CrampQUESTION
Hi Dr Darren.
I have experienced cramps in my thighs since the age of 25, but they were mild and bearable, not affecting my life dramatically. Now I am 62 yrs old and it affects me when I do housework like sweeping or mopping the floor. I feel perfect while I walk and usually do walk for one and half hours a day, five days a week. When I sit on a sofa for a little while and get up, I experience cramps and can’t walk normally. I have to massage my thighs and then feel normal again. Sometimes its embarrassing and feels like I am getting crippled. I have been to few doctors over the years and all of them told me there’s nothing wrong with my legs. I told them I feel like I am getting crippled. All the doctors say the same thing – that is a problem with the Sciatic nerve. The state hospital is giving me slow mag which I am taking daily for the past 3 years – with little or no effect. Nothing I have tried seems to be helping me and when I tried to help my father who was unable to bath, my leg was twisting. I found it difficult to help him and I am losing hope. I have this twisting feeling from my thighs. Also weakness in my legs and I need support to move sometimes. I also try to wear socks and sports shoes and health socks to support my legs.
Please can you help or tell me what is wrong with me and what I can do from here. You will never understand how much we appreciate and look out for your column every week. For people that don’t have medical aid, it is very hard to get help sometimes.

ANSWER
The topic of cramps is certainly one that becomes more and more popular with seasonal variation as well as activity.
Simply put most of us describe a cramp as a contraction or tightening of our muscles and who can forget the tummy cramps .Debilitating and certainly very challenging sometimes. Cramps refer to the intense muscle contractions that seem prolonged and often lead to pain. This type of pain is most commonly experienced in the lower extremity. They usually last less than one minute, but may last several minutes before the contraction subsides. In some patients, the spasms occur primarily at night, and can awaken the patient from sleep. More severe leg cramps can cause pain that lasts several days after the cramp occurs.

Leg cramps occur when the muscle suddenly and forcefully contracts. The most common muscles to contract in this manner are muscles that cross two joints. These muscles include the calf (crossing the ankle and knee), the hamstring (crossing the knee and hip), and the quadriceps (also crossing the knee and hip).

BACK TO BASICS
If you think about it simply – no matter where the muscle spasm, when you cannot voluntarily release or ‘relax’ muscle, it can cause discomfort
You should also remember that the muscle cells receive a rich blood supply and venous drainage and when muscles go into spasm or cramp up – blood supply is diminished. Patent blood vessels and muscle fibres that contract and relax in a smooth sequence of intricate mechanisms, drive successful and comfortable movement. High performance athletes have to condition these muscles and fine tune these mechanisms to optimize peak performance. Conditioning the muscles is the flavour of the day.

Risk factors that predispose cramps:
• Muscle fatigue
• Heavy exercising
• Dehydration
• Overweight – not necessarily obesity
• Electrolyte imbalances
• Medications (statins, prednisone, others…)

SO WHAT CAUSES CRAMPS?
The most common cause that is typically seen in patients who develop leg cramps when changing a routine of activity – either more activity or a different exercise. Leg cramps are more common in young (adolescent age) and older (over 65) patients.

HOW DO I PREVENT MUSCLE SPASMS
• Hydration
All muscle cells need water and electrolytes to function. The intricate mechanisms of muscle contraction and relaxation are dependent of essential elements like calcium , magnesium and energy. Also drink plenty of fluid before, during, and after exercise.
• Stretch Regularly
Stretching can relax muscle fibers. After rigorous training ,a stretching routine can help relax muscles and prevent cramps. Make sure you cool down after exercising, and do not exercise vigorously just prior to sleep.
• Progressive training
Don’t go too big too soon. Avoid sudden increases in activity. The “10% Rule” is a good rule of thumb: never increase your exercise over one week by more than 10% compared to the week before. Sudden changes in activities can cause leg cramps. Most athletes that have leg cramps, such as long-distance runners, have increased their level of intensity or duration of activity too quickly.

DR DARREN’s CRUSH CRAMP HITLIST
• Massage the cramped muscle and stretch the muscle gently and slowly.
• Take a hot shower or bath
• Persistent and recurring cramps should be referred to a physician problem
• Electrolyte imbalances are often treatable reversible causes of cramps
• Muscle relaxing medications can be prescribed if the muscle cramping is a problem, particularly at night
• Finally, your medications and medical history should be reviewed to investigate for possible factors contributing to your leg cramps.

CRAMPS! …what causes it ?

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