Exercise associated muscle cramps are skeletal muscle cramps that occur during or shortly following exercise in healthy individuals with no underlying metabolic, neurological, or endocrine pathology. It could affect single or multiple muscles.
Exercise-associated muscle cramps are common in both the recreational and the competitive athlete.
Causes of Exercise-associated muscle cramps
The cause is unknown. Dehydration and/or electrolyte imbalances and neuromuscular causes have been suggested.
It is unlikely that a single factor is responsible and the combination of factors are responsible.
Two theories that have been presented are dehydration–electrolyte imbalance theory, and neuromuscular theory.
First theory proposes that exercise-associated muscle cramps are the result of fluid and electrolyte depletion, which results in the sensitization of select nerve terminals.
The neuromuscular theory proposes that muscle overload and neuromuscular fatigue cause an imbalance between excitatory impulses from muscle spindles and inhibitory impulses from Golgi tendon resulting in enhanced excitability at the spinal level results
Both the theories have not been proven and have their limitations.
Clinical Presentation
Exercise-associated muscle cramps are recognizable by acute pain and stiffness that occurs after the exercise. There could be visible bulging or knotting of the muscle, and soreness that can last for several days.
Treatment of Exercise-associated Muscle Cramps
Because there is a dearth of experimental data and the causation has not been defined, the specific treatment is not available, only empirical approaches, many of which are anecdotal and unsupported by experimental research.
These include sports drinks, cryotherapy [cold application], thermotherapy [heat application], massage, decreasing exercise intensity, intravenous infusion, and transcutaneous electric nerve stimulation therapy.
Other treatments include ingestion of plenty of fluids, up to 2 liters per hour during the training,
Stretching, quinine, and beta-blockers have been used with stronger levels of evidence.
If the athlete has no underlying illness, then the most common treatment for exercise-associated muscle cramps is stretching.
Prevention of Exercise-associated Muscle Cramps
Maintaining hydration and adequate electrolyte levels is a good prevention strategy for individuals susceptible to exercise-associated muscle cramps though there is not enough evidence available.
Fluids should be available and easily accessible throughout practices and competitions. A balanced diet, plyometric exercises may be beneficial.
Endurance training may also serve as an effective means of preventing exercise-associated muscle cramps by expanding plasma volume and delaying neuromuscular fatigue
References
- Bentley S. Exercise-induced muscle cramp: proposed mechanisms and management. Sports Med. 1996;21:409-420
- Bergeron M. Muscle cramps during exercise: is it fatigue or electrolyte deficit? Curr Sports Med Rep. 2008;7: S50-S55
- Bye A, Kan A. Cramps following exercise. Aust Paediatr J. 1988;24:258-259
