Almost every athlete complains about them, from professionals to the weekend warrior. Exercise-associated muscular cramps or (EAMC) are those sudden, involuntary, spasmodic and often very painful contractions of the muscle. A complete review of athletes muscle cramps appears in the July 2007 issue of the Journal of the American Academy of Orthopaedic Surgeons.

Lead author Javier Maquirrian, MD, from Buenos Aires, Argentina says the muscles more commonly affected by EAMC are:

-- Calves and Feet
-- Hamstrings
-- Quadriceps
-- Triceps

These muscles are already often contracted and in a shortened position during sports activities. Dr. Maquirrian stated that muscle cramps occur more during competition rather than in training, but delayed or nighttime cramps in fatigued athletes can also be attributed to exercise.

"There are some muscular cramps that develop in healthy people simply linked to certain circumstances or conditions such as exercise or pregnancy," said Maquirrian. "However, muscle cramping (non-cerebral) that is sometimes inherited can also be a symptom of other underlying medical conditions like Parkinson's disease, hypothyroidism and diabetes, as well as electrolyte disorders, metabolic or vascular disorder, nerve root damage, low serum magnesium levels or medication use, such as statins."

Symptoms of athletic muscle cramps include:

-- Explosive onset
-- Acute pain
-- Visible, palpable contractions presenting in one or more muscle
-- Swelling
-- Persistent soreness lasting two to three days

To help prevent muscle cramping, athletes should:

-- Be well conditioned for the activity
-- Avoid dehydration (drink plenty of fluids before, during and after athletic activity and exercise, especially in hot humid weather - sports drinks with electrolytes become more important in endurance type activities lasting over one hour)
-- Do routine and periodic stretching, particularly of affected muscle groups;
-- Maintain a well balanced diet (including electrolytes and carbohydrates) to avoid fatigue during the exercise
-- Reduce the intensity and the duration of exercise if necessary

When athletes have recurring cramps, orthopaedic surgeons must rule out other muscle conditions including spasms, antalgic contracture (which causes a person to change position or gait to lessen pain and which may last several days), pain without contracture and painless contractures.

On occasion muscle biopsy or eletromyograms (EMGs) (which take recordings of the affected area) maybe necessary to discover the cause of cramping, including metabolic muscle disease. However, some rare genetic conditions, such as myalgia, often cannot even be detected with an EMG.

Athletes presenting severe or generalized cramps in muscles not subjected to exercise, or localized cramping together with confusion, altered state of consciousness or other signs of central nervous system involvement should receive immediate emergency medical attention. This will help rule out volume depletion, electrolyte imbalance, acute renal failure, intracranial disorders or other nervous system conditions.

Academy of Orthopaedic Surgeons