Muscle Cramps: Inevitable or Preventable with Physical Activity?

Ginger Vieira (T1D)If you experience painful, involuntary contractions of your muscles, you’re having a muscle cramp. They can occur in any muscle but are most common in the legs, feet, and muscles that cross two joints, such as your calf muscle (the gastrocnemius, which crosses your knee and your ankle joints), quadriceps and hamstrings (the front and back of your thighs), and your feet. Not all of them are that painful; they range in intensity from a slight twitch to severe cramping that makes the muscle feel rock hard and that can last from a few seconds to several minutes. They can also ease up and then re-cramp several times before disappearing.

Although the exact cause of muscle cramps remains unknown, they are not inevitable. More than likely they’re likely related to either poor flexibility, muscle fatigue, and/or doing new physical activities. Athletes are more likely to get cramps in the preseason when less conditioned and more subject to fatigue. Cramps often develop near the end of unaccustomed intense or prolonged exercise or during the night following the activity.

Of course, if you’re exercising in the heat, cramps can also be related to dehydration and depletion of electrolytes (sodium, potassium, magnesium, and calcium) lost through sweating. When these nutrients fall to certain levels, you’re more likely to experience cramping, and it’s good to keep in mind that many people with diabetes already have low blood levels of magnesium. In people with diabetes, taking magnesium supplements may help reduce cramping issues. The other electrolytes like potassium and sodium can also become unbalanced during periods of uncontrolled hyperglycemia when water losses through urine are usually greater. Finally, cramps may also occur as a side effect of certain medications and other substances, such as lipid-lowering agents (statins in particular), antihypertensives, beta-agonists, insulin, oral contraceptives, and alcohol.

Cramps usually go away on their own without treatment, but there are effective ways to deal with them. For starters, stop the activity that is causing your muscles to cramp (if you can). Then, gently stretch and massage the cramping muscle, holding your joint in a stretched position until the cramp stops (such as pulling your toes toward the top of your foot if your calf muscle is cramping).

To try to prevent cramps, increase your fitness level and avoid becoming excessively fatigued during an activity. They appear to be best prevented by reducing the risk of developing premature muscle fatigue. Warm up before you start intense workouts and stretch regularly when you’re done exercising, focusing primarily on your calves, hamstrings, and quads. Avoid pointing your toes if your calves are involved. Also, always make sure to stay adequately hydrated, especially when exercising in hot and humid environmental conditions, and eat a wide variety of healthy foods that will help replenish lost electrolytes naturally. Supplementing with sports drinks can help replenish electrolytes as well, but they add excess calories and extra (rapidly-absorbed) carbohydrates, making them less desirable in most instances except when more carbohydrates are needed during exercise to prevent hypoglycemia (low blood sugars).

In summary, there are many possible causes of muscle cramps, but they do not inevitably result from physical activity prevention. Taking some simple precautions can prevent them (such as preventing dehydration and extreme fatigue during activities), and cramps can also be effectively treated if they do occur on occasion.

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