Heat Cramps

Heat Cramps: Prevention and Treatment

Written by Stacy Ciarleglio, a licensed athletic trainer and ultra runner. 

Last week, we all got a taste of something that we weren’t ready for...heat and humidity! It’s that time of year when runs become a little more difficult and potentially more dangerous if we don’t take care of ourselves properly. The combination of heat and humidity is nothing to mess with, as it can result in serious conditions such as heat exhaustion and heat stroke. One of the more nagging conditions that can occur, especially in runners, is heat induced cramping. Most commonly, cramps are experienced in the calf muscles, but can occur in the hamstrings, quads, and feet.

A cramp can put an end to your run, quickly!  A cramp is a persistent, involuntary muscle contraction. This contraction comes on suddenly and is very intense and painful. Typically, the cramp will occur during exercise, but it can also occur after, or even at night after exercising during the day.

The exact reason behind cramps isn’t well understood. Cramps typically occur during hot weather, but they can also occur in cold conditions. It is believed that dehydration and electrolyte imbalance play a large part in cramping.

How can we prevent and treat cramps? Eat bananas, right? That used to be the thought, but not so much anymore. While eating bananas may be part of the equation, it certainly isn’t the only thing that should be done to prevent cramps. If your hat or shirt ever looks like the picture below after a run…..read on! 

Our body is made up of roughly 60% water and our blood is 80% water. Water is vital to our health.  During exercise, the heart pumps blood through the body to working muscles. The blood carries oxygen and other vital nutrients to those muscles. When the body gets hot, it draws excess heat through the blood vessels, which carries it to the surface of the skin in the form of sweat. It is then evaporated into the air and our body is able to cool itself.  Problems start to occur if we lose too much sweat without replacing our water content. Since our blood is made up of mostly water, our blood volume will begin to decrease. This means less blood being pumped through the body and less oxygen being delivered. If the blood volume gets too low, there is not enough blood to circulate back to the heart, the body can’t cool itself efficiently, and problems such as cramps, dehydration, heat exhaustion, and heat stroke can occur.

Drinking water is the most basic thing you can do to prevent cramps and dehydration. Drinking before during, and after activity is the key to maintaining hydration. Dehydration is cumulative. If you do not properly replenish after a run on a Monday, you will be going into your Tuesday run in a slight state of dehydration compared to your normal level. If you don’t rehydrate enough on Tuesday, you will be in even more of a deficit by Wednesday. This is why it is important to keep up with your hydration, especially during the summer months when it’s frequently hot and humid. Run with a water bottle or belt. Bring a water bottle with you when you go to work or are running errands. Weigh yourself before and after a run. For every pound you sweat out, you want to replace about 20 ounces of fluid. This is a good guideline to help you maintain a good level of hydration from day to day.

Now here’s where it gets a little tricky. Our muscles rely on electrolytes for proper contraction. These electrolytes are sodium, potassium, magnesium, and calcium. When we sweat, we lose electrolytes. If these are not properly replaced, muscle cramps can occur. This is where the old thought of eating bananas comes in. Bananas replenish potassium, which is important, but recent research shows that it is not the most important electrolyte involved in cramping. The culprit is sodium! 

Did you ever go for a run and come back with white stains on your hat or your shirt? The presence of salt (sodium) in your sweat is what causes those white stains. Sodium must be replaced after sweating it out. If you lose a lot of sodium during a run or workout and all you do is drink water to replenish yourself, you’re missing something! Most people consume plenty of sodium during their daily intake of food. However, if you are running and sweating heavily on a regular basis, it’s not a bad idea to be aware of your sodium intake and increase it a bit when necessary. Did you ever crave something really salty after a run? Maybe some salty chips or pretzels? That’s your body telling you something! Listen to it. If you are going to be performing physical activity for an extended period of time, or you are a heavy sweater in general, it is a good idea to consider using some nutrition products that contain electrolytes. There are a variety of gels, chomps, and fluids to help you maintain your electrolyte balance. Experiment with a few different products on your runs to figure out what works best for you. For those of you that enjoy a post run margarita with salt, try the margarita flavored Cliff Shot Bloks to help keep your sodium levels up on the run!

Even if you try to do everything right to prevent cramps, sometimes you still get them! So what now? If you experience a cramp on the run, keep in mind, it is an involuntary contraction of the muscle. Trying to stretch it is going to hurt and it might even be counterproductive. If you are trying to pull the muscle in the exact opposite direction that it wants to go, it’s not going to be happy. Try massaging the cramping muscle. This will help bring blood and oxygen to the area, hopefully resulting in a relaxation of the muscle. Once the cramp is released, it is ok to attempt some very gently stretching of the involved muscle.

Since cramps are typically due to dehydration or an electrolyte imbalance (or both), once they occur, it is likely that they will occur again during that same workout if you do not stop. Your body is already in deficit of fluid and electrolytes. At that point, it is best to stop and replenish yourself. Continued exercise almost always results in repeat cramping.

You might find that the muscle that was involved in a cramp is very tight and sore for days following a cramp. This is normal. A cramp is a very intense contraction, the muscle that cramps will feel sore as if it was involved in a difficult workout. Icing the area for 20 minutes at a time may help with the soreness. After a couple of days, switch to moist heat. Massaging the area and performing trigger point release of the involved muscle will help to return it to its normal state of function. Wearing compression socks or sleeves on the days following the cramp will help to increase the blood flow to the area and encourage healing. If you are prone to calf cramps, wearing compression sleeves on the run might be beneficial. While the sleeves will not help to prevent the underlying cause of dehydration, they will help to keep the blood flowing to the area, which will increase oxygen flow and decrease fatigue.

As the temperature heats up this summer, slow your pace a little, and give your body time to acclimate. Be smart about hydration…before, during, and after you run. Not only will you feel better, but you will help to prevent cramps and more serious heat related conditions. Drink up, stay cool, and enjoy your summer runs!