Cramping Your Style
Cramping during athletic competition can be a great deterrent of performance. Cramps can be present for a variety of reasons, all which must be thoroughly investigated to determine why they are occurring so the proper treatment may be applied. In this issue, I am going to discuss the chemical-nutritional role in cramp involvement.
The balance between calcium and magnesium in the body is crucial. A normal level of one nutrient can be perceived low by the body if the opposing nutrient is high. This is seen often in women taking a high dose calcium supplement. They may have a functionally low magnesium level, sometimes evident in a blood test, especially those who consume a high carbohydrate diet. A high carbohydrate diet tends to increase the body’s need for magnesium, an issue I have touched upon slightly before.
A cramp due to calcium deficiency is many times overlooked. Although not as common as a cramp brought upon by a sodium-potassium imbalance, the calcium cramp is tricky because it is usually due to calcium displacement, rather than lack of the nutrient. Simply put, that means you can consume all the calcium you want, but what your body does with it is another matter. Soft tissue calcium starvation is what causes these types of cramps, not calcium deficient bones.
To prevent calcium starvation of tissues, three factors must be present. First, and obviously, you must have the calcium available. Second, the form should be in a more acidic (rather than basic-neutral) form, such as calcium lactate or citrate. Calcium carbonate should be avoided; it is very difficult for the body to absorb. People who take cheap calcium carbonate supplements, oyster shell calcium, and TUMS are taking the wrong type. Third, and what most people lack, is a proper fatty acid balance. That means a diet rich in “good” fats – Omega 3 and 6 oils such as nuts, seeds, vegetables, and fish and flax oil, to name a few. It also means eliminating all trans fats, also known as partially hydrogenated fats, from your diet – not decreasing them, but eliminating them. This is due to their inflammatory and destructive effects on the body. It is these “good” fats that allow the calcium to be driven into the soft tissue to prevent cramping and a host of other problems (such as bursitis and kidney stones).
What are other soft tissue calcium deficient symptoms? A big one is a cold sore/fever blister. Many people take the amino acid lysine for their cold sore, aiming to bump out arginine and starve the sore away. But for the vast amount this doesn’t help yet calcium with the proper fats works wonders. The cold sore acts as a blessing in disguise; they know when their body chemistry is off, and can address the problem before it spills over into other symptoms. This is also evident in those who get their cold sores in temperature extremes, such as exercising in the hot sun.
Cramping of the calves at nighttime, especially those that are of the “Charley horse” type, can indicate calcium deficiency or displacement. Lying in bed for a prolonged period without being able to fall asleep can be an adrenal symptom as I’ve mentioned before, but it can also be from a calcium issue.
The sodium-potassium balance becomes an important factor in cramping for athletes, particularly those under a great deal of stress or during high volume training. The aerobic base is crucial to help maintain healthy adrenal function and sodium re-absorption by the kidneys. An overtrained athlete leaning more towards the anaerobic side will show signs of adrenal fatigue, resulting in sodium loss. This can reveal itself with symptoms such as cramping, physical and mental fatigue, a chronic feeling of thirst, a feeling of dizziness or lightheadedness upon standing, and craving for salty foods. Though salt tablets and sodium-rich foods may help the athlete short term or through a race, the key is to address rebuilding the adrenals so the sodium isn’t lost.
Sodium is more of a culprit in this case than potassium. However, there are those whom extra sodium will cause more cramping which potassium will prevent. These individuals will also have signs of overtraining but due to a hyper-adrenal function (high cortisol), rather than that of the tired, low-adrenal output. Yes, it can get complicated.
Cramping can also be a result of dehydration. That may sound obvious, but you’d be surprised how many athletes don’t drink enough water during the day and during training/competition. This is why, for example, the carbohydrate gel packs tell you to drink water with consumption. The suddenly high glucose solution entering your stomach will draw fluid from your working extremities to absorb the glucose. This can help with the energy, but leave your limbs tired and cramped. Adrenal fatigue can result in an under-hydrated body from the constant loss of sodium. So even with water, like calcium and all nutrients, you can drink plenty of it, but it doesn’t mean you’ll absorb it.
A 24-year old woman came into my office complaining of fatigue, menstrual cramps, and difficulty falling asleep, along with some general aches and pains. Her running performance had been sub-optimal for the last few months for unknown reasons. She was taking a calcium supplement for some time recommended by a friend for the cramps, as well as a multi-vitamin, and was on a high carbohydrate, low fat diet. Using manual medicine techniques, a fatty acid imbalance was revealed, and she noted that her bread contained partially hydrogenated vegetable oil, and she used margarine, also a trans fat. She also showed a need for flax oil, and was advised to continue with her calcium supplement, but reduce her carbohydrate consumption and eat more “good” fats and eliminate all trans fats. She returned a month later noting that she didn’t get the menstrual cramps that she thought “every woman gets” and was sleeping much better, and her energy picked up. Most all of her nagging aches and pains had subsided, most likely from her body’s ability to now properly fight inflammation, rather than provoke more. There were adrenal issues to treat due to the stress she had been under, but a simple change in diet had made a world of difference.
You can see that the value of a nutrient can be looked at not only as a therapeutic agent, but a clue to what may be awry in the body. An athlete constantly needing salt to prevent cramps needs to address the adrenal glands, not live off the salt. Another whose cramps are prevented by magnesium need not take mega-doses of the nutrient, but understand why they need so much, perhaps due to carbohydrate intolerance, or an unmanaged stress pattern.
There are also structural-physical reasons for cramping. Muscle imbalances and gait disturbances can cause a muscle cramp. These tend to reveal themselves in the ever so familiar “side-stitch”. Some athletes live with these pains constantly, pushing through the agony and only having a good day when the pain decides to give them a day off. It doesn’t have to be that way, but that is a story for another day.
“Cramping Your Style” is an excellent article. As a follow up, I’d appreciate some information on the treatment of calcium displacement which I believe is the cause of my early morning leg cramps, mostly in the calf muscles. I get my calcium from yogurt and raw or steamed veggies. I eat roasted almonds and roasted sunflower seeds daily. I don’t take any calcium/mag/potass supplement as that has led to morning leg cramps in the past. What am I doing wrong? And what other things should I be doing. The cramps are daily. Thank you.
Thanks Randy. Consider either a need for omega 3 fats or betaine HCL (stomach acid supplement) as I note in the article. You most likely have the calcium available, but you’re not using it correctly because it can’t get into those soft tissues without fats and acid. Some people use apple cider vinegar (1-2TB a day) to get the acid. Almonds and sunflower seeds are omega 6. Omega 3 is fish oil, flax, and walnut.
If that doesn’t work, consider a blood sugar handling issue. Calcium parallels with blood sugar. So if you’re waking up hypoglycemic, then Ca levels may be low too. The fix for that would be to make sure you’re eating frequently thru the day, including a sufficient amount of protein.
Let’s hear what works…
Hello, I play indoor volleyball and don’t usually suffer from leg cramps, however when I play beach volleyball I get servere cramps in pretty much ever muscle in my legs. It gets to a point where i can no longer stand and any position i try to stretch to relieve the pain causes cramp elsewhere. My fitness levels are exellent and I have gone through trail and error with plenty of water and changes in diet. Can you give any advice on what the problem may be? Many thanks.
Cramps like that are typically due to your inability to actually hold onto the water. So you may drink plenty of water but still be very dehydrated. Salt and carbohydrates are two main reasons for this (lack of either one, or both). If your sodium level is low, you can’t hold onto water – this could be because you are not getting enough salt in your diet or because your adrenal glands are fatigued, so you don’t hang onto sodium well.
If your glycogen levels are low that could cause you to cramp too – either you’re not getting enough carbohydrates in your diet, or you’re training too anaerobically so you use up stores constantly. I had this problems many years ago racing triathlons – I’d get intense cramps to the point I had to stop. Once I ate more regularly, with adequate carbohydrates, especially after high intensity or long duration training, the cramps went away. Interestingly, my body weight went from 150 to 158 with no fat gain. I was about 8 pounds chronically dehydrated.
I have been getting cramps during intensive cross country mountain biking after about 2 hours. I have been told to reduce salt in my diet by my GP to prevent Hypertension, which seems to have worked. I make a point of avoiding transfats, eat fish, cook with olive or peanut oil and take a fish oil supplement daily. I always hydrate with purpose made drink before and during training and eat ‘shot blocks’ every 10 or 15 minutes. This weekend during a prolonged ride and getting cramp I experimented with a Calcium Carbonate tablet and my crams had gone within a few minutes and didn’t come back for the rest of the ride. Have I taken my lack of sodium in my diet too far?
Did you have high BP prior because salt does not cause high BP unless a person has kidney issues? Salt may provoke hypertension that is already a factor from another reason, but removing salt from your diet can do more harm than good. It’s a necessary nutrient, and one that many athletes are deficient in. As noted in this article, fatigued adrenals often result in athletes dumping too much salt in their sweat and urine and then cramping.
The shot blocks are okay but only if you’re training anaerobic or long aerobic (2-3 hours or more). If you’re not, then you’re shifting your body from fat-burning to sugar-burning during training and that can deplete your glucose and glycogen stores and along with that you’ll lose water and cramp.
Could be a calcium problem since that helped you but calcium parallels blood glucose so it may just be a Band-Aid during that time and not addressing the true problem. Sounds much more like a glycogen depletion/dehydration problem to me since it happens during intensive riding, or a salt issue. More aerobic training will help too and getting carbs in immediately after training should also help a lot.
Hi – The excruciating leg cramps returned after resuming my BP meds(Norvasc) and now the magnesium powder (Calm) isn’t as effective. They start in the evening and move from one leg to the other, usually triggered when attempting to stretch after sitting or resting an hour after working out.I workout 1-2 hours a day, mostly aerobics, but 2-3 hours of light to medium weight lifting. I recently started eating 8 – 10 veggies a day. Not getting enough protein, just 4 – 6 oz, and bingeing on bad carbs about 1 – 2 times per week. Any clues on why the leg cramps are so severe?
Norvasc is a calcium channel blocker and thus can be the reason for your cramps. Since they returned after resuming this med I’d say that’s pretty much your answer. You should talk to your prescribing doctor about this.
Hello Dr. Ganegmi,
I read your article after doing a search on adrenals and sore muscles, very informative, thank you.
I have adrenal fatigue and recently started working with someone who started me on a diet that included foods I didn’t eat. In the past when I would drink orange juice, I noticed I wouldn’t feel well for a few days.
The diet had me drinking about 4oz of OJ a few times a day, eating yellow squash and peaches, all of which have a lot of potassium. I was also eating salt during the day as well.
In two weeks, the diet has my sleep dropped back and, my leg muscles tensed up and very sore. I stopped eating the foods a few days ago but my legs are still sore.
This morning, after five hours of not great sleep, after I got up, my heart rate went up to 130, muscles tensed. I ate some salt, it took the HR down some but my body still won’t relax and my HR is still high. Salt would help before but it isn’t right now.
I read about potassium and salt, there has to be a balance but I’m not finding that after eating those foods. This was not happening before.
Do you have any ideas as to what I could do?
Any suggestions you can give would be more than appreciated!!
Thank you kindly,
Lisa
Hi Lisa, salt and potassium supplements may help short term, but they are not the way to fix the problem. Think of it like someone with blood sugar handling issues – even to the point of diabetes. If your blood sugar is low – you eat some sugar/carbs to increase your sugar. If it is high, you either exercise vigorously or take insulin to bring it lower. Obviously the ideal way to address this is to eat right and change the lifestyle so blood sugar swings don’t occur and the body heals. Same goes for the K/Na balance. You’ve got to figure out what is causing the adrenal fatigue and address it that way – proper diet (not orange juice!), exercise, lifestyle, etc. That’s about the best I can tell you without seeing you or a phone consult.
Hi I get foot cramps when I swim. I’m not sure if it’s because I am kicking at a wrong angle of my foot or if its another factor. Have you ever had anyone else with this problem? I drink plenty of water before swimming and make sure to stretch my foot a little right before getting in the pool. I am also an avid runner and I never cramp when I run. any help would be greatly appreciated.
It is probably from a muscle imbalance in one of the calf muscles. If course, stretching won’t prevent the cramps. Check out the Achilles Tendonitis video on the sock-doc site to learn how to treat the trigger points in the gastroc and soleus.