Muscle cramps occur at the most inopportune moments, whether during sporting events, light exercise, or even while sleeping. The surprise attack of muscle cramps during any sort of workout can render an athlete temporarily, yet painfully disabled. Their victims can range from elite athletes to sedentary individuals. Any inconspicuous movement can precipitate muscles in all body parts to suddenly spasm, ranging from a slight tic to an extremely painful contraction. Muscle spasms can also cause a fracture in an individual who is in advanced stages of osteoporosis.
Technically, a muscle cramp is a sustained, involuntary muscle contraction, occurring when a muscle tightens and shortens, causing sudden severe pain. Although the exact physiologic mechanisms behind muscle cramps are not fully understood, they are believed to be caused by a variety of factors. The most common cause is overexertion, which causes oxygen deprivation, leading to lactic acid buildup in the muscle, and forcing it to react in the form of a spasm. Other factors include: dehydration, low glucose, electrolyte imbalance, inadequate conditioning, and fatigue. Electrolytes such as sodium, magnesium, calcium, and potassium help cells function normally. An imbalance occurs when there is too much or too little of one or more electrolytes in our system.
Muscles in most all parts of the body can be affected by cramps. They generally occur in three different muscle groups; the quadriceps, the hamstrings, and the gastrocnemius. The first treatment approach is usually massage. You should gently massage the cramped area with your hands. Then, stretch the muscle out slowly, as long as you don’t feel pain. The following stretches can relieve cramps of the quadriceps, hamstrings, and gastrocnemius muscles.
Quadriceps: Lie on your side with cramping leg on top. Keeping the bottom leg straight, grasp the ankle of the cramping leg and pull backward, attempting to touch your heel to the back of your leg. Hold for 20-30 seconds and repeat as needed.
Hamstrings: While lying on your back, raise the affected leg and bend the knee so your hip and knee both form 90 degree angles. Grasp the back of your knee with your hands and try to straighten your knee until you feel a comfortable stretch in the back of the thigh. Hold for 20-30 seconds and repeat as needed.
Gastrocnemius: Stand about three feet from a wall. Keeping your knees straight and heels on the floor, lean forward into the wall supporting yourself with your hands. You should feel the stretch of the lower legs. Hold 20-30 seconds and repeat as needed.
Another method of relieving skeletal muscle cramps is to apply antagonistic pressure to the cramping muscle. Every muscle group has an antagonist: a muscle that acts in opposition to another. For example, the hamstring muscle is the antagonist of the quadriceps muscle. Use the following procedures to apply antagonistic pressure to the quadriceps, hamstrings, or gastrocnemius muscles.
Quadriceps: If the right quadriceps is cramped, sit and place the left ankle behind the right ankle and pull back with the right ankle while pushing forward with the left. If the cramp occurs in the left thigh, reverse the procedure.
Hamstrings: If the right hamstring is cramped, sit and place the right ankle behind the left ankle. Push forward with the right ankle while applying resistance with the left. If the cramp occurs in the left hamstring, reverse the procedure.
Gastrocnemius: If a cramp occurs in the right calve, sit or lie down. Place the left foot over the right instep and pull the right foot up toward you applying resistance with the left foot. If the cramp occurs in the left calve, reverse the procedure.
In addition to these three muscle cramps, there is a fourth, very common cramp that occurs at the abdomen and is not caused by dehydration or electrolyte imbalance. Most people refer to this as a “stitch in the side” and it’s usually located on the right side, just below the ribs. This stabbing pain is actually a spasm of the diaphragm and it can leave a runner dead in their tracks. The diaphragm is a muscle that stretches across the chest cavity below the lungs. As we inhale, it expands downwards, and as we exhale, it contracts upwards. The side stitch can be caused by inadequate oxygen delivery to the breathing muscles, the diaphragm and the intercostals, or even excessive deep inspirations and expirations. They can occur when we run too fast or breathe too rapidly without getting enough air into the lungs during inhalation, or when we don’t expel enough air during exhalation.
Combating the “stitch in the side” often focuses on proper breathing technique. If you typically take a lot of shallow breaths while running, the diaphragm remains in a high position and never lowers enough to allow the connective ligaments of the liver to relax. The diaphragm becomes stressed and a stitch results. Learning how to “belly breathe” can prevent the stitch from occurring. To belly breathe, contract your abdominal muscles and pull your stomach in as you exhale. Try to force as much air out of the lungs as possible. Then inhale as much as you can. As you inhale, your abs should swell, pushing your stomach out and allowing room for your lungs to fully expand.
Once a side stitch occurs, pressing on the side may relieve some of the discomfort. You may have to stop and walk for a few moments while concentrating on deep breathing. Bending forward and contracting the abs can help expel all the air in the lungs also. Continue running after the stitch has gone away. If you find the stitch continually occurs while you run, try altering you breathing / stride pattern. If you always exhale when you right foot strikes the ground, try exhaling on left foot strike. This may provide relief because the organs attached to the diaphragm on the left side of the body are not as big as those on the right; therefore, there is less strain on the diaphragm.
Some other factors that contribute to the “stitch in the side” include running downhill which increases the forces exerted on the entire body, eating too soon before exercise, running in extremely cold temperatures making it uncomfortable to inhale fully, and weak core muscle. Simply try jogging slowly down hills until you’ve mastered deep breathing, then progress by increasing your pace. Avoid eating food within one hour of exercise with the exception of water or Gatorade. Liquids empty from the stomach faster and shouldn’t cause a problem. Also try some sort of warm up indoors before venturing outdoors in the cold and strengthen your abdominal and lower back (core) muscles.
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