Don't cramp your style this humid season

Hi Folks

"No one ever drowned in sweat."
*But they did cramp!!*

These are tough times - with temperatures high and fluctuating, and with
humidity levels high and steady - in most parts of India. When you see
yourself sweat - you think that you could single handedly solve the water
crisis of the world - ' If only there was a personal desalination plant'

One of the many surmised causes of cramping is dehydration - and as many of
us attempt to brave the humid heat and run - we thought what better info
that advice from a guy who has had acute cramping and has seemed to have
done a thesis in the area and also got in touch with Danny Carrol - a guy
who overcame cramps to run the 89km Comrades Ultra Marathon this year.

I am enclosing a note from Arvind Singh on a simple and well researched
piece on cramping - he seems to have overcome it - so anyone running now -
take heed and read on.

Arvind has run through the cold Winters in Gurgaon and has run through humidity where
you could sit on the humid air around you - a definite must read - if you
don't want to cramp your style!!

A DEFINITE must read

We want to see you smile
Best
Rahul Verghese

My Experience With Cramps – Arvind Singh

On 11^th July 2010 – I tried a 32 K run led by the running stalwarts of Running and Living, Gurgaon. At around the 25 K mark I seized up with severe cramps in the legs which first brought me down to a crawl and then rolling on the ground in agony, until two fellow runners (Vinod and Shashank) loaded me onto a tractor driven by a good samaritan and brought me back.

Having suffered from cramps for long, although never the sort of attack that I suffered on the 11^th of July, I tried to read up on cramping to see what I could do to avoid or at least minimize cramping. Rahul put me in touch with a friend of his – Danny Carroll – who also suffered similarly but researched and worked through it till the point that he ran and finished Comrades! Danny was good enough to download a whole host of extremely useful information to me. In addition, I went through a ton of other information available on the web and tried to figure out what my problem was.

I don’t think I have figured it all out as yet, but have made a start. I joined the Gurgaon gang in a 21 K yesterday (25^th July) – part undulating road, part trail – and finished it without cramping and felt good at the end. Ran slightly tentatively, but if this goes on, the confidence will be back. Personally, this is the most frustrating part of my distance running endeavours, as in all other respects I feel good enough to run much longer than I ever have.

Rahul suggested I put together a short note of what I have learnt for the benefit of others, so here goes.

Definition

Anyone who has suffered cramps even once does not need any definition to understand what a cramp is. However for the fortunate few who have never cramped – a cramp is a sudden involuntary contraction of a muscle which does not relax. It can come along in spasms that last a few seconds to a few minutes, and might repeat until they go away. In its worst form, the spasms are so severe and uncontrolled that muscle tissue damages and could take days or even weeks to recover. For runners, the most common muscle to cramp is the calf (back of lower leg), followed by the hamstring (back of thigh) and then the quadriceps (front of thigh).

Causes

Unfortunately, the exact cause of muscle cramps is still unknown – something which I discovered to my chagrin. However there is a common strain of the most probable causes that sports physicians talk of, and therefore a bunch of suggestions on what to do. The good thing is that almost all the suggested remedies are good for runners in any case, and therefore should be followed anyway – whether you cramp or not.

The most common causes are:

1. Muscle Fatigue - if you violate the cardinal rule of running and do too much too soon. Unless you are gifted with a unique physiology, you cannot increase the intensity of your workout suddenly without suffering the consequences.

2. Inadequate blood supply – which could be caused by restrictive clothing, or poor circulation caused by inactivity. In the worst case this could be caused by a narrowing of the arteries (as in arteriosclerosis), which of course only a doctor can diagnose.

3. Dehydration – contributing to electrolyte loss, poor circulation and fatigue.

4. Nutritional Deficiency – which may lead to a lack of or imbalance of electrolytes. In order of importance – calcium, magnesium and potassium.

5. Weather – running in excessive heat and humidity.

6. Biomechanical – which basically means poor running form. Overpronation (too much inward roll of the feet caused by flat feet or poor support in the running shoes), poor running technique, uneven strides, even poor breathing – all these are possible causes for cramping.

If I look back at what happened to me, it was probably a combination of many of these. I went from running 6 km a day (even though I ran all seven days a week) in cooler climes to trying a 32 km run in the heat and humidity (especially the humidity!) of a Gurgaon summer day. I wish I could call this bravado. In fact this was plain and simple stupid.

Cramp Prevention

1. Stretching – something that everybody talks of but in reality practices poorly. From what I read, studies suggest 15 minutes of stretching both before and after the run/event – with emphasis on the problem area. Some pointers on stretching:

• Long term stretching is more beneficial
• Stretch opposing muscles (eg. hamstring and quadriceps)
• Stretch after a light 10 minute warm up

Tips on calf stretches – the most vulnerable to cramping:

• The calf has two muscle groups – for simplicity’s sake the upper calf and lower calf.
• Keeping the knee straight (of the leg where the calf is being stretched) stretches the upper calf. This is a common stretch that we tend to do – placing our hands on a wall and extending the leg straight back with the heels on the ground.
• The same stretch – but with the knees bent (both legs) with heels on the ground stretches the upper calf.

Caution on Stretching

While stretching is a great way to treat a cramp, never stretch a cramp as soon as you get one – this can seriously damage the muscle. When a muscle goes into a cramp, it’s is an all or nothing thing. Once the muscle has started its contraction, it will continue until it’s finished. If you stretch while it’s trying to contract, muscle fibre damage is possible. You have to first help the muscle finish it’s contraction, by helping the blood flow. Best way – squeeze, pump and knead the muscle. Once the muscle has relaxed out of the contraction, do the stretches. For those who believe in homeopathy – carry a tube of arnica gel around and apply it while squeezing and stretching. This is easily available in India. I have started using it when I feel some strain in the muscles and find it helps muscle recovery – and this from a person who has never tried a homeopathic treatment in his life. The underlying hypothesis is that arnica gel (or the famous Tiger Balm) is quickly absorbed by the skin and helps in increasing blood flow to the muscles.

2. Electrolytes and Nutrition – it’s a no brainer that an unhealthy diet leaves you prone to muscle cramps. You need a proper balance of calcium, magnesium, potassium and phosphorus within the muscle fibres. Sodium is also important, but our normal diet provides us enough of it in the form of common salt. Rock salt is even better. The most common deficiency and the least recognized is normally that of calcium. The famous banana before the run provides a reasonable amount of potassium but not calcium. As we grow older, the normal food intake we have provides nowhere close to the amount of calcium that we require. As you would imagine, dairy products provide the best form of calcium, followed by fruits and vegetables. The average person needs 1000 mg of calcium, and if you’re a regular runner – it’s more like 1200 mg to 1400 mg.

Again in my own case, I actually did a calculation of my calcium intake and found it to be not more than 500 mg. While I will try and bring about dietary changes, I have started taking a calcium supplement. For those of you who want to try a supplement – try to make sure it is in the form of a calcium citrate compound. Unfortunately the most common forms of supplements available are in the form of calcium carbonate or shell calcium – all of which finally deliver less calcium to the body than in the form of a citrate.

3. Carbohydrate Intake – if you look at fatigue as a factor in cramping, the answer is to increase the amount of energy that is available to the muscles, which means carbohydrates. Which brings us back to the basics of “carbo-loading” prior to an event and imbibing sports drinks that deliver carbs during the run.

4. Dehydration – there are skeptics who disregard the correlation between dehydration and cramping, but for the majority of us, cramps are associated with high heat, high humidity environments where we sweat for extended periods. The role of hydration, from a common sense point of view, is critical. The role of sweat is to cool the body down. An average run of an hour will burn energy at the rate of 1000 kcal/hour, which equates to about 1.5 litres of sweat to remove this extra heat. Studies show it only requires 2-3% dehydration for body function to be impaired. So if you want to avoid dehydration fatigue and the possibility of cramping from dehydration you need to plan your hydration through the run.

In addition, because you’re burning energy, you need carbohydrates. But the processing of carbohydrates also requires water. So in order to replenish your muscle glycogen reserve, you need more water. And if you don’t replace it, it will be taken from the blood stream, accelerate dehydration and thereby cramping.

Hydration Tips

• It is important to have enough water and sports drinks to reach a “full” feeling before an extended training session or event. Make sure that your pee is colourless.
• Similarly it is important to intake fluids to reach that “full” feeling after the run, to aid muscle recovery. A good protein shake is also well worth it.
• Thirst is not a good indicator of the need for water! If you’re thirsty, it’s already too late – so stay continuously hydrated.
• Alcohol after an event significantly slows down rate of replenishment and rehydration, so that celebratory drink should be avoided. This is of course something that I personally don’t necessarily practice, and might not go down well with my running buddies – but that’s what they say!

5. Training – conditioning and strength play a very important role in the onset of cramps. Muscles not properly conditioned will have an earlier onset of fatigue which leads to increased nervous stimulation and cramping. In training, work on your flexibility – especially the hams, quads and calves. Work on the “core” strength. This is the bodies stabilizing mechanism and impacts all other running muscle groups if not strong.

6. Running Style – the standard suggestions of a good running style apply to preventing cramps as well.

• You should be upright and not slouching when running – run tall!
• Concentrate on keeping your muscles relaxed. Ease up the minute you feel your muscles tightening – much before cramping - and figure out what you’re doing wrong in your running stride.
• Hit the ground mid foot and not with the heels. Land softly. If you can hear yourself land, something’s wrong.
• Don’t extend your stride beyond your hips. Kick back and up towards your butt with your legs, but don’t extend or reach forward.

7. Other Remedies

• Tight clothes that restrict blood flow in any way are a no-no. On the other hand compression shorts and socks which aid blood flow help.
• Physiotherapy and massage (by a practitioner experienced in the field of sports therapy) helps.

That summarises what I’ve learnt so far. I wish all this research could guarantee no more cramps – but god knows. I will keep trying though, searching for that joyful carefree run.