Debilitating leg cramps after ride today

Debated putting this under nutrition/hydration, but I guess either would do. Went for a ride with a few friends today. It is HOT in NC, but now as hot as it has been. Started the ride at 8:00 when the temps were around 80 and finished by 11:00 and low 90's. Very humid. The ride was almost 40 miles and not particularly windy or hilly.

One of my friends did great on the ride but had a little leg cramping at the end but walked it out. We all had lunch in an air conditioned restaurant. When we were almost finished, her legs started cramping to the point she was yelling in pain and could not stand or walk. We started to call an ambulance, but it eased up, and we carried her to a back room where she could lie down. After two hours of powerade, mustard, tums, stretching, kneading, whatever anyone had ever heard of that would help with cramping, we finally got a wheelchair and were able to get her to the car (her husband had come). He took her to an urgent care where they administered some IV fluids and said she was dehydrated. She was still cramping until about half the bag was in, but has not had any further problems.

She said she had breakfast (I don't know what specifically). She had two bottles of water and one bottle of gatorade on the ride as well as one bar of some type. I had 3 bottles of fluid also, but two of mine had electrolytes in them. I ate a similar amount. I started feeling like the heat was affecting me about 20 miles into the ride and had to slow down, but felt better after a while. She has been riding for a couple of years now, although had to take a few months off in the winter due to knee surgery. Today was probably her best ride in terms of speed since the surgery, so she probably pushed it, but was feeling good on the ride and after until the end of lunch.

A contributing factor, I think, is that she and her husband have been on the Atkins diet for a month or more now. I read that leg cramping is fairly common among people on that plan. Is that true?

Anyway, I have seen people with bad cramps, but I have never seen anything like this. Have any of you experienced anything similar? Do you think it was too little electrolyte replacement, the Atkins diet, both?

When I get cramps in that kind of conditions it's almost always because I'm low in magnesium. Gatorade doesn't replace magnesium or calcium at all - did she have any other electrolyte replacement? It sounds like overuse definitely contributed.

I don't know that much about Atkins, but I would think that people who take it to mean eating a lot of meat would be functionally low in both calcium and magnesium, just because they would be getting so much phosphorus?

Just speculation and personal experience ...

No, just the Gatorade, but that is good information to have. Just checked my camelbak elixir tablets and was happy to see they do have magnesium, and some flavors have calcium as well.

unless you are adequately hydrated before you ride, drinking on the ride still tends to leave you a bit dehydrated. The trick is to super hydrate in the afternoon, evening and night before the ride and then drink regularly and often when you are riding. While this doesn't eliminate the possibility of low potassium or low magnesium issues, it does help with the general dehydration issues.

We always have Cramp-ze spray or salt tablets in our underseat bag as DH gets bad cramps on long rides. But he's a large guy with huge leg muscles and this makes him prone to it.

Remember you can also "overdose" on plain water as you dilute your salt levels in your body, so when hydrating you should include some salts in the water. People have died from drinking too much plain water.

I have never seen Cramp-ze spray anywhere. Where do you find it? Salt tablets too, for that matter. I wouldn't mind having something with me in the future.

Here are the theories:

http://www.nytimes.com/2008/02/14/he...on/14BEST.html

Cramping is still pretty much a mystery; mostly because no one has really studied the issue in enough detail.

There are three leading hypotheses about how to treat cramps and how to prevent them.There’s the dehydration proposal: you just need more fluid. But, Dr. Schwellnus said, he studied athletes who cramped and found that they were no more dehydrated before or after a race than those who did not have cramps.

Then there’s the electrolyte hypothesis: what you really need is sodium and potassium.
Michael F. Bergeron, who directs the environmental physiology laboratory at the Medical College of Georgia, said the electrolyte hypothesis applies to a specific type of cramp that is related to excessive sweating. It occurs, he said, when the fluid that bathes the connection between muscle and nerve is depleted of sodium and potassium, which was lost through sweat. The nerve then becomes hypersensitive, Dr. Bergeron said.
“Usually you feel little twitches first,” he explained. “They last for 20 to 30 minutes and if you don’t do anything you can be in full-blown cramps.” Those cramps, he continued can move from place to place on your body, from one leg to the next, to your arms, stomach, even your fingers or your face.
The solution, Dr. Bergeron said, is to drink salty fluids like Gatorade (the company sponsors his research). He said he had prevented cramps in tennis players this way.
But asked whether there are any rigorous studies to confirm this hypothesis, he said no. “We haven’t done the study yet,” he said. “We’re at the point of kind of connecting the dots.”


The third hypothesis is advanced by Dr. Schwellnus. He questions the electrolyte hypothesis because his studies of Ironman-distance triathletes as well as other studies of endurance athletes found no difference in electrolyte levels between those who suffered cramps and those who did not.
DR. SCHWELLNUS proposes that the real cause of cramping is an imbalance between nerve signals that excite a muscle and those that inhibit its contractions. And that imbalance, he said, occurs when a muscle is growing fatigued.
His solutions for cramps are to exercise less intensely and for shorter times, to be sure you had enough carbohydrates to fuel your muscles, to train sufficiently and to regularly stretch the muscles that give you problems. These recommendations are based on his recent study of Ironman triathletes, Dr. Schwellnus said.
But while he advocates those practices, he said, they have not been proved in a rigorous study.

So, possibly she didn't have enough carbs to fuel her fatigued muscles.

In my experience as well as what I've read, there's some difference between cramps I get during exertion and the ones I get afterward.

During exertion, the cramps I get can be any number of things ... the more unaccustomed the effort, the more likely it is to fit Schwellnus' theory. IIRC, his study examined only people who cramped during their Ironman races. Along those lines, it's pretty common for me to get foot cramps late in a long race, though I almost never get them on a long run at an easier pace.

The ones I get later on, and most particularly the leg cramps that wake me up at night - I can treat them pretty effectively with a quick-absorbing calcium-magnesium supplement, and I can mostly prevent them as long as I titrate my maintenance calcium-magnesium supplement along with the amount I sweat on any particular day.

I'm pretty prone to a mild hyponatremia, but AFAIK I've never had cramps related to sodium levels. YMMV.

In conjunction with lack of hydration, I recently overheard a doc on an event ride asking a crampee if he had any alchohol the night before - indeed, the guy had partied it up with his team and likely had a hangover. The doc told him the alchohol combined with not enough fluids on the ride was the cause of his cramps.

Quote:

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Originally Posted by marni

unless you are adequately hydrated before you ride, drinking on the ride still tends to leave you a bit dehydrated. The trick is to super hydrate in the afternoon, evening and night before the ride and then drink regularly and often when you are riding. While this doesn't eliminate the possibility of low potassium or low magnesium issues, it does help with the general dehydration issues.

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Agreed with Marni...diet and hydration is just as important on days leading up to your long ride vs. the day of. Overall, proper diet and hydration are very important when it comes to longer rides especially in heat. I can't see where an Atkins diet would help in providing the proper nutrients given the situation and conditions of the riding.

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Originally Posted by Grits

I have never seen Cramp-ze spray anywhere. Where do you find it? Salt tablets too, for that matter. I wouldn't mind having something with me in the future.

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Details can be found on these websites-

www.crampeze.com
www.saltstick.com

I got the name of the spray wrong- it's Cramp Stop as per this link. http://www.globetrekker.com.au/first...op-25ml-spray/

+100 on the Salt Stick capsules that Kiwi Stoker provided a link for, I was going to post that same link until I saw she beat me to it. I find my body seems to like them better than Endurolytes. There is some interesting information on their website about the science behind it all.

Thanks for the links, Kiwi, and the recommendation, Catrin. I haven't ever had a problem with cramps myself, (knocking on all available wood products around me), but these sound like something I could use in place of a sports drink and would be easily transportable, and I would like to carry some extras in case someone with me needs some.

Quote:

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Originally Posted by Grits

Thanks for the links, Kiwi, and the recommendation, Catrin. I haven't ever had a problem with cramps myself, (knocking on all available wood products around me), but these sound like something I could use in place of a sports drink and would be easily transportable, and I would like to carry some extras in case someone with me needs some.

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I've really not had problems with cramps, but I do like to take them on really hot rides or other very hot outdoor activities. They decrease the need for shot blocks or gels - and they are nice to have extra just in case.