Muscle Cramps

Muscle cramps can be frustrating. Especially after you have searched google for a couple hours without any remedy other than chugging pickle juice or mustard (there’s both research based and empirical based evidence for this).

While these strategies may provide relief during a bad episode of cramps, it doesn’t resolve the cause.  

A Common Cause

I see it time and time again in the clinic. A patient comes in. I manually muscle test them. They cramp. Then I find the more proximal muscle (closer to the center) is extremely weak.  

For example, someone cramps with hamstring muscle testing and then displays severe weakness in their glutes. At the beginning of treatment they can’t do a bridge without a hamstring cramp. Then after strengthening and facilitating proper neuromuscular glute activation they are able to perform progressive bridge variations without any cramping. 

So it’s not always a fluid or nutritional problem.  

Sometimes it’s a neuromuscular movement problem. 

Study of Marathon Runners

In 1986 Maughan performed a study on marathon runners to determine the cause of exercise induced muscle cramps.

He assessed many variables, including: serum electrolyte concentrations (including sodium and potassium) and plasma volume/haemoconcentration (calculated from the changes in circulating haemoglobin and haematocrit).

What did he find? 

There was no difference between the crampers and the non-crampers. Meaning the marathoners who cramped were not cramping due to less sodium or a decrease in fluids.  

  • “The results suggest that exercise-induced muscle cramp may not be associated with gross disturbances of fluid and electrolyte balance.“

So why did they cramp?

There are many hypothesis’s out there.

But from my clinical experience I know decreased strength, endurance, neuromuscular control, and impaired movement patterns definitely play a role.

Maybe the runners that cramped had a weak link? Maybe they were compensation for a mobility deficit? Maybe they surpassed their aerobic capacity? 

Maybe if you’re having cramping you should get assessed by a competent physical therapist.  


Muscle cramps can be complex. It’s important to get the appropriate diagnostics when appropriate  

This is a great review that summarizes some of the complexities. 


Bottom Line

Often times the solution to exercise induced muscle cramps is to optimize the movement system...through better exercise.

Unless you really like pickle juice, I recommend finding a physical therapist to help with ongoing muscle cramps.