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The Irish Society of Chartered Physiotherapists

Cramps by Stephen Coleman

Most people will likely have experienced a muscle cramp at some point int their lives. Muscle cramps during exercise and sport are very common and are referred to as exercise associated muscle cramps (EAMC). A cramp is essentially a painful involuntary contraction of a working muscle group or a spasm. It is usually localised and found in one muscle at a time with the calf or gastrocnemius muscle being the most commonly affected. The hamstring and a part of the quadriceps muscle known as rectus femoris are also prone to cramping as cramps usually occur in muscles that involve two joints.

The likelihood of experiencing a cramp increases with increased exercise frequency, duration and intensity. A cramp can then take anywhere from a few seconds to a few minutes to resolve. They are especially common in duration over long distance events like marathons and triathlons, although they are prevalent in many different sports at all levels.

Despite EAMC being very common, it is poorly understood in terms of what actually causes it to happen. There are two leading theories. The first is to do with an electrolyte imbalance, that would typically increase with dehydration. K

ey electrolytes like sodium, potassium and chloride play an important role in keeping body fluid balanced. They also play a role in how effective nerves are at transmitting electrical signals that control muscles. During exercise the body sweats and these electrolytes

are lost in that sweat. This can result in an impaired ability for the nerves to control the muscles effectively and a cramp is initiated as a result.

The second theory is that there is altered neuromuscular control, which essentially outlines how due to muscle fatigue and overload, there is a mismatch in how the nerves excite and inhibit the electrical signals to the muscle, which results in an over excited impulse that contracts the muscle in a painful cramp.

So, what to do if you experience a cramp? The best thing to do is usually reduce the level of activity and therefore reduce the load on the affected muscle. Static stretching is also a first line of treatment, which as long as it is slow and sustained should be able to lengthen the affected muscle and reduce the nervous system excitation in the area. Maintaining good fluid balance with proper hydration and electrolyte maintenance is also advisable.

A cramp can leave soreness in a muscle that can even last for a few days. However, there is very rarely any lasting damage that is caused and with rest and proper care and activity modification following a cramp, you will be able to return to exercise in a few days at most. If however, you are experiencing regular intermittent muscle cramps that are not exercise induced you should get it checked out by a GP or healthcare professional in case there is another potential reason for it.

If you want to see a handful of stretches that can be done for the calf muscles, check out the video on the topic on our Facebook Resource Group, (10) Galway Bay Physio Resource Group | Facebook

You can also get it touch with us at Galway Bay Physio on 091 569 706 or visit us at to book an appointment, and we will be able to help you with any pain you may be experiencing.

Stephen Coleman
Chartered Physiotherapist

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