Can you do anything about cramp?

Posted on 19 August 2019

Most long-distance runners have suffered from cramp at least a few times – and often, they have no idea why. Before you take on the upcoming 2019 Sanlam Cape Town Marathon, here’s your guide to cramping: why it happens – and what you can, and can’t, do about it.

“The first time I ever experienced a cramp was at night, after a long run. The second time was as I finished a half-marathon when I collected my medal and then fell over. And the third time was mid-race, at the Soweto Marathon,” says runner and sports writer Liam Smith. “Cramps set my calves and hamstrings on fire, crippling my stride and leaving me hobbling in pain until I grind to a halt and collapse on the ground.”

“I spoke to many people after each of those cramps, many of them experts in physical training and endurance sports. Each of them had a different answer as to why I kept cramping and I adopted a different strategy based on their different pieces of advice from different experts. Convinced it was because I was stiff, I stretched like a yogi at the starting line. Then, having read I may have been dehydrated, I downed litres of water as I ran. Finally, I settled on the idea I was suffering from an electrolyte deficiency and ate my way through that marathon like I was at a free breakfast buffet.”

Nothing worked for Liam. He still cramped.

A comprehensive essay in The Guardian outlines how some experts believe it is tied to our breathing, and others point to our sweating, while others still espouse the importance of sodium in our pre-race diets.

So what do you do, when it feels like you’ll never shake it? Step number one, says Dr Leigh Gordon, from the Sport and Exercise Medicine Project at the Sports Science Institute of South Africa, is to understand your own cramp.

“Cramps occurs when the muscle over-contracts and cannot relax properly,” she says. “The latest research suggests it has to do with the nerves that supply the muscle, and that the circuit between the muscles and the spinal cord is over-stimulated.”

That said, while exercise-associated muscle cramp has been attributed to many causes, often dehydration or salt imbalances, there is simply no good scientific evidence that either is responsible, says Dr Gordon. Because doctors find it difficult to point to a cause for cramping, they can find it equally hard to prevent or treat it.

“Cramp usually happens in fatigued muscles, which are working in a shortened position – such as calf cramp in swimmers whose feet are pointing while they kick,” says Dr Gordon. “Different runners have different genes which may affect them, but more importantly, they have different running styles and biomechanics, which affect the way their muscles work and therefore they experience fatigue differently.”

Each runner you speak to seems to have come to their own home remedy for cramping. “It appears that better conditioning helps reduce cramps, so working on strength of muscles in the gym will help. Regular stretching also helps to reduce the risk before running and will help relieve the pain during a cramping spell.”

While cramps might be incredibly painful, Dr Gordon says they are not usually dangerous or indicative of an underlying medical condition.

“If a runner regularly gets cramps in many muscle groups, they should probably be checked out by a sports and exercise medicine physician,” cautions Dr Gordon. “And if they suddenly develop cramps all over their body, they need to go to an emergency ward immediately, as this may be a very serious condition related to their blood calcium levels called hypercalcemia.”


Published in Exercise

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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