Changes

Cramps are spasmodic, painful, involuntary [[Muscle|muscle ]] contractions. This page is focused on Exercise Associated Muscle Cramps (EAMC), though there are other types. Many runners suffer from cramps, and sometimes cramps can be severe enough to prevent the completion of an event, or catastrophically impact performance. There are two leading contenders <ref name="twooptions"/> for the cause of muscle cramping; [[Sodium Deficiency]] and muscle fatigue.

[[Sodium Deficiency]] is easy to treat and pretty much risk-free. [[Sodium Deficiency]] can be either chronic (long-term) or acute (short-term). Increasing the salt in your diet can help prevent chronic [[Sodium Deficiency]], and any excess will be naturally excreted. You may need to add far more salt to your diet than you expect. To prevent acute [[Sodium Deficiency]] you should add extra salt to the drink you take while running. I generally add a 1/4 teaspoon of salt to each quart of drink. To treat [[Sodium Deficiency]] triggered cramping, one recommendation is 3 g (1/2 teaspoon) of salt added to 0.5 L (~16oz) of water or sports drink<ref name="twooptions"/>, which is rather salty and unpleasant shouldn't trigger [[Nausea|nausea]]. [[Heat Acclimation Training]] may also help prevent cramping.

There is also evidence<ref name="pickles"/> that even small amounts of pickle juice can help limit cramps. Coaches often recommend<ref name="NYT"/> pickle juice for athletes who suffer from cramping. While pickle juice is quite salty there is evidence that it is not the sodium that is helping prevent cramping. Studies on pickle juice show that it takes effect within seconds and well before any of the pickle juice would've been digested. Instead it is believed that it is the vinegar (acetic acid) that is triggering a reflex that stops the cramping. There is some suggestion that small quantities of vinegar are just as effective as pickle juice. (For those interested in the details, the hypothesis is that the pickle juice triggers a reflex in the [http://en.wikipedia.org/wiki/Oropharynx oropharyngeal] at the back of the mouth, which acts to reduce [http://en.wikipedia.org/wiki/Alpha_motor_neuron alpha motor neuron] activity in the cramping [[Muscle|muscles]].)

There is evidence<ref name="Helin"/><ref name="Schwellnus2009"/> that as [[Muscle|muscles ]] become tired the activity of the nerves changes. The mechanisms that activate muscle contraction become more active in the mechanisms that inhibit muscle contraction are weakened. This is a particular problem for muscles that will work in a contracted state such as the calf or hamstring and for muscles that do not have the opportunity to relax periodically. There are a number of potential treatments for cramping caused by muscle fatigue beyond the over simplistic and naïve approach of not exercising so hard.

* Other electrolytes beyond sodium, such as calcium or [[Potassium|potassium]], are unlikely to have any bearing on cramping. Low levels of these electrolytes are extremely rare outside of serious medical conditions such as kidney failure or AIDS.