By Kathleen Choate, ATC, CSCS, CEAS
Athletic Trainer
MUSC Health Sports Medicine

Most of us have seen it or felt it. We see an athlete go down on the field with an injury during a game. The athletic trainer runs out, lifts the leg, pushes the toes back, and starts massaging the calf. This athlete is likely a victim of exercise associated muscle cramps (EAMC) and can cost players valuable playing time. Many players swear by treatments to prevent it such as bananas, pickle juice, Pedialyte, or sports drinks. For some they work, for others they don’t. My goal is to help you learn what strategies are most likely to effectively prevent and treat EAMC.

Causes and Prevention

The currently accepted theory for EAMC is called the “altered neuromuscular control theory.”1  In a nutshell, this theory means that the muscles cramp up because of muscle fatigue.

The strategies for preventing EAMC that have been backed by scientific evidence include the following:
• Training for competition by addressing neuromuscular endurance and muscle imbalances. Plyometrics could be helpful in this area.1
• Tapering workouts in the days leading up to competition.1
• Warm-up prior to exercise. I always recommend a dynamic warm-up.1
• Rest breaks during or in between competitions.1
• Start the competition in a controlled effort.1

While hydration and electrolytes are not currently accepted ways of preventing EAMC, they could help prevent a variety of heat related illnesses. For that reason, you should still plan to hydrate with water or sports drinks prior, during, and after physical activities.

Treatment

The strategies for treating EAMC that have been backed by scientific evidence includes stretching and ice.1  Please don't force the stretch since being too aggressive can cause a strain in the muscle. While ice is effective and a less painful treatment, I’ve noticed that this method usually takes the longest to relieve the cramp.

While still an unproven hypothesis, I personally believe massage or use of a foam roller or stick roller on the affected muscle are also extremely effective. Brace yourself for the pain, because this is also the most painful treatment.

In extreme cases where the cramps do not resolve, especially if multiple body parts are involved, they may have to be treated by a physician in the Emergency Room. If you have muscle cramps frequently, and nothing you’ve tried seems to prevent them, discuss this with your physician to identify any other potential causes and treatments.

References

Edouard, P. (2014). Exercise associated muscle cramps: Discussion on causes, prevention and treatment. Science & Sports, 29(6), 299-305. doi:10.1016/j.scispo.2014.06.004