Cramps and stitches

Cramps and stitches, who needs them? Here’s the lowdown…

What is a cramp?

Cramp is a sudden, tight and intense pain that most commonly occurs in the leg muscles especially the gastrocnemius (calf), hamstrings (back of thigh) and quadriceps (front of thigh). It can range from a slight twinge to an excruciating pain, and may last for a few seconds or several minutes.  A cramp can be a one-off occurrence or repeat several times before the muscle relaxes and the pain goes away.

The cause:

  • Cramp is caused when a muscle involuntary and forcibly contracts and does not relax. Cramp is more likely to occur in tired muscles therefore poor fitness or exercising at high workloads can increase the likelihood.  Inadequate stretching may also contribute.
  • Dehydration may contribute to cramp especially when fluid and sodium losses are high.  Sodium is involved in initiating nerve signals that make muscles contract.  A deficit of sodium and fluid may “irritate” muscles causing them to contract uncontrollably.
  • Cramp has been attributed to the depletion of potassium and minerals such as calcium and magnesium. It has been suggested that magnesium is relocated in the body during exercise rather than lost in sweat.  Therefore, a magnesium imbalance in relation to other electrolytes such as sodium and potassium may be involved.
  • The use of creatine has been linked to cramps, based on anecdotal reports from athletes and the hypothesis that a creatine-loaded muscle cell may become so “full” with the storage of creatine and fluid, that the integrity of the membrane is disrupted. This theory is currently being tested in research studies.

Treatment of cramps:

  • Allow adequate recovery and rest after hard training sessions.
  • Increase strength and fitness. Stronger muscles are more resilient to fatigue and cramps.Remember, fatigued muscles take longer to adapt to increased workload so progress slowly.
  • Wear comfortable, unrestrictive clothing and footwear.
  • Stay well hydrated during exercise by drinking appropriate amounts of fluid.
  • Stretching helps to decrease the muscle contraction and allow the muscle to relax.
  • Massaging the area may help to alleviate pain.
  • When cramps are severe, applying ice can stop the spasm and help to relieve pain.

Does cramp indicate a more serious problem?

In most cases, cramps are a temporary event and do not lead to serious problems. You should always see your doctor if cramps are severe, occur regularly, fail to improve with simple treatment or are not related to obvious causes such as strenuous exercise.

What is a stitch?

Stitch is a localised pain usually felt on the side, just below the ribs.  It is sometimes accompanied by a stabbing pain in the shoulder joint.  The pain can range from sharp or stabbing to mild cramping, aching or pulling.  Sometimes people can exercise through the pain however, usually the sufferer is forced to slow down or stop exercising.  The pain usually eases within a few minutes after ceasing exercise although some people do experience soreness for a few days. A stitch seems to be more prevalent in activities that involve vigorous upright, repetitive movement of the torso.  Activities such as running and horse riding may be more prone to stitch but it can occur in any type of activity.

The cause:

Scientists are unsure of the exact cause of stitch.  For some time, stitch was thought to be caused by a reduction in blood supply to the diaphragm in favour of supplying the large muscle groups. This theory has since lost popularity as both the diaphragm and the limb muscles need to work harder during exercise so it is unlikely that an inadequate blood flow is directed to the diaphragm.

A more recent idea is that stitch is caused by irritation of the parietal peritoneum. Two layers of membrane, the peritoneum, line the inside wall of the abdominal cavity. One layer covers the abdominal organs. The other layer, the parietal peritoneum attaches to the abdominal wall. The two layers are separated by lubricating fluid which allows the two surfaces to move against each other without irritation. The parietal peritoneum is attached to a number of nerves. It is thought that the stitch occurs when there is friction between the abdominal contents and the parietal peritoneum. This friction may be caused by a distended (full) stomach or a reduction in the lubricating fluid.

Eating and drinking inappropriately prior to exercise may exacerbate stitch by causing a full stomach or dehydration. Poor fitness, an inadequate warm up and exercising at high intensity may also be factors. A sudden change in biomechanics such as increased stride length or frequency may increase the risk of stitch by affecting the way that the torso moves.

How can I avoid stitch?

•     Eating too closely to exercise or consuming inappropriate foods and fluids seems to exacerbate the stitch.

•     Concentrated fluids such as soft drink and cordial empty slowly from the stomach therefore are likely to lead to a fuller stomach.  Water and sports drink empty more quickly and are a better option.  It is also preferable to adopt a pattern of consuming small amounts of fluid at frequent intervals during exercise rather then trying to drink large volumes all at once.

•     Stitch may also be minimised by following a training schedule that progressively increases in intensity and duration. Sudden increases in intensity are more likely to cause stitch.  It is much better to start at an easy level and slowly build up.

How should stitch be treated?

Sometimes the stitch eases if you slow down and drop your intensity for a period.  However, the most common way to alleviate stitch is to bend forward while pushing on the affected area and breathing deeply.

Another option is to lie down and elevate your hips.

Does stitch indicate a more serious problem?

The stitch is rarely a sign of more serious problems.  However, any pain that is persistent and does not ease when exercise ceases should be investigated by a doctor.

The more you know, the more you grow.

Source:Australian Sports Commission

About Christine Kambourakis

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