25 questions about cramp

1. What is cramp?
Usually not all fibres in your muscles are active at the same time. While part of the fibres contracts the rest "takes a rest". The "working" and "resting" alternates at high frequency. This way a muscle can continue performing over a longer period of time.
Cramp is a sudden, involuntary contraction of all muscle fibres of a muscle, mostly during or after intensive training.

2. How does cramp develop?
Muscle cramps occur when sinews that make the muscles contract, respond wrongly and send too many signals to contract. Sometimes a muscle cramp occurs without obvious cause but most of the times, the cause can easily be found.

3. What is the cause of cramp?
The phenomenon of cramp is still not entirely clear. Possible causes are:
*Disturbed supply of blood with a shortage of oxygen in the muscle as a result by, for example, wearing too tight stockings.
* Low glucose (sugar) levels in the muscle.
* Salt shortage because of a low-salt diet.
* Loss of water (extreme sweating), which could lead to a disturbed balance of electrolytes.
* Overloading (exhaustion) by e.g. insufficient conditional training.
* Tiredness.

4. Where could I get cramps?
In principle you can get cramps in every muscle. There are certain "favourite" muscles though. Most common is cramp in calf, foot, shinbone muscles and hands. With gymnasts cramps occasionally occur in the toes. Cramps can occur in other muscles as well, for example in the jaw and even in the sphincter muscle of the eye.

5. How do I recognize a cramp?
The muscle will feel hard and tense and is rather painful. Moving is difficult and no swellings or bruises are visible.

6. Can I do something about cramp?
First you should check if it really is cramp. Sometimes a whiplash in the calf could look like a cramp. If in this case you start stretching the muscle you only increase the damage.

7. If it really is cramp, what next?
With cramp it is important to break the occurred reflex so that the muscle fibres will return to their normal pattern of contracting and relaxing. This can be done best by trying to stretch the affected muscle. Because stretching is hard on "toe cramp" one could switch to "rubbing and squeezing" of the area to break the reflex.

8. How should I stretch?
Stretching is done by elongating the muscle. For example: if you are having a cramp in your calf muscle you could try moving your foot upwards. On cramp in your foot you can move your toes upwards.

9. Could I just give a good pull?
No, in no case. Stretching muscles should always be done carefully and without "bouncing". With quick movements comes the risk of muscle rupture in the end.

10. I am not that lithe that I can reach, legs stretched, all the way to my toes.
In that case you can pass a towel under the ball of your foot (legs stretched). Take both ends with your hands. Pull the towel with your arms, carefully, so as to lift your toes. You could also ask someone to assist you.

11. Does massage help against cramp?
Yes. When the worst cramp is gone, massage could help increase blood flow and further restore peace in the muscle. If the cramp is caused by heat and dehydration one should not do massage.

12. How do I do massage?
Self-massage is difficult. More convenient is when someone else, with calm strokes, massages the muscle. One starts at the "furthest" point of the muscle and works his way to the centre. To let the hands go smoothly across the skin, massage oil is needed. This way, one can massage for 5 to 10 minutes.

13. Do (warmth) rubbing oils work?
No. The warmth medicine only get to the skin and will not reach the muscle. It could even work in opposition because the blood that is needed for the muscle will be transported to the skin. It is true on the other hand that it will feel better and provide some diversion.

14. What else could I do against cramp?
It could help to warm the muscles by means of warm clothing (leg warmers), a hot pack or a visit to the sauna. If the cramp is caused by heat and dehydration all this is of course not an option.

15. What is a hot pack?
A hot pack is the counterpart of the cold pack. It is a plastic bag with liquid. After having put this in the microwave or in hot water it can be put to the muscle where it will share its heat.

16. Could I return to my activity right again?
It is advisable to quit the exercising activity because the risk of the cramp reoccurring is definitely there.

17. Are there any risk factors?
I named a few in the causes part. Another well-known risk factor is too low a water temperature for swimmers. In their case, too stiff or flippers that do not fit properly could also cause cramp.

18. What should I do if I get cramp while in the water?
In any case, do not panic. Best thing to do is to try and swim ashore or to stretch the muscle while floating on your back. Never take on longer swimming routes without assistance or buddy.

19. What about minerals and supplements?
Anyone thoughtful about his diet will not suffer from mineral shortages. It could happen though that the balance is temporarily disturbed by exhaustion, dehydration or heat. Regularly complementing the body fluids, sugar and salt in endurance performance is wise, from this point of view.

20. Is there any good in calcium and magnesium?
If you are suffering from cramps very often you can, in consult with your physician, choose to complement your diet. The physician will take a blood sample for research and look for shortages.
The methods and need for this are subject of an ongoing discussion these days.

21. If dehydration is the cause, how much water should I be drinking?
Two litres a day at least and also before and after an endurance performance. Preventing thirst is the point. If you are feeling thirsty it is too late already and you can no longer "drink in". Loss of performance is immanent and the risk of cramps is increasing.

22. I am a creatine-user, does that add to the risk of cramp?
Sometimes creatine-users get cramp in their muscles. This cramp is caused by water shortage. Creatine-users should drink more water than non-users.

23. I only suffer from cramp at night.
You can try to prevent nightly cramp by relaxing your muscles well before you go to sleep or by going for a short walk. Pre-warming the bed could also work as a prevention.

24. Is cramp always innocent?
Not always. A less innocent form is the calf cramp that occurs with older people during walking; so-called "window legs". This is caused mostly by narrowing of the blood vessels to or in the leg due to arteriosclerosis (hardening of the arteries). Arteriosclerosis develops from smoking and collecting of fat (like cholesterol and sugar) in blood and connective tissue. With sportsmen this is not very common because they do not smoke. Isn't it?
With swimmers and divers cramp is naturally also not without risk.

25. Can I do something in prevention?
Before training or competition you could do a nice warm up and afterwards a good cool down with stretching exercises. Do not train harder than your condition allows. Drink extra water every now and then. And especially: listen to your body, that is your best advisor.


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