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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

April 1997

Muscle Cramps Cramping Your Style?

By Rick Allen, DC

Picture this: you've practiced for months for the competition tomorrow. In fact, like some of the competitors I interviewed last issue, between work, family, and dance practice, you've really been burning the midnight oil. It's 2 A.M. in the morning and you're just dozing off, when IT STRIKES! Your calf contracts uncontrollably. You writhe in pain, rubbing you leg, trying to make the pain go away because your calf is tied up in a knot! Call it a charley horse, call it a cramp, call it #!@@#*%. What's going on? What caused it? What can you do right then to stop it? What can you do to prevent a reoccurrence?

What's going on? What caused it?

No one knows for sure the exact, step by step mechanism of the involuntary muscle cramp. Several factors predispose you to a cramp. Muscles that are overtaxed, injured, or exposed to extreme temperatures may be particularly vulnerable. When the muscle begins to fatigue and is placed under a sudden stretch or contraction, the muscle may cramp involuntarily. Dehydration may be the most important factor. Muscles cramp more easily when your body is dehydrated. Electrolyte imbalance is also often cited as an underlying problem. A imbalance of the electrolytes sodium and potassium imbalance can lead to cramps. Deficiencies in the minerals calcium, magnesium, and sometimes phosphorus may also be contributing factors. The muscle won't return to normal until fluid is replaced and electrolyte and mineral balance is restored.

A limitation of blood flow to the muscle may cause cramping. Athletes, including dancers, who let their muscles become tight and fibrotic, so they feel like ropes under your fingers, are at risk for cramping. More serious underlying conditions including arteriosclerosis or diabetes, which limit blood flow to the muscle. Pregnant women may notice an increase in muscle cramps.

Malalignment of the lower extremity may predispose the muscles of the foot, leg, hip, or low back to cramping. A leg length discrepancy may cause chronic strain and, eventually, cramping.

What can you do right then to stop it?

The natural reaction to massage the muscle is an appropriate one. An additional "trick of the trade" employed by massage therapists, physical therapists, chiropractors, and medical doctors with experience in physical medicine is to have the client contract the opposing muscle against resistance. For instance, if your calf is cramping, try to push your toes upward (dorsiflex) against your hand. Your body will relax the cramping muscle naturally, because that's how you are "wired" neurologically. You may need to repeat the process several times until the cramping subsides. Then be very careful -- the muscle is fragile -- and cool it with an ice pack for about ten minutes. Drink lots of water over the next hour. You may have to force yourself to drink to replace enough fluid, because you will quench your thirst before you satisfy your body's needs. Later on, apply moist hot packs or sit in a Jacuzzi for twenty minutes and massage the muscle.

What can you do to prevent a reoccurrence?

Conservative treatment starts with drinking lots of water, six to eight glasses each day. While exercising, drink before you are thirsty. It is possible to lose as much as two quarts of sweat per hour when dancing vigorously. That doesn't count alcohol or coffee, tea or soft drinks which contain caffeine. These are diuretics and cause you to actually lose water through increased urination.

The electrolyte imbalance or mineral deficiencies can usually be easily corrected by eating lots of fruits and vegetables. Bananas are an excellent, convenient source of potassium. Although salt lost through sweat can contribute to cramps, Americans tend to consume more sodium than their bodies need. A lack of sodium is not common. However, if you use salt sparingly and exercise hard, try adding a little more salt to foods.

In the past, salt tablets were frequently recommended for helping prevent muscle cramps during exercise in hot weather. However, recent studies have show that salt tablets do not help and, in fact, may be detrimental. They tend to draw water from your bloodstream and may irritate your stomach. (A side note on stomach irritation -- stay away from casual use of NSAID's, such as ibuprofen, for muscle pain. They can put you in the hospital with gastrointestinal perforation and kidney failure long term.)

Stretch and shape up slowly. Allow your muscles adequate time to make adjustments. Don't shock them. Something as simple as slightly changing the heel height of your shoes can increase the stress on you calf muscles, resulting in cramping. Break in new shoes gradually, wearing them for short periods at first until the muscles become accustomed to the new angle.

Almost every athlete sustains a muscle cramp at one time or another. Usually, conservative care will solve the problem. However, if cramping is repeated, professional evaluation is advised. There may be a serious underlying condition requiring treatment.

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