Article image

by Elaine K Howley

August 6, 2024

Science is still unraveling what causes cramps and how best to manage them

Cramps happen. Whether during a tough kick set or even while you’re sleeping, many swimmers have experienced the stabbing, sudden pain of a cramp. Often located in the calf muscle—but possible in virtually any skeletal muscle—cramps can really put a crimp in your swim plans.

For a long time, scientists thought that cramps—which can be a real problem for not just athletes but laborers as well, especially as the climate warms—were related to an imbalance between fluid and electrolyte intake. But recent research has suggested there might be more to it than that, or that various types of cramps could exist, meaning that a blanket recommendation for how to cope with a cramp remains elusive.

The generally accepted view of exercise-associated muscle cramps remains that they are related to a loss of electrolytes due to sweating. Not just simple dehydration, they appear to result from an imbalance between water intake and the critical substances such as sodium, potassium, and magnesium that conduct electrical charges (hence the name “electrolytes”) that facilitate the normal function of cells.

This sweat-induced view of EAMC applies to swimming, too, because even if you don’t realize it, while you’re swimming, you may well be sweating just as much as you would when working out on land. And anytime you sweat, you’re losing electrolytes. That means cramps can sneak up on you, especially if the water is warm.

But Kevin Miller, a professor of health and human performance at Texas State University who has studied EAMC extensively, has suggested that there’s more to the story than a simple fluid or electrolyte imbalance. For example, Miller has noted that stretching the muscle against the cramp is a sure-fire way to alleviate the cramp that works quickly in almost every case.

In addition, Miller has floated a new theory of EAMCs, which suggests that cramps occur “when fatigue and other risk factors contribute to a final common pathophysiological pathway to produce an imbalance between excitatory and inhibitory stimulate at the α motor nerve.” In short, there’s a spiderweb of external and internal factors that could be contributing to cramping, which it turns out, is probably a highly individualized experience.

In a 2021 study published in the Journal of Athletic Training, Miller and his team summarized that “recent evidence suggests that EAMCs are due to a confluence of unique intrinsic and extrinsic factors rather than a singular cause.” 

Miller told Triathlete magazine in 2022 that this updated view of the causes of EAMC is a bit like spaghetti sauce. “Just like there are about 500 different recipes for spaghetti sauce, you might have 500 different recipes for cramping. Your recipe for cramping might be different from my recipe for cramping,” he said.

From Miller’s research and his alternative views of cramping, which he first started publishing in 2009, have arisen a variety of new ways to treat EAMCs that don’t rely on a simple electrolyte-and-fluid beverage combination, ala Gatorade. Instead, Miller has suggested that for some people, pickle juice seems to work well alleviating cramps, and it may be more about how receptors on the tongue communicate with the brain than it is about supplying some dietary compound that’s been sweated out.

In a 2010 study, Miller found that participants who drank pickle juice saw a reduction in cramp duration of 40%, and it worked faster than digestion would suggest it could—about 90 seconds from ingestion to cramp resolution. If cramp relief were related to some nutrient being absorbed into the body, the timeline should have been significantly longer, roughly 25 minutes or so.

Miller and his team continue to investigate what that reflex in the mouth could be or whether they were witnessing a placebo effect. Meanwhile, companies such as HotShot have sprung up to offer athletes intensely flavored products that appear to help some people resolve EAMCs quickly.

How to Manage Cramps Today

While the debate about exactly what cramps are and how they might alter the neural system continue, there are some things you can do to fend off and manage cramps right now if you’re prone to them.

Get checked out by a doctor. Some cramps can be related to underlying medical issues, so be sure to check with your health care provider to rule out any medical causes for frequent cramps.

Stay appropriately hydrated. Every cell in your body needs fluid to perform, so staying well hydrated is always a good idea. It is possible, however, to take in too much water, especially when exercising, which can lead to the electrolyte and fluid imbalances that have long been considered the cause of EAMCs. So how much is enough? The U.S. National Academies of Sciences, Engineering, and Medicine recommend about 15.5 cups (3.7 liters) of fluids a day for men and about 11.5 cups (2.7 liters) of fluids a day for women. Those levels are intended for the average, healthy adult, so talk with your health care professional or a registered dietitian about how much is best for you based on your age, medical conditions, activity levels, and other relevant factors.

Make note of when cramps strike. If you always seem to get a cramp in the last 10 minutes of practice, make a note of that, as it may point to an underlying cause or help you better manage fluid intake. Or have a product such as HotShot, pickle juice, or another option at the ready when the cramp arrives.

Experiment with remedies. If you struggle with cramps often, try the different types of remedies out there to help you figure out which one tends to work best for you. And when you find something that works, stick with it.


Categories:

  • Health and Nutrition

Tags:

  • Health