Why do athlete’s cramp?
(from ‘Muscular Cramp in Athletes’ eBook, 2023)
Numerous factors are thought to be involved in muscular cramp during prolonged exercise, including muscle fatigue, prolonged muscle contractions, muscle damage, restricted muscle blood flow, diabetes, dehydration, and hyperthermia (Katzberg., 2015; Craighead et al., 2017). Similarly, from the fifteen articles included in Fattahi, et al’s., (2021) review paper on exercise-associated muscle cramps in runners, studies showed that the causes of EAMC were: dehydration and electrolyte deficiency, cold, prolonged training or competition, increased body temperature during training or competition, history of muscle injuries and cramps in the past, increased intensity of training in a short time, and dietary restrictions. Bordoni et al., (2021) described two hypotheses behind exertional muscular cramps. The first is related to the concept of dehydration and electrolyte imbalance, while the second, most recent theory is linked to a transient peripheral neurological disorder. Their major findings indicate peripheral fatigue of neurological origin as a cause for the appearance of cramps.
As previously mentioned, there have been a number of possible theories why athletes get cramp during their training or during a match, for example, there is the ‘muscle fatigue hypothesis’ which suggests the neural mechanisms designed to inhibit muscle contraction in response to muscle tension detected by the Golgi tendon organ, are disrupted or depressed. At the same time, enhanced excitatory activity from the muscle spindle triggers an intense and sustained involuntary muscle contraction that is unopposed by Golgi tendon organ control (Bergeron., 2008). This theory, also referred to as ‘altered neuromuscular control theory’ is supported by other researchers, including, Schwellnus, 2009; Miller et al., 2010; Minetto et al, 2013; Edouard, 2014; Panzaet al., 2017, Qui & Kang et al., 2017; Giuriato et al., 2018; Jahic & Begin., 2018; Troyer et al., 2020; Bordoni et al., 2021. Therefore, the ‘altered neuromuscular control theory’ seems to be the most scientifically acceptable theory, based on the available scientific literature and its level of evidence (Edouard, 2014) rather than dehydration or electrolyte deficits (Miller et al, 2022).
To explain further, Qui & Kang et al., (2017) suggested muscle cramps can be viewed as a consequence of a sustained alpha motor neuron discharge that occurs when the enhanced excitatory activity of the muscle spindle that triggers an involuntary muscle contraction is unopposed by Golgi tendon organs designed to inhibit such a muscular response and recommended moderate stretching of the affected muscle to alleviate the cramp. In addition, muscle overload and fatigue affect the balance between the excitatory drive from muscle spindles and the inhibitory drive from the GTO (Jahic & Begin., 2018). Since the dehydration and electrolyte depletion are systemic abnormalities, it is not clear how these changes would result in local symptoms such as cramping of the working muscle groups.
References by request
https://www.barnesandnoble.com/w/muscular-cramp-in-athletes-steve-bedford/1142845577