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 Nancy Clark, M.S., R.D.                                   

MUSCLE CRAMPS: Do they cramp your style?

 "I get excruciating cramps when I play tennis in the heat. Could something be wrong with my diet...?" "I cramped so badly during the marathon. I had to quit a few yards from the finish line. I just couldn't go any further." "Should I drink pickle juice to prevent cramps...???"

 If you've ever experienced the excruciating pain of a severe muscle cramp, you may fearfully wonder if it will strike again. You may also wonder if nutrition imbalances are at the root of the problem and if diet changes would be the simple solution. Muscle cramps are poorly understood. 

Historically, no one has been able to predictably cause a muscle to cramp; this hindered the ability to study the underlying mechanisms that contribute to the these unpredictable spasms. 

Just recently, researchers have found a way to cause cramps. Hopefully, this will open the door for more research on ways to prevent them from happening. We do know that muscle cramps most commonly occur among athletes who work their muscles to the point of exhaustion. The overexertion theory of muscle cramps goes like this: When a muscle gets tired, the numerous muscle fibers that comprise the muscle fail to contract in a synchronized rhythm. This is likely related to overstimulation from the nerves that trigger the muscles to contract.

 What to do What should you do if you get a cramp? Popular remedies include massage, stretching, acupressure (relaxing the affected muscle by applying pressure to it), and giving yourself a hard pinch squarely on the upper lip. What about nutritional remedies? Previous theories have suggested cramping is related to fluid loss and electrolyte imbalance. These theories do not always hold true. (For example, musicians, who do not get sweaty, often complain of muscle cramps.) Yet, if you are plagued by cramps, you should at least rule out any possible factor that might contribute to getting them. Here are a few food tips to help you rule out theoretical nutritional causes.

 Theory #1. Lack of water. Cramps often occur when an athlete is dehydrated. (But even athletes who are well hydrated get cramps.) To reduce the risk of dehydration-associated cramps, simply drink more than enough fluids before, during, and after you exercise. On a daily basis, drink enough fluids so you have to urinate every two to four hours. Your urine should be light colored and copious. During extended exercise, drink as much as tolerated, optimally 8 ounces every 15-20 minutes. 

Theory #2. Lack of calcium. Calcium plays an essential role in muscle contractions. Anecdotal stories suggest that athletes who eliminate calcium-rich dairy products can become plagued by muscle cramps. For example, a ballet dancer who added yogurt and skim milk back into her diet reports her cramps disappeared. A mountaineer resolved his muscle cramps by taking calcium-rich Tums. Exercise scientists question the validity of these anecdotes, believing a calcium imbalance is unlikely to be the cause of muscle cramps. After all, the bones are a calcium reservoir and can supply the body what's needed for proper muscle contractions. Never-the-less, to rule-out any possible link between a calcium-poor diet and muscle cramps, I recommend that athletes plagued by cramps consume calcium-rich foods at least twice a day, such as low fat milk on cereal and a yogurt for a snack. This good nutritional practice certainly won't hurt them, and may possibly help.

 Theory #3. Lack of sodium. Many health-conscious athletes restrict their salt intake on a daily basis, believing this will help prevent blood pressure problems. However, if these athletes are losing a significant amount of sodium through sweat, they may be putting themselves at risk for developing a sodium imbalance that could contribute to cramps. This situation is most likely to occur in extreme sports such as an Ironman triathlon or 100-mile trail run, particularly if the athletes have consumed only plain water during the event, no sodium-containing food or beverage. 

Theory #4. Lack of potassium. Athletes who sweat heavily may lose some potassium, but they are unlikely to become potassium depleted. And if they did, the whole body would be affected--not just one muscle. Never-the-less, eating more potassium-rich fruits and vegetables will hurt no one. 

Theory #5. Lack of pickle juice. Some football players and athletic trainers swear two ounces of pickle juice taken ten minutes before exercise prevents cramps. The reasons are unknown and untested, but there's no harm in trying...! The above suggestions are only suggestions, not proven solutions. But you might want to experiment with these dietary tips if you repeatedly suffer from muscle cramps. Adding extra fluids, low fat dairy products, a sprinkling of salt, extra fruits and vegetables, and even some pickle juice certainly won't harm you and may possibly resolve the worrisome problem. I also recommend you consult with a physical therapist, athletic trainer or coach regarding proper stretching and training techniques. Nutrition may play no role at all.

Nancy Clark, MS, RD specializes in nutrition for exercise. She offers private nutrition consultations at Sports Medicine Brookline. Her popular Sports Nutrition Guidebook, 2nd edition ($14.36) and The New York City Marathon Cookbook ($23) are available via Amazon.com