All About Muscle Cramps

Learn how to deal with - and prevent - severe muscle cramps (aka "charlie horses")...

Everyone's experienced it. Your New Year's resolution was to get more exercise. You felt good as you jogged those first few laps or took a short ride on your bike. But the initial euphoria about your own strong motivation was soon replaced by the aches and pains of cramped muscles. You got a "charlie horse" - a very painful muscle cramp!

Anyone who demands too much from his muscles or who makes them perform unaccustomed tasks is sure to feel the painful consequences later on. The time lag varies from a few hours to a day or two. Overworked muscles are sore, sensitive to the touch, and exhausted. The affected muscle groups are prone to cramps during this period. The pains usually reach their peak from one to three days after the muscles have been exercised, and the discomfort may persist for as long as a week before it gradually disappears. Although a "charlie horse" heals completely and isn't at all dangerous, aching muscles are very unpleasant and can significantly interfere with your freedom of movement.

What Exactly is a "Charlie Horse" Muscle Cramp?

Experts have long disagreed about the causes of sore muscles. In the past, most experts believed that the pain in the muscles was caused by excess acidity, i.e. by the accumulation of lactate, a "waste product" created when muscles generate energy. But because muscle cramps typically occur among beginners or in association with unfamiliar movements, and because lactate is produced in the muscles of advanced athletes as well as in the muscles of beginners, scientists were forced to abandon the lactate theory. Nowadays, physicians who specialize in sports believe that muscle pain develops when extreme mechanical stresses (e.g. playing squash) or especially long-lasting demands (e.g. running a marathon) cause tiny injuries to muscle cells. The overtaxed muscle fibers tear at particularly sensitive locations.

Because nerve cells are situated in the fascia, i.e. the sheath of connective tissue outside the muscles, these microscopic lesions in the muscles do not cause pain immediately. Inflammation and swelling occur as a natural response to the injuries. This puts pressure on the nerve cells and on the muscle's blood vessels, and this pressure is experienced as pain. Under a microscope, miniscule injuries can be seen in muscle specimens taken from marathon runners after they've subjected their muscles to severe stress. Researchers have also observed that the damage initially increases during the course of the healing processes. This explains the time lag between the exercise and the onset of the discomfort.

What Causes Muscle Cramps?

The situations that are likely to cause a "charlie horse" have one thing in common: incomplete muscular coordination. Some examples include:

1. Physical activity by untrained people or after a long pause in athletic training
2. Unfamiliar movements by well-trained athletes
3. Extreme stresses

So-called "eccentric contractions" are particularly likely to cause aching muscles. Such contractions occur when a muscle simultaneously works and stretches (e.g. running downhill). The severe strain which this movement puts on individual muscle fibers can cause them to suffer injury.

How Can Muscle Cramps Be Prevented?

The best way to protect yourself against a severe muscle cramp is to have already put it behind you. The muscle coordination functions more smoothly as you become accustomed to particular sequences of movement, and this familiarity prevents individual muscles from being overtaxed. The only other surefire way to avoid cramps is to prevent them: first, by avoiding the combination of severe stress and unfamiliar movements; and second, by doing a thorough warm-up, stretching, and gradually increasing the intensity of your workouts. All these measures contribute towards optimal coordination.

Nutrition & Muscle Cramps

Nutrition also plays an important role. The body needs sufficient amounts of calcium and magnesium to support optimal muscular function. Because the body cannot manufacture these two minerals, it must be supplied with them in foods and beverages. An inadequate supply of calcium and magnesium can lead to problems with muscular coordination. Mineral deficiency generally manifests itself as an increased tendency to suffer muscle cramps and "charlie horses". The best sources of calcium are milk and dairy products (e.g. yogurt, cultured milk, cheese, etc.). Milk and dairy products are the only sources of calcium that are worthy of mention; if no such foods are eaten, then one should definitely drink calcium-rich mineral water (150 mg of calcium per 100 ml of water) or eat calcium-enriched foods such as breakfast cereals or special energy bars. Some of the newer calcium supplements may also be helpful.

The best way to improve one's supply of magnesium is to drink a suitable mineral water that contains at least 50 mg of magnesium per 100 ml of water. Athletes are particularly at risk because increased perspiration causes greater mineral losses, and these losses must be compensated for. Dehydration can also manifest itself as problems with muscular coordination or as cramps, so athletes should drink mineral-rich athletic beverages before and during workouts, especially when the temperatures are high and the stress is intensive.

Do Vitamins Help?

Supplementary doses of vitamins C and E have been tested as a possible pharmacological treatment to prevent muscle cramps. As was also discovered in many other studies of vitamins, these tests showed that vitamins have no affect whatever on the development of muscle aches. On the other hand, long-term doses of carnitine (throughout a three-week interval) improved blood circulation in the muscles, and better circulation can help to minimize the intensity of the pains associated with muscle cramps. The beneficial effects, however, require a daily dosage of at least 3 grams of carnitine. Meeting this carnitine requirement by eating ordinary foods, however, isn't a good idea. Doing so would require the consumption of extremely large amounts of meat (circa 500 grams of beef per day), and this is not recommended from a health-related point of view.

A Summary of the Preventive Muscle Cramp Measures:

• A well-balanced, mineral-rich diet (milk products, mineral-rich athletic beverages)
• Regular endurance workouts (several times per week, if possible)
• Don't immediately subject untrained muscles to excessively severe or long-lasting stress
• Only gradually increase the intensity of your workouts
• Always thoroughly warm up your muscles before sports and always stretch them well afterwards

What Can One Do If Muscle Cramps Have Already Developed?

If you've already got a "charlie horse" muscle cramp the only thing you can do is try to relieve the pain and accelerate the healing process. Therapies that encourage circulation can be helpful, for example:

• Encourage circulation by taking saunas and hot baths, or receiving gentle massages, which may be combined with substances (e.g. arnica, rosemary, camphor) that encourage circulation
• Pains can be relieved by rubdowns with ointments that encourage circulation
• Light exercise
• Easy jogging

If muscle cramps are particularly severe, taking analgesic medications which relieve inflammation (e.g. Advil) can support the healing process. If the discomfort doesn't disappear after several days have passed, you should consult your doctor. Other causes may be responsible for your muscle cramps and aches.

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Useful Links:

MedlinePlus Muscle Cramp Resources
Yahoo Health: Muscle Cramps