Thanks, Mark.

That whole series on the Sport Scientists blog was a good one. Must read stuff!

Still current as I don't think human physiology has changed much since then! ;-)

---

---

Steve Fleck @stevefleck | Blog

Interesting article. I suffer from cramps and they have wrecked two of my most important races last year. Oddly, one was during a half marathon at mile 8. The other started during the final meters of a swim leg in a HIM race...and then it felt like a bullet went off in my leg when I pulled off my wetsuit. Honestly, those cramps were some of the worst pain I could imagine. I was paralyzed in both cases for 10 to 15 minutes. The cramps passed and I was able to finish both races with dissapointing results.

What is ironic is I didn't cramp once during my training (at the same race pace) for either race. I monitor my heart rate so closely that I have started to wonder if anxiety or stress plays some role on some level. On longer races and workouts during the year, I never cramped, even though my speed, fitness and HR were all similar. I see that there is no set resolution towards cramps, but I am in the boat that I will try anything to avoid having that pain again.

Friends and family are all full of suggestions from pickle juice, to salt, to enduralytes, to electrolytes, to bananas, to compression shorts, to yoga, to pinching my upper lip (really that was my MIL's suggestion).

I have tried them all and will try anything to avoid that experience again.

What is ironic is I didn't cramp once during my training (at the same race pace) for either race.\\

I do not know what is causing your cramps in races only, but what I have done and withnessed myself in the past, is that too much water goes in the days and morning before the race. I was always told to" really" hydrate before races, but I neglected to support all that water with the right amoung of sodium. You drink so much water, that it appears that you actually dilute your bodies stores. I did some tests and found out I piss out twice the amount of magnesium of a normal person. Nothing to worry about the doc says, it is all individual. But of course it was something to worry about as I piss twice as much as the average person, like we all do. When you do the trianing we do, you just drink more, thus piss more, so I was doubling up on my losses. Once I started loading water with minerals, I did a lot better race day. And there has been a lot more studies now about hypernutremia and its problems.

And yes, stress can burn up minerals. When I have a cold, flu, or just general bad feelings, I burn through sodium like a wildfire. It is the only other time that I will cramp outside of sport, during bouts of illness. And if I supplement during that time, it has the same affect as in training..

if I cramp it's usually toward the end of a long workout, specifically if that long workout is bike or run and then finishing with a swim. I'll get cramps through the bottoms of my feet or my calves.

---

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

That's interesting. I only get them swimming if my feet and calves have already been hammered with bike or run.

---

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Interesting (and lively, as usual for this topic!) discussion. A couple of quick points/answers:

“My point is that the result of salt loss measured before/after, only reflect that, not the actual level before.”

The pre-race sodium levels were 139.8 (+/-1.8) in the non-crampers and 139.8 (+/-1.5) in the crampers – so there was no difference in pre-race sodium levels.

“crampers’ sodium levels dropped 0.1% (+/- 1.9%), while the non-crampers increased 0.4% (+/- 2.6%). Doesn't this bit from the study at least suggest that sodium loss could be a factor???”

One way of trying to understand whether an apparently small difference between two groups of numbers is significant is to look at the “p-value,” which tells you the probability of getting this difference purely by chance. Most scientific studies consider a result significant when p<0.05, meaning there’s only a 5% chance the result could have occurred by chance. In the case of these this data set on % change in sodium levels, p=0.836. That means there’s an 83.6% chance that difference between -0.1% and +0.4% is just random statistical fluctuation, and a 16.4% chance that it represents a real physical difference.

“the user suggesting pickle juice - the reason why it works at replenishing electrolytes is because of the salt content, not really a special characteristic to pickles.”

One of several reasons that researchers don’t believe that electrolytes explain pickle juice’s effect on cramps is the time frame. In the initial pickle juice study, it took an average of 85 seconds for pickle juice to relieve cramps. Earlier studies have found that it takes at least 30 minutes for small volumes of pickle juice to even leave the stomach, let alone be distributed throughout the body.

“It is almost never my working muscles that cramp first, but my stomach one.”

Stomach cramps are a completely different phenomenon than muscle cramps, with a completely different set of causes. Given that electrolyte levels do affect how quickly fluid leaves the stomach, it wouldn't be at all surprising if you noticed a correlation between electrolyte use and the incidence of stomach cramps.

One last general point (even though I’ve already rambled on far too long): this is a simple correlational study. It most certainly doesn’t disprove the possibility that electrolytes influence muscle cramps through some pathway that isn’t clear to us. But if they are a factor, the question is: why can’t anyone find any solid evidence to show it?

******************
Alex Hutchinson
www.sweatscience.com

Stomach cramps are a completely different phenomenon than muscle cramps, with a completely different set of causes. Given that electrolyte levels do affect how quickly fluid leaves the stomach, it wouldn't be at all surprising if you noticed a correlation between electrolyte use and the incidence of stomach cramps.

Thanks for jumping in here, but I already explained that it was not my stomach that cramped(not sure that is even possible) but my ab muscles surrounding my stomach. Perhaps you are referring to a side stitch?

And I find it a little puzzling that you got the exact sodium levels in such a large group of athletes. I'm pretty sure I could have two blood tests 10 minutes apart, and get different numbers. You talk in probabilities, what is the probability that all those people had the exact same sodium levels??

I know you don't want to believe in these studies for whatever reason, but if I drew your sodium levels 10 mins apart they would be ... the same. We have millions of chem-7 (for example) panels drawn every day in this country with a really nice set of lab values and understanding of them over the past 50 years. Humans are amazing similar all over the earth in these respects ;-)

Now, what may truly cause muscle cramping may remain a mystery (neurologic, metabolic, mechanical, etc.), and *we* keep looking, but there is NO link found to date in electrolyte depletion. Simple as that. Period.

---

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

I never used to get cramps on long rides until a couple of years ago. I could do 100 mi + long rides and never have a worry. Then I started getting bad cramps (quads/calves/hams) at about 60-80 miles into my ride. Anyway, I started using First Endurance EFS, not a worry since no matter how long or hard I ride. That EFS stuff is the shit.......never have to worry about cramping anymore.

---

**All of these words finding themselves together were greatly astonished and delighted for assuredly, they had never met before**

I know you don't want to believe in these studies for whatever reason,//

It is not that I do not want to believe in them, I just cannot given what I see in the real world. And all the studies I have seen, like this one, do not give a concrete conclusion. I believe this field of study in athletes is where wind tunnell testing was 20 years ago. I just dont think the right protocals have been studied enough within the right population. I want it to be true that there is some other mechinism at work in my cramping, but after 30 years of trying everything that was avaiable, or adjusting training and racing stragedies, only supplementation has worked. I can gurantee it is no placebo affect, and it only works as long as I'm able to absorbe the minerals. So for a hot ironman I am shit out of luck, I got to where I could survive 4 hours or a 1/2 ironman in hot weather. If it is cold, I can race all day, it is like I'm two different athletes. And I know of, and have seen plenty of responses in these threads that mimick mine, that something has to be there that the no supplement crowd will not acknowledge.

And do you really think that all those athletes had the exact same starting sodium levels? You sound like you are in the field, go back and find even two people that were exactly the same to the tenth, let alone a much larger number. Sure we are all about the same, but the variance is pretty wide when you see the top and bottom numbers that are considered normal. I have seen dozens of my friends blood tests, and I do not think we would have anything "exactly the same number"/

I'm not sure I understand your question. All 209 athletes in the study didn't have identical sodium levels -- it's just the average of the two groups that was the same, which isn't unusual. You're right that I "talk in probabilities" -- ultimately, that's all that science can deal in. If you don't believe in probabilities, then there's no study in the world that will ever convince you of something you don't want to believe.

In terms of abdominal cramping, I'm still inclined to suspect that you're dealing with a different physiological trigger than someone whose calf, for example, cramps during a run or bike. Abdominal cramping, which involves the muscles around the abdomen, is commonly associated with digestive issues. Here, for example, is a study published last month that found that the specific ratio of carbohydrates in a carbohydrate-electrolyte solution affected the frequency of abdominal cramping in a cycling trial. The abdominal cramping in this study is not the same thing as the muscle cramps discussed in the Ironman study.

I misunderstood what you were saying, and I do believe in probabilities and stats, as far as you can trust them. I still find it unusual that two groups would have the exact starting average, but not as unbelievable as everyone having the same. You will see that some here defended that possibility anyway, probably a billion to one of 209 people with the exact sodium level on the same morning.

And as to my ab cramping, it is almost certainly the same as calf, quad, or any other muscle cramping. I know this because it is almost always just the first to cramp, soon followed by all those other muscles. Not likely it is just a coinsidence that everytime my ab cramps, I just happen to have others as well. And the treatment is the same for all of them, take sodium and magnesium, and they all go away. Eventually they go away without supplementing, but that is usually a 5 hour wait vs 30 to 60 minutes with supplements..

I have done very long training for triathlons and have never cramped. More than twice I have accidentally put myself in a severe hyponatremic state and havent cramped. The only time i have ever really cramped was during some very intense training I did in rescue swimmer school in the coast guard, go figure.

So... The only time I cramp is kicking while swimming. And that comes in really early, and it's been like that for 30 years. Help! (I like wetsuits as they minimize the need for kicking for me :o)

A warm welcome to sweatscience. Big addition to the forum in the training/physiology area. Smart guy. Writes very well and he has a book coming out that I am sure will be of a great deal of interest to triathletes, and endurance athletes of all kinds.

Follow him on Twitter here - http://twitter.com/sweatscience

---

---

Steve Fleck @stevefleck | Blog

Ive got to chime in here, seeing as Im very interested in sweating/cramps/hydration status.

Research is growing in regards to pickle juice/vinegar/mustard as a supressor/reliever/inhibitor of cramping.

One study found:
"rapid inhibition of the electrically induced cramps reflects a neurally mediated reflex that originates in the oropharyngeal region and acts to inhibit the firing of alpha motor neurons of the cramping muscle."

Theres a bunch others too. Ive tried pickle juice poolside for a foot cramp-worked for me. I wonder if theres any other "success" stories out there.

I also wonder the gastric issues from pickle juice in your bike bottle, vinegar, or mustard packets on the run.

My n=2 experience suggests this is not a simple issue.

Between my wife & I we have 40 years of endurance sports experience. For me, the only time I've ever cramped has been after long hard efforts on hot days. No surprise there.

My wife OTOH, is a different story. When younger, before having kids, she was an ultra distance athlete. Did all kinds of crazy and extreme long distance stuff. Much of what she did was pretty much impossible to do without overextending herself in some way. Won't go into detail in order to protect her anonymity. She rarely had cramps. (And her training wasn't all lsd stuff either, included fast and intense stuff as well.)

Fast forward 20 years, have kids, go through a period of not training much, now more than half a decade of moderately serious training, but much less than what she once did. Now cramping is a constant problem. Not just during races, either, it's induced by training as well. Seems to have some connection to hydration but there's clearly a lot more to it than that. She takes electrolyte supplements and thinks they help a little bit but not that much.

For those that say the cramping is just a matter of overextending yourself, how can she overextend herself if the race hasn't started and she gets cramps in her wetsuit while waiting for the swim to start? And why didn't she have these problems when she was younger and doing events that lasted days rather than hours, in the desert, etc. etc.?

BTW, her mother has lots of trouble with cramping as well, so that suggests a genetic element to this.

rroof, all the studies i've seen on this seem to make the (common) mistake of assuming that the phenomena is unimodal. my impression from reading cramp studies is that its a polymodal phenomeon, with different individuals subject to zero, one or different mechanisms that lead to cramp. unless you do a study which first isolates subjects by mechanism, its not likely that you'll see any correlation between any factor and the appearance of cramping. but you can't isolate them by mechanism since we don't know what the mechanism is, so the best we can probably do at present is to use some sort of "perceived experience" differentiation. for example, we might divide subjects into:

• those who never experience cramping
• those who always cramp (given a few requirements)
• those who always cramp in certain muscles
• those who only cramp given certain weather conditions
  
• those who cramp and find it relieved by X (where X could be salt, general electrolyte mixes, acid etc)

having done this partitioning, one could then repeat a study much like the one being referenced here, and the results would be quite a lot more interesting. i am also guessing that you would see a link to electrolyte depletion in some of the subject groups.

Re: [The pre-race sodium levels were 139.8 (+/-1.8) in the non-crampers and 139.8 (+/-1.5) in the crampers, so there was no difference in pre-race sodium levels].
Alex, thanks for the clarification on this, as I brought up the question as a possibility that the cramping group may have had lower pre-race sodium levels than the non-crampers. Is it possible that, if sodium levels are related to cramping, that the cramping group, as individuals, require a higher level of sodium than "average".

I appreciate that these measurements are averages and that individuals may need to be assessed as such. As others have discussed and in Rappstars Ironman nutrition plan (noted elsewhere on the forum) clearly demonstrates, experimentation to determine what works for an individual may be what's really required. I doubt most people would have access to the tools to adequately measure sodium levels in training and it's going to be more of a trial and error process.

My concern initially, is what I see as the tendency to look at electrolyte supplements (over and above what's in the on-course energy drink, for example) as an essential part of every Ironman athlete's nutrition plan, when either; they don't have any specific issues that may require extra supplementation, or they do have cramping issues that may be caused by a combination of (lack of) conditioning and/or a race intensity that's simply too high.

What are your thoughts on Ironman race intensity, with respect to cramping?
Regardless of whether or not it can be proven (or disproven) that there is any possibility that electrolytes influence muscle cramps (in Ironman), I think a study that looked at a similar group of athletes and their respective race intensities and the incidents of cramping would be very interesting. Maybe theres been one done....Anyone?

Thanks

---

KC
**********************

Agreed. I didn't start with truckloads of sodium. I slowly, and steadily, increased the amount in moderation until I found something that worked. But I had plenty of bad races where I cramped and walked sections of the run that led me to try things.

---

"Non est ad astra mollis e terris via." - Seneca | rappstar.com | FB - Rappstar Racing | IG - @jordanrapp

The reason said "study' has not been done is that we don't really know why muscles cramp - only that it doesn't appear to linked to an electrolyte depletion.

---

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

EFS!!

I have the same problem.
I attribute the problem to two issues: 1) Not spending enough time in the pool. I have to swim at least four days per week to avoid this. 2) A really hard workout. My new swim coach tells me that I'm not used to working hard.

I used to. Then my father suggested I take salt pills before races. That helped some for shorter races, but not for HIM. Then I discovered Thermolyte, and then SaltStick, and now I do not cramp anymore. N=1. I don't really care what N=100 or 1000 says about electrolytes, because-for me-they work.

---

"Non est ad astra mollis e terris via." - Seneca | rappstar.com | FB - Rappstar Racing | IG - @jordanrapp

The more I see threads like this, the more convinced I am that "exercise physiology" is a complete waste of time.