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Review
. 2022 Jan 1;57(1):5-15.
doi: 10.4085/1062-6050-0696.20.

An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps

Kevin C Miller  1 , Brendon P McDermott  2 , Susan W Yeargin  3 , Aidan Fiol  2 , Martin P Schwellnus  4
Affiliations
Review

An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps

Kevin C Miller et al. J Athl Train. .

Abstract

Exercise-associated muscle cramps (EAMCs) are common and frustrating for athletes and the physically active. We critically appraised the EAMC literature to provide evidence-based treatment and prevention recommendations. Although the pathophysiology of EAMCs appears controversial, recent evidence suggests that EAMCs are due to a confluence of unique intrinsic and extrinsic factors rather than a singular cause. The treatment of acute EAMCs continues to include self-applied or clinician-guided gentle static stretching until symptoms abate. Once the painful EAMCs are alleviated, the clinician can continue treatment on the sidelines by focusing on patient-specific risk factors that may have contributed to the onset of EAMCs. For EAMC prevention, clinicians should obtain a thorough medical history and then identify any unique risk factors. Individualizing EAMC prevention strategies will likely be more effective than generalized advice (eg, drink more fluids).

Keywords: best practice; dehydration; electrolytes; fatigue; risk factors.

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Figures

Figure 1
Figure 1
Multifactorial theory for pathogenesis of exercise-associated muscle cramps (EAMCs). Dashed arrows used to help with clarity of understanding the hot, humid, or both environmental conditions and repetitive muscle exercise pathways. Reprinted by permission from Miller KC. Exercise-associated muscle cramps. In: Adams WM, Jardine JF, eds. Exertional Heat Illness: A Clinical and Evidence-Based Guide. Springer; 2020:117–136.4
Figure 2
Figure 2
Decision tree for the individualized treatment of exercise-associated muscle cramps.
See this image and copyright information in PMC

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