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MUSC Health Blog

Keyword: warm-up

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.


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.


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

Guest Post by:
Ethan Konoza, ATC, SCAT
Athletic Trainer
MUSC Sports Medicine

Since we were young, coaches, fitness professionals, and gym teachers alike have instructed us to warm up prior to exercise and athletics. However, for many athletes, the value and importance of a proper warm up often times gets neglected. For the elite and professional athletes a proper warm up is a necessity and serves multiple purposes in their daily exercise routine and should never be ignored.

Defining a warm up

So what is a warm up? A warm up is a period of time prior to physical activity in which light cardiovascular exercises (exercises that raise your heart rate) are performed in combination with static and dynamic movements as well as stretching.

How long should a warm up last?

There is no set amount of time on how long warm ups should last, however it is suggested that warm ups last at least 20 minutes. During this time athletes should gradually get ready for activity physically as well as mentally.

What benefits does warming up serve?

Improved physiological function for physical activity

During a warm up, cardiovascular exercises are performed, whether that is walking, jogging to running progression, cycling, etc. The effects of cardiovascular exercise on the body include an increase in body temperature and a gradual increase in heart rate, which ultimately improves blood circulation to the muscles that will be used during physical activity as well as facilitates joint lubrication and readiness.

Improved mental preparedness

We know that participating in sport and exercising is both a physical and mental task. If you look at the elite athletes of the world, such as Usain Bolt, Lionel Messi, or Simon Biles, they are not only incredibly gifted athletes, they have mental fortitude and resilience as well. The fact that these athletes “get it right” as consistently as they do speaks volumes of not only their athletic ability but also their mental preparedness. A proper warm up is of vital importance to each of these athletes’ routines, to prepare their mentally and physically, prior to both daily training and competition.

Reduction/prevention of injury

There is a vast array of evidence in the current literature that suggests warming up prior to physical activity helps to reduce the likelihood of musculoskeletal injury during exercise. Keeping the muscles warm will help to prevent acute injuries such as strains as well as overuse injuries by allowing the body to prepare gradually and safely.

Sample Warm-up Routine

The type of physical activity you are going to partake in, as well as fitness levels, will dictate the type of warm up you perform. This example should be used as a general guide and not necessarily as a one-warm-up-fits-all example.

  • Light jog/run ~ 5-10 minutes
  • High knee walk ~ 10 yards (there and back for all movements after initial jog)
  • High knee skip
  • High knee run
  • Heels to buttocks
  • Straight leg skips
  • Backward jog
  • Backpedal
  • Forward lunge walk
  • Stride 50%
  • Stride 75%
  • Stride 90%
  • Stride 100% - (Finishing through the line)

After these exercises your muscles should be warm and you should have some perspiration. After your muscles and body are warm this is the best opportunity to get the most out of stretching.  Below you will find general stretching guidelines.

General Stretching Guidelines

  1. You should only stretch to the point of mild tension in your muscles.
  2. There should be NO PAIN when you are stretching!
  3. Make sure that you breathe.
  4. Hold stretches for 30-45 seconds.

Final Thought

Warming up provides many benefits and should be a staple to everyone’s pre-competition and daily workout routine.  Whether you’re a professional or amateur athlete, in order to perform at your highest level and reduce the risk of injury, take time for an adequate warm-up and remember the usefulness it provides!


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