Cramps: a pain to deal with

Most of us know how it feels to get a muscle cramp: Just plain excruciating!

Although doctors are not in complete agreement about what causes muscle cramps in athletes, there are some steps that all of us can take to try to prevent them, says Andrew Tucker, medical director of the Union Memorial Sports Medicine program.

Most of us have experienced a cramp - an involuntary contraction in one or more of our muscles. What causes the muscle cramps that athletes often suffer?

It's controversial. Most researchers now believe that the most common cause of "exertional" cramps has to do with loss of salt from excessive sweating over prolonged periods of exercise. For example, an athlete exercising strenuously for two hours in very warm weather can sweat as much as 1 to 2 liters an hour. You can lose a lot of sodium chloride in that amount of time.

Do nonathletes also get cramps?

Adults may suffer from two basic types of muscle cramps: the kind athletes get from exertion and a kind that elderly people get. Why the elderly get them isn't known; sometimes it is due to electrolyte or potassium or calcium imbalances or side effects from medicines.

Children also sometimes get what seem to be cramps in the middle of the night; what about those?

I don't know if anyone has a precise reason for those nighttime "Charley horses" or so-called growing pains. They could be related to fatigue from a lot of physical activity, or one theory is that it is due to changing bodies or growing bones and muscles.

Are some people more prone to cramps than others?

There do seem to be people who are prone to cramps, but it is difficult for us to understand why. We think that people who lose more salt when sweating are probably more prone, meaning that not everyone loses the same amount of salt when sweating.

Let's say you have a muscle cramp right this moment. What should you do?

You usually have to stop whatever activity you're doing because it is so painful. You can use an ice massage on the muscle and the muscle groups, and maximize your hydration. Drink - and especially drink fluids that have electrolytes in them including salt. Sometimes the cramps can be controlled, and the athlete can return to the activity.

You're the head physician for the Ravens. What do you do when one of the Ravens gets a cramp during a football game?

Their muscles are stretched by the athletic trainer. The trainer usually will massage or ice-massage the affected muscle. If we can't get them settled down that way, we will consider IV fluids. That seems to help, but we don't know if it is the hydration or the salt [in the fluids] that is helping. Muscle cramps are common, especially in the warm weather. At games in August or September, we could have anywhere from a couple to a half-dozen players who will cramp significantly.

It is a little daunting to hear that even among professional athletes, muscle cramps are so common.

Yes, they are in tremendous shape, and they are educated about the importance of hydration. Despite all this, when you are working out that hard and that long in extreme environments, it is still going to happen.

What can be done to try to prevent cramps?

Prevention is usually focused on hydration and the importance of maintaining a lot of salt in one's diet to help replace the salt. But I am talking about athletes: the 10K competitor, the marathon runners or athletes who play team sports like football or soccer. If you are less active or have blood-pressure issues or other health issues, you should talk to your doctor.

You also should avoid stimulants or supplements that contain stimulants. Those stimulants may increase the risk of muscle cramps. And this includes caffeine-containing stimulants; many supplements designed to increase your energy may have caffeine in them.

When should someone who suffers from muscle cramps consult a doctor?

If you have recurrent cramps associated with activity whether with extreme temperatures or not, I think a doctor should be consulted. Sometimes muscle cramps can be associated with certain nerve disorders or gland or endocrine problems. So anyone with recurrent cramps, whether associated with exercise or not, should consult with a doctor.

• DENTAL RECEPTIONIST

• CLERICAL

• BOOKKEEPING

• DIETITICIAN

• DENTAL RECEPTIONIST

• View all Top Jobs