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Ester Marsh column: What causes leg cramps?

Have you ever had a leg cramp? I think most people have, whether it is in the middle of the night while they are sleeping or during or after exercise.

The most common leg cramps are exercise associated muscle cramps (EAMC). These can happen during or after exercise but typically occur when muscles are very tired. Dehydration and sodium deficiency seem to be the main causes, but there are many cases where treatments for these factors are unsuccessful and the main cause remains unknown. Without a clear cause, prevention and treatments are often unsuccessful. But as we all know hydration is an important part of a healthy lifestyle and many people do benefit by hydrating appropriately. The “rule of thumb” is drink half of your body weight in ounces each day; I weigh 140 pounds, so I should take in 70 ounces of fluids (preferably water). If you sweat a lot, include a sports drink to balance your electrolytes.

There’s another symptom that feels like leg cramps but isn’t — chronic exertional compartment syndrome (CECS). It’s an exercise-induced muscle and nerve condition where the muscle swells within its facia (a thin sheath of fibrous tissue enclosing the muscle). This is most common in athletes who participate in a sport that involves repetitive impact such as running or fast walking. In severe cases surgery is required to alleviate the pressure within the fascia.

A very uncommon cause could be popliteal artery entrapment syndrome (PAES). It’s an anatomical “defect” where the artery in the poplital fossa (or “knee pit,” the indention behind the knee) becomes entrapped, typically during exercise, causing lower leg pain/“cramps.” An MRI (a technique that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body) and MR Angiography (a medical test that helps physicians diagnose and treat medical conditions related to blood vessels) can diagnose this congenital deformity.

So if you are someone who is stricken with many leg cramps, start recording when they happen. Is it exercise induced? Is it right after or during exercise? At night? Have you started exercising too much too soon? Are you hydrating enough? If it continues, have your doctor check your sodium levels. And when needed, the doctor will order a MRI and/or MR Angiography.

I have had leg cramps. They are very painful and the discomfort lasts days after the initial cramp. I believe awareness, proper hydration and nutrition and a sensible exercise plan can prevent muscle cramps for most people. If it doesn’t, consult your family physician.

As you are reading this I will be visiting my family in the Netherlands! Have a GREAT week!


Ester H. Marsh is health & fitness director for the JF Hurley Family YMCA.



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