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Solving the Cycling Cramps Prevention and Treatment Mystery

Muscle Cramps - The intense, involuntary contraction of a muscle either during or immediately after exercise. Not only can they be painful, but can shut down your race, ride or celebration. This episode looks at some science-based treatments, some no so science-based treatments, and how to finally solve the mystery of your cramps to get you riding stronger than ever.

They are so common that I’m willing to bet that almost everyone who has tried cycling has had a muscle cramp or has a friend who’s had one. When I mention cramps, I’m talking about Exercise-Associated Muscle Cramps or EAMC, which are localised cramps rather than all over cramps.

Something else that is shitty about muscle cramps is that they are a medical mystery. There is no really convincing biological explanation for them.

One quick note: There is a lot of people that deal with cramping in absolutes which is just garbage. Absolutes are never the case in most things - so whether it’s a scientist, sports nutrition company or me telling you the best and only way to do something - do take it on face value, prove it for yourself.

A review done on cramp-related studies done in 2010 concluded the following:

“Despite the prevalence of EAMC, few experimental data exist on their cause, treatment, and prevention. Although several theories have been postulated for their cause, much of the evidence is nonscientific or observational; thus, causation cannot be inferred. Numerous untested, anecdotal prevention strategies exist for the prevention of EAMC (eg, pickle juice). The level of evidence for these prevention strategies is low (level 4 or 5). It is likely that the cause of EAMC is multifactorial. Stretching appears to be effective regardless of the cause of EAMC.”

It’s not very satisfying to hear this, but it doesn’t stop people from having a bunch of different recommendations.

As far as studying cramps is concerned, I couldn’t pinpoint why it’s hard to study cramps. I believe it’s more to do with how hard it is to induce realistic sports cramps.

The three leading hypotheses about how to treat cramps and how to prevent them:

  1. There’s the dehydration proposal that you just need more fluid. This common belief that dehydration causes muscle cramps and muscle spasms are becoming less credible.
  1. Then there’s the electrolyte hypothesis that what you really need is sodium, magnesium, and potassium. Not proven - I’ll link to a great article that goes through the 4 studies done on this since 1986.
  1. The third hypothesis is an imbalance between nerve signals that excite a muscle and those that inhibit its contractions. And that imbalance is said to occur when a muscle is growing fatigued. This also has not been proved in a rigorous study.

Interestingly enough though, the guy that studies this hypothesis, Dr. Martin P. Schwellnus, a professor of sports medicine at the University of Cape Town.Used a recent observational study on triathletes to recommend the following

Four risk factors for developing muscle cramps:

- Aggressive pacing strategies

- Racing at a higher intensity than what you normally ride in training

- Riding for longer than  you‘re used to

- Doing another type of exercise you’re not used to

The difference seems to be that the cyclists who try to punch above their weight on any given day increase their risk of cramping.

Cramping Prevention

So it doesn’t appear that nutrition has much at all to do with localised muscle cramps during exercise. Sadly many sports scientists and dieticians still advocate disproven remedies for preventing EAMC, despite recent scientific evidence to the contrary.

Training and Bike Based Cramping Fixes

  1. Strength Based Training - If you think your cramps are due to a fitness issue - not necessarily cardiovascular fitness, but muscular fitness in specific areas of the body, these deficiencies can be worked on. EMAC is localised muscle, so the one or two groups of muscles could be worked on the improve strength.
  2. Bike fit - If you are not setup correctly your body could be putting more strain or stress on a certain area of your body, meaning it wears it down quicker.

Nutritional Cramping Remedies

Finally, for a bit of fun, I thought to go through the cramp remedies that are around, might help you out. You never know -  you might find the one that'll work for you, and because I am not willing to rule them out - and scientific studies generally lag behind what’s happening in the real world.

To help with salt absorption through the skin. Debunked, but I thought I’d throw it in. I never heard of something so crazy.

Quinine has been used to treat muscle spasms or muscle cramps. It has been taken off the market in tablet form (for over the counter sales) because it can damage blood cells. It is not approved in Australia or the US for treatment of muscle cramps, the other type of cramps mind you, not the ones related to cycling.

There was a study down in 2002 that showed that short-term treatment with 400 mg quinine per day can effectively prevent nocturnal leg cramps in adults without relevant side-effects. This is not a direct link to EAMC. http://www.ncbi.nlm.nih.gov/pubmed/12074203

Interestingly though, if you want to try this, be aware that there is about 83 milligrams of quinine in a liter of tonic water. So you would have to consume nearly 5 litres of tonic per day to replicate this study.

Based on the premise that Certain mechanisms within muscles misfire when a muscle is extremely tired. Small nerves that should keep the muscle from over contracting malfunction, and the muscle bunches when it should relax. Pickle juice may work by countermanding the malfunction. Something in the acidic juice, perhaps even a specific molecule of some kind, may be lighting up specialized nervous system receptors in the throat or stomach, which, in turn, send out nerve signals that somehow disrupt the reflex melee in the muscles.

Ultimately, it’s probably the vinegar in the pickle juice that activates the receptors to relieve cramping more quickly when drinking pure vinegar over pickle juice.

The recommendations on how much a couple of ounces, so well under 100mls.

Some athletes turn to fast-food restaurants for a more unlikely source of cramp prevention: mustard packets.

Cramps can be caused by a deficiency in acetylcholine, the neurotransmitter that stimulates muscles to work. Mustard contains acetic acid, which helps the body produce more acetylcholine.

One or two spoonfuls of mustard, the equivalent of a fast-food packet, are all that’s needed to provide relief. Some athletes take mustard prior to races or strenuous workouts or during a session.

Replenish lost sodium. A mustard packet has about 200 mg of sodium in one tablespoon of mustard, which is the same as eight ounces of Gatorade Endurance.

As for the dozens of commercial products out there: I’m saying they’re bullshit. But test the result you are going for. Otherwise, they just become expensive crutches.

How to Identify Your the Solution to Your Cramping

Here’s what I would do, and this is based off my buddy Craig’s approach to cramping.

Pick 5 of the lowest friction options. By low friction I mean, the easiest/cheapest to implement. Order them from easiest to not so easy. And work down the list.

Be aware this is pseudo-science - as it’s an experiment of one. So it needs some controlling factors. Especially at the testing phase.

A couple of things to consider:

a. Conditioning and cramps occurring during hard/long rides and races. You will need to simulate these conditions. Saying that though, you don’t want to experiment on race day.

b. Keep all other things consistent. Only focus on one item at a time, it makes the process longer, but it makes life a lot easier when you pinpoint the reason.

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