ASK DR J – ISSUE 255 – CURSES, CRAMPS!

INJURY

In the last few weeks I have increasingly been getting cramps in my hands, especially my thumb, while climbing. At first it was just after a hard session of crack climbing, but lately it’s happening to me on easy warm ups, and it completely stops me from climbing anything else. What can I do? – Julie

I recently awoke to an odd building discomfort somewhere down south. I don’t normally wake in the middle of the night for a code brown. I sat on the loo for a while, but something was amiss. I didn’t need to go to the loo yet something was contracting down there that made it feel like that. Then it became uncomfortable. And then painful. And then more so. Ever heard of proctalgia fugax? Anal cramp! How could I possibly have sinned so much?

Anyway, being a lateral thinker, I figured it needed a quick stretch just like a cramping calf muscle, but with a more tricky approach. I am a problem solver by trade, and my mind gravitated to some “things” in a nearby drawer that might be useful. I know, it’s all quite embarrassing— try not to picture it—but suffice it to say I swiftly had it all under control while also exploring some personal boundaries,. Cramps remain a physiological enigma. There are some obvious situational correlations, like extreme muscle fatigue, but how does that mesh with electrolyte loss for instance? Is fluid loss the cause or is it something that is in sweat that is lost? Or does electrolyte depletion just correlate and is not causative at all?

If we limit the discussion to muscles that we voluntarily control—skeletal muscle—there are some likely contributors.

Low blood levels of minerals such as potassium, phosphorus, magnesium, and sodium that are involved in the conduction and regulation of nerve signals can result in muscle cramps, or at least there is a higher incidence of cramping in that biochemical environment. Dehydration, muscle fatigue and even certain medications are also known provocateurs.

I suspect your situation is different, however, in that you experience the cramps at low levels of activity, which had previously been fine. This smacks of muscle tissue that is not functioning at its full potential, probably due to chronic overload. Have you been doing a lot of crack climbing recently? Muscle tissue that has been affected by the continual assault of training without sufficient rest will behave much like a muscle that is in a mid exercise bout—it will be weaker, and quickly fatigue. To say that you will also cramp earlier is not a particularly long bow to draw, albeit the intricacies of why are unknown.

If there were an easy solution for exercise-associated muscle cramping you probably wouldn’t be suffering them right now. Without knowing even the basic fundamentals of why we get them it’s hard to formulate a remedial approach. There is some evidence that taking B-complex vitamin supplements can reduce cramping, although there is no consensus on this. Same goes for mineral supplements. Get a regular massage to keep yourself supple. Take an Epsom-salt bath. Eat a well-balanced diet.

Give your thumb muscles a good massage—10 minutes each—every other day for the next couple of weeks and back off the training and/or climbing. In short, give your body every chance to recover before any further hard training.

 

CRAMP VOODOO

Google knows you have cramps. If Google knows, everyone who wants to sell you “a little-known remedy” will also know. Silly ads will appear on your preferred weather-forecast page. Be skeptical.

Mineral supplements are a shot in the dark, but stranger things have happened in the dark, so that is probably a good place to start if you suffer regular cramps. Blood tests would be a good precursor.

You do not have to drink two liters of water a day to ward off cramps; that is not only a myth, it is a thoroughly debunked one. In fact, drinking too much water might deplete your “precious bodily minerals,” actually leading to cramps.

If, on the other hand, you have been sweating a lot, then it’s a good idea to drink accordingly. Whether it is the loss of fluid volume in the body or the loss of sodium through the skin that contributes to the incidence of cramps is up for debate. Certainly excessive sweating, and sodium loss in particular, seem more important than other factors in the cramping command chain.

Magnesium is the new cure, if you believe the marketing hoopla of recent years. Cough-cough-bullshit. Perhaps it is for some, but it is not the elixir of muscle health that you are being led to believe.