The Muscle Cramps Guide
You won’t need a diagnosis to know when you’re having a cramp. It usually happens in one of the legs, and to say the pain is severe is an understatement. Cramps are very common in athletes and seem to occur more in hot, humid playing conditions than in other weather conditions. As bad as they hurt, they are not long-term sports injuries and they usually subside within a few minutes.
One of the problems dealing with cramps is that they tend to recur after the initial muscle spasm has returned to normal. In athletes with recurring cramps, some modifications in training (becoming acclimated to the exercise environment) and diet (more fluids and a better balance between fluids and minerals—salt, potassium, magnesium and calcium—lost in perspiration and those taken in) may be needed to provide a long-term solution.
How They Happen
There are several theories but no absolute explanations regarding how or why muscle cramps occur in athletes. They probably develop for different reasons in different people and are the result of a combination of factors, but according to Dr. E. Randy Eichner, team internist for the Oklahoma Sooners, the common denominator seems to be "salty sweating."
Among other possible causes are muscle fatigue, heavy exercise, dehydration and dietary mineral deficiencies—especially salt. A typical scenario is a football player who develops a cramp early in the season, late in the game or practice session, with fatigued muscles and playing in hot weather. It’s a perfect storm for cramps. Another is a tennis player (again early in the season, perhaps his or her first tournament of the year) toward the end of a match, stressful conditions and hot, humid weather. By the time all of those factors come together, it may be too late to correct the problem on the spot.
By the Numbers
The percentage of the general population that develops muscle cramps
The percentage of muscle cramps that involve either the quads, hamstrings or calves, according to one study
Who’s at Risk
Athletes who play outdoors in hot, humid conditions and sweat a lot are the most susceptible. Football players are the prime example, but tennis players, soccer players, field hockey and lacrosse athletes are at risk because of the nature of their sports and the time of year they usually practice and compete. Basketball players who train hard, are not well hydrated and play in gyms that are not air-conditioned are also targets for muscle cramps.
- Sudden, involuntary muscle contractions or spasms
- A hard knot of muscle tissue that may be visible beneath the skin
- Extreme pain
- Massage or put pressure on the area.
- For cramps that last off and on for several days, apply cold packs for 15-20 minutes, 3-4 times a day for several days.
- Use moist heat or warm baths later, 20-30 minutes at a time, several times a day.
- Gently stretch the affected muscle or muscle group (for a calf cramp, try putting your weight on the affected leg and slightly bending your knees).
Start a diet and hydration program that includes plenty of fluids and salt.
Incorporate these these prehab exercises into your comeback routine:
1. Soft Tissue Massage
- Gently massage major muscle groups with a foam roll before and after activity, especially those prone to cramping.
2. Gentle Active Stretching
- Use the muscle on the opposing side to stretch the cramping muscle. For example, with a cramp in a hamstring, lie on your back with your legs straight, keep one leg on the ground and lift your other leg up toward the ceiling.
How to Avoid It
- Drink a sports drink containing 6-8 percent carbohydrate to help give you more energy during intense training and long workouts.
- Drink a beverage that contains a small amount of sodium and other electrolytes (potassium and chloride).
- Drink 10-16 ounces (two cups) of cold fluid about 15 to 30 minutes before workouts.
- Drink 4 to 8 ounces of cold fluid during exercise at 10 to 15 minute intervals.
- Practice drinking fluids while you train. Use a trial-and-error approach until you find the drink that works for you.
- Give yourself as much time (preferably 1-2 weeks) to acclimate yourself to the environment in which you will train or compete.
Incorporate these movement prep exercises before and after exercising:
- Soft Tissue Massage
- Active Isolated Stretching: Calf, Quadriceps / Hip Flexor, Adductor / Abductor, IT Band / Glute
- Any Movement Prep Activity (5-6 reps per side)
- Knee Hugs
- Leg Cradles
- Forward Lunge Elbow to Instep
- Inverted Hamstring Stretch
- Drop Squats
- Lateral Squats
- Backward Lunge + Twist
Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.
- Jennifer Lewis, PT, DPT, ATC, Performance Physical Therapist, Athletes’ Performance, Phoenix, Arizona
- Cornell University Athletics
- Gatorade Sports Science Library
- The Science of Sport
- University of Michigan Health System