Jan 29, 2015
Conquering Cramping

By Dave Ellis, RD, CSCS

Sports dietitian and strength coach Dave Ellis, RD, CSCS, has been refining and field testing his three-step Fueling Tactics sports nutrition system for over 26 years. He recently released his nutrition system on DVD at his Web site: www.fuelingtactics.com. Dave has experience at all levels of sport, which has made him a valuable asset for some of the most demanding sport coaches and a valuable sounding board for our readers. Recently Dave’s work at the Olympic level was recognized when he was named a finalist for the 2007 USOC “Doc” Counsilman Science Award.

There are a lot of ways to cramp, so you can bet the information on this topic is going to be confusing. The debate over the best way to prevent or resolve Exercise Associated Muscle Cramps (EAMCs) has historically sparked lively discussions in scientific settings like annual American College of Sports Medicine meetings.

Typically, the showdowns occur between a scientist who is funded by a major sports drink company seeking to validate water, sodium, and glucose as the best intervention method for EAMCs and another scientist who is not affiliated with any company, but is just looking to get to the bottom of the issue. I wish aleviating cramps was as simple as getting enough Gatorade down an athlete’s throat, but there is more to the story of EAMCs. Here is where we currently stand on this topic:

There are multiple factors involved in the events leading to EAMCs, the content of which we would struggle to cover in a three-day long symposium. So please excuse the brief synopsis here.

Fatigue is at the core of EAMCs. A variety of mechanical damage and metabolic events can set the stage for slowed muscle relaxation and vulnerability to EAMCs. A dehydrated-hyponatriamic muscle (low sodium) can definitely speed up the rate that a muscle exhibits fatigue properties that lead to EAMCs.

However, after watching athletes hyper hydrate with salt-laden sports drinks, sometimes to the point of vomiting while still cramping, I can assure you there is more to preventing and resolving EAMCs then ingesting sports drinks. I base this on 26 years of work with cramp-prone populations like American football athletes.

At one point during my 20 years of work in the collegiate ranks, a young athletic trainer suggested we use a very soluble source of buffering agent like citrate and bicarbonate to intervene with EAMCs during games instead of just having the athletes ingest Gatorade. So we started keeping one-liter bottles of non-aspirin Alka Seltzer (acid indigestion formula) on the sidelines during early-season games where EAMCs were more common. We started to force feed the buffered solution to athletes while they were doing some stretching and muscle cooling activities. That helped resolve muscle pH (free radical) inflammation issues–precursors to fatigue and slowed muscle relaxation.

At some point, athletes are going to exceed their capacity to cope with mechanical damage and metabolic insults that come from doing too much too quick. When these conditions occur in association with inclement environmental conditions, the insult is compounded and we see very rapid onset of fatigue characterized by slowed muscle relaxation (accumulation of calcium in the sarcomere). Low pH (acidity), free radicals, and inflammatory compounds all slow the rate that calcium leaves the muscle after contraction. And a host of acute interventions like buffering with Alka Seltzer or proactive buffering with intracellular buffers for known crampers (phosphorous, carnosine precursors like beta-alanine, histidine, glutamine, etc.) all have a great track record in the applied trenches of sport. These interventions can help prevent and resolve EAMCs in those most vulnerable.

Our team leaders often exhibit some vulnerability to cramping that comes from their exertion on and off the field of play. Starters who didn’t pay the price in the off-season are also vulnerable early in the season because they are not yet caught up to the team’s level of conditioning and do not have the capacity to cope with pH, free radical, and inflammatory insults. Also, athletes who have been ill leading up to a competition and compete prior to being fully recovered are vulnerable to EAMCs.

Because a tissue’s ability to cope with regional free radical insults can result in EAMCs, vascular-specific antioxidants may also be proactive interventions to build up tissue before an invasive bout of work. This includes Vitamin E and anthocyans (found in berries and apple skins).

If we can get athletes who are exhibiting EAMCs to keep voiding their bladders while alkalizing their blood with Alka Seltzer, we can typically keep the athletes in the game. When their drive to drink slows with a full bladder and no place to void, we may not be able to stay ahead of the demands of the compromised tissue. Alkalizing blood also helps hemoglobin release nitric oxide, which keeps hard tissue profuse with blood, allowing for us to move CO2 out of the tissue–a very important buffering process. Blood with low antioxidant status can result in low nitric oxide status as free radicals scavenge free nitric oxide, setting the stage for faster fatigue and slower recovery from exertion. The weaker the natural antioxidant status of the athlete and the less committed they are to off-season conditioning, the more vulnerable these athletes will be to EAMCs.

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