Cramps are one of the main racing nemeses. Along with toilet issues and nausea, suffering with leg cramps is a deeply painful and often PB-ending running experience.
Over the past month I’ve had a runner battle through an ultramarathon with his leg spasming and another nailing his sub-3 marathon with cramping near the end. Both runners were male, well-trained, well-hydrated, well-fed and well…-salted.
Who cramps – and why?
There are a couple of peculiar patterns around cramping. Digging into the science, the risk of muscles spasms and cramps increases among those with “underlying chronic disease, medication use, a history of running injuries, and experienced runners.”[1]
Other risk factors identified by a study of Ironman athletes found cramps linked to “(1) exercising at a higher intensity during a race that may result in premature muscle fatigue, (2) an inherited risk (positive family history), and (3) a history of tendon and/or ligament injury.”[2]
And in another, those who suffered greater muscular damage had a higher rate of cramps; damage due to an absence of strength conditioning prior to their race.[3]
So, broadly speaking there seems to be two core causes going on. Something underlying – an allergy, a history of cramps etc – which unfortunately just puts some runners at greater risk of cramps. The other group (the larger group) are those experienced runners, who are exercising at a high intensity, without the strength in their muscles that the race demands.
What causes leg cramps?
Historically, cramps were considered as related to dehydration and mineral loss, and to a certain extent there is still merit in that view. A dehydrated runner puts their muscles under a lot more pressure to respond to requested work than a well-hydrated one. But as ever, correlation does not mean causation and digging deeper, the current explanation for cramping is the “altered neuromuscular control” hypothesis.
This hypothesis posits that through extended use, neuromuscular fatigue increases abnormal spinal reflex activity – rapid, involuntary responses which are crucial to our survival. Think when you touch something hot and how your hand pulls away, that’s what we’re dealing with. Disruption there leads to an imbalance in receptors where our tendons attach to muscles, and those that detect muscles length, contraction etc.[4] In layperson’s terms – we start short circuiting.
This happens more often when the muscles contracts while it is already shortened – which is why stretching (i.e. lengthening it) can help. The level of muscular fatigue is individual to each, well, individual – meaning that one person’s threshold to trigger these changes will be different to another.
How to prevent, and cure, leg cramps?
The reality is that with leg cramps, there is a whole bunch of causes – environmental, dehydration and neuromuscular – and therefore if you suffer from cramps, taking a multi-pronged approach will help.
Preventing cramp
1. Stay hydrated. The scientific literature hasn’t ruled out dehydration as a partial cause, and logically keeping on top of fluids and minerals is only going to support your muscles in the long run (pun intended). If you can feel the start of cramps mid-run, drink. And go into the race as topped up as possible.
2. Increase muscular fatigue resistance. Obviously I’m going to say do some strength and conditioning, but it really does work.[5] Build the resilience in your legs to make sure they can withstand the impact races put under them. You need to build strength in muscles under contraction – so they don’t panic and start short circuiting – and resilience under lengthening, to decrease their tendency to switch off. Focus on load for building strength, plyometrics and those targeted towards the neuromuscular system. Quads, hamstrings, glutes and calves. Love them and they will love you.
3. Consider KT taping*, compression garments and/or massage therapy (or a combination thereof) if you’ve got a particular concern or difficult race coming up.
*Ladies: KT taping can help with period pains too.[6]
When cramp strikes
1. Passive stretching. Lengthen the muscle that hurts. Rest for a bit. Walk for a bit. Use a different part of your foot to run on (e.g. up hills, try getting off your toes).
2. Take on salts. I know! Exciting isn’t it, this science stuff. So lack of salts may not trigger cramp, but taking on salt can help cure it. If you can, pickle juice has been found to be one of the best things due to its vinegar content. If not, try salt and vinegar crisps.
Optional 3. Swear. Ask a marshal for a hug. Swear again.
Cramping is very frustrating, but with knowledge of the breadth of potential triggers, taking a preventative holistic approach will help avoid having to accost marshals while being a sweaty mess.
[1] Underlying Chronic Disease, Medication Use, History of Running Injuries and Being a More Experienced Runner Are Independent Factors Associated With Exercise-Associated Muscle Cramping: A Cross-Sectional Study in 15778 Distance Runners – PubMed
[2] Factors associated with a self-reported history of exercise-associated muscle cramps in Ironman triathletes: a case-control study – PubMed
[3] The Journal of Strength & Conditioning Research
[4] Exercise-Associated Muscle Cramp-Doubts About the Cause – PMC
[5] Exercise-Associated Muscle Cramps: Causes, Treatment, and Prevention – PMC
[6] The Effect of the Kinesio Taping and Spiral Taping on Menstrual Pain and Premenstrual Syndrome – PMC
