Muscle cramps

A muscle cramp can be defined as an involuntarily and forcibly contracted muscle that does not relax.

What are muscle cramps?

A muscle cramp can be defined as an involuntarily and forcibly contracted muscle that does not relax. The cramp is experienced as a sudden tight intense pain that most commonly occurs in the extremities, such as the hands, feet and particularly the calf muscles, causing palpable or visible hardening of the involved muscle. It is not uncommon for a cramp to occur multiple times before going away. The cramp may involve part of a muscle, the entire muscle of several muscles acting together. Any of the muscles that are under our voluntary control (skeletal muscles) can cramp.

The occurrence of cramps is extremely common and increases with aging. Cramps are temporary events and usually do not lead to serious problems. Should they be severe or occur regularly, or fail to improve with simple treatment, you need to see a doctor.

Causes

Muscle cramps are caused by hyper-excitability of the nerves that stimulate the muscles and there are various factors that may contribute to the condition:

• Injury - persistent muscle spasm may occur as a protective mechanism following an injury
• poor fitness (muscle fatigue)
• rest cramps
• strain or overuse of a muscle
• exercising at high workloads, too little stretching
• dehydration especially when sodium losses are high
• dehydration in seniors due to poor fluid intake
• low blood levels of potassium or magnesium
• creatine use (reported from athletes)
• health problems, such as a spinal cord injury or a pinched nerve in the neck or back
• various medications can also lead to cramps

Symptoms

Muscle cramps range in intensity from a slight tic to agonising pain. A cramping muscle may feel hard to the touch and/or appear visibly distorted or twitch beneath the skin. A cramp can last a few seconds to 15 minutes or longer. It might recur multiple times before it goes away.

How to treat muscle cramps

• Stop doing whatever activity triggered the cramp.
• Stretching or gently massaging the muscle can relieve the pain.
• Apply gentle heat to tense/tight muscles, or cold to sore/tender muscles.
• If the cramp is due to fluid loss, fluid and electrolyte replacement is essential.

When to see a doctor

Should the cramps be severe or occur regularly, or fail to improve with simple treatment, you need to see a doctor.

Prevention

Practical tips:

Allow for adequate recovery and rest for muscles after hard training:

• Stay well hydrated during exercise but don't overdo it.
• Sports drinks (5-7 percent concentrations) are a good option since they empty from the stomach far quicker than more concentrated solutions or soft drinks (generally 10 percent concentration) and sports drinks help to replace sodium losses.
• Adopt a pattern of drinking small amounts of fluid at regular intervals during exercise rather than trying to drink large volumes all at once.
• Eat salty foods - Marmite sandwiches, pretzels, biltong and salty crackers.
• Breathe with the diaphragm, strengthen the abdominals and stretch. Progressively increasing the intensity and duration of your training will also help prevent stitches and cramps.

(Health24, February 2008)