For decades, we’ve been told that cramping is caused by an electrolyte imbalance or poor hydration status. But new science suggests that this probably isn’t why you cramp during exercise.
So why do you cramp? It all comes down to something called “altered neuromuscular control.” And how do you stop it? Well, that’s where things get even trickier. We called up the world’s leading athletic cramping expert, Dr. Martin Schwellnus, to find out.
Episode Transcript
00:00
Welcome to fast off the velonews podcast and everything you need to know to ride like a pro.
00:11
Driver.
00:12
Are you a Strava? Guy?
Trevor Connor 00:13
Absolutely. Well, you got me into it, you shoot swearing cursing you for all you’ve done to me.
00:20
I did I knew that you would be into Strava. Well, you can actually use Strava and your addiction to Strava to your benefit now, because if you head over to health iq.com slash velonews Health IQ, which is a company that provides life insurance for fit folks like us, you know, cyclists, runners, swimmers, vegans, whatever, whatever makes you fit, you can now use your Strava upload your Strava to health IQ, and use that to get a discount on life insurance. All you got to do is head to health iq.com slash velonews.
Trevor Connor 00:57
Do they provide for Canadians or will they just laugh at me?
01:00
No Canadians a lot. Sorry. Welcome back, dear listeners to another episode of Fast Talk. I am Kaylee frets senior editor here at Villa news and I’m sitting across the table from none other than Coach Trevor Connor, celebrity in the building. How are you, Trevor?
Trevor Connor 01:17
After that introduction, Kaylee, I’m doing great.
01:19
He’s looking swell. Let’s jump right into this today. The topic of today’s Fast Talk podcast is something that we get asked about all the time. I know that I get asked about it, and I definitely don’t have any answers. So I don’t know why anyone’s asking. Trevor gets asked about it all the time. He does have some answers. Lucky for us. The topic is cramping. Now I have had quite a bit of personal experience with cramping. Unfortunately, I have cramped really, really bad every single time I race Leadville. That’s all three times a race Leadville. That was really unfortunate and really painful. I’ve crammed to the end of long road races, I’ve cramped hours after long road races pretty frequently actually, you know, you sitting at the table at dinner and you put your foot behind you and all of a sudden your hamstring cramps up. That tends to happen to me all the time. And I’ve always kind of wondered why this is. Now there have been a lot of theories thrown around about cramping, sort of the most prevalent, I think, is this sort of electrolyte hydration based theory. And we’re here to tell you today that that is probably not the most likely reason that you are cramping. So this might be a little surprising to some of our listeners, because this electrolyte hydration story has been told for a long time. There are a lot of products out there that are reliant on this theory. So it’s wrong and it looks like it is then that has a dramatic impact on the things that you all do to keep cramps at bed. For more on this we caught up with Dr. Martin shrillness, head of the sports exercise medicine and lifestyle Research Institute at the University of Pretoria and director of an IOC accredited Research Center. He’s the guy who flipped the theory on cramping. We also catch up with Rob pickles, aka the illustrious Mr. Pickles, a world renowned physiologist currently working with pearl azumi and Kendall drapac. Pro, Tom squinch.
Trevor Connor 03:18
A quick note before we get started, Kelly and I recorded a podcast on cramping before he went to the tour. And then while he was away, I had this opportunity to interview Dr. wellness, which we definitely had to take, we combine the two together because we felt they both had some real value. But there are a couple points where the two recordings do contradict one another a little bit. It’s up to you who you want to believe. But personally, I would go with the guy who can legitimately claim to be the top expert on cramping in the world. So with that, let’s make it fast. Yeah, I will tell you I get asked about the electrolytes all the time and are asked about cramping all the time. And when I tell people it probably isn’t an electrolyte issue and taking those salt tablets that they think are going to cure their cramping might not work. I don’t get a lot of happy responses. It’s not what people want to hear people want to hear that. Yeah, you take some sodium and magnesium and the grand prize is going to go away.
04:13
So why is this controversial? Trevor? I mean, it seems like this is something that we would have figured out by now. This is this is a very common occurrence. This is a race ending issue. For a lot of people. It should be at the top of the list for the world’s sport physiologists and yet we don’t necessarily have any super definitive answers. And we may actually have been told the wrong thing for decades. That really surprised me as well. When I was doing my research on cramping actually, for an article that I wrote a couple years ago. I thought it was have a ton of science behind this.
Trevor Connor 04:44
It certainly has been researched a lot. But when you think about it, it’s a really hard thing to study. Because think about the times you’ve had a cramp. It’s often at the end of a long race. It doesn’t happen every race it seems to happen somewhat. Frequently, the issue is getting somebody into a lab hooking them up to the equipment and waiting for them to have a cramp. Which you just don’t know when that’s gonna happen.
05:09
And if I’m having a cramp I also don’t want to be hooked up to equipment. No, no, no. They have trouble.
Trevor Connor 05:15
They can electrically stimulate a cramp. But then really the only thing they can conclude about what causes crapping is we hooked up electrodes to you and shocked you, and that caused a cramp. So that really doesn’t answer why are you cramping out on a bike race? One of the the top researchers in cramping who proposed this alternate theory that’s that’s really what’s taking over now is a Dr. Martin. I’m gonna butcher this but swell illness in Cape Town, South Africa. And he actually came up with some creative ways of studying it. One was, he got 210 Ironman athletes to participate in a study, when they were doing an Iron Man assuming that of those 210. During an Iron Man, at least a few of them are going to cramp. And that was the case they had 43 that cramped, and he took blood samples beforehand, he took blood samples after and to look at the whole question of electrolytes and found that there was no difference between the cramping group and the non cramping group in terms of electrolyte balance in terms of their plasma levels, anything, it just the evidence was not there for this electrolyte theory.
06:28
Interesting. Maybe we should start with what exactly a cramp is, do we know what a cramp is? Not what causes it, but like, what exactly is happening there. I mean, you as you said we can, they, they’re able to remake cramps in the laboratory by shocking you with electricity, which tells me that we at least sort of know what they are, if not what causes them.
Trevor Connor 06:48
Crap, it just quite simply a muscle contracting, and then not relaxing, and inappropriately contracting, that can be really, really painful for you, especially if it contracts hard. But also, let’s say you’re on a bike and you’re pedaling, and all of a sudden your hamstrings contract, that means they want to stay shorten, and every time you go through that pedal stroke, now you have to forcefully lengthen that muscle, it’s not gonna be happy about that. And that can cause tearing that can cause a lot of pain,
07:15
generally unpleasurable experience.
Trevor Connor 07:19
So I think part of the reason you saw people tend towards it’s an electrolyte issue is obviously you had a neural activation of the muscles. And the sodium potassium is I don’t want to get too much into the physiology of nerve cells. But it’s a release of potassium and take up the nerve cell taking up sodium that causes a nerve to fire. Likewise, what causes the muscle to contract is a release of calcium that’s then absorbed back up. So the thought here is if these electrolytes start getting out of balance, your your nerves aren’t going to fire correctly, and muscles are going to have issues contract. But that in itself somewhat disproves the theory because if you are getting out of balance, all your neurons are going to start having issues. So why do you only have cramping in specific muscles that are working
08:15
right and working sort of overworking? Right? Well, so the latest and greatest science is suggesting that the actual cause of cramping is something called altered neuromuscular control. Trevor, I think now is a great time to drop into your conversation with Dr. wellness.
Trevor Connor 08:33
So first of all, let’s introduce you. Then I apologize. My I have a co host for the show, but but he can’t be here. He’s been over in France covering the the Tour de France and isn’t back yet. But wishes he could be here. How would you introduce yourself?
08:48
Yeah, that’s right. I I’m a sports medicine physician or sports physician, Molly case, physician and I am having an academic appointment at the University of Pretoria and as the director of a an institute here, which is called the Institute for sport exercise medicine and lifestyle research. And I’m also involved with the IOC for many years. I’m the director of one of the IOC designated research centers There are currently nine in the world and I see athletes still consulting and see them clinically and and then obviously have some teaching responsibilities for postgraduate training of doctors physiotherapists, and in the equivalent in your part of the world with, you know, is the athletic trainer. And so I do some teaching day and then you know, obviously I am a very active research program.
Trevor Connor 09:49
Oh, that’s it. That’s very impressive. And let me I’m worried I’m gonna mispronounce your name. It’s doctors wellness.
09:55
Yeah, shrillness. We’ll see Ah, it’s like wellness like I don’t if you have it They called ship. So these are trips. So the first two was exactly the same slash wellness. Okay,
Trevor Connor 10:07
wellness. Well, that’s right away, please correct me if I get it wrong. So I guess where I’ll start with is I wrote an article, it was back around 2011 on cramping and and went through a lot of literature back then on what the science behind cramping, what causes it. And most of what I read was at the more traditional theories about electrolytes and dehydration. And I remember finding your study and reading a few other articles saying, hey, there’s this idea out there. But at the time, it really just seemed like it was an idea that was a little more on the people are just hearing about it side of things. So it was really interesting getting ready for this podcast to go back, review all the literature. And now it seems like this is the dominant idea, which has to be very exciting for you. And it really seems like there’s there’s almost no debate left about what’s what’s causing cramping. But I guess the first question I have for you is, what was the traditional theory behind cramping? And how did that come about? Because it doesn’t seem like there’s a lot to back
11:15
- Yeah, very interesting. And I looked at all of that quite carefully before writing a review. And that was back in 2009. There was subsequently published in the British Journal of Sports Medicine. And also, you know, research the whole history and background of the principally the two main theories for cramping, which were dehydration, and then I just call them electrolyte disturbances because they varied over the years in emphasis from chlorine, you know, low chloride concentrations in the blood, which was first found in a few cases of workers when they were working on the Hoover Dam, and had developed cramping, but quite severe cramping. And at that stage, they couldn’t measure serum sodium concentrations, but I could measure serum chloride concentrations and found low fluoride in a few of these workers. But in reviewing the actual original original descriptions of this, it was quite clear that a number of these workers, although they were working physically and, you know, in a hot humid environment, I think if I remember correctly, about 60 to 70% of them, the ones that develop cramping also had underlying other conditions. They had gastroenteritis in the form in the form of nausea, vomiting and diarrhea, which particularly if you’re volunteering a lot, you’re losing quite a lot of chloride from Semak so wasn’t surprising. But those few cases there were about five or six cases where the first case is described where a connection was made between possibility of dehydration and electrolytes. In that case, chloride could be the result of the cramping. They also anecdotal reports from workers in steam ships in the turn of the last century medical records from the medical office on the ships saying that they’ve got cramping in these coal shovel is in the in the steam ships. And so I guess that’s where the the concept that the hydration electrolyte disturbance was born. And then it was never really tested, it was just accepted for decades. And when we saw more endurance sports developing and becoming more popular, and in fact, other sports, and whenever somebody developed cramping, especially with exercise, it was almost just assumed that this was the hydration electrolytes. My own interest in this was when I was looking at as a one of the doctors initially and later on being the responsible medical officer at endurance events, particularly running events, where the most common reason for admission to the medical teams at the end of these races was in fact, muscle cramping. And, you know, we then said ourselves that we don’t really know what causes this. We don’t know how to treat it properly. And as a result, it’s it started my own investigation into you know, what are the possible causes of this? And that was sort of in the mid early 90s, mid 90s.
Trevor Connor 14:29
And I guess the problem is, it’s a really hard thing to test. You can’t just bring somebody into a lab and say, okay, have a cramp now,
14:35
well, believe it or not, you can do that, but it’s not the same mechanism. So the all authority models to induce cramping and if I said to you that you could induce bootcamping in yourself, you know, with a 70 80% chance that you will if you take a muscle and put it in a very shortened position. So this would be easier in muscles that span across more than one joint and then contract that muscle in that shortened position. That contraction for anything longer than, say, 30 seconds, 40 seconds, there’s about a 70 80% chance that you’ll be able to induce a cramp. And you can get to the cramp by simply stretching the muscle out again. So you can induce muscles muscle cramping in the lab. The problem is, it’s not exactly necessarily the same mechanism, as we’ve seen, in in, for instance, endurance athletes. So, you but you’re right, it’s not an easy thing to study. Because, you know, we are either reliant on these models in the in a laboratory, which are not reproducible, in the field, or you’re reliant on, on on the circled field studies or clinical studies at these events. So my most of my research is in the clinical field type setting, because that, to me, is the real setting. But I have we have we have experimented with some laboratory models as
Trevor Connor 15:58
well, going back to the these traditional theories related to electrolytes and dehydration, why haven’t they been holding up?
16:06
Well, we set out to prove that that’s the cause of camping. And that was in them in the mid 1980s, and early mid 1990s. And the way we did it is we argued that if, if I take a run out of cycles to anybody who presents in the medical facility, who’s clearly crimping, then at that stage, if they are rational electrode disturbances are responsible for the accounting, then what we should be able to do is when we measure those objectively, then we should see the abnormality. And then more importantly, if we wait until the crimp is subsided, whatever the treatment may have been, because these do settle eventually, then the hydration should be back to normal and electrolyte disturbances should be back to normal. And then the third component that would be even better to show is that before the person started the exercise at the beginning of say, the event or the race, if we also measured the hydration status at that point, and then also the electrolytes at that point, then we will have a reasonably good study to show a so called cause and effect. So that’s what we did. We, the first one of the first studies we did is we took a lot of runners who say that they cramp regularly, so obviously there’s a chance that they will cramping the rice, then we before they started, we measured the body weight. And we also took blood samples to measure the circled serum osmolality, the concentration of all those moderately active particles in the blood. And we also made it all the electrolytes in the blood, then we waited for them at the end of the end of the race. And it’s one of those classic experiments, we kind of hope, but you don’t hope but you do hope that they develop some cramping. And of course, some of them cramped and so we had a we then had a cramp group and then we had a lung cramp group. And we were able to measure repeat these measurements at exactly the same time when they were in the medical team with an active crimp. And then we we treated them. And then we repeated all those measures again at the end of the before they were discharged when the cramps completely subsided. And we argued that if for instance it was a dehydration there would be no ladder to start off with DeAndre did when they a when they have this acute cramp and back to normal hydration when the crimper subsided, and similarly with any of the electrolyte disturbances. And we also then had a control group or a group of people who who never crimped and we obviously could compare them exactly the same kind of responses to the control group. And essentially, the first study we did showed that there was no difference between the controls you never cramped and the cram group. And then while they were cramping, the electrolyte concentrations and the osmolality in the blood, which is the you know, they’re a measure of dehydration other than body weight, which we also didn’t measure. We showed that there was no no difference between in not being cramping and not cramping. So there was a complete association between cramping and any of these two things, the hydration electrolytes, then we subsequently repeated that in a number of different populations and in much larger groups of athletes. One study was in triathletes. And we had a large number of triathletes in this particular in particular study. So we reproduce the same results in three different populations. And by that stage, we were convinced that, you know, dehydration and electoral districts were not related to cramping.
Trevor Connor 19:36
What then led you to this? So I believe in your research, you’ve called it the the altered neuromuscular control theory. What led you to in this direction,
19:47
right. That’s also a very interesting story because one of my very early research students, when we were sitting out doing this, we designed a question in two administered to a number of marathon runners and asked him about cramping. Not just only, you know, how did they cheat it and so forth, but you’re trying to ascertain what other factors that could be related to the cramping that they identified? And I, I can’t remember why we put in this question, but it’s just one of those things that didn’t pop into the question, but we asked them a question about prior to the onset of the cramping, were you able your muscles more fatigued than usual? In other words, was that a, you know, a precursor to cramping. And we found that a very large proportion of the of the runners indicated that that was the case. So one of the early onset symptoms of muscle cramping is that a that then that particular muscle in the rumpus said that they were more fatigued than, than perhaps in other muscles. So I went back and investigated whether anybody has ever looked at what happens to muscle control, the relaxation, contraction, and then relaxation of the muscle, when the muscle becomes fatigued. And they were two neurophysiologist, who published two papers, they work together. So one, one of them was the first author in the one paper, and then the other one was the official from the other paper, and they, Nelson and Hutton. And it was partially missed on sports, I think, in the mid 80s, if I remember correctly, and they they showed in these two papers, in an animal model, that if they stimulate a muscle that it becomes completely fatigued, then two very important reflexes that control you know, involuntary muscle contraction altered, so the one reflex is the so called muscle spindle reflex, which is the the reflex that if the doctor taps your tendon, and you then have a knee jerk, you know, the knee jerk reaction. And that’s the when the muscle spindle a very special organ in your in the muscle gets stretched, and then sends a signal to the spinal cord, and then the inter neuron and urine in between and then there’s a immediate signal from the main nerve that goes to the muscle called the alpha mo Janiero, and then that activates that muscle to contract. So that’s why when you tap somebody standing in your knee, and when they relaxed, then you get this knee jerk reaction,
Trevor Connor 22:23
right. So it’s basically a reflex reaction to protect the muscle from any sort of damage
22:28
and the muscle contracts in response to the stretching of the spindle. What happens when you muscle get fatigued and this is in the one paper from from these two neurophysiologists is that this reflex gets a highly exaggerated that the muscle spindle activity more than doubles in the muscle that gets fatigued. So if you like the muscle becomes more twitchy when it becomes fatigued. Then the second paper they showed is that the reflex that is does the opposite that causes a relaxation of muscle function or muscle contraction is a another organ which is called the Golgi tendon organ. And as the name says, it’s in the tendon. And when the when the muscle is contracted and stretched for a long time in usually 10 or 15 seconds, then the Volga tendon organ gets activated, sends a signal back to the spinal cord and releases not an exciting what we call an exciting neurotransmitter that releases and inhibitory neurotransmitter, and that in other words, inhibits the alpha merchant here and this nerve going to the muscle and it actually causes a relaxation. So you know, these are these are control mechanism as many many, many many organ systems in the body there’s always a, a in this system that elicits a response and another system that dampens or reduces the response. So in fatigue muscle they the same group, they also happen to Nelson showed that the Golgi tendon organ activity is mostly reduced. So you’ve got two problems, then when the muscle fatigue the one is you it becomes more excitable, why are they exaggerated muscle spindle reflex, and it becomes less able to relax this normal physiology by a dampening down or in inhibition of the Golgi tendon organ reflex. And in my one early papers, I drew a diagram it was like a, a balanced situation with the alpha motor neurons and that’s the the nerve that controls whether our muscle contracts or relaxes, that alpha motor neuron has inhibitory and excitatory signals going to it. And when these muscle fatigue then the excitatory signals increase and the inhibitory signals decrease. And that was the beginning of the the thought that this was a alpha, abnormal neuromuscular control mechanism. Of course, the situation is much more complex than that because there are many other reflexes and many other neurons that also connect to this alpha merchant neuron. And that can affect its control. So initially, we thought that the main reason for the cramping is muscle fatigue. The mechanism is this alpha Virginia and controlled spindle and kogatende organ. But now we understand that there are many other many other factors that could influence this alpha merchant neuron. And so the theory has moved away from the muscle fatigue theory to the abnormal muscle control theory. But we think that’s the common final common pathway of why people would develop a cramp is if there is an abnormal control at this alpha merchant neuron at the neuron that controls muscle contraction, we also now understand we’ve got quite a lot of good data to show that the fatigue bot is manifests itself when somebody where they are exercising or competing at a much higher intensity than what they normally train, train it, or the conditions are such that they are, you know, much more harder. It’s a tougher race, for instance, people training on the flatten is lots of hills, then it would be one of those factors that would increase the risk of developing this fatigue.
Trevor Connor 26:02
Imagine, that’s also why you would see a lot of cramping early in the season and athletes who aren’t used to race intensity yet.
26:10
Absolutely. And we have lots of data to show that cramping occurs in the last quarter or immediately after the race, not in the first quarter or in second quarter said. And it’s we also know that in athletes where the average running pace, they go out faster, they run faster than what they normally train it. Those are the you know, factors that would lead to premature fatigue. And to bring in the environmental issue as well, people say to me, you know, there’s this condition called heat cramps. Well, we don’t believe that there’s a condition called heat cramps, but hot humid environmental conditions are well known to be associated with early fatigue, right? So it is not the heat, but it’s the fatigue. That’s the problem, because people can develop cramping in cold conditions as well. So it’s not the temperature, it’s the it’s the fatigue. Is there anything else you want to cover? The risk factors, which I haven’t mentioned, we consistently find in all the studies that males or more frantic renting and females and older males are more prone to camping than younger males. And that there are some other underlying conditions. And I want to just mention injuries. In one study, we showed that if you don’t type for instance, before a race, in other words, you’ve trained hard, hard hard right up to the race, you haven’t given your muscles a chance to raced, they, when we do a blood test, we can detect that there’s been some muscle subtle muscle damage through the blood test called the creatine kinase or seek activity. And when you enter your race with a high seek activity, in other words, the subclinical, you’re not maybe not aware of it, but some muscle damage, you’re more likely to cramp. So the answer, you know, what I wanted to mention is just these other, you know, risk factors. So being male being older, and then also, you know, the pre race, muscle damage or injury. These are also risk factors for cramping that we have established and would be part of any advice practical advice on on how to prevent it.
28:20
Okay, so, Trevor, that conversation with Dr. shrillness was occasionally a bit over my head. Let’s just do a little recap here. So, altered neuromuscular control, quick definition, what do we need to know about this latest science in cramping?
Trevor Connor 28:37
simplest way to explain it is you have let’s call them organs or structures in your muscles that can control your muscle locally obvious example is you go to see the doctor he hits you on red underneath the kneecap with a mallet and your leg jumps. So you have these ways of causing muscles to contract relax locally. What this theory is saying is that normally, we always have a pretty good balance of impulses that excite the muscle and cause it to contract and impulses that inhibit and cause the muscle to relax. When a muscle becomes fatigued, that gets out of balance and what you see is an overbalanced towards the excitation. And also really important to know that it really only happens when the muscles in a shortened state, not when the muscle is lengthened. So when the muscles shorten, you can get this imbalance towards excitation that causes the cramping
29:33
Is this why when I’m sitting at a dinner table a couple hours after a bike race and like, move my my heel up close to my butt, and shorten my hamstring, all of a sudden my leg cramps in your hamstring disgust Yeah, it’s nice that make weird noises. Right.
Trevor Connor 29:49
And this is also remember we talked about this briefly in the interview. Most cramping occurs and muscles across two joints so your hamstring cause crosses your knee. It also cross crosses your hip, because those muscles can go through a very big range of shortening and lengthening. And especially, as you said, if you’re sitting down at the dinner table, if you’re on a bike, it’s easy to let that hamstring short.
30:16
So susceptability Why do I get a lot of these and some people don’t get any of them? I think that’s very rude. Then
Trevor Connor 30:28
one thing that has come out of these studies, were they electrically stimulate a cramp. And who would volunteer for that? I don’t know. But people do. They have found that people, there’s what’s called a threshold cramp threshold. It’s how much of an electrical stimulation they need to get before they can produce a cramp. And this again, further backs is altered neuromuscular control theory. People who tend to report cramping more in races have a lower threshold.
30:59
You just tell me I’m slow.
Trevor Connor 31:01
No, I’m telling you pick your parents. Actually, I like Kelly’s parents apologize to them. There they have
31:10
mom and dad. Yeah, worst.
Trevor Connor 31:14
So I’ll just pause it, take it out on your family.
31:18
I’m really disappointed in my parents right now. Because they really hurt and I really hate cramps. Anyway, sorry, continued over
Trevor Connor 31:25
other factors that can contribute that you can’t do much about age, older people tend to cramp a little more. Men tend to cramp more frequently than women. And injury can also be a big factor. If you think about it. The cramping starts with fatigue. If a muscle is injured, and it is not firing Well, it’s going to fatigue much quicker. So you are more susceptible to a cramp. But ultimately, this is fairly consistent in several studies that I read, you see a fitness issue, and you see an intensity issue. So when they took track athletes who were all about equal level, and then had them self report, when they were cramping in races, the triathletes who cramp more tended to go harder in the races. So they tend to put out better time, which makes sense if it’s a fatigue issue. You are going to fatigue the muscles much quicker. If you’re going harder, then you’re going to a higher percentage of your max.
32:27
Yeah, I mean, purely anecdotally, I tend to cramp when I’m not actually prepared for the race that I’m going into, which would explain my my cramping at Leadville. After covering the Tour de France every year, you know, the maximum I’m getting is hour and a half rides a couple times a week for all of July and then jumping in a seven hour mile bike race and beginning of August, it’s not too surprising that I get three quarters of the way through that and my legs start to essentially fail me,
Trevor Connor 32:51
right. And cramping tends to happen more at the beginning of the season, when people are less fit and where they’re going to fatigue more quickly because their bodies aren’t used to that intensity. As a matter of fact, the the team physiologist for Team Sky, said the same thing. So that’s when the cramping happens in the teams and in the early races when they’re just not the fitness isn’t quite there.
33:12
We’ve actually seen that in the classics quite frequently. We’ve seen we’ve seen guys like Peter SOG and cramp in some of the early classics and then not cramp at something like paragrah Bay.
Trevor Connor 33:21
But one of the questions I get asked a lot is why do you cramp more in the heat? And I haven’t found a single study that said that back set up says when we are actually and have people report on cramps, not a single one said yeah, we saw a correlation with hotter races cause more more cramping. So that might be a bit of a perception thing versus a strong reality
33:43
or because we were told for so long that this is a hydration and electrolyte imbalance issue that we just sort of went from put two and two together when when two and two maybe didn’t actually equal four there.
Trevor Connor 33:53
Right. And the fact of the matter is, when people ask me about cramping, and I tell them about this, they hate me because what they’re expecting me to tell them is, well, taking more sodium taking more magnesium, and you’re gonna be good and said I’m telling them well, you’re not fit. So go get fitter.
34:09
train harder.
Trevor Connor 34:10
That’s you get the I don’t want to hear that.
34:13
Alright, Trevor, you’re in town here. You’re in Colorado for about a week and a half. I happen to know that you went to a bicycle race on Sunday, how did that bicycle race go for you?
Trevor Connor 34:22
I was fighting a bit of a plague. So not my best. Not your best.
34:26
That’s okay, though, because you can still use that race and that race result even though it was not a particularly good one. To get a better rate on life insurance from health IQ. All you got to do is head to health iq.com slash velonews. And then you can upload your race results from USA cycling. You can upload your Strava as we said earlier in the show, and you can get a better rate on your life insurance. Because, you, Trevor, despite the fact that you were racing with a plague on Sunday, all right fit individual.
Trevor Connor 34:54
Now that we’ve covered the basic theory, let’s hear from Rob pickles, who’s worked with countless athletes in the lab setting and Help many with cramping issues. Talking from experience he finds a crappy may not be a single syndrome as you’ll see doctors wellness agrees.
35:08
cramping. Yeah, cramping is a topic that makes you go Hmm. cramping. You know the reason for that is it’s not well understood, because in my opinion cravings multifactorial, you can cramp for a variety of different reasons. And what’s important is that your strategy is something that combats that particular reason that you’re cramping, right. And so, we can cramp from exhaustive exercise because we’re glycogen depleted, we can craft from exhaustive exercise because, you know, our ATP and ATP situation is out of whack and we can’t release that actin myosin crossbridge we can cramp because of neuromuscular issues. You know, there’s products out there like the what’s that new thing called a,
35:53
Trevor?
35:54
The USB, it’s the nerve. It’s, um, it’s in the black bottle with a red cap. You know what it is? It’s like cayenne pepper bass.
Trevor Connor 36:03
I’m trying to think seriously.
36:05
I’m an idiot hand, you’re an idiot. Yes, we both are today. Perfect. There are products out there that are trying to combat cramping by stimulating your nervous system when you swallow their spicy drink. And so I think it depends on the cramp that you’re having if you’re having localized cramp in your calf muscle because you’ve been riding up steep hills. That’s different than having whole body cramping from an electrolyte situation and you need to deal with the two of those differently. localized cramping might not necessarily respond to electrolytes, it might not respond to your salt tabs. For me, unfortunate. And maybe I’m not as much of an expert in these areas. I could be because I’m not really a crapper. If I do an extremely hard, grueling ride that I’m not quite ready for, then sure my muscles get sore, and maybe they start to lock up a little bit toward the end. But in all honesty, for me, that’s an anomaly more than anything else. And I do know that other people, they cramp regularly, and they need to find what is their solution.
Trevor Connor 37:07
So this is where I wish I had Kaylee with us my co host, because he’s always the one that gets me from digging too deep into the science and brings us back to the the practical side. So looking at this from the athlete perspective, you said fatigue can be part of it?
37:24
Well, we think it’s still a big factor, you know, it would fatigue would be a major, one major mechanism, but there are other mechanisms that we think also play a role.
Trevor Connor 37:33
So from an athlete perspective, what would be some other factors?
37:36
Okay, certainly, maybe at this point, let me let me also, you know, make another big point. And there is a common misconception, and that muscle cramping or exercise associated muscle cramping is we’ve turned it is one condition with one cause. And we now understand that that’s not the case. Because, you know, it’s really a worldview culminates in a clinical syndrome. There is a clinical syndrome is defined as just a group of symptoms, and manifestations or signs. And it’s a bit like saying that, you know, it’s like a headache when I’ve got when I’m complaining about a headache, it could be the symptoms and signs are so hard and might have some muscle tension and so forth. But there are many many different causes of a headache, it could be anything from meningitis to, to sinusitis to tension headaches, etc, etc. So, in the same way, exercise especially muscle cramping is really a syndrome, we now understand it with a number of different possible causes, it can also range quite a lot in severity. So, it could affect a single small muscle group or a single muscle group in a limb or it could affect more than one muscle group including so called non exercising muscle muscles, which in the case of serenade would be your triceps muscle in your in your arm is a non exercising muscle. And then it could also be associated with a whole body whole body abnormality whole body disturbance, when they are things like altered consciousness involved, somebody feels dizzy collapse these comatose all the muscles contracts, in the body, etc. So, it is a more complex situation than being a single diagnosis and a single day for single cause. So I can understand that athletes and you know, people looking after them having to try and prevent this or treat it can become confused about this. And so people need to understand that, you know, this is this is just a sex thing. I’ve good knee pain, but there are many, many different causes of knee pain and I need to work out what is the what is the cause In my case, so, not to make it too complicated in arenas I think that we should be referring to these as either a you know, sort of primary muscle exercise, especially muscle cramps, and then circled secondly exercise Association. Sometimes the secondary ones, or when there’s another underlying, you know, secondary condition. And that’s associated. So we’ve just published a paper, we shown in a very, very large group of runners, that there are a number of different factors that are associated with athletes, particularly those with recurrent cramping. And so let me give you one example. And you’ll understand so if you take certain types of medication for anything from asthma, one of the pumps that, you know, the so called bt do stimulant pumps, or in many runners, older runners, they take a statin drug that’s used to lower cholesterol concentrations in the blood. Those two drugs for an exam, as an example, are associated with muscle cramping. And so if you take a statin or if you take a beta two agonist in a high dose, then you are more likely to develop muscle cramping because those also affect that neuromuscular control mechanism separately from from fatigue. You know, every runner every athlete develops cramping. If it’s a single episode, then it’s probably in most cases in most runners that I see. And I see lots of athletes with cramping, one can work out that in that particular event, what the precipitant was it that caused the premature fatigue, it’s usually not well conditioned for the rise going up too fast environmental conditions that were conducive to development of temperature, fatigue, etc. and that’s usually in the in the runner with the athlete with a one sort of episode. And we do get worried and can smoke concerned when somebody complains of regular repeated episodes of cramping all the time. And in those instances, we need to look at those what I would call the secondary causes. And we need to look at you know, have they got underlying chronic disease of some sort. You know, I’ve seen many campers with recurrent camping that have got a number of underlying conditions and mentioned one or two for instance, an underactive overactive thyroid gland. And as an example and and as I mentioned, the medication use as well. So, we go through all of that and they need to really recurrent companies to be seen by someone and then have a full on assessment of the entire health status and sometimes have to do some investigations to look at these more subtle conditions like hypothyroidism in order to make the right diagnosis because no no degree of training or you know drinking more fluids or electrolytes will so that the problem is the person has got a hypothyroidism for instance.
Trevor Connor 42:29
So somebody if one of our listeners right now is having very frequent cramping, basically they should be going in and getting a full medical evaluation.
42:38
Yep, exactly. That’s exactly right. They should have a full medical evaluation and and have a look at these so called secondary causes of cramping. We also I said that the it’s a it’s an athlete with recurrent camping I’ll just give a few other you know, more red flags. Somebody who should seek help would be if there’s a strong family history of muscle cramping, we have shown in one paper it’s a it’s a very very early Association but there there is a genetic components perhaps related to cramping so that your family issues the second one. The third one is if the crimping episode was associated with a whole body cramping in all muscles also non exercising muscles if they occur at waist, also not just during exercise, if the cramping has ever resulted in being singing, confused, comatose, altered loss of consciousness and then the last one would be if the cramping was associated with a very dark urine almost like red or black urine, you know, just after the cramping or in association with cramping and those are all you know, we call them red flags that should make an A an athlete with cramping go and see the doctor and explain what has happened to them so that they can be appropriately investigated.
Trevor Connor 43:54
Okay, and just to not over scare our listeners if you’re thinking well I’m a frequent crapper but you’re cramping in long hard races where you’re tearing yourself apart, we’re not necessarily saying that you need to say seek or that you have a medical issue that you need to go and seek help for right away. So we’re really talking about unusual and and frequent cramping here that often doesn’t seem to have a clear relation to Hey, you just ripped yourself apart on the bike and now you’re cramping.
44:22
Yeah, exactly. So but it emphasizes that if you have a you know, confused comatose a very dark urine blood, which is other which is usually a reflection of other blood red pigment from the muscle called myoglobin in the urine. Now, do you think that you need to get some help because, you know, that’s you may have heard of a condition called rhabdomyolysis but cramping and rhabdomyolysis can sometimes go hand in hand and that could be a serious condition. So I would also suggest that those people get to get some help but having said that, you know, a pollution but like 1000 you know, cyclist or runners with maybe listening to this camping. We talking about These serious forms of cramping that need medical help has probably been less than 10%.
Trevor Connor 45:04
We asked Tom scrunch his thoughts and crappy most because we love having Tom’s on the podcast, though I’m not sure whiskey is the best solution for cramping. So we’ll follow that up with some of our thoughts and then finish out the podcast with Dr. wellness, his advice, which is definitely the advice you should listen to
45:21
it just just drink pickle juice.
45:23
That’s actually that is a that’s like legit. I don’t do that. It’s awesome.
45:28
I won’t prove it is Oh, pickles in general.
45:33
I’m gonna just eat up a couple.
45:36
There we go. Like, you know, call up a tom saw them on the radio like,
45:41
hey, pickle juice?
45:45
No. I have, however, asked for whiskey.
45:51
Really? Yeah.
45:52
That was like one I think it was in Colorado, like one of the really cold days. And I saw a gas station. I was like, there’s a gas station, give me some whiskey.
46:03
And they just stopped for coffee. I was like,
Trevor Connor 46:07
Oh, it’s warm enough. So what I tell my athletes when they’re having cramping issues, and we’ll go, this will actually be a good segue. Let’s
46:16
talk about some of the things you can do. So there must be ways to prevent these things. Right,
Trevor Connor 46:21
right. But one of the things I tell them is before key races or before the start of the season, you need to go and get that intensity. So I send them out to those hard group rides and tell them rip yourself apart. And part of that is trying to prevent that cramp when I have an athlete who is very susceptible to cramping. I do tell them don’t make your first important race, also your first race, because you’re going to cramp. So So get it out of your system.
46:48
Okay, so, ways to prevent cramping. We’ve talked about training more. That’s that’s a way to prevent all sorts of different ways you can lose bike racing. What is there anything else that can be done? I mean, the way that you were using two terms for essentially, what’s forcing a contraction versus what’s forcing a a on contraction, a loosening of the muscle that I don’t actually remember. But you also mentioned earlier that the loosening of a muscle, the stretching of the muscle is a good way to stop a cramp. And that’s actually one of the things that has pointed to this altered neuromuscular control theory is the fact that you could stretch and essentially stretch out of a cramp. maybe explain that because that’s a good way. If you do run across cramps in the middle of a race, that’s a good way to get rid of them. That’s how I’ve always done I mean, at Leadville, I cramped to the bottom of Columbine on the way back, this is like 40 miles to go and still finish the race because you just sort of stood up for a bit, I probably lost two or three minutes stood up stretched, kept riding, it was okay. Right.
Trevor Connor 47:50
So let’s separate prevention from what to do when you’re experiencing a cramp. And maybe we start with what do you do and when you experience it, because you’re bringing that up. And still, the best treatment for a cramp when a cramp happens is stretching that muscle. Sometimes there’s ways to do it on the bike. And if you watch the Tour de France every once a while, you’ll see riders unclip from the pedal on a downhill and they’ll stretch their quad or we’ll try to stretch their their caps don’t
48:17
try this at home
Trevor Connor 48:19
At home, but I get periodically cramps in my calves. And so one things I learned in the research is going back to the injuries make any more susceptible is actually having a back problem. There was a whole study on rugby players and they found that back problems cause cramping in calves, which was a real light bulb for me because I’ve been having back problems for the last couple years and right when, at the same time that my back problems started having happening that’s when I started getting my cramping in my calves on training rides and and races and I kept trying to address the calves. It was actually a back problem. It was weakness in the back that was causing my calves to fatigue more quickly and cramp.
49:04
So what exactly is it about stretching that ends a cramp or prevents a cramp or keeps coming back.
Trevor Connor 49:10
So think about when you’ve done a stretch and you’ve held it for a couple minutes, you have this initial point where it feels like the muscles fighting against you. And then after you hold it for 30 4045 seconds, maybe a minute, you just kind of have this feeling and the muscle releases and all of a sudden you can sink deeper into that stretch. That is the Golgi tendon activating and and sending that inhibitory signal to reduce the excitation of the muscle. So again, this is why backs that neuromuscular theory, because that’s quite literally what the stretching is doing is shifting that balance between the inhibitory Gogi tendance and the excited x. I can never pronounce this
49:55
excited. Very excited.
Trevor Connor 49:57
Very excited. Very excited spindles So the crappiness caused by that imbalance, where the spindles are taken over and causing excitation. So stretching actually shifts the balance back and says no, now we’re gonna have the Golgi tendons dominate bogey tendons is a hilarious word. Like that one, I like
50:14
that one, it’s part of all of all the physiology terms that we throw around avasta Gogi tendons might be one of my favorites.
Trevor Connor 50:21
So another one, a little trick that I have employed. After I learned about all this, I went back to my old physiology books and looked up where the Golgi tendon is located because you get little clusters. And what I’ve actually done and I, I was in a race last year, we hit the base of a hill that was the critical Hill and I cramped. And what I literally did was jammed my thumb, right into an area where I knew I had a cluster and pushing on them can activate them, and that actually reduce the cramp enough for me to continue racing.
50:57
Hmm. I’ve heard about Yeah, like actually acupuncture and things being used, you know, dry needling being used to sort of alleviate really bad cramps,
Trevor Connor 51:05
no and same thing. You look at what the effects of massage has on the muscles, it again, reduces excitation increases inhibition, but unfortunately, nobody has done that study and until the study is done, it’s a theory but there’s no evidence for it.
51:21
So what else can people do if you’re in the middle of the bike race and you start cramping?
Trevor Connor 51:25
So here’s a couple weird ones
51:27
are like weird ones.
Trevor Connor 51:30
And this one, I don’t get it. But there have been two studies that show this is effective. hyperventilate, weird. The theory being that acidosis of the blood influences cramping. And if you hyperventilate, you are changing that base acid base balance in a way that’s going to reduce the cramping
51:56
is this sort of like drinking water upside down to get rid of the hiccups?
Trevor Connor 51:59
Probably. Except there’s actually research to back this one. I’ve never seen this. I’ve looked for a study and upside down with hiccups. My grandma says that that is the way that you do it to her. Okay. Yeah, Haley’s grandma is never wrong. strew Oh, hyperventilate, hyperventilate, gets rid of cramps. Okay,
52:18
that’s an interesting one. What else can people do?
Trevor Connor 52:20
So here’s one that I hate to bring up. And I don’t know if this is more preventative than what to do at the time, because I’m not sure anybody would take this with them in a bike race. And this was one of the bits of evidence that they they had for the hydration, electrolyte theory, drinking pickle juice. And a lot of people suffer from cramping swear by pickle juice. And I did actually find a study that showed that, yeah, hey, pickle juice helps a bit. But they even said, we don’t think it’s the sodium, we don’t think it’s actually the electrolytes there. Let me let me find this because I don’t want to get this wrong. what they said is they think it is the acidic acid that you find in pickle juice, and it actually affects a neural transmitter, that could then ultimately affect that inhibition, excitation balance,
53:11
weird pickle juice. So pickle juice, hyperventilation, stab yourself in the legs.
53:18
That’s it, that’s
53:19
another option with your thumb with your thumb. Nothing, nothing too sharp. Stretch, what else is there?
Trevor Connor 53:27
So that’s what the only things I can offer to do at the time. So let’s talk about prevention. And here’s one of my favorites that this is a quote out of one of the studies. That is possibly the nicest way that I can think of saying this, it says minimizing fatigue is the best strategy, which is a really diplomatic way of saying get fitter.
53:51
Right, makes sense.
Trevor Connor 53:53
But there are actually a lot of things that you can do to help beforehand. So we already talked about massage, hydration and electrolytes can help. But now the theory is it’s not because the dehydration or the the loss of electrolytes is what’s causing the cramping. It’s more that they delay fatigue. And that’s just proper nutrition and hydration, right?
54:15
Yeah,
Trevor Connor 54:16
you don’t get your electrolytes you don’t hydrate during the race, you know, what’s going to happen to you that contributes to fatigue. So if you’re taking them, you’re not going to fatigue as rapidly
54:25
returning to the training thing. Is there anything like is there a rule of thumb we should be going by here, you know, if you’re if your race is five hours long, your longest ride should be six hours long or something like that is there’s kind of a rule of thumb that people can use to make sure that they you know that they’re shocking their body to the right levels. And like I said, we’re seeing Peter sagen cramp in early classics races and then not cramp later. I mean, clearly, it’s just a repetitive repetition thing, right.
Trevor Connor 54:50
So you’re getting more my opinion as a coach and run experience. We
54:55
want your opinion as a coach Trevor. That’s why we have a podcast which Episode is this first time kalea said this, I gotta go.
Trevor Connor 55:05
Whenever I have an athlete that or a new athlete, and they say one of the big issues is cramping, that’s one of the things that I see a lot is they’re doing three hour races, and they’re doing a lot of one or two hour rides, or they’re going and doing the the group rides and racing for 35 minutes get ready for their two, three hour race. And then they always say it’s in the second or third hour of the race, and I’m cramping you go, right, your body is not used to that much intensity for that long, so the muscles are fatiguing, they’re not ready for this. And that’s why you’re cramping. So I am a big believer in you don’t have to do it a ton, but you should be doing rides that are at least as long, preferably longer than your races. And what I like to have them do is, again, I see a lot of riders ago, okay, I’m going to go out and do a four hour ride to do a bunch of intensity in the first hour and then ride really easy. I’d prefer the do some work at the beginning. But let’s throw in some really hard intensity in that third or fourth hour to get your muscles used to going hard when they are fatigued. And when I use those sorts of protocols with athletes, that seems to build the sort of fitness that reduces or eliminates their cramping, other prevention, and you might have already thought of this one. So we said a short muscle is more susceptible to cramp it because when a muscle is short, that causes the Golgi tendon to be less active. So to do this gets really confusing for a lot of people when you say it inhibits the Golgi tendon, and that inhibits the Gogi head tendons in inhibition which causes excitation of a loss. Yep, yep.
56:43
But that’s cool, but I got the I got I got the gist.
Trevor Connor 56:46
So the point is, short muscle is more susceptible to cramping. So getting a good bike fit is a factor and tell that when you go when you go into a good bike fitter, tell them I get a lot of cramping say in my hamstrings, what might be happening is you are in a position perhaps your saddles too low that your hamstrings are constantly in a shortened position and you’re making yourself more susceptible and they can adjust your position. So you keep that muscle a little more lengthened and you’re less susceptible to cramping. Interesting. Last one is what they call in the research corrective exercise. So it says it right in the title. It’s altered neuromuscular control. So doing things that help the neuromuscular sides of your muscles, there was a little bit of research, the plyometrics can help and that’s that activity that you do in the winter. Or you can even continue during the season of short explosive motions like jumping off of a box and then jumping again, as you hit the ground jumping over cones, those sorts of things, strengthening again a weak muscle fatigues quicker. And there was an interesting study where an athlete had a weakened glute muscle, which put a greater load on their hamstring and that was causing cramping. So as soon as they strengthen the glutes, the cramping went away. So off the bike strength work in the winter, if you are somebody who cramps a lot will likely help you.
58:12
Alright, stretch, poke yourself in the legs, hyperventilate, train more, and do box jumps.
Trevor Connor 58:23
All the parts of a good training program, this is what all my athletes do. Certainly for an athlete who’s cramping a lot in races, they might even want to just look at how are they prepping? For the races? Are they coming in, doing way too much training for it and maybe just want to think about resting for several days into the race to make sure that they’re they’re a little more recovered and see if they’re just going in with too much muscle damage. What are other things that athletes could do to help prevent cramping and a critical race? You know,
58:55
we spoke about the secondary causes underlying medical conditions, medication use, and so on. So, so if we’re not, you know, that would be one thing that our current campaign against the the other guidelines as to when they should seek medical help, but if it doesn’t fall into that category, then it’s all about avoiding and premature fatigue situation by the following main thing. So you know, it comes down to the training that they do in preparation for the race should be appropriate for the race, they should be well trained for the race. We spoke about immediately before the race, let’s say the week before that is definitely needs to be a taper for recovery so that they don’t go into the race with subclinical damage when they go into the race, then it’s a question of assessing what are the novel external factors that could be particular factors on a day and what environmental conditions will result in premature fatigue so they may need to taper down or turn down the intensity based on that. Rather, start off a little bit at a low intensity and And see how they progressed with the rise rather than going too fast at the beginning. And if the course with its cycling or running is a particularly demanding course being, say more hilly than what they used to, then we need to take that into account. So that you again, you don’t expose the muscles to premature fatigue, then be aware of the early warning signs of muscle cramping. And we didn’t really speak about this a lot. But we coined the term, the cramp prone states, other colleagues of mine have done some research in the US in ultra multi stage ultra events called the pre cramp state, and an athlete would can experience this and it’s when the muscle a muscle starts becoming tired and starts twitching. Now, the worst thing that you can do at that point is to try and run through that, right. And so I would advise them at that point to regard that as an early warning sign, and I’ve slowed down a little bit. And if there is an opportunity that could stretch the muscle, because stretching the muscle activates that call between an organ and causes a reduction in the twitching as we’ve discussed before, so they can do that. And they may have to reduce the intensity for a period. Until, you know, let’s say until the cost is now over the appeal part and now the download part and so on. So, the math, you do that for a time, and then need to manage the intensity of exercise do not aggravate that so called campaign stay to go into full camp, you know, then there would be other general things I mean, any any any athlete who’s involved in endurance sport, you know, the dietary factors are important. So in providing nutrients so that you don’t develop amateur fatigue, it would be a question of enough external nutrients in the form of carbohydrates or if you fat adapted athlete in fat intake would be important. So let me just generally call that in the nutritional strategies to prevent fatigue would be important. As far as food is concerned, I mean, we we advocate fluid intake, in in proportion to thirst, over hydration is a danger for development of hyponatremia, which can cause generalized body cramps as well and, you know, in fits. So hydration is a problem. And if anything, be rather slightly under hydrated and hydrated if you plan to cramping, so it’s opposite to what most people would believe. As far as other supplements and things are concerned, we haven’t really found any evidence and other colleagues of ours have also not found any evidence of taking salt tablets or magnesium or anything else. Maybe the last point that I would like to make is recent interest in substances which are marketed which, or pungent, various forms of it, but they’re, you know, hot chili peppers and pickle juice and a whole lot of other substances. And these substances, or sub city activates channels in the mouth, particularly on the upper gastrointestinal tract, do they overload the nervous system with a sensation, and are then used as a possible treatment of an acute cramp and then
1:03:20
recently advocated also as even preventing cramps, and the science behind that is very thin, the theory may be a good one, because it does it is one mechanism to perhaps alter this neuromuscular control by kind of tricking the nervous system into saying I’ve got a bigger problem with a lot of chilies in my mouth, and when my muscles and then, you know, hyper sensitization of these channels will cause a, a dampening down of muscle contraction to mean that sorts out perhaps the symptom and not the cause, and the causes the same, the cause is not a deficiency of Hot Chili Peppers in your mouth of cramping. So that’s not an answer to a problem that it would be a much wiser for an athlete to look at. What are they? What are the risk factors? And what are the causes of a particular cramping as we’ve outlined and discussed this afternoon,
Trevor Connor 1:04:12
right? I do remember reading about pickle juice, and they were saying that it actually affects neural pathways versus what a lot of people thought, which is just the high salt content of the juice.
1:04:22
Yeah, I think that’s the biggest contribution. I know the researchers who’ve done that research with the pickle juice and there’s a really good study, what they what they set out to do was to say, Okay, what we’ll do is we’ll give a high concentration of sodium chloride in the mouth, we’ll measure the concentration of sodium chloride. And if pickle juice in the mouth works, then what will happen is that it will increase the sodium chloride concentration in the blood and they will be no cramps. So what I did find actually was that it did delay the onset availability in new strength, not a you know, we spoke about that earlier, not one in the field, but it happened within a few seconds. So It’s impossible and they measure the concentrations of these ions in the sodium in the blood, then, of course, they wouldn’t have changed in a few seconds. So the main contribution of that research was that they concluded that this was on the basis of neuromuscular control problem and not a electrical problem. Okay, so what they started to do was to prove the electrolyte problem, and they actually prove the ledger, the abnormal neuromuscular control issue.
Trevor Connor 1:05:23
That’s fascinating. In that situation where you’re in a race, and that cramp hits you. What can you do?
1:05:31
So that’s a good question. And the best answer is, is what most athletes we’ve done a lot of research, what most athletes would say is the most effective treatment is to stretch it. And as it turns out, that stretching is the is the is that is the most physiological mechanism because it activates cells called the tendon organs, which then inhibit the muscle. So the most effective treatment for cramp is to, is to stretch it, a passive stretch, the initial 10 seconds may make it a bit worse, because you’re activating that very sensitive spindle. And then after about 10, or 15 seconds, in your whole stage, then the muscle will relax because it activates the Golgi tendon organ. And we proved that very, very well, it was using an EMG activity to measure that many, many years ago. So that’s the most effective acute first aid treatment of a cramp. The problem is what happens after that, because as soon as you get up, you can check this muscle again in a shortened position that can’t make come back. And so the the there will be a time lapse between that kick cramp and in the relief with a strange that the muscle just needs to recover from its fatiguing fatigue state. And in that time period, it will be an issue of you know, you can’t really go back to your your your race or your exercise, there will be quite hard. And you just have to let it rest. You can eat something to replenish energy, you can drink something, but not over hydrate yourself, but you just go drinking according to your fist. And then we would have to go back and analyze why did I get that? You know, where did I go wrong? Was it on the hill? I was going too fast? Or did I start off the race with them? You know, with sort of very hard training sessions right after the end of the race. You know, we didn’t speak but one of the other secondary causes is perhaps an acute illness. Did I not feel well, in the in the few days before the race? Maybe, you know, as I said, his use of medication? Am I using any medication that was recently prescribed? It’s interesting that the athlete needs to go back and work out. You know, what did what went wrong? Yeah. And then when you do get some professional help from people to understand as to duties it allowed,
Trevor Connor 1:07:48
and I guess the the one last thing I’d also throw in there just you mentioned the the issue with with shortening that you sent tend to see cramps more in the muscle that shortened. If an athlete is experiencing cramping, frequently the same muscle. Right now I’m talking about cyclists, I would also imagine going and getting their their position checked on the bike, because perhaps they’re in a position where the muscles constantly in a shortened state and length muscle might help.
1:08:15
Yeah, that’s a really good point. Thanks very much for bringing it up. You’re right. The other thing to do would be, you know, not to get yourself into a state where you are constantly sitting in exactly the same position to vary as much as you can, you know, while you cycling, while you’re running to actually very, very, you’re running style very this when you run to the surface that you run on, going but fast again, but slowly, we know you know, there’s a variation would be a good thing, do not get into that position where it’s in one one single position over time.
1:08:42
That makes a lot of sense.
1:08:45
All right, I think that’s a pretty good I think that’s pretty good little roundup of cramping and what to do about it and what causes it and the fact that and this is the big one here, the electrolytes you’re taking in or probably not, or the lack of electrolytes you’re not taking in are probably not the cause of your cramps, yet the cause of your cramps is probably something more like you need to train harder, which is again, as you as you alluded to earlier, Trevor, maybe not what our listeners want to hear. But alas we are we are here to bring you the hard truths here at Fast Talk dude out there.
Trevor Connor 1:09:18
I like that. The hard truth. This is Trevor Connor and Kelly frets and this is 60 minutes.
1:09:27
That was another episode of fast dock. As always we love your feedback. Email us at Webb letters at competitive group comm subscribe to Fast Talk on iTunes, Stitcher, SoundCloud and Google Play. Be sure to leave us a rating and a comment. While you’re there. Check out our sister podcast, the velonews podcast, which covers news about the weekend cycling. You can hear me share my amazing thoughts and opinions on that podcast as well. I actually know what I’m talking about. And that podcast I’m like this one where I just asked lots of questions. Become a fan of Fast Talk on facebook@facebook.com slash velonews and on twitter@twitter.com slash velonews That stock is a co production of Connor coaching and velonews which is owned by competitive group. The thoughts and opinions expressed on fast stock are those of the individual for Trevor Connor. I’m Kaylee fretts. Thanks for listening
