Mastering Breathing for Better Running Performance

Muscle cramps are a common and painful issue that can hinder your performance during workouts and races. Many endurance athletes, including marathon runners and triathletes, have experienced cramping during events, with studies showing that up to 67% of triathletes and 50% of marathon runners report cramps. While cramps can sometimes be attributed to underlying medical conditions or chronic diseases, the main causes of exercise-associated muscle cramps (EAMC) are muscle fatigue and changes in neuromuscular control.

Understanding why cramps occur and how to prevent them is key to maintaining optimal performance. By taking a proactive approach to managing fatigue and neuromuscular control, athletes can reduce their risk of cramping and improve their chances of success during an event.

The Science Behind Muscle Cramps

While hydration and electrolyte balance are often blamed for cramps, recent research suggests that they are not the primary causes. Instead, muscular fatigue and altered neuromuscular control are more significant factors. Muscle fibers contain receptors that monitor tension within the tissue, and when these receptors aren’t functioning properly, cramping can occur. Specifically, muscle spindles sense increased load and signal the nervous system to cause stronger contractions, while Golgi tendon organs (GTOs) work to inhibit contractions if the load is too high. When muscle fatigue sets in, muscle spindles become more active, while GTOs become less responsive, leading to spasms or cramps.

Factors That Increase Cramping Risk

Several factors can increase your likelihood of experiencing cramps. These include a history of previous cramps or injuries, poor pacing strategies, inadequate training for your event, poor posture, and tight muscles. By addressing these factors through proactive planning and targeted strategies, you can significantly reduce the risk of cramping.

Proactive Strategies to Prevent Muscle Cramps

1. Monitor Your Pacing and Heart Rate
   Test your heart rate, pace, and power ranges to determine the optimal levels for your performance. By training within these ranges, you can avoid early muscle fatigue that often leads to cramps. VO2 and threshold testing can help you identify your personal ranges, and monitoring for cardiac drift during longer events can help fine-tune your pacing and hydration strategy.
2. Establish a Solid Fueling Plan
   While hydration alone may not directly cause cramps, insufficient fluid intake can lead to premature fatigue. Make sure your fueling strategy is aligned with your race requirements, as maintaining hydration is crucial for overall performance.
3. Optimize Movement and Load
   Injuries can cause compensatory movement patterns, where certain muscle groups take on more work than others. This can lead to early fatigue in those muscles. To prevent this, incorporate motor control exercises to retrain your nervous system and use all the muscles necessary for movement. Additionally, resistance training can help strengthen muscles and improve the efficiency of your movement patterns under load.

Reactive Strategies for Cramping

Even with a proactive plan in place, cramps can still occur. If you find yourself dealing with muscle cramps during a race or workout, these strategies can help relieve the discomfort and get you back on track:

1. Stretch the Affected Muscle
   Gently stretch the cramped muscle to apply tension to the Golgi tendon organs, which can help relax the muscle. This active stretching technique can alleviate the spasm and provide relief.
2. Try Pickle Juice
   Some studies suggest that small amounts of pickle juice can reduce the duration of an active cramp. This remedy may help alleviate cramps more quickly during events.
3. Slow Your Pace
   If cramping occurs, slow down your pace by walking or soft pedaling for several minutes. Gradually ease back into your pace, avoiding any sudden accelerations that could strain the muscle fibers further.

Conclusion

Muscle cramps can be a frustrating challenge during exercise, but with the right strategies, they don’t have to derail your performance. By proactively managing factors like pacing, hydration, and movement patterns, and knowing how to respond if cramps occur, you can stay in control and keep moving toward your goals. Prevent cramps before they stop you in your next race, and make sure you’re prepared to handle them if they do strike.

As a physical therapist, I’m often asked, “How long will it take to heal?” or “When can I get back to running, tennis, or my sport?” It’s one of the most common questions, and my go-to answer is always, “It depends.” There’s no simple timeline, as recovery is influenced by a variety of factors. The healing process varies depending on the nature of the injury, the type of tissue involved, and the effort put into recovery. Let’s dive into what influences recovery times and how tissue heals.

Factors That Impact Healing Time

While there are general timelines for healing, how long an injury will take to recover depends on several key factors:

• Sleep and Nutrition: Proper rest and diet are essential for supporting tissue healing.
• Underlying Health Issues: Conditions like low energy availability, autoimmune disorders, or imbalances in lab values can slow recovery.
• Activity Modification: Following prescribed activity restrictions and avoiding re-injury is crucial for speeding up healing.

Once these factors are addressed, the healing process for the injured tissue generally follows a predictable path. While the recovery time can vary, certain tissues have a more reliable healing timeline.

Healing Times by Tissue Type

Different tissues—bones, muscles, tendons, ligaments, cartilage, and nerves—heal at different rates. The reason for this variation lies in blood flow. Tissues like bones and muscles have a good blood supply, enabling them to heal faster. Tendons and ligaments, on the other hand, have less blood flow, which makes their healing process slower.

Healing is generally broken down into three stages, each dictating how much load the injured area can handle and when it’s safe to return to physical activity.

Phases of Healing

1. Inflammatory Phase

The inflammatory phase begins immediately after an injury and can last from hours to days. During this phase, blood vessels dilate to increase blood flow to the injured area, which brings cells that help clean up the damaged tissue. You’ll often notice redness and warmth as a result. Swelling is also common, which can inhibit muscle function. The tissues are at their weakest during this phase, and it’s important to protect them from excessive strain. While inflammation is a necessary part of the healing process, it can be problematic if it lingers longer than expected—usually beyond a week.

2. Proliferation Phase

This phase focuses on tissue repair and can last anywhere from several days to several months. During this time, new cells, blood vessels, and the extracellular matrix begin to fill the injury site. Collagen—the building block of connective tissue—is laid down in a disorganized manner, providing a framework for new tissue. At this stage, the tissue can start to handle some load, but it’s still relatively weak. The collagen fibers need time to mature and align in a way that supports the healing tissue.

3. Remodeling Phase

The remodeling phase is where the real strengthening occurs. This phase can last from months to even years after the initial injury. As the tissue adapts to stress, the collagen fibers realign according to the forces they experience, which improves the tissue’s ability to handle load. For example, tendons will realign based on the lines of tension, and bone density will increase under weight-bearing conditions. During this phase, excess scar tissue is broken down, and the tissue begins to regain its strength and flexibility. Gradual, progressive loading is crucial during this phase to restore function and ensure full recovery.

The Role of Physical Therapy in Recovery

While the healing process can feel slow and frustrating, having a physical therapist guide you through proper rehabilitation and exercise progression is key to a successful recovery. A well-planned physical therapy program can help you return to your sport safely and prevent future injuries.

Understanding the stages of healing and the factors that influence recovery time can give you a better idea of what to expect. Patience and adherence to the recovery plan are essential, but with the right approach, you’ll be back to your activities stronger than before.

Thanks for reading!