How to Beat Muscle Cramps

You're on the ninth of 10 x 100s and push off the wall, psyched to bring the set home. After a burst of three dolphin kicks off the wall, it feels like a knife has suddenly pierced your calf muscles. Why does this keep happening? You grab the lane line and grimace while rubbing the screaming muscles and hoping the agony will subside.

“Cramps are involuntary muscle contractions that can be extremely painful,” says Jason Collins, a Sarasota, Fla.–based orthopedic surgeon and sports medicine physician. Some cramps last seconds while others can linger for up to 15 minutes and damage tissue. They can also put a swimmer's safety—particularly in open water—in peril.

Having served as team doctor or assistant team doctor for the Miami Dolphins, New York Rangers, Florida International University Athletic Program (including swimming and diving teams) and other sports teams over the years, Collins is an expert in dealing with the unique health needs of athletes. He shares some common causes and cures for this frustrating malady.

• Fatigue. Fatigue is a primary cause for cramps. Muscles worked hardest and that cross multiple joints are the most susceptible to cramping. This doesn't mean you shouldn’t push yourself, it means you should train appropriately for your current level of physical conditioning. “Train with shorter swims and build your way up to longer swims over time,” suggests Collins.
• Dehydration and electrolyte imbalances. Overexertion, excessive heat, or inadequate fluid intake can lead to dehydration and/or electrolyte imbalances and, ultimately, muscle cramps.You should drink plenty of fluids before, during, and after workouts. And you should avoid alcohol, which contributes to cramping. “Avoid harsh weather conditions especially extreme heat while swimming. Training in climate-controlled conditions such as an indoor pool may be helpful,” Collins says.
• Age. As the years march on, we all become more susceptible to cramping. The loss of strength, volume, and elasticity of muscles associated with aging is to blame, Collins says. To help alleviate some of this, “Warm up with a short swim or light walk or jog before starting.”
• Medications. Medication-related cramps are common. High blood pressure pills, lipid- or cholesterol-lowering drugs, insulin or diabetes medications, and oral contraceptives are all associated with a higher incidence of cramping, Collins says.
• Genetics. Some people are genetically predisposed to cramping and conditions such as Parkinson's disease, hypothyroidism, and diabetes can increase a person's chances of experiencing muscle cramps.

When muscle cramps strike, Collins suggests:

• Stopping. “I recommend immediately stopping the exercise activity. Get to land or, at the very least, hold a flotation device,” Collins says.
• Stretching. “Gentle stretching and massage of the cramped extremity will help alleviate the cramp. Hold the arm or leg in a stretched position until the cramp resolves.”
• Applying heat or ice. “If the muscle is tense or tight, apply gentle heat. If the muscle is sore or tender, ice may applied for 15 minutes intervals.”
• Rehydrating. “The cramping swimmer should be vigorously rehydrated,” Collins says. “A sports drink with electrolytes (i.e., Gatorade or Powerade) is typically sufficient but in extreme cases an IV may be necessary.” Research published in 2010 suggests that sipping pickle juice can also help. Scientists believe the acidic or salty taste triggers a reaction in the brain that stops the cramp. (Read more about this study and how to prevent and alleviate cramps in “Rigor Mortis Lite,” by Jim Thornton, in the July-August 2015 issue of SWIMMER magazine.)

“If you experience persistent, painful cramps after following the above recommendations, I would recommend seeing a doctor and being evaluated. Also speak with your doctor about cramps if you have a family history of cramping or a chronic medical problem that limits your ability to swim,” Collins advises.