When Muscles Attack…


Monday February, 12 2018

When Muscles Attack…


Congratulations on your resolution to push yourself physically this coming year.  But if you’re one of the many who suffer from severe, temporarily debilitating “charley horse” muscle cramps during or after a hard swim, run, cycling challenge, or other physically demanding effort, you may be dreading the exertion you’ve scheduled.  These painful muscle spasms can stop you completely during the middle of a race or may seize up your muscles hours after a strenuous effort.

Fortunately, there are steps you can take to keep your muscles from putting the brakes on your good physical fitness intentions – steps based on new research that challenges long-held assumptions on causes and cures.


If misery truly loves company, then find comfort in knowing that muscle spasms affect even trained athletes.  Some studies have shown significant cramping in 21 percent of Ironman athletes.  And one need only spectate between miles 20 and 26 of a marathon race to see many runners suddenly stop and clutch at the back their legs or hamstrings to know that many suffer from the painful charley horse cramp.

“I too had my season finale ‘A’ race, a Half-Ironman, absolutely demolished by severe cramps for two consecutive years,” says orthopedic surgeon Ronald E. Michalak, M.D., FAAOS, MS, also known as Dr. Ron, medical consultant and blogger for IceSpike.com.  After two years of dedicated training, only to perform worse than he had at his first Ironman attempt three years ago “was quite depressing. I had achieved the appropriate swim-bike-run volumes. I had several blood tests to investigate, all with normal results.”

What could have gone wrong for Dr. Ron, and for others whose efforts to push themselves are thwarted by muscle cramping? “Walking the last 11 miles of what was supposed to be my crowning achievement gave me ample time to strategize about how to prevent this from happening ever again,” he says.
The next day he began his research.


What brings on severe muscles spasms during or after a hard workout?  Not all experts agree, which is one reason why the problem is not easy to treat.  Theories abound:

  • Some experts contend that insufficient pre-workout stretching of muscles is to blame, even as others say that over-stretching is the cause.
  • Another theory is that the emotional exuberance or anxiety that accompanies a competitive event causes muscles to “over-fire” and thus cramp up.
  • “Electrolyte imbalances and dehydration have often been blamed but the anecdotal evidence is quite weak,” Dr. Ron says. “In more recent (and more scientifically rigorous) studies, these have not been supported.”

Instead, focus is shifting towards neuromuscular fatigue as the main culprit. “This often occurs when pushing distance or pace – such as longer training runs while building aerobic base, higher intensity interval sessions, or (as in my case) races,” Dr. Ron explains.


Once the cramping begins, most runners and physicians agree that stopping and stretching out the spasm-laden muscle is an effective way to getting the cramping to subside. But, obviously, you cannot have your best race performance unless you can keep the spasm from occurring in the first place.

Because the causes are not clear cut, solutions to exertion-related muscle spasms have proven elusive and often contradictory.  But new studies and new data are offering solutions worth trying, as are some anecdotal remedies worth discussing.  If one does not work for you, another might.

Given the recent research that sheds new light on the subject, we’ll start there.  Dr. Ron advises that, “Prevention of cramps requires dedicated strength training and plyometrics.” Plyometrics – exercises based on maximum-force exertion in spurts to increase both speed and power – will “help to prevent the neuromuscular fatigue that leads to cramps.”

According to Dr. Ron, “Aerobic exercise (running, cycling, swimming, etc.) is not an efficient way to build strength. Adding more miles to your training schedule (i.e. over distance training) may help to prevent cramps on race day, but may also put you at risk for other overuse injuries and suboptimal race performance.”
Instead, Dr. Ron advises appropriate strength training and judicious use of plyometrics to reduce your risk of injury and prevent cramps. “My cramps were focused in my hamstrings. I added suspension training and plyometric exercises specifically targeting hamstring strength three times per week that winter during the off-season. I was shocked at how weak my hamstrings actually were at the start of this program despite training over 500 hours the previous year (mostly swim-bike-run),” he admits.

“I kept up this strength program once weekly during the high-volume summer peak season. The next year, despite being two years older and lower training volume, I went back to the same Half Ironman, got my PR (personal record), and had no cramps – Redemption was mine!”

Dr. Ron has continued this strengthening routine and has since made the jump to the full Ironman 140.6 distance successfully, and “as part of the 79 percent of finishers who did NOT cramp.”


If cramping is holding back your exercise program, Dr. Ron recommends that you consult with your physician. “There are some metabolic issues (although uncommon) that can cause cramps that need to be ruled-out first.”

His other recommendation: “Work with a local coach or trainer who may be able to help with this type of program if you are not well acquainted with this plyometric type of exercise as improper technique or progression can lead to injury.”

For more info and solutions or recommendations related to muscle cramping:

You can read Dr. Ron Michalak’s frequent article contributions on fitness at blog.icespike.com.

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