When I was younger than I am now, I was an avid mountain biker. I loved the outdoors (and still do) and going fast on a mountain bike seemed like the right thing to do at that time.

I was with some friends at our favorite location in the Trask Mountain area of the coast range in rural Oregon. We just finished the accent from Flying M Ranch to to the top of the Trask and were heading back down a logging road. I was clipping along in front of my buddies at about 40mph and, unfortunately, felt my quads shorten and quit responding to the signals from my brain. My hands were the first body part to the rescue and they squeezed the brakes and as soon as my bike slowed to an acceptable pace.  I fell over and started rolling around in the dirt. It’s a pitiful thing seeing full grown man-child in such a state and when my friends came around the corner, they graciously came to a stop and helped. I asked for help and one of them said “What can we do? I said, “rub my quads.” Now these guys were solid and without hesitation they helped me but that will go down as one of the most embarrassing moments of my life. Whatever. The cramps went away after a couple of minutes and life went on but I wondered what I could do differently in that situation.

Cramps are no fun, but most of the time they don’t last and easily avoided if you know what to do. Most people think that cramps are only caused by dehydration and electrolyte depletion from a loss of sweat which contains electrolytes. Both of these conditions can be contributing factors, but they are no longer considered to be the primary reason for muscle cramping.

A muscle cramp is an involuntary contraction or shortening of a muscle that may be caused by  to the following conditions:

Dehydration and electrolyte imbalance – Yes, I know that I said in the paragraph above that electrolyte loss from sweating wasn’t a primary cause. There is alot of debate about this one. We know that depletion of calcium, magnesium or potassium or excess of phosphate (altering the calcium/phosphate balance) can lead to muscle cramping in medical study settings and there are causes for each of these including low function parathyroid gland, low vitamin D3 levels, medication use, The funny thing about this is that, because it’s an easy suggestion people think that all they have to do is drink some Gatorade or some other electrolyte mix and they’ll be fine. In truth it’s not likely that a mere deficiency of any of these important nutrients is the cause. It may be due to a loss of electrolyte balance rather than an individual depletion that causes cramping. Making sure to have your doctor check your vitamin D3 status on occasion, staying hydrated, and eating a balanced diet will ensure that neither of these problems contribute to your risk for muscle cramps.

Alteration of acid/base balance This can caused by hyperventilation for long periods of time or through the excessive ingestion of alkaline salts. Overconsumption of foods that are considered acid or alkaline producing probably won’t cause the muscles to cramp as some would have you believe, but ingestion of alkaline salts has been shown to induce tetany in the muscles. Given that the activities above require a lot of effort, avoidance of those behaviors will decrease your risk for developing muscle cramps.

Lesions in the brain – What I mean by “lesions” is areas of the brain that are not functioning properly due to physical changes in the tissues. Basically, if you have a problem in a certain area of your brain, you can develop muscle tetany or cramping. But this is not a very common condition if you have it, you will know long before you sat down to read this article.

Medication use – blood pressure medications that alter electrolyte balance can lead to an increased risk for developing muscle cramps. Antipsychotic medications have been shown to do the same, especially in elderly populations. Always check the side effects of medications you use before taking them so you can understand how it will affect you.

Poor neuromuscular control – This happens when you have a voluntary muscle contraction under load that is beyond your ability to control. Translation: you are asking muscles to do activities that your brain doesn’t think they can do. Your brain is either protecting those muscles by causing them to contract or there is a miscommunication between the brain and the muscle because the muscle has been stretched beyond the point where the brain can effectively control it. I don’t know that science has determined the exact reason but suffice it to say, you should not perform activities that are over and above your bodies’ ability to deliver. The way we deal with this is we do CARS and PAILS/RAILS exercises originally developed by Dr.  Andreo Spina. These exercises improve joint mobility train your muscles and your brain to develop greater neuromuscular control at end range and allow you to do more activities and decrease your risk for cramping.

Muscle cramping is a complicated process that usually requires simple interventions in order to avoid experiences like I had when I was a pup.

~ Dr. Hyatt


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