Cramps and spasms are one of those rare and wonderful things that happen inexplicably and with no reason – and yet are one of the most debilitating and awful pains to endure. Nothing can ease the pain when a leg decides to lock up for no reason whatsoever as you are playing football, completing your marathon or swimming in the ocean in deep water far from shore. These issues come about with no warning and seemingly no indication that they are about to curtail your action and render you completely incapacitated.
So what is it that actually causes cramping or spasms? The truth is that no-one really knows for sure. It’s one of those wonderful cases of modern science where there are so many elements at play that no-one can definitively say that ‘this is the reason’ that cramps occur. There are lots of factors at play such as diet, heat, hydration, muscular tone and action. The truth is that because there are so many reasons, they all contribute to the nature of muscular health and how a muscle contracts or relaxes(or doesn’t) that any one or a combination of many factors can all contribute to muscular cramps and spasms.
What is it?
Spasms or an involuntary muscular contraction of muscle. Sustained periods of hypertonicity with the difference between whether it is a spasm or a cramp is minor enough to warrant grouping the two together to us lay people. For the sake of the argument, though you can have spasms internally in muscle (spastic constipation for example), we are dealing with the involuntary contraction of skeletal or voluntary muscle.
It is commonly held that there are 4 main causes of skeletal muscle cramping:
Nutrition – the balance between calcium and magnesium which are both used in the contraction of skeletal muscle, can and do influence muscle tone. Calcium is used in contraction, magnesium in relaxation of fibres. The delicate balance between both can result in an over supply of one or the other and this can result in tissues being unable to relax or contract due to levels of the nutrient being available. Other elements such as high carbohydrates in the diet means that magnesium can be depleted, or even not having enough ‘good fats’ in the body which drives calcium directly to soft tissue muscles so that the nutrient is available for use.
Ischemia – a lack of oxygen likewise creates a detrimental nature to muscular function. Oxygen is vital for muscles to function, relax and contract. A decrease in this element results in a gradual tightening of fibres as they try to create tension and find oxygen for function. This gradual process is most typical of muscular tissues and the resulting ‘locking’ is merely the last stages of this issue. Any tissue devoid of available blood supply is in danger of suffering from ischemia. Thus nervous system disorders and circulatory issues can contribute to cramping – even pregnancy with the fetus laying on the femoral artery which can cut off oxygenated blood supply to the lower limbs.
Exercise – this is by far one of the big elements in cramping/spasming and those images of athelets who suffer from cramping on long matches or events of extreme athletic prowess is well documented. Dehydration, hyperthermia (too much heat) and electrolyte imbalance may all be contributing factors though research does actually indicated that these types of cramps are actually associated with neurological abnormality (read nerves) that overstimulates and excites the muscle spindles and proprioceptors while inhibiting the nerve cells (golgi tendon organs) to stimulate relaxation of the spindles that make up muscular fibres.
Splinting – is concerned with traumatised muscles that have endured severe injury. This is the body locking up areas to prevent movement which may indeed cause further injury or issue. E.g Whiplash. The ligaments have been ‘severely overextended’ and the body senses imbalance and potential for injury, thus it spasms the interspinous and intertransverse ligaments to stablise the cervical spine as a protective mechanism.
With cramping, identifying the type of cramping and the nature of the cramp is primary. As in the splinting variety, if you are attempting to rectify a cramp that has actually has benefit to protecting the area then you may be harming the body. Similarly, by releasing a ‘splinting cramp’ you may only get temporary benefit and this may only result in the muscle re-cramping when movement occurs and sometimes as a worse condition than previously. Muscles unable to release spontaneously are very much in need of release and this can come down to electrolyte imbalance, nutrition etc as mentioned. However treatment of the area can downgrade the initial stage of spasm and assist with encouraging a generic release for short term benefit. Stretching tendons and antagonist muscles (braking muscles for an action) is by far the most beneficial way to deal with most cramps/spasms without causing further damage to fibres.
Remedies? Salt Drinks? Massage? How to treat.
Ideally cramps that are caused by nutritional imbalances need to be addressed with diet. However ingesting loads of Gatorade may not be the answer required. There can be a complex blend of factors at play and identifying which one becomes the real reasoning behind what to prescribe or administer for an athlete suffering cramps.
Sodium-potassium imbalance is a real culprit and can be directly related to over-training. Sodium needs to be re-absorbed by the kidneys. An overtrained athlete involved in anaerobic activity needs to balance adrenal fatigue with sodium loss. If Adrenal fatigue is the main contributing factor then salt tablets/sodium supplements may only be offering temporary solutions as the adrenals just keep stealing the sodium to maintain it’s own levels. High adrenal activity (often brought about by increased cortisol levels) is the real reason behind the cramping and needs to be addressed primarily.
Dehydration is more than just about getting water into your system. The consumption of food stuffs or food supplements moreso can be more harmful to your cramping muscles than helpful. When ingesting high glucose gels that many cyclists swear by, you can be drawing valuable water reserves out of the muscles and into the stomach to deal with the high energy needs for absorbing the glucose in the replacement gel. This leaves your limbs feeling fatigued and cramping as there isn’t enough water in the muscles.
Calcium and Magnesium are similarly important in preventing cramping. And it’s not just about taking supplements to keep them at high points. With this balance, if one nutrient is in vast quantities over another, the body will actually perceive a low level of the missing nutrient and this can result in cramping. Often brought about through female supplements of calcium to ensure bone health, this can interrupt the magnesium balance. High ingestion of calcium particularly combined with a high carbohydrate diet (that needs magnesium to support the break done of the carbohydrates) will leave an imbalance in the system and can thus create dramas of cramping particularly around menstrual periods.
In supplementation it is also very important to consider the type of supplement you are taking. In calcium supplementation, some people may be taking calcium carbonate supplements. These are not necessarily the most correct form of calcium supplement with calcium lactate or citrate, which is absorbed much more readily being more beneficial for the system. Acidic calcium is best as it is absorbed readily and not at the expense of other nutrients (such as water).
So as you can see, often there are many points to consider when dealing with cramping and spasms. If you are an athlete and suffering from cramps when engaged in training and performance, there is much more to consider than just tight muscles. There’s a delicate balance at play and most often there is a need to really consider all elements for optimal performance. Analysing dietary, health and soft tissue issues together, without prioritising one over the other is the best way to address cramps and the debilitating pain it can cause.
One size doesn’t fit all for cramping relief.