Recently I completed my first 1/2 Ironman in the hot and humid conditions of Cebu in the Philippines. I had prepped well and was set to go. It was “33 deg, feels like 44 deg” due to the humidity. It was going really well until 5km’s into the run. ll of a sudden, my quadriceps, hamstrings and calves all cramped up at the same time. The pain was so immense I was unable to walk, and had to shuffle to the medical tent, which was luckily 2 metres from where the cramps hit me. I received deep heat treatment to all cramped areas over the next 5-10 mins which soothed the pain and I was able to move again. Unfortunately, this process would repeat itself 5 times before the end of the 21 km run which really cramped my performance for the whole race.

So, muscle cramps. What are they? Why do they occur? What are the best measures to prevent them? How do you treat them once they kick in.

Muscle cramps are a sudden involuntary muscle contraction that can cause mild to extreme pain and paralysis to the affected muscles. They can occur in skeletal muscle or smooth muscle (involuntary muscle of the gut/internal organs).

There are a couple of hypothesis as to why they occur. One theory is that muscle cramps are caused by muscle fatigue and a shortage of electrolytes (e.g. low sodium/potassium/magnesium). A newer hypothesis is that muscle cramps are caused by  neural excitability and that the central and or peripheral nervous systems playing a significant role. More research still needs to be done to pinpoint the exact cause, but it is most likely some combination of the theories above.

To prevent cramps, it is important to stay ahead nutritionally to make sure you keep your sodium/potassium/magnesium levels up if you are doing any sustained physical activity. Nutrition is individual, but you can put yourself ahead of the game by ensuring consistency and timing. Your body can only digest 400 calories or so per hour, so hold off eating during the race until you have burnt off the calories from breakfast. Secondly, be consistent with your nutrition – eat the same foods on race day that you have been eating on your training days.

Stretching out a cramping muscle is the most effective means to treat a cramping muscle. If pain makes stretching difficult or impossible, incorporating deep heat should assist in alleviating cramping. That was the treatment that got me through the Iron Man.