Muscle Cramps (cont.)
How can muscle cramps be prevented?
Activity: Authorities recommend stretching before and after cramps that are caused by vigorous physical activity, along with an adequate warm-up and cool down. Good hydration before, during, and after the activity is important, especially if the duration exceeds one hour, and replacement of lost electrolytes (especially sodium and potassium, which are major components of perspiration) can also be helpful. Excessive fatigue, especially in warm weather, should be avoided.
How much should I drink?
Hydration guidelines should be individualized for each person. The goal is to prevent excessive weight loss (>2% of body weight). You should weigh yourself before and after exercise to see how much fluid you lose through sweat. One liter of water weighs 2.25 pounds. Depending on the amount of exercise, temperature and humidity, body weight, and other factors, you can lose anywhere from approximately .4 to 1.8 liters per hour.
Pre-exercise hydration (if needed):
1. 0.5 liters per hour for a 180-pound person several hours (three to four hours) prior to exercise.
2. Consuming beverages with sodium and/or small amounts of salted snacks or sodium-containing foods at meals will help to stimulate thirst and retain the consumed fluids.
During exercise:
1. Suggested starting points for marathon runners is 0.4 to 0.8 liters per hour, but again, it should be individualized based on body weight loss.
2. There should be no more than 10% carbohydrate in the beverage, and 7% has generally been considered close to optimal. Carbohydrate consumption is generally recommended only after one hour of exertion.
3. Electrolyte repletion (sodium and potassium) can help sustain electrolyte balance during exercise. Particularly when
- there is inadequate access to meals or meals are not eaten,
- physical activity exceeds four hours in duration,
or
- during the initial days of hot weather.
Under these conditions, adding modest amounts of salt (0.3 to 0.7 g/L) can offset salt loss
in sweat and minimize medical events associated with electrolyte imbalances (for
example, muscle cramps, hyponatremia).
Post-exercise:
1. Drink approximately 0.5 liters of water for every pound of body weight lost.
2. Consuming beverages and snacks with sodium will help expedite rapid and complete
recovery by stimulating thirst and fluid retention.
Pregnancy: Supplemental calcium and magnesium have each been
shown to help prevent cramps associated with pregnancy. An adequate
intake of both of these minerals during pregnancy is important for
this and other reasons, but supervision by a qualified health
professional is essential.
Dystonic cramps: Cramps that are induced by repetitive nonvigorous activities can sometimes be prevented or minimized by
careful attention to ergonomic factors such as wrist supports,
avoiding high heels, adjusting chair position, activity breaks, and
using comfortable positions and equipment while performing the
activity. Learning to avoid excessive tension while executing
problem activities can help. However, cramps can remain very
troublesome for activities that are difficult to modify, such as
playing a musical instrument.
Rest cramps: Night cramps and other rest cramps can often be prevented by regular stretching exercises, particularly if done before going to bed. Even the simple calf-stretching maneuver (described in the first paragraph of the section on treatment), if held for 10 to 15 seconds and repeated two or three times just before going to bed, can be a great help in preventing cramps. The maneuver can be repeated each time you get up to go to the bathroom during the night and also once or twice during the day. If nocturnal leg cramps are severe and recurrent, a foot board can be used to simulate walking even while recumbent and may prevent awkward positioning of the feet during sleep. Ask your doctor about this remedy.
Another important aspect of prevention of night cramps is adequate calcium and magnesium. Blood levels may not be sensitive enough to accurately reflect what is happening at the tissue surfaces where the hyperexcitability of the nerve occurs. Calcium intake of at least 1 gram daily is reasonable, and 1.5 grams may be appropriate, particularly for women with osteoporosis. An extra dose of calcium at bedtime may help prevent cramps.
Supplemental magnesium may be very beneficial for some, particularly
if the person has a magnesium deficiency. However, added magnesium
can be very hazardous for people who have difficulty eliminating
magnesium, as happens with kidney insufficiency. The vigorous use of
diuretics usually increases magnesium loss, and high levels of
calcium intake (and therefore of calcium excretion) tend to increase
magnesium excretion. Magnesium is present in many foods (greens,
grains, meat and fish, bananas, apricots, nuts, and soybeans) and
some laxatives and antacids, but a supplemental dose of 50 to 100
milligrams of magnesium daily may be appropriate. Splitting the dose
and taking a portion several times during the day minimizes the
tendency to diarrhea that magnesium can cause.
Vitamin E has also been said to help minimize cramp occurrence.
Scientific studies documenting this effect are lacking, but anecdotal
reports are common and sometimes quite enthusiastic. Since vitamin E
is thought to have other beneficial health effects and is not toxic
in usual doses, taking 400 units of vitamin E daily is approved,
recognizing that documentation on its effect on cramps is lacking.
Next: Are there medications to prevent muscle cramps? »
- alprazolam, Xanax, Xanax XR, Niravam - Learn more about Alprazolam (Xanax), including a description, generic and brand names, drug class and mechanism, preparations, storage, reasons for prescription, dosing, drug interactions, effect on pregnancy and nursing mothers, and common side effects.
- Electrolytes - Read about blood electrolytes (sodium, potassium, chloride, and bicorbonate) and the effects of electrolyte imbalances like kidney failure, low blood pressure, hypokalemia, and hyperkalemia.
- Dehydration - Read about dehydration (definition: excessive water loss) in children, treatment, symptoms (thirst, dry mouth, dark urine) and causes (vomiting, diarrhea).
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