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Injuries Related to Being Active with Diabetes: Part 6 (Prevention of Muscle Cramps and Soreness)

Dec 5, 2009



Muscle Cramps: Are They Preventable?

If you experience painful, involuntary contractions of your muscles, you’re having a muscle cramp. They can occur in any muscle but are most common in the legs, feet, and muscles that cross two joints, such as your calf muscle (the gastrocnemius, which crosses your knee and your ankle joints), quadriceps and hamstrings (the front and back of your thighs), and your feet. Not all of them are that painful; they range in intensity from a slight twitch to severe cramping that makes the muscle feel rock hard and that can last from a few seconds to several minutes. They can also ease up and then recramp several times before disappearing.


Although the exact cause of muscle cramps remains unknown, they’re likely related to poor flexibility, muscle fatigue, or doing new activities. Athletes are more likely to get cramps in the preseason when less conditioned and more subject to fatigue. Cramps often develop near the end of intense or prolonged exercise, or the night after. Of course, if you’re exercising in the heat, cramps can also be related to dehydration and depletion of electrolytes (sodium, potassium, magnesium, and calcium) lost through sweating. When these nutrients fall to certain levels, you’re more like to experience cramping.

Cramps usually go away on their own without treatment, but there are effective ways to deal with them. For starters, stop the activity that is causing your muscles to cramp (if you can). Then, gently stretch and massage the cramping muscle, holding your joint in a stretched position until the cramp stops. To prevent cramps, increase your fitness level and avoid becoming excessively fatigued during an activity. Warm up before you start intense workouts and stretch regularly when you’re done exercising, focusing on your calves, hamstrings, and quads.

Treating and Preventing Muscle Soreness

Feeling stiff or tight after training is neither uncommon nor cause for alarm. Stretch out all your muscles and joints after workouts. If you find yourself slightly sore the day after exercise, low-level exercise, light stretching, and gentle massage can help. But if you are still rather sore a day or two later and you feel stiff and weak, you are likely experiencing delayed-onset muscle soreness (DOMS), which peaks 24 to 72 hours after an activity. You may even be so stiff and sore that you find it difficult to walk downstairs or fully straighten out your joints.

Although unpleasant, DOMS is different from an acute injury and requires no special treatment. DOMS is a common occurrence, particularly if you are just beginning an exercise program or changing to a new or unusual activity. The cause is likely minute tears in your muscles and connective tissues. As these damaged areas become inflamed and swollen, your nerves are sensitized and you feel the pain. Two or three days may pass before you reach the maximum point of pain, and a week or more may be required to resolve completely. Mild activity, stretching, gentle massage, hydrotherapy (such as getting into a hot tub), and NSAIDs can all help relieve discomfort, but they don’t speed up the healing process — the best healer is simply time. The good news is that your body responds with "stress" proteins that it builds into the repaired muscles, almost eliminating the possibility that you will reach that level of soreness in the same muscles for six to eight weeks afterward, even if you overdo it again.

The amount of tearing (and resulting soreness) depends on the activity, the intensity of your workout, and the duration of the workout. Any unaccustomed movement can lead to DOMS, but eccentric muscle contractions (when the muscles are contracting while lengthening) cause the most soreness. Examples of eccentric muscle contractions include going downstairs, running downhill, lowering weights, and doing the downward (gravity-assisted) part of squats and push-ups. As far as diabetes goes, the bad part about DOMS is that you won’t be able to restore glycogen in affected muscles until they’re fully repaired, which can lead you to be insulin resistant and cause your blood sugars to be harder to manage. In addition, certain muscle pain or soreness can be a sign of a serious injury, so if the soreness doesn’t get better within a week, consult your physician.

This column is excerpted from Diabetic Athlete’s Handbook (2009), which contains essential exercise-related information and examples for Type 1, Type 1.5, and Type 2 diabetic exercisers of all ages. More information is available at www.shericolberg.com.

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