Most everyone has experienced cramping during various athletic events or workouts. Often times we attribute cramping to be the result of dehydration or electrolyte imbalances, but there is some literature that indicates that this may not be the most appropriate theory. While the muscle is the tissue that experiences a cramp, it may not actually be the driver behind the cramp. Instead, literature generally accepts that cramping is actually nerve mediated, whether peripherally (nerves outside of the spinal cord) or centrally (spinal cord/brain) driven is still up for debate. What is evident though, is that cramping and fatigue normally go hand in hand.
Imagine you’re running a race, normally we feel pretty good in the early stages of that race and begin to fatigue near the end. When we fatigue our form breaks down and we have to drag ourselves across the finish line, often experiencing early symptoms of a cramp or a full-blown collapse-to-the-ground-cramp. The explanation for some of these exercise related cramps actually comes from the idea of neuromotor control. When our muscles fatigue there is normally miscommunication between nerves. Essentially the nerves that tell the muscle to work harder over-power the nerves that tell the muscle to calm down, resulting in over excitability of the nerve causing cramping to the muscle.
So what to do when we get a cramp? Normally people resort to stretching and drinking fluids, which have been shown to be effective, but may not be getting to the root of the issue. Some more recent literature even indicates that capscaicin (the spicy ingredient found in peppers) is effective in stimulating the nerve thus calming it down to stop cramping. But ultimately if we understand that cramping can be the result of neuromotor fatigue, we must also understand that neuromotor endurance is key in preventing fatigue that feeds into cramping.
Improving neuromotor control and endurance comes from thousands of repetitions of quality form and technique when performing an athletic movement. However, it is often difficult to self-regulate our form, and even harder when we are fatigued. This is where getting a quality movement-based examination may help. Physical therapists who perform in-depth movement analysis examinations would help identify any potential faulty movement patterns that may contribute to less than optimal performance. From there, your physical therapist will give you targeted exercises and cues to help you perform and self-regulate these movements better, ultimately leading to more efficient muscle contraction and potential riddance of pesky cramps.
Jake Reynolds is an orthopedic physical therapist at Funcitonize Health and Physical Therapy. He specializes in treating athletes, both elite and recreational level, with expertise in swimming and running athletes. His methodology includes a whole body approach, helping individuals find the source of theirs symptoms by understanding their story and addressing the entire system and not just one specific body part. Jake received his Bachelors in Exercise and Sports Science from the University of Alabama, completed his Doctorate in Physical Therapy at Mercer University, where he also completed his residency in orthopedics. Areas of personal interest include sports, pain science, neurodynamics, manual therapy, and clinical reasoning.
Minetto MA, Holobar A, Botter A, Farina D. Origin and Development of Muscle Cramps. Exerc Sport Sci Rev. 2013;41(1):3-10