Exercise Associated Muscle Cramps
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Transcript of Exercise Associated Muscle Cramps
By Cor inne Casey
REDUCING EXERCISE-ASSOCIATED MUSCLE
CRAMPS
What is it Cause
Exercise-associated Muscle Cramps (EAMCs)
single, multijoint muscles (eg, triceps surae, quadriceps, hamstrings) when contracting in a shortened state
Electrolyte Depletion Theory Dehydration Abnormal serum electrolyte
concentrations Altered neuromuscular
control hypothesis Muscle spindle & golgi tendon
proprioceptors
Exercise-Associated Muscle Cramps
Cooper E. R. et al.2006
The Role of Hydration and Effects of Dehydration
Signs of Dehydration
Fatigue Difficulty Concentrating Irritability Lightheadedness Decreased AlertnessCrampingNauseaWeakness
ACSM Recommendations
Body weight (in pounds)/2= daily fluid needs (in oz.)
16 ounces, 1 hour before competition
5-12 ounces of fluid every 15-20 minutes
> 1 hour
sports drinks containing 7% carbohydrates
For every pound lost per hour16-24 ounces of fluid
Percent Dehydration Effect on Physiological Function
Percent Weight Loss
Effects on the Body
1 to 2 Increase in core body temperature
3 Significant increase in body temperature with aerobic exercise
5 • Significant increase in body temperature with a definite decrease in aerobic ability and muscular endurance • Possible 20 to 30% decrease in strength and and anaerobic power• Susceptible to heat exhaustion
6 Muscle spasms and cramping
10 or more • Excessively high core body temperature • Susceptibility to heat stroke •Heat injury and circulatory collapse with aerobic performanceAlabama A&M & Auburn Universities,
2003
Electrolytes: Recommended Intake and Function
http://www.kbnutrition.com
Pro Cons
Approximately 25% of certified athletic trainers advocate
drinking 30 mL to 60 mL of pickle juice relieves an EAMC within 30
to 35 seconds after ingestion
PickleJuiceSport
1-2 ounces recommended 2 times to 20 times the
dosage Decreased gastric emptying
high salt and low fluid content contribute to dehydration-
induced hypertonicity prolonging dehydration increasing the risk of
hyperthermia and poor performance
The Pickle Juice Debate
Miller K. C., Knight K. L., Williams R. B., 2008
Composition of Fluids
Miller K. D., Mack G., Knight K. L, 2009
Plasma Levels
Miller K. D., Mack G., Knight K. L, 2009
Electrolyte Concentration Post-Ingestion
Miller K. D., Mack G., Knight K. L, 2009
Pickle Juice and Deionized Water Composition
Miller KC, Mack GW, Knight KL, 2010
Gastric Volume of Pickle Juice and Water
Miller KC, Mack GW, Knight KL, 2010
Plasma Sodium Concentration
Miller KC, Mack GW, Knight KL, 2010
Cramp Duration DI Water vs. Pickle Juice
Miller K. C., Mack G. W., Knight K. L., et al., 2010
Increased Running Speed and Previous Cramping
Schwellnus MP, Drew N, Collins M. , 2010
Anatomy Increased Excitatory Input
Altered Neuromuscular Control Theory
Schwellnus, M.P., J. Nicol, R. Laubscher, and T.D. Noakes., 2004
http://www.sweatscience.com.
Practical Implications
There is no one cure for EAMCs Find a method that works for you
Pickle juice needs to be further investigated to determine optimal quantities and timing. Should not be used for the first time during competition
Fluid, electrolyte and energy supplementation is desirable to support circulatory, metabolic and thermoregulatory functions.
Sports drinks should not be used in exercise less than 60-90 minutes
Stretching and strengthening of musculature is possibly important for avoiding EAMCs.
Future Research
Only 18 studies on pickle juice and carbohydrate solutions All but three are anecdotal
Mechanism of pickle juice’s role in EAMC alleviation Optimal treatment parameters
More case studies rather than anecdotal findings
Research into the oropharyngeal region Increased focus on the environmental factors
influence on dehydration
References
Cooper E. R., Ferrara M. S., Broglio S. P. Exertional heat illness and environmental conditions during a single football season in the Southeast. J Athl Train. 2006;41(3):332–336.
Jung, A.P., P.A. Bishop, A. Al-Nawwas, and R.B. Dale. Influence of hydration and electrolyte supplementation on incidence and time to onset of exercise-associated muscle cramps. J. Athl. Training. 40:71-75, 2005.
Levin, S. Investigating the cause of muscle cramps. Phys. Sportsmed. 21:111-113, 1993. Maughan, R.J., J.B. Leiper, and S.M. Shirreffs. Restoration of fluid balance after exercise-induced dehydration:
effects of food and fluid intake. Eur. J. Appl. Physiol. Occup. Physiol. 73:317-325, 1996. Maughan, R.J., S.J. Merson, N.P. Broad, and S.M. Shirreffs. Fluid and electrolyte intake and loss in elite soccer
players during training. Int. J. Sport Nutr. Exerc. Metab. 14:333-346, 2004. Maughan R. J., Leiper J. B. Limitations to fluid replacement during exercise. Can J Appl Physiol.
1999;24(2):173–187. Miller K. C., Knight K. L., Williams R. B. Athletic trainers' perceptions of pickle juice's effects on exercise
associated muscle cramps. Athl Ther Today. 2008;13(5):31–34. Miller K. D., Mack G., Knight K. L. Electrolyte and plasma changes after ingestion of pickle juice, water, and a
common carbohydrate-electrolyte solution. J Athl Train. 2009;44(5):454–461. Miller K. C., Mack G. W., Knight K. L., et al. Reflex inhibition of electrically-induced muscle cramps in
hypohydrated humans. Med Sci Sports Exerc. 2010;42(5):953–961. Roeleveld, K., B.G. van Engelen, and D.F. Stegeman. Possible mechanisms of muscle cramp from temporal and
spatial surface EMG characteristics. J. Appl. Physiol. 88:1698-1706, 2000. Schwellnus, M.P., J. Nicol, R. Laubscher, and T.D. Noakes. Serum electrolyte concentrations and hydration
status are not associated with exercise associated muscle cramping (EAMC) in distance runners. Br. J. Sports Med. 38:488-492, 2004.
Schwellnus MP, Drew N, Collins M. Increased running speed and previous cramping rather than dehydration or serum sodium changes predict exercise-associated muscle cramping: a prospective cohort study in 210 Ironman triathletes. Br J Sports Med 2011;45:650-656
Pre-Ingestion Urine Levels
Miller K. D., Mack G., Knight K. L, 2009
Pre-ingestion Plasma Levels
Miller K. D., Mack G., Knight K. L, 2009
When to Use When not to
Within 1 hour of exercise
During a work out lasting >60-90 minutes high intensity intervals
>30-60 min Immediately after
workouts kick starts rehydration
and refueling
Everyday drink For the first time
during a race To replace meals
and snacks on non-race days
During low intensity/short duration workouts
Do’s and Don’ts of Sports Drinks