How to prevent cramps from interrupting a scoring drive

by Eric Kohn DPT, OCS, CSCS

It is that time of year again!  The fall season with cooler weather, back to school and of course, football! On Friday nights, stands are filled with students, family and friends and two football teams playing their hearts out.  This is why we love fall and the opportunity to see our favorite teams play on the field. Unfortunately, there are some common injuries that can keep athletes off the field and on the sideline.  My goal is for you, the reader, is to understand them, to prevent them or to return back from them quicker.

Welcome to the first article on a series of sports medicine topics that are common in the sport of football.  During the first few games each year, there is one silent stopper of great athletes and their performance on the field.  No, it is not a 300lb nose guard, though that would help most teams. No, the silent culprit is cramping.  There is no quicker drive stopper than a skilled position player going down with cramps in their lower legs, usually the calf or hamstring. What do we know about cramping and how can we prevent it from happening and recurring in the first place?

A tonic muscle cramp is a contraction of the muscle fibers for an extended amount of time.  The full-on constant contraction can last for a few seconds up to minutes, depending on severity.  The most commonly affected muscle is the gastrocnemius or the calf muscle.  This usually occurs after a player exerts a significant effort on a play, usually from running or cutting.

Why does this occur?  There are a number of reasons that act alone or in combination to create the muscle cramping of the athlete.

1. Deconditioned muscles. There is a reason that most of the cramping occurs in the first few weeks of the season and one might be because the athlete has not played or simulated the physical exertion of a game.  Some players are just not in “game shape” yet.
2. Our bodies are made predominately of water.  If it is warm out and excessive sweating occurs, we can lose significant fluids.
3. Electrolyte imbalance. Our muscles require a specific amount of sodium and other electrolytes such as calcium, magnesium and potassium to function correctly.  If there is loss of electrolytes from sweating or not enough electrolytes in the body before the game, this can lead to cramping.

What can we do BEFORE to decrease the probability or severity of cramping?

1. Preseason conditioning along with mobility drills.
2. Hydration with water starting the day before and with adequate electrolyte drinks such as Gatorade, Powerade or electrolyte replenisher like Pedialyte.

The biggest key to preventing cramps is making sure the athlete has enough sodium, potassium, magnesium and calcium in their bodies to prepare for excessive muscle usage.  Most sports drinks will have all or most of the much-needed electrolytes but be aware of the sugar content in some of the drinks.  Other nontraditional drinks and foods are coconut water and eating bananas a few hours before the game.  They both contain high levels of potassium to decrease cramping.

What should you do when a cramp occurs?

1. Stop what you are doing and go down. Further damage to your body can occur by trying to run through a muscle cramp.
2. The sports medicine team will stretch and simultaneously massage the affected muscle to decrease the spams.
3. Massaging the muscle with ice on the sidelines has been shown to decrease the spasms.
4. Taking small sips of pickle juice or vinegar has not been proven effective through research, but there are some athletic trainers and athletes that feel it works for them. The proposed mechanism is throug ingestion of acetic acid that is in both liquids. This may decrease the alpha motor neurons through a reflex inhibiting excitability and thus decreasing the muscle cramp. This is still not supported by research, but when you see elite tennis players drinking pickle juice in between sets you start to wonder about effectiveness.
5. The use of warm Epsom salt baths have been known to decrease cramps due to the magnesium sulphate in the salt, but it also hasn’t been proven through research.

Take home points from all of this talk on cramping is to stay hydrated all of the time with a combination of water and electrolyte drinks 24 hours before the game, keep your muscles mobile and in good condition to prevent this silent run stopper.

Eric is a Board Certified Orthopedic Clinical Specialist, Doctor of Physical Therapy and Certified Strength and Conditioning Specialist.  He practices at St Cloud Orthopedics in central Minnesota and is an adjunct professor at The College of St. Benedict/St John’s University.

Eric is a Board Certified Orthopedic Clinical Specialist, Doctor of Physical Therapy and Certified Strength and Conditioning Specialist. He practices at St Cloud Orthopedics in central Minnesota and is an adjunct professor at The College of St. Benedict/St John’s University.