Cartoon illustration of a man with a leg cramp.Fred Matheny has suffered from leg cramps throughout his cycling career. Whenever he mentioned that in the RoadBikeRider.com Newsletter -- as he did after his crampfest on one epic Colorado ride -- RBR would receive a rash of remedies from subscribers.
In fact, Fred reckons he’s now heard about every cramp cure known to science -- and some that should be placed more properly in the realms of folklore, voodoo or the occult.
But as Carol Torgan points out here, cramps are multifactorial. No single cause seems to exist.
By Carol E. Torgan, Ph.D., FACSM
National Heart, Lung and Blood Institute
Cramps are miserable. I'm an exercise physiologist who specializes in skeletal muscle, so let me give everyone a little background about cramp causes and prevention.
A cramp is an intense, involuntary contraction of a muscle that usually occurs during or immediately after exercise. Cramps were traditionally thought to stem from fluid or electrolyte imbalances, but they are not always the reason. Cramps may occur following chronic muscle use by individuals, such as musicians, who are not sweating.
Cramps have also been attributed to extreme environmental conditions or metabolic abnormalities, but again there are examples where this doesn't hold. Cramps typically occur in situations that cause muscle fatigue, such as toward the end of long, strenuous or intense rides.
A current theory suggests muscle cramps result from fatigue that triggers abnormal neural activity. There's an increase in neural input telling the muscle to contract, and a decrease in signals telling the muscle to relax. The result is a vigorous contraction of part or all of the muscle.
The presence of dehydration is thought to accentuate muscle fatigue, adding insult to injury.
Cramps are most common in muscles that span two joints. The hamstrings are a great example. Other two-joint muscles include part of the quadriceps (thigh muscle) and the gastrocnemius (calf muscle).
Here’s a checklist for every cramp-afflicted person to think about.
Do you get cramps in muscles that are not working very hard during cycling (such as the biceps)? If you do, this suggests a systemic factor is the main culprit (e.g., an electrolyte imbalance or dehydration). However, if cramps only occur in the muscles doing all the work, then fatigue is probably to blame. *
Do cramps occur only in hot conditions, or do you get them if you ride hard on mild days? Review your training diary and look for patterns a la Sherlock Holmes. Check weather conditions, type/length of ride, eating/drinking patterns the day before, during and after the ride, location(s) of the cramps, etc. For example, if your cramps always occur in the same muscle when you ride a certain bike in a certain position (i.e. aero), then you can pinpoint it to local muscle fatigue and train accordingly.
Because different riders cramp for different reasons, somewhere in the following collection of cramp remedies you might find the one that'll work for you.
ALAN E.: Tums help prevent cramps. On long, hard rides, I take a roll and chew down a few at the first signs of cramping. Tums helped me get through my first double century.
KERRY I.: I have used electrolyte drinks, but they didn't seem to make much difference. However, I have popped a Tums and felt much better -- no threat of cramps and a generally better "body feeling" with more pedaling comfort. Tums are low sodium, and I'm generous with the salt shaker in my diet, so sodium is not the factor. Calcium seems to be their mystery ingredient.
PAUL B.: Apart from the obvious solutions of water, a quality sports drink and plain old potassium supplement pills (pop one before and a couple during a potentially camp-producing ride), try chewing a few Tums with calcium every now and then. The fruit flavored ones taste pretty good, and you can buy them at almost any roadside convenience store or gas station.
RON M.: I live in the great San Joaquin Valley of central California where it is not unusual to be out there grinding away in 100F+ degrees. I've been cycling for about 15 years and for 13 of them I suffered with more cramps than I would like to remember. Two years ago I started using Endurolytes by E-Caps. I’m a 56-year-old cyclist who now enjoys cramp-free riding.
J.S.: I can almost assure you the a product called Endurolytes will prevent cramping. And your legs will be a lot less sore after hard rides, too. I've "fixed" countless people who had chronic cramping with this product. Also, keep note of your weight before and after rides. As time goes by, you will get a read on how well you are managing hydration. If you lose more than 2% of your weight, you are not drinking enough.
ELI M.: Endurolytes is the best electrolyte replacement supplement I have ever tried. Take a few before riding, then 1-3 every hour during. Great for hot days or any long ride.
RICHARD M.: On the toughest 65 miles I've ever ridden (95F degrees, high dew point, many steep climbs) I took one Endurolyte per hour and had no cramps. Perhaps the stuff worked, or perhaps it was just a coincidence.
DREW C.: Try Endurolytes from Hammer Nutrition. Much of their stuff is a tad placebo-ish for my tastes, but I have found these to work well in the heat.
TOM B.: I take Hammer Nutrition’s E-Caps first and often, way before I need them -- 2 or 3 every hour after the first three hours. Plus Tums. On a double century, I will start with Tums by midmorning and then have 2 or 3 at lunch. More in the afternoon, maybe 8 or 10 total for the day. It’s the same or more for the E-Caps.
I keep these products in a box on my top tube, in sight and in mind. When in doubt and heat is a factor, I eat a couple extra of each.
I also like guarana for my afternoon caffeine, but that has nothing to do with cramps. Plus, a couple Advil helps, but no more than 2 or 3 all day.
I drink a lot of Gatorade, carried in my water bottle. I also mix it with Hammer's Sustained Energy in my CamelBak for my primary hydration resource.
I drink 12-18 oz. of tomato juice or V8 at any stop that has them. This stuff is magic for me on the afternoons of long rides.
I finish up a rest stop with an extra glass of water or Gatorade right before jumping on the bike. I have found that shorter is better at rest stops for cramp elimination.
RANDY I.: No one who has used SPIZ for any event of any kind lasting more than three hours has ever cramped (that I know of). In 2002, Dr. Bob Breedlove set the over-50 U.S. transcontinental record obtaining 95% of his calories from SPIZ and had no cramping, even in the 110F-degree California desert. SPIZ has 600 mg of sodium per serving, enough that if you down a bottle every 60 minutes or so, sodium is replaced faster than you can lose it.
FRANK D.: I mix up a custom blend of "lite" salt -- half sodium chloride and half potassium chloride, Extran and Accelerade. I use a huge backpack-style hydration system, around 4 liters, and fill it for a long summer ride. The salt varies from a tablespoon in the winter to two or slightly more in the summer. The terrain here in SoCal is reasonably steepish where we ride, so my 52-year-old legs get hammered pretty good.
I believe since I don't add salt to my food, nor do I eat many packaged salty things, I'm probably sodium shy. The addition of the potassium chloride seems to be beneficial also. Before I added it to the brew, I had everything from tingly cramps to outrageous cramps and seemed to retain fluids.
This is all anecdotal, of course, but I've honed my mix over the last couple years. Since the addition of Accelerade some time ago, I am happy to say I haven't had one cramp. Maybe it’s the protein (who knows?). Your mileage may vary.
AMY R., M.D.: One key is in eating a well-salted breakfast, such as one little salt packet on each -- the eggs, the hot cereal, the potatoes. I haven't gotten a headache or cramp since I started this pre-loading.
Another key on a hot, sweaty day is to drink V-8 juice, a veritable liquid salt pill, containing lots of sodium and potassium. If it's too strong, water it down some. One four-ounce can at noon is a great booster for me, and light enough to carry behind my saddle. When I start thinking that licking my salty, sweaty, sunscreened arm is a tasty-sounding idea, I know I'm behind. Get out the V-8!
A caveat: I was on a nine-day ride in hot southern Utah. We all got into downing lots of V-8. Fine, until the ride was over. The day after, my salt load began to show in swollen legs, which I'd never had, and it took days for them to come down. That was educational. Next time, I’ll back off the last day or so, which shouldn’t hurt performance. Hypertensives beware!
Also, have you noticed how much sodium there is in Fig Newtons? Mercy! They’re better than pretzels as a salty snack. I like beef jerky, too, sometimes. Read the small print on snacks. It's illuminating.
Besides true-riding experience, my only other credential is that I'm an M.D. (anesthesiologist). For what it's worth!
LEE R.: I've got a couple of methods that I employ for 6-hour endurance races. First, eat a small can of Pringles (pizza flavored is my favorite) an hour or two before the start. Second, add a pinch of kosher salt per bottle to enhance your sports drink. I wouldn't recommend using regular iodized table salt as it adds an unpleasant "tinny" taste.
MIKE B.: Do as the tennis pros do. They keep salt in a baggy, and between sets they consume a tablespoon or so with their drink. I’m careful to take in as much salt as I can. I’m a triathlete, and salt deprivation is probably the leading cause of spectacular blowups!
KENT W.: In the Death Ride here in California, at most of the rest stops they have boiled salted red potatoes. Real food for the long ride, with lots of salt to help prevent cramps. Also, Mexican food the night before a hot, sweaty ride gives you lots of salt.
BEN C.: If you’re like me, your helmet straps get crusty with salt. Your face gets gritty with salt. And it’s not uncommon to have bands of salt marks on shorts and jerseys.
Forcing yourself to consume water even when you don't want to drink more is only part of the solution/problem. Replenishing the electrolytes that you sweat out is also key.
Now here's the trick: replenishing the electrolytes in the same concentrations you are losing them!
It’s not good enough to consume lots of water and lots of salt and potassium. If you consume too much salt, you can make yourself sick. If you don't consume enough salt, you ultimately will "hit the wall."
If you consume only half as much salt, for instance, as you have lost but consume an equal amount of water as you have perspired, then you have diluted your salt replenishment. Over time, this will do you in.
I don’t have a foolproof way for being certain that you are consuming enough salt and other electrolytes to offset this loss. But by being aware of the need to maintain a balance, it may help you come a lot closer.
HANK G., M.D.: I've done many centuries and always seem to cramp. When I heard Arnie Baker speak, he recommended taking more salt to prevent cramping. So before a 200-mile ride, I ate potato chips and a couple of Snickers, in addition to lots of peanut butter on a bagel. It was the first time I didn't cramp on a long ride, and it was the longest one-day ride I've ever done. I'm convinced that the salt in those foods made a difference.
GILLIAN M.: Magnesium is the "anti-spasmodic mineral." I work with many people in my practice who suffer from cramps. If they get good levels of potassium, magnesium and calcium, the painful problem may subside. I prefer liquid forms of these minerals because they work so much faster and are absorbed better.
A supplement with a 1:1 ratio of calcium/magnesium brings some relief after a week or so of using it. For some people extra vitamin E is helpful, and so is Aangamic DMG (used to be known as B15), which cuts down lactic acid buildup.
PAT C.: Since taking 550 mg of potassium a day, I can't seem to get myself to cramp during swims, bike rides, runs and two hours of karate a day.
PETE K.: Try Kool ‘n Fit, a liquid pain reliever. This stuff is magic! I've had a cramp the size of a golf ball just above my knee, sprayed on Kool ‘n Fit, and watched it release. It doesn't solve the cramping indefinitely, but it will get you back on the bike and rolling again.
It comes in a large bottle, so I put it in a little travel pump hairspray bottle for rides. It also takes away the my-legs-are-made-of-wood feeling that you get late in a ride, even when you aren't cramping. Magic, I'm telling you!
DAVID F.: I've been a long-time sufferer of cramps, some of which have been immobilizing. Recently I have been using a product called E-Lyte, and my cramping has stopped.
A number of my teammates had been bugging the rest of us to use E-Lyte, which
became a sponsor of our team. I ignored them, but after sweating buckets and suffering one horrible bout of cramps on the indoor trainer, I decided to try it. Since then, remarkably and to my surprise, I have not had cramps. The stuff works.
GENE P.: I have successfully prevented cramps by drinking dilute Hydra Fuel from TwinLab. My computer has an interval function, which I set to beep every 10 minutes to remind me to take a drink. Every other beep, I also eat a bite of an energy bar or some gel. I recently completed a double century feeling great with this formula.
CLIFF K.: Here in New Zealand, there is a product called HCH Cramp Stop. It's sold via a website and works for everyone that I know who has tried it.
It comes in a small plastic spray bottle that's hardly noticed in your jersey pocket. When cramps start, a couple of sprays under the tongue is all it takes for everything to be back to normal between 30 seconds and two minutes The time seems to vary from person to person.
GREG C.: RendiMAX is available in drug stories, like Medicine Shoppe, that specialize in homeopathic medicines. I keep a few pills in a sandwich bag on long rides and dissolve them in my mouth at the first sign of cramping. That and Cytomax, plenty of liquids and a salty pretzel or two pretty much keeps me cramp-free.
TOM G.: I had cramping until I started taking Thermotabs, available in drug stores. Now I do not cramp due to heat and decreased minerals/electrolytes.
GRAHAM F.: I had suffered from cramps for years. When I was racing in England, my coach told me to drink a liter of tonic water the night before every hard day. Tonic water contains quinine, which doctors added to water for British soldiers when they were cramping during fighting in the heat of the northwest frontier in India. Now I race in the U.S. and always drink tonic water before a hard day.
MARGIE B.: I know this sounds crazy, but my husband is an avid tennis player and one of his partners swears by pickle juice for cramps. He keeps a flask during long matches.
TERRY M.: I live in Louisiana where the heat is almost relentless. It’s not uncommon for us to have a heat index of 110-115F degrees, and of course the humidity is never under 70%.
One thing that prevents cramping is pickle juice. Yep, plain ole pickle juice. I learned this trick years ago when I played football in college. Some of the NFL teams use it also, especially when playing in the South. I don't recall all the why's and how's of it working, but it has worked for me many years. Just a couple of ounces, and it isn't bad tasting, either.
JAMES W.: I had brutal cramps on TOMRV, a two-day ride up the Mississippi River Valley and back. I cramped so hard at the end of 110 miles on the first day that I could not walk, stand, sit, bend over, or anything. I had competing cramps on opposite sides of my legs!
I did everything I could think of to ward them off, but to no avail. I tried eating bananas, kiwi, oranges. I drank 140 ounces of Cytomax and 60 ounces of water. I ate pretzels and trail mix for the salt. Nothing worked.
My conclusion was that the cramps were not heat or exercise induced so much as undertraining induced. Not much I could do about that except train more for the next time. Lesson learned.