SKELETAL MUSCLE CRAMPS
DURING EXERCISE
The most commonly seen ailment
at marathons and triathlons is skeletal muscle cramps. The
causes and treatment of this physiological phenomenon
has not been completely defined. Many conditions
can elicit muscle cramps, such as congenital abnormalities
or neuromuscular diseases, but in athletes the condition
is usually exercise-associated. Establishing a thorough
medical history is the most effective way to determine
if the cramps are exercise related or the result of
another medical condition.
Muscle cramping due to exercise
is a spontaneous, painful, and involuntary contraction
during the course of, or at the cessation of exercise. Exercise-associated
muscle cramping does not occur in resting skeletal
muscle.
The concern with muscle cramping
first appeared in the early 1900’s with reports
of persons cramping in hot and humid conditions, such
as coal and steamship workers. This led to the
current thought that bodily hydration, or lack of,
and the environment play a key role in the occurrence
in muscle cramping.
Recent theories suggest that exercise-associated
muscle cramping is due to a neurological short circuit. It
is posed that the "abnormality of sustained alpha
motor neuron activity, which stems from aberrant control
at the spinal level." Tired muscles cause
the muscle spindle to be continually stimulated therefore
causing the inhibition of the Golgi tendon organ to
shut down the activity.
The muscles must commonly affected
are ones that cross two joints. During activity
two- joint muscles, such as the calf and hamstring,
are in a shortened position during contraction. "Contraction
in this state produces decreased tension in the tendons
of the muscles as well as decreased Golgi-tendon activity."
The best way to decrease muscle
spindle excitation is passive stretching. It
helps to eliminate to cramp and increase Golgi-tendon
activity thereby inhibiting the constant excitatory
response. This treatment follows the theory of
abnormal spinal reflex activity.
This indicates that stretching
is an important factor in eliminating exercise-associated
muscle cramps and that endurance events such as running
can quickly tire muscles, which may lead to cramping.
Exercise-related cramps often present
themselves with significant discomfort and a muscle
belly that is hard to the touch from continuous contraction. Athletes
do not usually show any other signs of physiologic
distress, either dehydration or hyperthermia.
The most effective treatment for
exercise-associated muscle cramps is stretching of
the pertinent muscle or muscle group. It is best
to hold the stretch until the cramp subsides and is
released. If the cramps continue or are extremely
severe then further medical treatment should be sought. It
should be explained to the athlete that if they experience
any other symptoms such as lack of urination or unusually
colored urine they must get medical attention immediately.
The best way to decrease the risk
for muscle cramping during intense exercise is good
conditioning, proper stretching, and proper nutrition
and fluid intake. The best offense is a good
defense.
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