The Mysteries of Cramping

Today, people still do not understand the true reason behind why cramping happens – unless you have some sort of neuromuscular disorder or disease where cramping is a symptom. The misconception is that cramping occurs because muscles are depleted of water, minerals and electrolytes through sweating. This is false, in fact, cramping has nothing do with the muscles and everything to do with the nerves. This was theorized back in the 1990s by Martin Schwellnus. Schwellnus hypothesized that neural signals between the muscle and spine are distorted do to muscle fatigue. A distorted signal could cause the muscle contraction signal to keep firing, hence causing a cramp. Schwellnus came up with this hypothesis after it had been proven (2 decades ago) that there is no correlation between electrolyte levels and cramps. So why do we still think electrolytes are the answer to prevent cramping?

I believe the answer is simple – the 10 billion dollar sport drink industry. Gatorade, founded in the 1960s, still to this day has commercials about how their product stops cramps. Others are doing the same thing and this is false advertising. I would say hydrated muscles complete with electrolytes would perform better than the converse, but it does not stop the process of muscle fatigue.

Scientists are finally starting to catch on to Schwellnus’s theory. Two neuro scientists – Bean and MacKinnon, have created a supplement that has ion-channel activators that controls the nerves within the digestive track which simultaneously calms nerves throughout the body making it much harder for fatigued muscles to disrupt the nervous activity between muscles and the spine. This supplement should be available on the market soon.

Of course, I have been preaching something similar for years. I have Cramp Fasiculation Syndrome (CFS). I am an avid fitness enthusiast, but with CFS exercise is increasingly more difficult due to muscle pain and cramps. People would tell me to hydrate more and drink Gatorade, but I would explain that I am fully hydrated. They would argue and say “you can’t be hydrated if you are cramping”. I would say “Oh, yes, you can!”. I am living proof of this.

With CFS, my muscles are constantly in pain and are fatigued. Why? That is the 6 million dollar question, but I contribute this to two factors. First, people with CFS have a tough time resting and sleeping properly due to all the fasciculations occurring in their bodies. It feel like bugs are crawling under my skin. Secondly, I have constant small muscle fiber fasiculations (twitching), 24/7/365. Hence, my muscles never rest and this is a good reason why they are fatigued, even before I start to exercise. And this explains why they are more apt to cramp than a person without this type of peripheral nerve disorder.

Bean and MacKinnon are working on a drug that would help people with MS and ALS who have cramping symptoms. CFS has some of the same onset symptoms of MS and ALS, but with one major difference. CFS symptoms are due to an imbalance at the nerve endings, MS and ALS symptoms are triggered from the brain. MS and ALS causes muscle atrophy in most patients. Smaller and weaker muscles fatigue much easier than normal ones. Hence, it is easy for someone to conclude muscles for MS and ALS patients can cramp easy.

People with restless leg syndrome get cramps because their leg muscles are fatigued, not because they need Gatorade. This is so intuitive to people with muscular disorders that cause cramping. Obviously, the first thing I did was drink all the time to eliminate cramping and it did not work. It did absolutely nothing to help me. I even experimented further: I found that I could ride 30-40 hard miles on my bike and the chances of my cramping was about the same whether I started on an empty stomach and 16 ounces of water, or if I ate a full meal and had 32 ounces of Gatorade. I ate and drank nothing during the ride to control the experiment. In fact, my performance was not much different in either case. With my legs, cramping is likely to kick in after 3 hours of constant exercise and that threshold could go down depending on the intensity of the workout. It could happen within 30 minutes if I am really pushing myself to the limit in say a time trial activity.

Bean and MacKinnon’s company is Flex-Pharma: http://www.flex-pharma.com/. I have written them and will see what they say about their supplements and drugs for treating CFS.

The Keys to Training

Everyone has their keys to training. I have not read any books on it, but having a neurological disorder I have found the following works training plan works for me:

Go – You may not feel like working out, but once you start you will get into it. If you do not get into a bad habit of missing days, then you will train your body and mind to want physical activity and it will feel deprived on days you miss a work out. I sleep worse on my days off – it is like my body did not get what it needed during the day.

Get a computer – Having a computer on my bike has helped me immensely. It tracks my workouts on GPS (gains and distance), speed, cadence, power and heart rate. These are great pieces of information that will enable you to put together a great workout plan. It helps you compete against yourself anyone else who may have done the rides or runs you do. For instance, data from a hill climb race I saw how much time I lost over the last 1.8 miles to other riders. I did great up to that point, so my hill climbing endurance is not where it needs to be. The downside is that a computer may take you away from enjoying rides and focusing on the beautiful scenery.

Work Out Hard – I lived on the philosophy of riding and training hard every day. I am not that gung ho anymore – I do some recovery rides and take some rest days. But most days, I really do push myself. Some think I over train, and that may be the case. However, I am willing to have shorter workouts if I work hard (1-3 hours). I do not think that is any different than people going on 3 to 5 hour rides at a medium rate of intensity.

Compete – The best way to learn and push yourself is to compete. The more I compete the more relaxed I became about doing it. This is key to me, because stressing out only makes my symptoms worse and it makes it impossible to sleep. I have to try to stay away from that vicious cycle.

Work Out Alone – I do not ride with others. It may become too easy to draft off others and not get as good a workout. There is plenty of time for drafting in races. On the other hand, riding with others does teach you how to handle riding in groups. Riding in groups can be intimidating, but competing will address that.

Cross train – Anything that works on your core is good. Unfortunately, for me, I cannot do many of the exercises I enjoyed in the past – so I stick with just cycling and some strength lifting and exercises.

Get a Coach – If that helps motivate you or gets you the tips you need to train correctly and improve.

Train at altitude – It has really helped to expand my VO2 levels. This is one way to naturally dope your body with red blood cells.

Get good gear – It is very easy to be stingy and get cheaper gear. Good gear is better. I have not spent anywhere near what others spend on the race circuit. They have multiple bikes for competing. I have one bike, but it is a good bike. I convert it between a time trial bike and road bike. I still do just fine without a specialized time trial bike, but the key is that I got a good bike.

Enjoy pain – The few times I have ridden with others I can hear them say “Oh crap here comes a hill” while at the same time I am saying “Oh boy here comes a hill”. I accelerate to the hill with joy while others put their heads down before they even hit the hill. Maybe it is easy for me to enjoy pain because I already live in pain – so what is the difference? I probably suffer more after similar workouts than others so I do not know if that is a good reason. However, I can tell the difference between good and bad pain and more good pain is a definitely a good thing especially if it masks bad pain.

Improve – I am not happy if I am not improving. If you are not improving change things up. Competing is a sure way to get better.

Enjoy life – I am grateful for every day I get. I had my scare that I was dying of some neurological disorder. Now I understand that I am lucky, I get to live with paresthesia in the hands and feet, irritable bowls, and muscle pain, fatigue, stiffness, and cramping. This may not sound like a bunch of joy, but there are so many people that have it worse than I do – so I truly believe I am really lucky.

Listen and Learn – A lot can be learned from other more experienced people in your sport.

Evolve – If one sport is not working out so well, do not be afraid to try other sports. I found cycling after other sports washed up for me. It sounds crazy that I can bike but at the same time I have a tough time walking without lots of pain. I have pain in cycling but trust me it is so much more tolerable than the pain I have from other activities.

Live in the Moment – I used to fear how long I could cycle – I figured it was just a matter of time before that became too painful or dangerous due to paresthesia symptoms in the hands. That day may come much sooner than later, but right now I am going to live in the moment and try to enjoy what I have.

Never give up! – It is easy to quit. I could have quit a long time ago. Instead, I quit some other activities and moved on to another section of my life.