First Author: Katie Russell

Second Author: Caitlin Brown

Article

4.4.9. Muscle Cramps

• The causes of muscle cramps are not fully understood, but there are several possible causes^[1]
  • Insufficient stretching before exercise
  • Exercising in the heat
  • Muscle fatigue
  • Vitamin deficiency
    • Thiamine (B1)
    • Pantothenic Acid (b5)
    • Pyridoxine (B6)
    • It's not sure if vitamin deficiencies have a direct or indirect, or any link at all to muscle cramps.
• Types of cramps
  • "True" cramps
    • Hyper-excitability of the nerves that stimulate the muscles
  • Tetany Cramps
    • Nerve cells in body are activated
  • Contracture Cramps
    • Muscles are unable to relax
  • Dystonic Cramp
    • Repetitive muscle motions (eyelids, jaws, neck, etc)  
• Muscle cramps occur when muscles involuntarily contract and cannot relax. ^[2]
  • The skeletal muscles are the muscles most likely to suffer cramps.
    • Muscles in the calf, thigh, and arch of the foot are most common
•  Muscle cramps usually occur during or after exercise and are "sudden, powerful, involuntary muscle contractions"^[3]
  • Afflict 39% of marathon runners
  • Estimated that 95% of people will suffer a cramp at some point in their life.^[4]
• 3 possible ways to treat/prevent muscle cramps^[5]
  • Dehydration: body needs more fluids (water)
  • Electrolyte: body needs sodium and potassium (sport drinks: Gatorade or Powerade)
  • Imbalance: imbalance between nerve signals that excites a muscle and causes contractions because of muscle fatigue (rest)
• Most muscle cramps can also be prevented by other means^[6]
  • Stretching before and after cramps
  • An adequate warm-up and cool down
  • Good hydration before, during, and after physical activity.
• Hydration Guidelines^[7]
  • .5 liters per hour for three to four hours before exercise (180 lb person)
    • Beverages or snacks with sodium will help the body retain the consumed fluid
  • 0.4 to 0.8 liters per hour depending on body size during exercise
    • There should only be 7% carbohydrates consumed while hydrating.  Carbohydrate consumption is recommended for one after hour activity.
  • 0.5 liters per every pound of body lost after exercise is finished
    • Consume beverages or snacks with sodium to help speed up recovery by increasing thirst and fluid retention
• Side Stitch - sharp pain below rib cage ^[8]
  • caused by uneven shallow breathing
  • take deep even breaths while running

4.4.10. Plantar Fasciitis

• Occurs in the heel of the foot because of inflammation of the tissue that connects the heel bone to the toes^[9]
• Causes of Plantar Fasciitis^[10]
  • Excess physical activity
    • Running, jogging, and running can put too much stress on the heel bone and tissue that causes minor tears and irritation
  • Arthritis
  • Diabetes
  • Improper shoes
    • Shoes that do not absorb shock like thin soled, no arch, or too loose 
    • High heels cause the Achilles tendon to shorten and put strain on the heel and tissue if worn too much
  • Faulty Foot Mechanics can cause plantar fasciitis 
    • Being flat footed
    • having a high arch
    • abnormal walking pattern

4.4.11. Shin Splints

• Pain that circulates on the inner part of the tibia as a result of fatigue and trauma to the muscle's tendons^[11]
  • The muscles exert force on the bone in order to stabilize the ankle and lower leg, which results in the tendons being partially torn from the bone
  • Example of Shin Splint
• •  
  • Exercises to prevent shin splints
    • Toe Flexor^[12]
      • Sit in a chair with you feet on the floor and a towel beneath your feet
      • Curl your toes around the towel and pull until the towel is underneath the arch of your feet
      • Keep heels on the floor the entire time
    • Stretching exercise^[13]
      • Kneel on the floor
      • Point your toes behind you and gently sit back on your heels pressing the tops of your feet on the ground

4.4.12. Stress Fractures

• Stress fractures are one of the most common sports related injuries. They occur primarily in the lower weight-bearing bones of the leg and/or foot when the muscles become fatigued and cannot properly absorb the added shock of running or athletic training. The fatigued muscle will eventually transfer the stress overload to the bone, causing a small fissure, or crack.
• ^[14] 
• Athletes participating in track and field, gymnastics, tennis, and basketball are those who most commonly experience stress fractures. This is due to the repetitive stress of the foot striking the ground during workouts. Women also tend to be more likely to experience a stress fracture. This could be because of amenorrhea, eating disorders, or osteoporosis.

• Stress fractures are caused by a variety of elements, including: 
  • Increasing the amount of activity or intensity too quickly 
  • The impact of an unfamiliar surface in your workout (such as switching from a soft track to concrete)
  • Improper equipment (worn out running shoes)
• The biggest indicator of a stress fracture is pain while engaging in activity. Stress fractures are most often diagnosed with x-ray's or even sometimes MRI's.
• Treatment for stress fractures can be difficult; especially if stressful activity resumes too quickly. Common treatment methods include:
• • rest for up to 6-8 weeks
  • shoe inserts
  •  braces
• In order to prevent stress fractures it is important to  
  • Maintain a healthy diet. Especially incorporating calcium and vitamin D. 
  • Use proper equipment (shoes that fit correctly and are not worn out.) 
  • Cross train and set incremental goals, so that you do not overwork the muscles.
  • Rest if you begin to experience any pain in the lower leg or foot while engaging in activity.

Example of a Stress Fracture