“ARGGHHH!” What’s that? Oh, that’s me cramping on the side of the trail. NBD, I just can’t walk.
Cramping is the quickest way to ruin a fun day. And it seems to strike indeterminately and at any time.
One minute, you’re set for a PR, the next, you’re sprawled out on the forest floor, trying to stretch out a hamstring that’s bunched itself into a ball the size of, well, a Christmas ham. (Hyperbole, people!)
I have friends who measure success (or lack of success) of their race based on how badly they cramped compared to last year. “It was a good ride! I didn’t cramp until mile 30!”
I have other friends that seem incapable of cramping, and others that cramp when they take the garbage can to the curb.
Weekend warriors, amatuers, athletes, and seasoned pros: cramps can turn all of us into contorted heaps slamming pickle juice on the side of the trail.
Despite cramping being a universal problem, scientists still aren’t entirely sure what causes cramps. Here’s a closer look at the mechanism behind cramping, a few potential causes, and better yet, a look at supplements that reduce cramping.
What causes muscle cramps during or after exercise?
A muscle cramp is a painful, involuntary, spasmodic muscle contraction.
When your muscles contract normally, your brain sends an electrical signal via neurons to muscle cells. Through a complex interaction of proteins like actin and myosin (the key ingredients in muscle), compounds like acetylcholine, elements like calcium, and electrical nerve impulses, your muscle cells change in tension or length.
This change in length or tension is what allows you to run or hold a book.
The Golgi tendon organ is a structure of the nervous system found throughout the body at the intersection of muscle fibers and tendons. It’s in charge of keeping muscles from too much contraction.
You can imagine that without something overseeing muscle contraction, your muscles could damage themselves or the tendons attaching them to bone.
During a cramp, the Golgi tendon organ goes haywire. Somehow, the Golgi tendon organ becomes desensitized from prolonged or intense exercise.
It’s not getting the right amount of electrical stimulation it needs to regulate the muscle. Simultaneously, electrical impulses continue telling the muscles to contract. The result is a spasmodic muscle contraction.
It appears that we all have a cramp threshold, or the amount of electrical stimulation needed to produce a cramp.
The cramp threshold seems to vary from person to person, which might help explain why some athletes cramp sooner, longer, or more frequently than others.
Fascinatingly, scientists aren’t 100% certain why or how the Golgi tendon organ goes off-script.
A few of the more promising theories claim that an increased firing of neurons, a drop in PH, or a decrease in glycogen could produce the spasmodic response.
There are a few conditions that appear to increase the rate, frequency, and likelihood of exercise-induced muscle cramping in athletes. These include
- Exercising in extreme heat
- Abnormally intense exercise
- Prolonged exercise (when duration is longer than normal routine)
- Beginning a new routine or trying a new sport
Heat-induced cramping
Many athletes believe that exercising in the heat produces cramps.
This isn’t exactly true, although there does appear to be a link between high temps and cramping. For example, one study found that 95% of cramping in football players occurs when the risk of heat illness is high. (Cooper)
You likely didn’t need to read a study to know that. Watch any event or race in hot weather and you’ll see a lot of cramping. Cramping does seem to occur frequently during conditions that could cause dehydration and electrolyte imbalance.
But, heat-induced cramping doesn’t explain how or why athletes cramp in cool weather.
One study found that when carbohydrate-electrolyte fluids were ingested at a rate that matched sweat loss, Exercise-induced cramping still occurred in 69% of athletes (9 of 13). (Miller)
Perhaps this means that dehydration or electrolyte imbalances (lost via sweat in high temperatures) exacerbate, prolong, or increase conditions necessary for cramping.
Of course, it’s possible that multiple mechanisms cause cramping.
Actually, most experts argue that it is unlikely that a single factor, such as dehydration, electrolyte imbalance, or neuromuscular factors, is responsible for causing cramps directly.
It’s probable that a combination of factors and conditions team up to wage war on your Golgi tendon organ.
Whatever the cause, one thing is certain: cramps suck.
Luckily, there are a few supplements that can lessen the frequency, intensity, and/or duration of muscle cramps.
Best supplements for cramping before, during, and after exercise
Because scientists aren’t confident in how or why cramps occur, there are a ton of treatments for cramping. And they range from effective to completely useless.
One of the most effective remedies for cramping is stretching during the cramp.
People who are prone to exercise-associated cramping have increased electrical activity in their muscles. When you stretch the affected muscle, you effectively help the Golgi tendon organ reactivate by doing its job.
It doesn’t appear that stretching before or after exercise reduces cramps.
As far as supplementation goes, most of the promising remedies involve replenishing conductive chemicals (electrolytes).
Although, it’s important to note that dehydration does not cause cramping, and the reason for taking electrolytes for cramping is not fluid retention. Instead, it’s theorized that electrolytes can help regulate electrical stimulation.
Other supplements may have ancillary effects.
For example, creatine likely does not directly impact cramping by regulating electrical impulses. However, creatine may delay muscle fatigue that causes cramping.
Still others may be complementary. For example, sodium chloride doesn’t directly reduce cramping, but it does have a complementary relationship with potassium (they work together to move water, glycogen, and waste products through the cell walls).
Magnesium
Magnesium is an electrolyte that helps regulate muscle contractions and can be lost via sweat. Research shows that the more you exercise, the more magnesium you need. (Zhang)
And even marginal magnesium deficiency impairs exercise performance. That’s a problem, because researchers found that “strenuous exercise apparently increases urinary and sweat losses that may increase magnesium requirements by 10-20%.” (Nielsen)
Magnesium has been shown to increase peak oxygen consumption, decrease heart rate during exercise, and increase total work output. (Pokan, et al.)
As far as cramps are concerned, more research is needed. Theoretically, replacing magnesium may help regulate muscle function.
When to take magnesium
Magnesium can be taken at any time during the day. Consider supplementing magnesium one hour before a workout, during exercise lasting longer than 90 minutes, and after hot, intense, or prolonged exercise.
What dose of magnesium
Based on dietary surveys and recent experiments, a magnesium intake less than 260 mg/day for male and 220 mg/day for female athletes may result in a magnesium-deficient status. (Nielsen)
Consider supplementing
- 400–420 milligrams a day for men
- 310–320 mg a day for women
- 350–360 mg a day for pregnant women
Too much magnesium can result in GI distress, lethargy, arrhythmia, and respiratory distress.
It may be beneficial to supplement magnesium with additional electrolytes.
Calcium
Calcium is an electrolyte that is lost in small amounts through sweat.
Calcium plays a critical role in muscle contraction, and when the body doesn’t have enough calcium to meet demands, it will break down bone to get it.
And athletes need higher intake levels of just about everything, including calcium. Calcium deficiency could exacerbate cramping.
When to take calcium
Consider supplementing calcium one hour before a workout, during exercise lasting longer than 90 minutes, and after hot, intense, or prolonged exercise.
What dose of calcium
There is little research on what dose of calcium athletes should take for cramping, but research has shown that supplementing 1 g of calcium per day for four weeks improved cycling time trial performance and decreased body fat. (Jawadwala)
Potassium
Potassium deficiency, or hypokalemia, can occur with any sudden loss of fluid. And high sodium intake without potassium accelerates potassium loss. That’s a problem because potassium is key for rehydration.
However, there is little research to suggest that potassium can directly help with cramping.
However, because of potassium’s role in hydration and blood pressure control, and because of its complementary relationship with sodium, potassium could have ancillary benefits not directly associated with cramping.
When to take potassium
Take potassium along with sodium chloride before intense exercise or exercise in hot weather. Continue taking potassium during exercise lasting longer than 2-3 hours.
What dose of potassium
The recommended dose of potassium is 3,500 mg per day. (WHO) However, athletes may need more potassium during prolonged, hot, or intense exercise. Consider consuming at least 300 milligrams of potassium to replace what you'll lose in one to two hours of intense exercise.
Pickle juice and mustard
Pickle juice and more recently, mustard, are often found at races. These foods are high in potassium and sodium.
However, at amounts tolerable (especially while exercising) these foods are likely not the most effective way to replenish electrolytes. A spoonful of mustard or a shot of pickle juice doesn’t contain meaningful levels of potassium.
A small study of 9 athletes showed that ingesting 1 mL pickle juice per kg body weight increased sodium and potassium after exercise. (Miller)
For a 140 lb athlete, that’s the equivalent of 635 mL of pickle juice. A standard sport bottle is about 500 mL. To see meaningful results, you’d have to drink a full jar of pickle juice. Yummmmm
Researchers from the same study pointed out that for the mustard group to ingest similar levels of sodium and potassium seen in the pickle juice group, participants had to ingest “a large mass” of mustard.
Mustard and pickle juice for cramps are more of a gimmick than a treatment because dose-to-efficacy is unpalatable. But, if you like to chase a shot of whiskey with a shot of pickle juice, have at it. Pickle juice definitely won’t hurt you--just don’t forgo the electrolyte drink.
What dose of pickle juice
Researchers used 1 mL pickle juice per 1 kg of body weight.
Sodium bicarbonate
Some theories hypothesize a pH imbalance causes cramping. Baking soda could reduce cramping.
A pH lower than 7 is acidic, around 7 is neutral, and above 7 is alkaline. In a normal state, your body has a pH close to neutral.
Exercise demands a lot of oxygen, and when your body exceeds the available supply, your muscles need a new way to make ATP. This pathway, called the anaerobic pathway, creates lactic acid.
Too much lactic acid changes the pH in your muscles, making them slightly acidic.
Baking soda is slightly alkaline (8.4), and a higher blood pH helps move lactic acid into the bloodstream, returning muscle slightly closer to a neutral pH. (Peart)
For this reason, baking soda can help athletes exercise harder, faster, and longer.
But, what about cramps?
An acidic pH can increase fatigue. Because exercise-induced muscular fatigue and cramping go hand-in-hand, it’s possible that baking soda could reduce cramping, although there isn’t any research to back up this claim. However, there is anecdotal evidence to suggest it buffers cramping.
When to take sodium bicarbonate
Try taking baking soda during high intensity exercise. Sodium bicarbonate can create GI distress, so consider experimenting with it on a training day.
What dose of sodium bicarbonate
Too much baking soda can cause diarrhea and vomiting, so hitting a tolerable dose is critical. Start small.
Consider adding ½ teaspoon to your usual electrolyte drink. Alternatively, try two chewable Tums.
Creatine
Creatine is one of the most common, safe, and effective exercise supplements for increasing strength. But creatine offers athletes a lot more than increased power.
It can improve ventilatory threshold (the point at which a person begins breathing hard; used as a marker of lactate accumulation), power output, and results from high-intensity exercise.
If it can do all that, can it also reduce muscle cramps?
A three-year study of college athletes found that those taking creatine had fewer cases of dehydration, muscle cramps, or muscle injuries than those not taking it. (Greenwood, et al.)
Another study looking at cramping associated with hemodialysis saw a reduction in the frequency of symptomatic muscle cramps by 60% in the creatine monohydrate group. (Chang, et al.)
Perhaps creatine helps reduce cramps by reducing lactic acid and therefore balancing muscle pH.
When to take creatine
Try supplementing creatine daily for four weeks.
What dose of creatine
Initially, try supplementing a smaller dose of 3 grams a day. For fast results, consider loading creatine. At larger doses, creatine can have some unwanted side effects.
Zinc
Zinc is an essential trace element, meaning very small amounts are needed for your health.
Zinc has shown promise for reducing muscle cramps.
Zinc supplementation reduced cramps in 10/12 patients suffering from cirrhosis-induced muscle cramps. Patients took oral zinc sulfate at 220 mg for 12 weeks. (Kugelmas)
However, it’s worth noting that no research has been performed on the relationship between zinc and muscle-associated cramping.
When to take zinc and what dose of zinc
The recommended daily value of zinc is between 8-12 mg, yet in the study above, patients received 220 mg. An effective dose of zinc for muscle cramps may not be healthy. The tolerable upper intake level of zinc is 40 mg/day. (NIH)
There is no information available on timing.
Taurine
Taurine is an amino sulfonic acid that is often added to energy drinks. It’s generally considered safe with no reported side effects at normal doses, and clinical trials have studied taurine at daily doses lasting up to 4 months.
Taurine can improve liver health, increase insulin sensitivity, and lower blood lipid levels. (Panella, et al.) (Kars, et al.) (Crosignani, et al.)
In human studies, taurine can reduce muscle fatigue, help burn fat, and decrease muscle damage. (Dawson, et al.) (Zhang, et al.) (Balshaw, et al.)
One study of oral supplementation with 2 grams taurine daily resulted in a “clinically significant reduction in the frequency, duration, and intensity of muscle cramps in patients with chronic liver disease.” Researchers concluded that taurine is a safe and effective intervention in the management of muscle cramps in individuals with chronic liver disease. (Vidot)
However, there aren’t any studies that specifically test taurine and exercise-associated muscle cramps, although there is anecdotal evidence to support this claim. Taurine may not directly reduce cramping, but its ability to decrease muscle swelling and damage, as well as increase the time to fatigue, may help athletes delay cramping.
When to take taurine
Take taurine as a preworkout and at least 15 minutes before exercise.
What dose of taurine
Researchers who studied taurine and exercise performance concluded that taurine could be dosed between 1-6 grams. (Waldron)
Supplements for cramps
While most researchers agree that muscle cramps are due to electrical imbalances, there does appear to be some correlation between cramping and dehydration, sweating, heat, and fatigue.
Assuming there is a link between those conditions and cramping, you may consider supplementing electrolytes before, during, and after intense exercise.
Common sports drinks and electrolyte tablets are missing many of the important electrolytes listed in this article. Look for an electrolyte supplement that includes calcium, iron, magnesium, chloride, sodium, and potassium.
Consider adding a pre workout that includes taurine to delay time-to-fatigue (and theoretically reducing time-to-cramping, as well) and experiment with small doses of creatine (3 mg).
Try adding ½ teaspoon of regular baking soda to your electrolyte drink, but remember that too much baking soda may cause GI distress.
Zinc may be effective at reducing muscle cramps. Consider supplementing with less than 40 mg/daily.
And of course, don’t forget to stretch! Stretching during a cramp appears to be the fastest, most effective way to alleviate cramps once they occur.
Matt Mosman (MS, CISSN, CSCS) is a research scientist, endurance athlete, and the founder and Chief Endurance Officer at EndurElite. Matt holds his B.S. in Exercise Science from Creighton University and his M.S. in Exercise Physiology from the University of California. Matt and his family reside in Spearfish South Dakota, where they enjoy running, mountain biking, camping, and all the outdoor adventures Spearfish has to offer.
References:
- Balshaw TG1, Bampouras TM, Barry TJ, Sparks SA. The effect of acute taurine ingestion on 3-km running performance in trained middle-distance runners. Amino Acids. 2013 Feb;44(2):555-61. doi: 10.1007/s00726-012-1372-1. Epub 2012 Aug 2.
- Chang CT1, Wu CH, Yang CW, Huang JY, Wu MS. Creatine monohydrate treatment alleviates muscle cramps associated with haemodialysis. Nephrol Dial Transplant. 2002 Nov;17(11):1978-81.
- Cooper ER, et al. Exertional heat illness and environmental conditions during a single football season in the southeast. J Athl Train. 2006 Jul-Sep; 41(3):332-6. [PubMed] [Ref list]
- Crosignani, A., Battezzati, P. M., Setchell, K. D., Invernizzi, P., Covini, G., Zuin, M., & Podda, M. (1996). Tauroursodeoxycholic acid for treatment of primary biliary cirrhosis. Digestive diseases and sciences, 41(4), 809-815.
- Dawson R Jr1, Biasetti M, Messina S, Dominy J.The cytoprotective role of taurine in exercise-induced muscle injury. Amino Acids. 2002 Jun;22(4):309-24.
- Greenwood, et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003 Feb;244(1-2):83-8.
- Hoy, Mary K, Joseph D. Goldman. Potassium Intake of the U.S. Population. USDA.
- Jawadwala, R. (2012). The role of supplementary calcium in submaximal exercise and endurance performance (Doctoral dissertation, University of Central Lancashire).
- Jones BH, Rock PB, Smith LS, Teves MA, Casey JK, Eddings K, Malkin LH, Matthew WT.
- Kars, M., Yang, L., Gregor, M. F., Mohammed, B. S., Pietka, T. A., Finck, B. N., ... & Klein, S. (2010). Tauroursodeoxycholic acid may improve liver and muscle but not adipose tissue insulin sensitivity in obese men and women. Diabetes, 59(8), 1899-1905.
- Kevin C. Miller (2014) Electrolyte and Plasma Responses After Pickle Juice, Mustard, and Deionized Water Ingestion in Dehydrated Humans. Journal of Athletic Training: May/Jun 2014, Vol. 49, No. 3, pp. 360-367. https://doi.org/10.4085/1062-6050-49.2.23
- Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr. 2000 Feb;19(1):13-5.
- Medical Complaints After a Marathon Run in Cool Weather.
- Miller KC, Stone MS, Huxel KC, Edwards JE. Exercise-associated muscle cramps: causes, treatment, and prevention. Sports Health. 2010;2(4):279–283. doi:10.1177/1941738109357299
- Miller, et al. Exercise-associated muscle cramps: causes, treatment, and prevention. Sports Health. 2010 Jul; 2(4): 279–283. doi:1177/1941738109357299
- Nielsen, Forrest H, Henry C Lukaski. Update on the relationship between magnesium and exercise. John Libbey Eurotext. Vol. 19. 2006.
- Zinc. National Institutes of Health Office of Dietary Supplements. 2019.
- Panella, C., Ierardi, E., De Marco, M. F., Barone, M., Guglielmi, F. W., Polimeno, L., & Francavilla, A. (1995). Does tauroursodeoxycholic acid (TUDCA) treatment increase hepatocyte proliferation in patients with chronic liver disease?. The Italian journal of gastroenterology, 27(5), 256-258.
- Peart DJ, Siegler JC< Vince RV. Practical recommendations for coaches and athletes: a meta-analysis of sodium bicarbonate use for athletic performance. J Strength Cond Res. 2012 Jul;26(7):1975-83. doi: 10.1519/JSC.0b013e3182576f3d.
- Pokan R, Hofmann P, von Duvillard SP, et al. Oral magnesium therapy, exercise heart rate, exercise tolerance, and myocardial function in coronary artery disease patients [published correction appears in Br J Sports Med. 2006 Oct;40(10):882]. Br J Sports Med. 2006;40(9):773–778. doi:10.1136/bjsm.2006.027250
- Vidot H1,2, Cvejic E3, Carey S1, Strasser SI4,5, McCaughan GW2,5, Allman-Farinelli M6, Shackel NA7. Randomised clinical trial: oral taurine supplementation versus placebo reduces muscle cramps in patients with chronic liver disease. Aliment Pharmacol Ther. 2018 Oct;48(7):704-712. doi: 10.1111/apt.14950. Epub 2018 Aug 23.
- Waldron M1,2, Patterson SD3, Tallent J3, Jeffries O3. The Effects of an Oral Taurine Dose and Supplementation Period on Endurance Exercise Performance in Humans: A Meta-Analysis. Phys Sportsmed. 1985 Oct; 13(10):103-10. [PubMed] [Ref list]
- Potassium intake for adults and children. 2012. ISBN 978 92 4 150482 9.
- Zhang M1, Izumi I, Kagamimori S, Sokejima S, Yamagami T, Liu Z, Qi B. ole of taurine supplementation to prevent exercise-induced oxidative stress in healthy young men. Amino Acids. 2004 Mar;26(2):203-7. Epub 2003 May 9.
- Zhang Y, Xun P, Wang R, Mao L, He K. Can Magnesium Enhance Exercise Performance?. Nutrients. 2017;9(9):946. Sports Med. 2018 May;48(5):1247-1253. doi: 10.1007/s40279-018-0896-2.