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Muscle Cramps

By:  Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S.

Lower extremity muscle cramps are one of the most common on-the-field problems in all sports.  Most muscle cramps occur in the calf muscle but they can also be seen in the hamstring and thigh muscle. 

Muscle cramps occur more often in climates that are hot and humid.  They also occur earlier in a season when athletes are not as well conditioned.  Muscle fatigue and twitching usually precede cramping.  They usually do not occur in the earlier part of an activity. 

Once a muscle cramp occurs the muscle tightens to such a large degree that the athlete is not able to move the leg properly.  The athlete usually falls down to the ground in pain and the affected muscle is firm.  This makes the foot very difficult to move as it is pointing down. 

It is important to be sure that the athlete has suffered from a cramp and is not suffering from any other type of injury which may include a fracture, ligament injury, muscle tear or Achilles tendon rupture. 

Once the trainers or coaches are certain that a cramp has occurred the treatment is to stretch the muscle that is cramped.  This includes gently bringing the foot up from its down position while keeping the knee locked.  This will stretch the calf muscle and lessen the pain and tension.  If it occurs in the hamstring it is necessary to keep the knee extended and to lean your body forward trying to touch your toes.  If it occurs in the thigh muscle it is important to flex the knee as much as possible while leaning your body back to stretch the muscle back to its original length.

Massaging the muscle also helps to relieve the cramp.  After the cramp has gone it is important to keep the muscle on stretch and not to sit as the muscle may retighten very quickly.

It is very important for the athlete to be rehydrated on the sideline.  Getting back into the game should be done after proper hydration and muscle stretching.  Cramping that is associated with severe dehydration may be a precursor to heat stroke.  It is important that the athlete be of sound mind before they return to playing.

Prevention of cramping includes proper preseason conditioning.  This must include strength training and muscle stretching.  Adequate hydration is necessary before each game.  Remember that drinking fluids immediately before a game is not the best way to prevent these problems.  Hydration is important hours before a game.  Fluids should be administered throughout the game to offset fluid loss during an activity, especially in warm climates.  Athletes who experience recurrent cramping need to be evaluated medically to be sure no underlying problem exists.