• Ally Gavigan:
• 06 July 2014

Leg cramps and stiches

What are they and how do you avoid them.

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Cramps: terrible pain in your legs, arms, hands, side, in fact anywhere you really prefer not to get them. However, what are they?

First I would like to discuss leg cramps, sometimes called Charley Horses  and Side cramps, commonly called stitches. I have occasionally suffered from these as well.

When I was young I used to get what was called a stitch in my side from either dance or running. Usually immediately after eating or not drinking enough water. . These days I have to make sure I get enough water into my system or I may suffer from a stitch while exercising, walking or perhaps getting lower leg cramps after doing a workout or in bed at night. Extremely painful!

But what are they?

This cramp is caused by a muscle spasm. When the muscle suddenly contracts too quickly this pulls on the tendons. The area that dancers suffer most is in the lower leg just below and behind the knee. Dancers can also get secondary cramps in the feet during this hard contraction. Although I should mention that foot cramps can of course flare up on their own. Another reason could be when an already short muscle is stimulated to contract. An already shortened muscle could contract further resulting in the muscle cramping. This is relieved by exercise.

Lower leg Cramps;

A cramp can last a short time but it will seem like a very long time as the pain kicks in. From a few seconds to a few minutes. In some cases over ten minutes.

The muscle can recover immediately or the area can be sore for the next 18 to 30 hours. Sometimes this will depend on the dancers overall physical condition and their age. Older people tend to get more night cramps. The reason for this is that leg cramps tend to happen when you are resting. However, they can occur when you sit cross legged, tuck your lower legs under you backside and generally put the legs into positions that can lead to pins and needles where blood flow is being restricted. Funnily enough, and you may not want to know this but, one common way to constrict regular blood flow is to cross your legs. There is a nerve which lies across the top or rather out area of your knee this is called the peroneal nerve. Sitting cross legged on an uncomfortable seat can make your foot go to sleep. However, in a small number of people, this crossing knees habit may damage that nerve.

A side stitch: Usually affects people who haven't warmed up properly and have eaten too close to exercise. Interestingly there are two basic theories for Side Stitches (side cramps).

This can happen in class when your blood flows from the diaphragm to the limbs. The diaphragm separates the abdomen (your tummy and the area under your chest and above your groin) and stomach from your heart and your lungs.

The diaphragm is one of the principle muscles involved in breathing. Subsequently a scientific thought is that this reduction in the supply of blood will cause the diaphragm to go into a stitch-cramp.

The second theory is that the cramp may be brought about by the body’s inability to digest fluids. This process can make the tummy muscles pull on the ligaments to the diaphragm thereby resulting in a cramp.

Either way both theories are relevant and almost unimportant when you are doubled up in excruciating pain.

How to avoid a cramp?

The point of this explanation is how I started this section. Do not eat too close to dancing or performing and sip water as opposed to gulping it down too quickly. Keep your hydration regular and slow.

Treatment:

Relief can be given by exercising the cramped muscles.

If you are prone to cramps then maintain a regular regime of exercise a couple of times during the day. Certainly you will know to warm up and cool down after class or when competing. Your teacher will probably have already instilled this very important aspect of dance training. Stretching and massaging the affected muscle can usually relieve an attack of cramp. Most cramps soon ease off. Painkillers are not usually helpful as they do not act quickly enough. However, a painkiller such as paracetamol may help to ease muscle discomfort and tenderness if the pain persists for up to 24 hours after a cramp has gone.

Drinking plenty of water, fruit and vegetable juices can be very helpful. Don’t overdo the fruit juices as these can also be full of sugars. Bananas are a source of potassium and this can be useful in avoiding cramps.

Watermelon you cannot over eat it and it is one of the foods that hydrates you!

When your body cramps, it has an overload of Sodium and Calcium...these help your muscles to contract. However,  a potassium deficiency could result in Sodium and Calcium being stored. What this means is that they will not be released  which is vitally  necessary for muscles to relax. The solution is to therefore eat foods that are rich in potassium and vitamins , especially Vit B12 or even the over the counter B Complex. 

Foods that increase Potassium levels; Potassium is an electrolyte, an essential dietary mineral macronutrient that helps the body to allow muscle contraction by sending nerve impulses.

The standard recommended allowance for potassium is 4,000 milligrams per day (4 grams)

Potassium rich foods include the fruits, avocados, apricots, bananas, dates, nectarines, oranges, raisins, vegetables, artichokes and spinach, dairy products such as yoghurt  and fish, cod, halibut and some shellfish. Always remember the daily limits. Some people need to go on a low potassium diet but this is where you can speak with your doctor or a dietician.

As a sport, competitive dancing needs a great deal of care in all of these areas and like any sport performed at a high level, you need to take advice in dietary issues.

Raw tomatoes are fine but they are actually better cooked as these are rich in enzymes which are far healthier for you. Taking this a little further natural tomato juice, in a cooked sauce with fatty nuts such as Cashews, Almonds and my favourite, pistachios.

The trouble is the fat content.  There is a small graph that examines this I discovered on the Nutriondata website:

1 cup of almonds has 670 mg. AND 822 calories
I cup pistachios has 1282 MG AND 699 calories

In comparison, a large potato has 278 calories and 1600 mg potassium

However, it should also be noted that that one ounce of almonds has 200 mg. of potassium. But one ounce of dry roasted pistachios has 295 mg. Hey, I love Pistachios.

Some foods are great for your vit B intake and include leafy greens, fresh soy beans  and fish.  For you omnivores,  if you have to eat meat, then only eat lean meat.

Finally Diet Indian Tonic Water has a trace of quinine which is a long used remedy for cramps. Not to be mixed with alcohol though as in G&T. Do not take Quinine unless under your doctor’s orders. I said ‘Diet’ Tonic Water but if you suffer from Migraines avoid any diet drinks.

Here are some stretching exercises.

Calf muscles: Find a step and stand half on the step (on the balls of your feet) you need to do this slowly: drop your heels downwards to just below the edge of the step. Count to 3 and slowly return. Do this as many times as you can and at least three or four times if this is a new exercise for you.

Lunge forward ( initially with a half lunge before working up to a full lunge) and lift the rear leg on to the ball of the foot and stretch the calf muscle by slowly raising and lowering the heel of the back foot. . Change position of the legs to work on the opposite calf.

Sit down and legs straight in front of you, slowly pull the top of your feet (holding the toes) backwards to stretch the muscles. .

If you suffer regularly from leg cramps, stretching the muscles in your lower legs could well help to prevent the cramps. Stretching the calf muscles before bed is also a good idea.

Stretching exercises are usually suggested. Conversely, there is a lack of good research evidence to prove that they work. However, many doctors feel that regular calf stretching does help.

Avoidance of Cramps:

Crossing your legs can lead to some issues such as slower blood flow, additional stress on the heart, development and possible exacerbation of varicose veins. In some cases constant crossing of legs can also lead to bad posture development.

This point should be considered in younger people whose bodies have not yet fully formed. I did mention in an earlier article that the body continues to form right into late teens so in reality this should be looked at. I see many dancers doing extremely bad things to themselves when preparing to dance such as cracking toe knuckles on the floor, sitting hunched up cross legged or on an auditorium seat cross legged.

Some of these are simply habits but all should be thought through and avoided as these can lead to cramps.

Other causes of cramps:

Not always contraction of tendons, cramps may be a symptom of another problem. This is a list that looks at some other reasons for getting cramps. It is really important to speak with your Doctor in regard to health issues including getting regular cramps.

• Some medicines can cause cramps as a side-effect, or make cramps occur more often. If you are taking medicines please read the side effects on the paper inside the packaging of all medicines.
• Dancers may also over-exert muscles.
• Dehydration.
• The balance of salts in the bloodstream (such as a high or low sodium or potassium level) can bring about cramps. Your doctor will explain this. Meantime avoid high salt foods such as packets of crisps and snack foods without reading the contents-always on the back of the wrapper.
• Some people who have kidney (renal) dialysis get leg cramps.
• An untreated under active thyroid gland.
• In mostly older folk, adult dancers and people of my age, peripheral arterial disease (narrowing of the leg arteries which can cause poor circulation).
• A very common problem for many health issues is excess alcohol.
• There are disorders of nerves which can cause cramps.
• Quite rare causes can include: cirrhosis of the liver; lead poisoning
• Another rare disease is Sarcoidosis which largely affects patients in their mid-20s to mid-40s but cases do happen occasionally in younger and older patients. It seems to affect northern people of Scandinavian origin. It is a disease involving abnormal collections of inflammatory cells. It can be caused by an immune reaction to an infection or some other trigger. It will more or less clear up on its own.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Craig Coussins has used all reasonable care in compiling the information but he makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. Anything written by Craig Coussins does not necessarily reflect the views and opinions of Antonio Pacelli but has been used as general advice to the readers of Craig Coussins Blog on the Antonio Pacelli Website. Craig Coussins is the original designer of Hullachan and has been involved in dance shoe fitting and design for over 50 years.

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