The most commonly seen ailment at marathons and triathlons is skeletal muscle cramps. The causes and treatment of this physiological phenomenon has not been completely defined. Many conditions can elicit muscle cramps, such as congenital abnormalities or neuromuscular diseases, but in athletes the condition is usually exercise-associated. Establishing a thorough medical history is the most effective way to determine if the cramps are exercise related or the result of another medical condition.
Muscle cramping due to exercise is a spontaneous, painful, and involuntary contraction during the course of, or at the cessation of exercise. Exercise-associated muscle cramping does not occur in resting skeletal muscle.
The concern with muscle cramping first appeared in the early 1900’s with reports of persons cramping in hot and humid conditions, such as coal and steamship workers. This led to the current thought that bodily hydration, or lack of, and the environment play a key role in the occurrence in muscle cramping.
Recent theories suggest that exercise-associated muscle cramping is due to a neurological short circuit. It is posed that the "abnormality of sustained alpha motor neuron activity, which stems from aberrant control at the spinal level." Tired muscles cause the muscle spindle to be continually stimulated therefore causing the inhibition of the Golgi tendon organ to shut down the activity.
The muscles must commonly affected are ones that cross two joints. During activity two- joint muscles, such as the calf and hamstring, are in a shortened position during contraction. "Contraction in this state produces decreased tension in the tendons of the muscles as well as decreased Golgi-tendon activity."
The best way to decrease muscle spindle excitation is passive stretching. It helps to eliminate to cramp and increase Golgi-tendon activity thereby inhibiting the constant excitatory response. This treatment follows the theory of abnormal spinal reflex activity.
This indicates that stretching is an important factor in eliminating exercise-associated muscle cramps and that endurance events such as running can quickly tire muscles, which may lead to cramping.
Exercise-related cramps often present themselves with significant discomfort and a muscle belly that is hard to the touch from continuous contraction. Athletes do not usually show any other signs of physiologic distress, either dehydration or hyperthermia.
The most effective treatment for exercise-associated muscle cramps is stretching of the pertinent muscle or muscle group. It is best to hold the stretch until the cramp subsides and is released. If the cramps continue or are extremely severe then further medical treatment should be sought. It should be explained to the athlete that if they experience any other symptoms such as lack of urination or unusually colored urine they must get medical attention immediately.
The best way to decrease the risk for muscle cramping during intense exercise is good conditioning, proper stretching, and proper nutrition and fluid intake. The best offense is a good defense.