Cramping Your Style

It’s an involuntary contraction that can happen at the worst and most inappropriate times, but it can be awkward and often impossible to try and hide it. Its unpredictable and spontaneous, I often have to make strange manoeuvres when in public in order to conceal it and sometimes I need my wife’s help to get rid of it, she hates dealing with it because she claims it’s self inflicted.  Sometimes I just wake up and I feel it.  Cold showers apparently help but they aren’t always available. But when it happens it is important to just act as naturally as possible. In most cases no one notices and shifting around only draws attention to it. Compression shorts can be used to help hide it but with blood rushing to the area these things can just pop up at pretty much any time. But I’m sick of it and I’m determined to find the cause and solution to my muscle cramps during and after long bouts of exercise. crampMost runners have experienced cramp, either during or after a race but I seem to suffer particularly badly from it, and it has affected every marathon I’ve ever done to varying degrees. It’s merely hindered some but destroyed others.  It has happened when using different food and hydration options, whether running aggressively (too fast) or conservatively.

Muscle cramps are intermittent, painful, involuntary muscle spasms that make it difficult if not impossible to keep running. The usual muscles affected are larger muscle groups like the diaphragm (your breathing muscle causing a side stitch), hamstrings, quadriceps and calves. Cramping, or more specifically, exercise-associated muscle cramping (EAMC), is as much a part of many runners marathon experience as gels and chaffing. Yet, it is remarkable how little either the scientific or the running community truly understand about cramping (Miller et al., 2010). Traditionally most runners believe muscle cramps are due to “an electrolyte imbalance” or a lack in sodium, potassium, or other essentials in the body caused by long bouts of exercise. But controversially, even though we don’t know much about cramping, we do know definitively that there is no association between blood (or sweat, or urine) salt concentrations or hydration status and muscle cramps!(Schwellnus et al., 2004). The risk of muscle cramping increases when trying to run further or faster than accustomed, with older age or in runners with higher body mass index (Schwellnus et al., 2011). But it may simply be due to your family history of cramping – there may be an inherited risk to muscle cramping (Shang et al., 2011).


As for prevention, frustratingly, my research hasn’t lead to a clear answer, just lots of advice – possibly tweaking the training plan, modifying the diet or even starting a cramp diary – noting down everything that came first the problem, including how long and hard the training or race was, the amount and quality of sleep the night before, runners and gear that was worn. Watch for patterns and, if possible, change them.



The references


Kamau JW, Wanderi MP, Njororai WWS, Wamukoya EK: Prevalence of overweight and obesity among primary school children in Nairobi province, Kenya.Afr J Phys Health Educ Recr Dance 2011.,17(2).


Miller KC, Stone MS, Huxel KC & Edwards JE. (2010). Exercise-associated muscle cramps: causes, treatment, and prevention. Sports Health 2, 279-283.


Schwellnus MP, Drew N & Collins M. (2011). Increased running speed and previous cramps rather than dehydration or serum sodium changes predict exercise-associated muscle cramping: a prospective cohort study in 210 Ironman triathletes. Br J Sports Med 45, 650-656.


Schwellnus MP, Nicol J, Laubscher R & Noakes TD. (2004). 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.


Shang G, Collins M & Schwellnus MP. (2011). Factors associated with a self-reported history of exercise-associated muscle cramps in Ironman triathletes: a case-control study. Clin J Sport Med 21, 204-210.


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I qualified with an Honours degree in Physiotherapy from Trinity College Dublin in 2004. Since graduating I have worked in St. James Hospital Dublin and have worked in all the areas of speciality within the hospital including cardiorespiratory, orthopaedics, rheumatology, care of the elderly, neurology, burns and plastic surgery among others . I have also completed a post graduate certificate in acupuncture in UCD 2009. The Physiotherapy Department in SJH has strong links with Trinity College Dublin (TCD) and I have supervised undergraduate and postgraduate physiotherapy students on practice placements and also delivered lectures on the undergraduate academic programme in TCD. I have a keen interest in all sports and currently plays with Cill Dara RFC 1st team squad, and Milltown GAA. I have previously worked as Physiotherapist to Co. Carlow Senior GAA Team, Milltown GAA, Leinster Junior Rugby Team and Cill Dara RFC. I am an experienced runner and competed in the Dublin City Marathon in 2002. I continue to participate in running events and multisport disciplines such as Gaelforce West, Gaelforce North and the Motivate Challenge. I have a particular interest in strength and conditioning. I utilise this knowledge of resistance training in the treatment of his clients. I am committed to continuous learning and development in order to ensure the optimal level of care is offered to my clients, and with this in mind I am currently undertaking a certification in Strength and Conditioning (CSCS) with the NSCA.

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