Cramping your style

WHEN CRAMPS ripped through lallemands legs he knew he was in trouble, EAMC can attack anyone but it can be prevented SAYS SHAUN HORROCKS

 

 

 

 

It was Five hours into The Ziyuan 24hr adventure race in China last August, when it hit and hit hard, Julien Lallemand’s entire right leg cramped up. Literally throwing him off his bike. ‘It felt like being knifed (in the leg) an open slash/sliced from knee to hip’ says Lallemand. He had been pushing it hard to stay with the leaders and couldn’t understand how one minute he was on his bike and the next on the ground doubled up in pain.

He had been training hard for this his first multi disciplined adventure race, putting in an average of 12-14 hours a week, running, swimming, and his greatest love mountain biking. “We had been training intensely, gradually building up our hours and our speed, but never as fast as we did on race day” says Lallemand.

As the first of the cramps subsided, he climbed back onto his bike and tried to catch up to the leaders, to make up some of the valuable time he had cost his team. But soon and without warning he suffered another even more excruciating attack of the cramps. There was nothing for it but to stop and try to ease the pain. “At first my race partner would thump my leg as it was knotted up, trying to get blood to flow, then he would deep massage the muscle and try to straighten the leg.” He continues” it happened every twenty minutes or so my leg would cramp whenever I went fast in low gear, high cadence or when I hit a pothole the shock would set one off.”

“It was intense, basically imagine having a root canal without anaesthetic.” He pauses a moment in recollection then adds “something I have experienced once. “ then laughs. He goes on to explain how at the time “It was really that intense but you know its going to stop eventually, but at the time all you can do is fall off the bike and scream.”

Lallemands experience is not unique; cramps are common among endurance athletes, marathon runners, tri-athletes, cyclists and particularly susceptible are ironmen competitors and adventure racers, who are generally stronger in one of the many disciplines that they must do in each event. And especially when they have been pushing themselves hard.

Exercise Associated Muscle Cramps (EAMC) according to Martin Schwellnus a professor from the University of Cape Town, UCT/MRC Research Unit for Exercise Science and Sports Medicine, is “ a painful, spasmodic, involuntary contraction of skeletal muscle that occurs during or immediately after exercise.”

There have been several theories proposed over the years as to why athletes suffer EAMC. The oldest dating back as far as the 1930’s but a recent study conducted by Schwellnus and associate Professor Tim Noakes may once and for all establish the true reasons as to why some athletes suffer more than others.

The first and most obvious of the theories proposed was dehydration. This would seem to make sense, especially in the hot and humid climes of Asia. Depending on the intensity of training an athlete can lose more than two litres of sweat per hour. Resulting in a reduction of body mass, blood becomes more viscous that depletes the muscles from oxygen. The intense exertion would also lead to a decrease in concentration of sodium, potassium, magnesium, chloride, calcium and other vital electrolytes. This imbalance of electrolytes and salts has also been put forward as a reason for cramping. Another theory is environmental stress, when an athlete is not fully acclimatized to the heat or altitude.

The above theories may bare some relevance as to why some athletes suffer EAMC, but they cannot be the only reason for cramping otherwise fully hydrated and acclimatized athletes would never suffer, which is not the case.

Schwellnus and Noakes believed that EAMC was brought on by increased spinal reflex activity, what would later become known as the neuromuscular theory.

With the help of athletes taking part in Cape Towns South African Ironman and the Two Oceans Ultramarathon they were able to garner volunteers, some with prior experience of EAMC and others that had never previously suffered. In the controlled research experiments all volunteers were weighed pre and post race. Blood was taken to access any electrolyte imbalances. And most importantly a Surface electromyography (EMG) – an instrument that records the minute electrical discharges of the muscles.

The volunteers where then split up into two groups, those who cramped and those who didn’t. The data was then compared Both groups data showed that they had similar body mass loss post race and that there was hardly any significant difference between the two groups electrolyte levels and blood counts.

The breakthrough came when they studied the EMG readings of the cramping group they showed an increased and sporadic muscle ‘twitchiness’ when compared to the non-cramping group. These increased EMG activity levels meant only one thing. That somehow abnormal muscle reflexes were behind EAMC. Finally they had enough evidence to produce a research paper.

The understanding now is, at the end of each muscle there are groups of neuron receptors called muscle spindles and golgi tendon organs (GTOs). These little guys are responsible for sending electrical signals from the spine to the muscle telling them when to contract and expand. When these receptors become over taxed, for example when your pushing it that little bit too hard they become fatigued, the muscle spindle activity becomes increased causing the muscle to contract, while the GTO’s are inhibited they cannot tell the muscle to expand, causing an imbalance of signals that lead to severe cramps.

Knowing the physiology is all well and good but to how prevent cramps. The solution seems to be as simple as starting a regimented stretching programme. Slowly stretch warm muscles for five to ten minutes prior to exercise. Never stretch cold muscles as you may damage them. More importantly, stretch after exercise. By strengthening your muscles connective tissues ypu will reduce the chance of cramping. A well-stretched and loose muscle can make all the difference when it comes to being competitive.

Once it strikes, what to do

You’ll know when you get the cramps the muscle tightens and the pain is excruciating. You may think that you can run through a cramp. Don’t, this can damage the muscle. Slow down, not that you will have much choice! If the pain persist or increases stop. Most cramps can be eased by a gradual stretching of the muscle. If you are suffering leg cramps and there is a wall handy, stand about two to two and half feet away then place your hands on the wall and lean into it while keeping your heals on the floor. Another good solution is to lie on the floor keep the legs straight and then pull the toes forward towards your head. It will hurt but the pain should eventually subside. It is a good idea to get a race partner to apply a gently but firm pushing pressure to the foot otherwise you may not get enough pressure.

Another good technique is to gently massage the cramping muscle to encourage blood flow,, hold the cramping muscle tightly for approximately fifteen seconds, release for fifteen then reapply until cramping as stopped. It is best to practice beforehand so that you will know what to do if the need arises

After a boat of the cramps slowly build up your speed again, give the time for the muscles to start working again. Don’t go rushing back at full steam otherwise the muscles will fatigue quicker an bring on the cramps again.

Prevent it

The reasons for EAMC may still be under some debate, but the question of how to prevent them, here all the experts do agree. By following these basic principals below you will be able to reduce the chance of having to suffer an attack of the cramps:

Stretching – the singularly most important thing you can do to prevent EAMC, is starting a regular stretching regime and more importantly knowing how to stretch your muscles properly. It is not only essential in the prevention of cramps but also reduces the risks for a plethora of other injuries (see side bar on how to stretch). According to Schwellnus lack of stretching or improper stretching "lead to an exaggerated myotonic reflex, thereby increasing spindle activity."

Take up yoga or plyomentrics: the gradual stretching of the muscles and tendons build up strength and coordination. It also helps to loosen tight muscles.

Core training – having a strong core and flexible torso means that the small muscles in the lower back wont fatigue as quickly meaning posture will stay strong and the larger muscles wont need to take up the slack.

Get ready – being physically and mentally prepared for your next race is important, make sure you have adequate training for the kind of conditions that you will experience, this is especially important if you are about to do an adventure race or other endurance event.

Avoid fatigue – muscles have memories and depending on how you train, your muscles will act accordingly. There is no point pushing your body too hard and too fast if it is not used to it, this will only fatigue the muscles and induce cramping. Gradually build up to race pace and train to the distances that you will be covering. Train at race pace at least once a week so that your muscles now what to do.

Acclimatize – your body may take up to a week to acclimatize to different environments, if your travelling to a destination that is substantially hotter or more importantly more humid or at a higher altitude than your used to give your body time to adjust.

Stay hydrated – although this new theory indicates fluid loss doesn’t contribute to EAMC it is always good practice to stay hydrated. Try to drink about 200- 400ml in small sips every twenty minutes or so, a camel pack is ideal for this.

 

 

 

 

 

Alternative remedies

GETTING PICKLED

Maybe the colonial Brits were onto something when they introduced the sundowner Gin and tonics to hot and humid Asia. Known for its anti malarial qualities, the quinine that’s in the tonic may also ease cramps. Apparently drinking between four to eight ounces of tonic water about an hour before exercise can reduce cramping. There is no scientific evidence to support this theory but people seem to think it works. The reason being, quinine decreases the excitability of the muscles. But be warned too much quinine can be deadly so take it easy in those G&T’s.

The Philadelphia Eagles of Americas NFL have a secret weapon when it comes to playing in the heat. Their coach gives the players a shot of pickle juice before each game! Although there is no scientific reasoning behind this old folk remedy Dr Richard Williams a professor in Health and Physical education at the University of Northern Iowa swears by it. He has found that a 2oz shot 10 minutes before arduous exercise to his athletes he trains prevents cramps. It is also reported to be effective against chronic attacks during exercise, one shot relieving symptoms of EAMC within 15-30 seconds, and more importantly apparently they don’t come back!

Williams believes it has something to do with the vinegar (acetic acid) and the salts found in the juice. The acetic acid helps the body to produce acetylcholine, a chemical that can stimulate the muscles neurotransmitters.

The same can be said for mustard whether its French or English, yellow mustards are rich in acetic acids and salts and according to Dr. Robert Agee of the Alabama Sports Medicine Institute, one packet of mustard washed down with water every two minutes while the athlete is cramping will quickly ease the pain.

IT'S A PINCH

One very unusual remedy that seems to be enthusiastically encouraged by some is the pinching of the upper lip just underneath the nose firmly for 15minutes. Why or if this works is anybodies guess. Maybe the pain from the lip distracts from he cramping, highly unlikely but if your out on the trail and you’ve forgot your pickle juice or mustard it may be worth a pinch!

BARKING MAD

The bark of the French maritime pine tree (Pycnogenol®) seems to have many beneficial properties from helping asthma to easing chronic venous disease. Studies conducted over the last three years at L’Aquila University in Italy and at the University of Würzburg in Germany and released in the June 2006 issue of Angiologyshowed that taking 200mg a day of the supplement can reduce EAMC by up to twenty five percent.

With little or no scientific evidence to back these claims up you have to wander about their validity, but if they appear to be working and most importantly are safe. They may be an option if all else fails!