that add to the risk of cramp?
Sometimes creatine-users get cramp in their muscles. This cramp is caused by
water shortage. Creatine-users should drink more water than non-users.
23. I only suffer from cramp at night.
You can try to prevent nightly cramp by relaxing your muscles well before
you go to sleep or by going for a short walk. Pre-warming the bed could also
work as a prevention.
24. Is cramp always innocent?
Not always. A less innocent form is the calf cramp that occurs with older
people during walking; so-called "window legs". This is caused mostly by
narrowing of the blood vessels to or in the leg due to arteriosclerosis (hardening
of the arteries). Arteriosclerosis develops from smoking and collecting of
fat (like cholesterol and sugar) in blood and connective tissue. With
sportsmen this is not very common because they do not smoke. Isn't it?
With swimmers and divers cramp is naturally also not without risk.
25. Can I do something in prevention?
Before training or competition you could do a nice warm up and afterwards a
good cool down with stretching exercises. Do not train harder than your
condition allows. Drink extra water every now and then. And especially:
listen to your body, that is your best advisor.
Arie Meijboom
Sportmassagepraktijk Meijboom
Castricum
http://www.blessure-aanwijzer.nl
1 maart 2004
Translation by Maaike de Wijs
