Learn what it is and how to treat it.

When you exercise hard, between 24 and 48 hours later you find you have aching muscles, which may last for two or three days. This is cramp, a type of late onset muscle pain.

In most cases you will be able to put up with it without it interfering with your normal life, but sometimes, particularly if you have exercised more strenuously than usual or this is after taking a break from exercise, cramp can be really painful, stop you from moving normally and require analgesia.

Why do I get cramp?

In the past, people believed that cramp was caused by crystallised lactic acid building up in the muscle fibres. This is because when a lot of glycogen deposits are burnt during strenuous movement, lactic acid is formed. This acid transforms into lactate and hydrogen ions which reduce the Ph. level in the muscles, making them less efficient and causing fatigue.

However, it has been shown that lactic acid build-up is not, in itself, responsible for muscle pain, because there are people who have a disease called McArdle who cannot produce this acid but who still suffer from cramp.

Based on this information, the most popular theory today holds that cramp is caused by micro-tearing of muscle fibres and tendons, which have been over-exerted, causing an inflammatory reaction that stimulates and irritates the nerves and causes pain. This inflammation resolves within a couple of days without problems and the muscles and tendons go back to normal.

How should I treat it?

The first thing you should be aware of is that drinking a glass of water with sugar in it is not going to prevent cramp or do anything at all to relieve it.

Your best cause of action if you get cramp is:

• Take a non-steroidal anti-inflammatory (NSAID) to relieve the pain.
• Apply an anti-inflammatory cream to the most painful area.
• Apply a cold pack to the area for no more than 20 minutes to reduce inflammation and relieve pain. A cold shower can also help, but it will not completely get rid of the discomfort.
• Continue to do the same type of exercise that caused the cramp, but take care not to overstain your muscles again. Although this may be uncomfortable and painful, it will stimulate blood flow to the area, reduce metabolites and ions as well as muscle pain.

Is there anything can I do to prevent cramp?

• Do not exercise too hard, too quickly. Step up the intensity gradually by no more than 10% of time, weight or distance per week, and give yourself some time to get used to it before increasing it again.
• Warm up your muscles before going into the hardest part of your workout.
• Remember to stretch each muscle group when you reduce the number of pulses, to keep each fibre longer.
• Keep your fluid intake up. Dehydration contributes to fatigue.
• Eat a suitable diet for sport. Include proteins to nourish the muscles and slow-release carbohydrates (pasta, rice, cereals, bread, no sugar) that release energy little by little.

Cramp is a common condition and it normally goes away on its own quickly. Otherwise, or if the pain is too acute, see your doctor.

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