Combating Muscle Cramps and the Side Stitch
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.