The causes of muscle cramps in athletes remain a controversial topic in the scientific world. There are competing theories about cramps, important studies and methods that can help relieve the symptoms.
The issue with cramps affected me in the past and led me through numerous experiments, all of which are explained in this article.
Although muscle cramps are a very common and widely studied phenomenon, nobody really knows the whole story about cramps. However, over the last ten years, I seem to have managed to control my cramp problems to a large extent. This has happened by modifying my diet and expectations of my body, based on what I've learned through a combination of reading and personal experimentation.
So what scientific explanations are there for the problem of cramps?
In the field of research, two main theories compete to explain the cause of exercise-related muscle cramps.
The Dehydration and Electrolyte imbalance theory and the Neuromuscular Theory.
The first and oldest one, the “Dehydration and Electrolyte imbalance”, suggests that a significant imbalance in the body's fluids or electrolytes, usually due to a decrease in total sodium reserves, causes a contraction of the interstitial fluid compartment around the muscles and a misfiring of nerve impulses, resulting in cramp.
In simple terms, if you lose a lot of sodium and don't replenish it (which is common when you sweat a lot), it can cause fluid changes in the body that lead to cramps.
The Neuromuscular Theory, is a more recent proposal which suggests that muscle overload and neuromuscular fatigue are the main causes of exercise-related muscle cramping. The hypothesis is that fatigue contributes to an imbalance between the excitatory impulses of the muscle spindles and the inhibitory impulses of the Golgi tendon organs, resulting in a localized muscle cramp. In other words, muscles tend to cramp specifically when they are overloaded and fatigued due to electrical misfiring.
An important factor that seems to support the neuromuscular theory is that stopping and stretching the affected muscles is a universally effective method for relieving a cramp when it is actually occurring. Stretching puts the muscle under tension, invoking afferent activity from the Golgi Tendon Organs (the part of the muscle responsible for telling it to relax) and causing the cramp to dissipate.
Regarding which theory has been more validated by the scientific community, the Neuromuscular theory likely holds more evidence. This is primarily due to the fact that researchers can control the testing environment, by ‘exciting’ muscles with electrical stimuli, and induce muscle cramps to measure what is happening at an electrical level. Consequently, there are more robust arguments supporting this theory compared to the Dehydration/Electrolyte Depletion model. However, it’s worth noting that there is a growing body of studies analyzing the impacts of electrolytes on reducing cramps.
It's important to note that some studies have established a link between cramps and low-sodium diets or inefficient sodium intake during sports practice. These studies have very effectively established this correlation. Today, the intake of electrolyte compounds containing sodium is widely recommended, always taking into account the individual characteristics of each athlete. There are athletes who are more or less prone to the amount of sweat produced and, consequently, to sodium loss.
So as Athletes in which way can we fight this problem?
Pickle Juice? fight fatigue or increase tolerance through specific training? Incorporate more sodium into your diet, especially during training and/or events? Are there any other strategies that could help us with this issue?
A bit of all of these.
I remember a few years ago, more than a decade ago, I used to struggle with cramps, especially during the first races of the year in the MTB Marathons. I developed various strategies and one of them was to arrive at these races in better physical condition by adapting my training to a sharper pre-competitive model. But until I came up with this answer, I found a small solution in pickle juice. I didn't drink it, I was just mouth rinsing and it worked, oddly enough. There were those who stuck pins in the muscle affected by the cramp… jesus…” I couldn't do that. I hate needles. I was buying pickles a lot in that time.
But what does Pickle Juice do? Partly connected with the emergence of the neuromuscular theory, there has been considerable interest in the use of compounds that can stimulate something in the mouth known as ‘transient receptor potential (TRP) channels’ and the potential effects these might have on cramping muscles.
TRP channels connect the mouth to the central nervous system, and the hypothesis is that stimulating these receptors somehow triggers a ‘shock’ reaction in the nerves that interrupts the signals causing a cramp.
So it’s believed that this is where the idea of using pickle juice to cure muscle cramps originates from. Pickle juice contains acetic acid, and it’s thought that this (rather than the high levels of sodium in it) stimulates the TRP receptors and helps alleviate cramps.
This is also consistent with the general idea that the root cause of some cramps is found in the nervous system, rather than being solely an electrolyte imbalance.
The sodium strategy
I believe it’s worthwhile to examine your sodium intake in relation to your sweat output. It’s a simple and inexpensive exercise with few downsides. It’s certainly a good idea if your cramps tend to occur during or after periods of intense sweating, in hot weather, towards the end of longer activities, or if you generally follow a low-sodium (or low-carb) diet.
However, a word of caution; if you decide to increase your sodium intake, especially in the form of electrolyte drinks, make sure they are strong enough to make a real difference. Most sports drinks are extremely low in electrolytes (despite the claims they make on their labels), containing only about 300-500mg of sodium per liter.
On average, human sweat contains more than 900mg of sodium per liter. Therefore, it’s a good idea to look for more than 900mg of sodium per liter in a drink and over 1300mg per liter if you suspect you are a ‘salty sweater’. Check this article.
If you’re consuming salt or sodium separate from your fluids, in foods or in capsule form, aim for a similar ratio (i.e., 900-1300mg of sodium along with each liter of water you drink).
Pre loading sodium could be also a strategy. Why not read this article, for this matter.
This well could be you’re solution. We tend to neglect qualitative hydration too much.
Other strategies
Fatigue also plays a role in cramps, so it’s logical to find ways to minimize it.
So training for the specific demands of the context where you want to compete. Beside this you should always know how is your fitness in the races and pace yourself accordingly.
A good taper is sometimes neglected.
A good a specific warm up to activate and create muscular coordination for the context.
There are few acclimatization strategies and protocols that could help our body thermoregulate more efficiently. The use of saunas, indoor training can also play a role.
Frequently get sports massage or the use of trigger point roller could help.
And of course, ensure you’re adequately fueled with plenty of carbohydrates before you start events and that you fuel adequately to avoid becoming glycogen depleted, which can contribute to premature fatigue.
The only thing worse than hitting the wall is hitting a wall... while simultaneously being seized by a leg cramp.
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