Real Life Runners with Angie and Kevin Brown

380: How to Treat and Prevent Running Cramps

• Angie Brown

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In this episode of the Real Life Runners Podcast, we discuss our tried-and-true strategies to prevent and treat muscle cramps that many runners face. We tackle topics like common causes of running cramps, such as dehydration, under-fueling, and improper footwear, as well as behavioral changes like attempting new terrains or intensity levels. We share solutions from our own experiences, including proper hydration methods, breathing techniques, and the importance of recovery and sleep, along with strategic muscle strengthening. We provide personal anecdotes about our cramping experiences, offering practical advice on handling different types of cramps and emphasizing preparation and prevention measures. Join us to learn how you can overcome these pesky cramps and run your life more smoothly!


03:48 Common Causes of Running Cramps

08:07 Footwear and Its Impact on Running

18:20 Treating and Preventing Muscle Cramps

23:36 Effective Techniques for Side Stitches

24:47 Understanding Diaphragmatic Breathing

27:30 Dealing with Leg Cramps During Runs

36:27 Hydration and Electrolytes: Key to Preventing Cramps

40:17 Breathing Techniques for Runners

44:20 Importance of Sleep and Muscle Strengthening

46:48 Warming Up to Prevent Cramps


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Angie:

Welcome to the Real Life Runners Podcast, episode number 380. Today, we're talking about how to prevent and treat muscle cramps related to running. Stay tuned. What's up, runners? We've all been there, right? Those darn Annoying painful cramps seem to come on without warning and just grab you in different areas of your body.

Kevin:

But the side stitch just feels like you're going to die. Like it's sometimes

Angie:

it does like

Kevin:

it's a knife to the side and you're like I will never be able to run again. This is life ending. And it's not, it's just like a little sharp pain in your side.

Angie:

Yeah. And it's actually one of the cramps that you can totally just run through because running through it as. Even though it is hard and feels like there is a knife in your side, it's one that will not cause further damage if you run through it. So that's a little side note as we get into the episode before we get into the episode. But before we jump in, welcome back Kev. Last week was my solo episode without you. And so I'm just happy to welcome you back and I'm sure our listeners are happy too.

Kevin:

Thank you. I'm so glad to be here. Sometimes you got to just take one of them on your own. And it was just. It was not working for us. It

Angie:

was a crazy week. Last week was homecoming our girl our oldest daughter is a freshman. Plus Kevin works at the high school too. And there was just a lot going on outside of homecoming week as well, just in, in life in general. The days got away from us and so it became a solo episode and I had a lot of fun. So I hope that you guys enjoyed this episode. That shorter solo episode that I produced for you last week, if you missed it, I was talking all about the common mistakes, the three most common mistakes that I often see women in perimenopause make with their training that can lead to a lot of problems. But today we're talking about a very universal problem, which is running cramps. We also coach a high school cross country team and there are a lot of kids that deal with cramping issues especially at the beginning of their running journey, especially those freshmen who have never run before because cramping does tend to be an issue that a lot of new runners deal with and But it also can affect seasoned runners as well And so today we're going to be talking about side stitches like we already mentioned a lot and a lot of other Common Cramping like areas for cramping and reasons for cramping so that you can understand why these things are happening and what you can do to treat them in the moment and also to prevent them from coming back.

Kevin:

Yeah. You talk about new runners often being This is a more common issue that shows up in new runners, but sometimes trying a new type of running or running on different terrain, running up and down hills, suddenly you're on trails instead of sidewalks or the reverse of that, just changes to your routine can start leading toward these muscle cramps. Especially side stitches, because that is so much related to breathing as we'll get into.

Angie:

Yeah. And I'm really glad that you brought that up or even location, right? If you notice changes in the location, if you. Travel and there's a difference in altitude from where you normally train to where you are training again because of those changes with your breathing And the oxygen that's getting to your muscles, you can experience cramping that you never had before when you were at your normal location with your running.

Kevin:

Yeah. Theoretically we have full oxygen here down at sea level, but it's 110 percent humidity. So I don't think it's actually full oxygen, but it's certainly more than if we went up into the mountains of Colorado.

Angie:

Oxygen laden with H2O.

Kevin:

Sure. That's what it is.

Angie:

All right, so let's start by talking about the types and the causes of running cramps, a general overview. So the, there are different types of running cramps. You can obviously get a cramp in any muscle in your body and there's lots of different muscles all over your body, but we're going to talk about some of the most common ones like side stitches. So a side stitch is that sharp, stabbing pain right under your rib, and it can be on either side, either the left or the right side, and Sometimes

Kevin:

both, that's the worst. Like the wraparound side stitch that you're getting on both sides simultaneously, oh, that one's brutal.

Angie:

Oh, yeah. Side stitches do tend to be more common with newer runners and you do tend to grow out of them as you Get in better shape because your diaphragm, which is your main breathing muscle that can sometimes go into spasm. That is one of the causes for side stitches. And as you train your diaphragm and your diaphragm gets stronger, like any muscle in your body those muscles, Incidences of side stitches tend to decrease.

Kevin:

Yeah. That whole, that muscle getting stronger is going to be a regular theme of this particular episode is that muscle just needs to get stronger, but that's why it's so much with newer runners. I used to get side stitches all the time when I started running. And then after I'd been going for a little while, I was fine, except when we would run. on trails and we'd go up and down hills because if we were ever going down relatively steep hills, I would freak out and as a response, I would hold my breath. What turns out holding your breath while running is not the best idea.

Angie:

Yeah, and you're probably more tense than normal to write. You're like bracing yourself and so you're tensing your body, which is going to over fatigue those muscles. And that's often what leads to the cramping too.

Kevin:

Yes. And but it wasn't until someone ran down a hill with me that they're like Are you holding your breath? I'm like I think I might be. And that was the issue.

Angie:

Yeah. So side stitches are a common area. Other common areas where runners can experience cramping are in your legs, mostly in the calf sometimes in the hamstring, but hamstring cramping tends to be more with like speed work and sprinting. So if you are doing speed work, you might notice some like cramping in your hamstrings, but they're more common for endurance runners in the calf muscles, you could also notice some cramping or tightness in your lower back or in your feet. So like in your foot or in your toe, those can be some of the more common areas that we're going to talk about today.

Kevin:

Yeah. There's some less common ones about like shoulder and neck. I hear that every once in a while. And usually it's because you're of your arm carriage where you're just, you're carrying your arms really high and tense. And that usually, if you can just relax, take a deep breath and just let your shoulders fall down from your ears, you're, it's a quick fix to that one.

Angie:

Yeah. And some of the general causes for running cramps in general, okay? And there are some more specific areas that we're gonna get into but number one you're new to running Okay This is like we said one of the most common reasons for side stitches because your muscles just aren't used to this new Running motion and the jostling that's going around with all of your internal organs and your body Isn't used to it and your muscles aren't quite strong enough yet So if you're new to running you are going to be at higher risk for cramping on all these fronts. Another major cause, like this is the number one cause that I typically go to, especially if you're not a newer runner which is dehydration. Okay. Dehydration can lead to a lot of muscle cramping. Especially with side stitches or really anywhere in the body, like in this goes for outside of running too. If you are experienced, any experiencing any sort of muscle cramping, first thing you should do is look at. Have I drank enough water today?

Kevin:

Yeah, enough water, but also taking in enough electrolytes along with that. If it's a particularly hot day you're pushing out there for an extended period of time. Water is not going to be your best answer. You're going to want to make sure that you're getting some actual salts into yourself also, because otherwise you might seem like you're hydrating well, but all of your salts are completely out of whack and then muscles can't. Fire and relax properly,

Angie:

right? And we'll talk a little bit more about that when we talk about the treatment and the prevention of the muscle cramping. Other common causes are under fueling. So you're not eating enough. And if you're not eating enough, that means that your muscle doesn't have the fuel, your body doesn't have the fuel that it needs. So when it doesn't have the fuel, then it breaks down. Your muscles in order to get that fuel and so what it's breaking down the muscles That's weakening the muscles and that can lead to cramping lack of sleep can be a major cause for muscle Cramps because your body is not recovering properly and then footwear So either the improper footwear that like a shoe that is not maybe the best for you Maybe the shoe size isn't the Ideal or the shoe type isn't ideal or you just changed footwear Maybe you change shoes not realizing what a difference there was between the new shoe that you're in and the old shoe that you used To run in.

Kevin:

Yeah, I want to highlight a couple things on this of the improper fitting Footwear is such a huge thing. Most runners don't realize that they need to be getting running shoes that are a half or probably a full size larger than their normal shoes. Like whatever your normal walk around or dress shoes are, you should be probably adding a full extra size to go into a running shoe. You want that space up in the front for your toes to be able to slide forward and backward slightly. It's not like your foot's flying all over inside the shoe, but you want, you don't want to feel like your foot is locked down and just gripped in there because your foot needs to move as you run. You're, all the bones and the muscles and everything, they all just need to move around every time your foot lands and pushes back off. The other one is a shoe that is too narrow, really causes drastic issues with people when it. Their foot just, their foot's going numb or like one of their toes. Sometimes my big toe will cramp pointing up or I've had my, like one of my little toes just cramp and just point just straight down for no good reason. Usually it's because my shoes are laced too tight, but people have an issue with this. If their shoes are too wide for them. And you can tell this, like if you look at the laces on your shoes, It should basically be like two parallel lines going up your foot. If your laces are splaying out into a big V, you need a wider shoe. And if your laces are like, normal width at the bottom, but then you've got them cinched completely together at the top where you tie the bow. Your shoe is too wide for you in general. Just a good overview on that.

Angie:

Yeah. And this can definitely lead to problems, especially in the toe area. So if you aren't aware of this already, it is very important for you to size up in your running shoes. So whatever your normal shoe size, like for your daily shoe wear that, just your normal foot size, you're going to want to buy your running shoes in either a half a size or even a full size bigger than your normal shoe size. And this is because your foot tends to swell. When you run, especially if you're running longer distances and especially if you're running in the heat, your feet will swell and your feet actually get bigger during the course of your run. So if you are wearing your normal shoe size, there's nowhere for your foot to go. There's nowhere for your toes to go up at the front. There's nowhere for your foot to expand, and that can lead to cramping. It can lead to black toenails. It can lead to painful toenails. And so By increasing your shoe size a half a size to even a full size that can prevent a lot of problems. It might take some getting used to I know I had to work up to this I started mine with a half a size up and then I Graduated to a full size up. So right now I wear like a seven and a half, eight, depending on the kind of shoe that it is. And I wear a nine and running shoes. So I'm like a full size, maybe even a one and a half sizes up. And it just has made my feet so much happier.

Kevin:

Yeah. You love the room. What you like to have your toes be able to expand sideways also.

Angie:

Because one of my issues is my fourth toe. I know that's a random toe, but my fourth toe on my right foot Is sometimes painful, and I found that there are certain shoe brands that make that pain worse, and there are certain brands that I don't notice it, and when I have a smaller shoe, I definitely notice it more. I can, sometimes I feel it when I'm just in flip flops or my sandals, like walking the dog. It's not always painful. Just shoe related because but I think it's more of the way that my foot is gripping the shoe underneath it. So But yeah, typically if I can get some more space in there, it's usually a good thing,

Kevin:

right? But up to a point because if you get too much space then You're going around in running shoes as though they're flip flops and with every step you're trying to grip with your toes And that is going to just Quickly exhaust the muscles in your feet because you shouldn't be gripping with every step.

Angie:

Yeah, and the other thing that you can look into and this is I think a little bit debatable one thing There's been a lot of talk about the width of the toe box and me as a physical therapist I do believe that we need a lot of room in the toe box because typical running shoes are Or I should say I shouldn't say typical running shoes because now there's really no such thing as typical, but classical running shoes, right? We're designed to have the toes narrow toward the tip of the shoe and they're making shoes now that have a much wider toe box so that your foot actually has room and your toes have room to splay out, which is much better for natural foot function. So toe boxes, wider toe boxes have been shown to be very helpful for a lot of runners. So one of the things that you might be able to do also is to, instead of worrying as much about the length of the shoe which that, that is definitely important, you can also look at the width. So So if you are especially a woman and you might notice that it's more comfortable for you to wear a man's shoe because a man has a wider width or move up into a women's wide width shoe because that will give your room, your foot more room. The only time that might be more of a problem is if you tend to have a narrower or slimmer foot, then that's going to be, there's going to be too much room and then you're going to, your foot's going to be sliding all over the place. So that's not going to give you good support.

Kevin:

Yeah. If you need the extra width up in front, but you have a narrow heel, then you have to do like a lace lock to bring your heel in. So the heel doesn't slip out. You get a blister back there, but you still want the width at the front. But you point out that a woman can go into a man's shoe. You just change shoe size by a size and a half, and then women go right into men's shoes.

Angie:

Yeah.

Kevin:

And that's

Angie:

the same as a woman's wide width.

Kevin:

A woman's wide is the same as a man in almost in, in most shoe brands. Theoretically. few shoe brands that the complete last of the shoe is a slight different shape on a women than it is on men's shoes because of the differences in literally like the middle of the bell curve of a woman's foot versus a man's foot. There's slight differences that women have slightly wider toe toe boxes.

Angie:

That women have wider toe boxes? Yes. Yes. Interesting. Another thing that we want you to think about too in regards to footwear is your normal daily footwear as well. Because if you are a woman that wears high heels to work every day, and then you're putting on a running shoe and going running after work, for example, or even the next day, it In the morning, like really running at any time without doing the proper mobility and kind of warm up for your ankles and your calves high heels. What they do is they shorten your Achilles tendon, especially if you wear high heels on a regular basis. They can also alter the anatomy of your foot because of the way that the pressure is placed on the ball of your foot in your heel. So that's something to keep in mind. If you are someone that does wear high heels every day, that can be a reason that when you go out for a run, you might be experiencing increased cramps in your calf or in your feet because your feet are in high heels all day. And so it's a different anatomical position and your muscles could either be overstretched or overshortened either way and that can lead to cramping.

Kevin:

So ultimately don't wear high heels. That's just it's not good for your feet.

Angie:

Agreed. Yes. High heels have a lot of problems associated with them.

Kevin:

Really? There's just there's no good redeeming long term value of wearing high heels ever.

Angie:

Although I am very interested, To try Sarah Blakely's new invention. Yeah, I

Kevin:

know.

Angie:

So Sarah Blakely, for those of you that don't know, she's the woman that invented Spanx and she just came out with a brand new line of shoes called sneaks and they are high heeled sneakers. They're high heeled tennis shoes and they supposedly. Take all of the problems that high heels had and fix them all. Like they are comfortable high heels. She spent years developing these and trying to solve a lot of the problems with foot anatomy and all the things that high heels got wrong. So I'm very curious to. Try some of those.

Kevin:

Okay, so we can fix the foot anatomy issues, but it's never going to fix that your Achilles is getting excessively shortened. So that's true. No matter what the high heel is, there's still going to be that issue. So if you're in high heels all day long, and then you immediately go for a run, you're going to want to do something to take care of your calf in that transition period, because that is going to be very jarring to go from one thing to the other. It's like sitting in a car for eight hours and then being like, all right, now I'm going to go run. You need to make sure that there's some bit of transition so that your muscles are going to be able to move properly.

Angie:

Yeah. So before we jump into part two, which are ways to treat. Muscle cramping and ways to prevent and avoid muscle cramping. I want to mention that if you are a woman in perimenopause I am running a Free class next week. So it's October 16th and 17th I'm running three different classes at three different times to try to hit as many time zones as I can So October 16th and 17th I'm going to be talking about how to run strong through perimenopause because as we get into our 40s, our hormones start to shift. We get into this phase of perimenopause. You might not even realize that you're in it, but if you are a woman in your 40s, perimenopause can start as early as your 40s. late thirties. So if you're starting to notice weight gain, more fatigue, slower times, even though you're still training and you're, you didn't change anything about your training and you're just feeling frustrated and you want to feel stronger and have more energy. That's what this free class is all about. So head over to real life runners. com forward slash Perry P E R I. And you can sign up for that free class today. So I'm just gonna throw that out here. Before we get into part two. So part two, ways to treat And prevent muscle cramping. So let's start with what can you run through versus when you should stop. Because I think that's a really important distinction that we need to make. Because sometimes when you get a muscle cramp, you can just keep running. Other times, it's probably not a good idea for you to keep running because you don't want to, create any sort of longer term damage to the muscle. So like I mentioned first before, side stitches are one of those things that you can run through as difficult as it is, but even though it's hard, Running through it will not cause further damage to your body. Okay. It's just going to be painful as heck.

Kevin:

And if you're running pretty hard for a long time through a side stitch, it's still going to be sore the next day. You didn't cause damage, but you had a muscle in spasm and you pretended that it wasn't, and you just kept running. So that is going to feel uncomfortably sore the next day. And since that muscle was your diaphragm, that literally means that. will lead to soreness the next day. I've had this, I had a side stitch that I'm like, nah, it's the middle of a race. And I pushed the last several miles of a race with a bad side stitch and it was still uncomfortable the next day. It wasn't like sharp and stabby. It was no longer the feel of a side stitch, but I just felt like soreness. Yes. I felt soreness in a belt around my whole abdomen the whole next day.

Angie:

Yeah. And that's normal. Or it can happen. I shouldn't say it's normal, but it can happen. It

Kevin:

can happen. But that doesn't mean that there's anything that I did not cause longterm damage, tear

Angie:

muscle or anything. Your muscle just got really tired and fatigued and is sore afterwards.

Kevin:

Yes.

Angie:

And that can, in a way be a good thing. I don't want to say too good. The goal obviously is not for you to be in this kind of pain, but you are making your muscles stronger as you start to Continue to push them right? Like you were over stressing your diaphragm in that case and your diaphragm then was sore the next day, but as long as you give your body enough recovery, your diaphragm is going to build back stronger. We've talked about that many times on the podcast. That's the point of doing strengthening and putting our bodies through any level of stress.

Kevin:

Yeah. You make a good point, but I think. If it was any setting outside of a race setting, I would have pulled back and slowed down. There

Angie:

are better ways to do it, right?

Kevin:

Yes. That's the thing is If you're in the middle of a track workout, do you need to have every time you do a speed workout grind yourself into a little puddle on the edge of the track at the end and no is the answer to that because it's not a good long term approach to do that every time. But occasionally do you want to push yourself really hard? And the answer is probably yes, because sometimes you need to see what does the edge feel like? So I found a way to do that. In that setting, I pushed through a cramp for an extended period of time.

Angie:

Yeah, but it's definitely not something that you want to be doing all the time. And there are better ways to strengthen your diaphragm and your breathing muscles than just trying to push through side stitches. But the reason I bring up side stitches is because if you are experiencing a cramp. muscle cramp in any other area of the body other than that spot right underneath your ribs where the side stitch appears and it is a sharp, shooting, stabbing kind of pain, you should probably stop running and get it checked out or address it in some way because a sharp, stabbing pain anywhere else could be a sign of something being torn or something being wrong, right? For some reason side stitches just don't apply to that rule. And so that's one of the reasons I wanted to point that out. Because normally when I tell my runners and my clients, like if it's a sharp and stabbing and shooting pain, like you need to stop running and address it or get some help or something, like figure out what's going on. If it's a side stitch you.

Kevin:

Or occasionally you can be off on a distance run and once you're up over an hour you will periodically get a sharp stabbing pain down in like your groin area and you just pretend that it's not there for a year and a half and then ultimately you have to have hernia surgery.

Angie:

Yeah, a year and a half. You had that thing for over five years. I know, but

Kevin:

like the specific sharp stabby pain that would every once in a while show up in the middle of running double me over and I just pretended didn't happen. Yeah. That part.

Angie:

You should probably address it.

Kevin:

You should probably address that, right? And

Angie:

Even if you can run through it should you run through it? Becomes the question. On that run, like it was fine. You were able to finish your run and make it. Make it home. Okay. But yes you should have addressed it and gotten it checked out.

Kevin:

Probably should have gotten this sharp, stabby pain address. Probably. Yes.

Angie:

We're still going probably. Okay. So on the line of side stitches, what happens if a side stitch pops up, especially in a race, right? That's the worst case scenario. Nobody wants that. That side stitch pops up in the middle of the race. You don't want to stop. You don't want to slow down. Like you're trying to. Push yourself. It's a race. A couple of strategies that you can use that we've tried successfully and unsuccessfully throughout the years because sometimes these things work and sometimes they don't work so well. Like it just depends. So Kevin and I are going to give you what has worked for us and for our runners in the past. So the first one that I typically try to do is I dig my fingers Into that spot really hard. Like I just try, I push on that spot super hard just to dig and it changes the pain. It doesn't make it go away. But it does change the pain and kind of distracts me from that. Sharp shooting pain. And then what I do is now that my fingers are in that spot I then try to breathe and take like slower deeper breaths and breathe into those fingers like try to Really expand and breathe into that spot as much as possible sometimes I have to Stop running and walk for a while to do this. Sometimes I tried to, if it's a race, I'll try to keep running and do this. Sometimes I might need to walk for a second and just really try to take a super deep breath and let my lungs expand as much as possible and really try to breathe into that one spot. That's been one of the most successful things I've found.

Kevin:

Okay, doctor, why should that work?

Angie:

Why should what work?

Kevin:

Why should breathing into that spot as you like apply pressure to the painful spot? Why should that actually work?

Angie:

Because when you're, when you take a really deep breath and basically when you're having a side stitch, your diaphragm is in a spasm. And so when your muscle is spasmed, it's tightened up and contracted on itself. And so what I'm trying to do is allow So, when I take a really deep breath and your diaphragm expands, your lungs expand, and your diaphragm lowers, it helps your diaphragm to relax. Does that make sense?

Kevin:

So that makes sense. So you're literally just It helps

Angie:

that, that piece, like the muscle cramp, let go. Because you're also increasing the oxygenation to that muscle, which when the muscle is in cramp In a cramped state, like it's not getting enough oxygen either because it's not getting enough blood flow. It's not getting enough oxygen. So I'm like directing, I'm basically using my hand, my fingers as biofeedback to tell my body where to direct the oxygen and the blood flow and everything to try to allow that piece of the muscle to relax.

Kevin:

Excellent. Okay. I like one of two options. One blowing raspberries is the easiest one to try and convince kids to do in the middle of a race. That's why I've had great success with this one myself, but also when in years of coaching cross country kids, when they run by and they're like, Oh, my side, it's easy to explain, blow raspberries as they try and go by. The other one,

Angie:

give us an example. Are you going to give us a demonstration?

Kevin:

Sure.

Angie:

There you go.

Kevin:

Perfect. Okay. I don't know if that was loud enough for the podcast. We'll see how that one goes. I didn't want to go crazy in your ear. The other one is to take your hand and make it into a fist so that there's like a very small opening made between your index finger and your thumb. And back on the pinky side is about as tight a fist as you can possibly make. So it's like a loose fist over on the thumb side and very tight on the pinky side and then blow into the opening on the thumb side. And you can see that you're going to be able to blow into the tiny opening on the one side, but no air is going to go out on the other. And I blow as hard as I possibly can into my hand. And I feel like it's the breathing version of digging your fingers into it. Like you're essentially breathing. forcing yourself to breathe as hard as you possibly can up against a very high pressure thing. And it's Oh wait, my diaphragm needs to focus on doing this difficult task. So it's no longer allowed to be cramping up anymore because it has to actually be effective at accomplishing this other task. And sometimes it just helps things relax a little bit.

Angie:

Yeah, so I'd love to hear your examples or your things that you've used for side stitches. So if you guys want to send us a DM over on Instagram at real life runners and let me know what you've used to treat your side stitches in the past because that's what's worked for us and the things that we've, told our runners. So I'd love to hear what other options there are. Okay. Okay. What happens if you get a leg cramp in the middle of a run? Number one, I think it depends on where it is. And again, it depends on the quality of that cramp. So cramping is usually that sharper, stabbing, tightening type of pain. Cramping can come on gradually and just start to tighten and then gradually continue to tighten with time. Oftentimes a cramp is more of a sudden, pain. So if you get that sudden sharp pain when you're running and the pain is located in your legs, I would suggest to stop and to stretch. So let's just take your calf, for example, like stopping and stretching the calves and allowing that muscle to try to relax is going to be a good thing, and then maybe you need to walk for a little bit and then start running again and see what happens. Now, on the other hand, that might be the worst thing for you to do as well, because this happened to me in the Key West half marathon, when I was running, I was getting. I could feel my calf muscles on both legs just start to gradually tighten up and I noticed that pretty much when I Started to push myself a little bit I think I did actually stop at one point and try to do a little stretching or do a little walking and like it Did not help at all and so I just started running again and I noticed that every time I tried to speed up because I was At about mile 12 when this happened I was trying to speed up so that I could finish the race strong at any time. I try. Actually, I think it started earlier than that. I think it started more around like mile 10 and then it started to get worse. And so I was trying to push myself when I got to that last mile and my calves basically said no, because anytime I started to go faster, my cramps were basically right on the verge of that grab. And I think if you've ever had a muscle cramp, you probably know what I'm talking about. It's I knew that if I just pushed just a little bit more, it would have just seized completely on me. So I just kept it at that level because it was at a discomfort level. That I could stand it wasn't sharp at that point It was just like this very dull Super tight feeling in my calves and I was at the last mile of my half marathon I was gonna go ahead and finish that

Kevin:

yeah But I think that the cause of that one was interesting so one you were pushing yourself like right to the edge because that ended Up being a very fast time for you But two, that was a super wet, sloppy course. So you were probably running a little bit different as you're going, like splashing through puddles. It was

Angie:

slippery.

Kevin:

It was slippery. And so you're gripping more with your toes than you were used to doing, which is using your calves more than you're used to doing. Yeah.

Angie:

And it was like a. Five minute PR for me to also. So I was running faster by a significant amount. So

Kevin:

you combine the half marathon PR with the wet and sloppy and slippery course. And that is a recipe for calves that are right on the verge of completely seizing up on you.

Angie:

Yeah I don't, I probably didn't do the best job fueling. I don't remember specifically my fueling strategy during that race right now. Cause it was like over five years ago. Yeah, I know. Isn't that wild? I was like, Oh, yeah, it wasn't that long ago, but yeah, it was. But I'm sure that I could have done a better job fueling, which again, that can be, that's our third aspect of treatment, which is making sure you get some water and some electrolytes into you. Okay. If you do have any sort of cramping, especially if you're in a hot environment and you're noticing cramping, that's a major sign of dehydration. So you're going to want to try to get water and electrolytes into you as quickly as possible.

Kevin:

Yeah, no, especially the electrolytes. If you're feeling that cramp come on, water is not going to be your fix. Like your fix is going to be some sort of sport or electrolyte mix that you can do this, especially if you've noticed that you are in general, a salty sweater, like if when you finish running, you perpetually look like you're like, salt crusted, you are probably a very high salty sweater. And so most of what you take in, whether it's a training run or a race or whatever it is, should not be water. There should be something in it. If you're in a race, figure out what the drink is that they're serving at all the aid stations. Make sure that you can handle that with some like practice runs during your training, and then take in that at all. All the aid stations that you possibly can. That was one of the things that I did. I don't know. A marathon I ran a few years ago is I literally stopped and walked through every single drink aid station and still ran a pretty close to the time that I was aiming to run. I missed it ever so slightly because I ended up running. I lost track of the. Pack and there were other things unrelated to hydration, but I walked through almost every aid station so I could actually drink a full cup of Gatorade at every station they were serving. And I don't think that it affected my time negatively at all. If anything, it helped me because I was not on the verge of cramping up. Like my calves felt completely fine by the end of that race. And at the end of most marathons, my calves are right on the edge. So I think that. Hydration, especially with electrolytes, super important.

Angie:

Yeah, I would definitely agree with that. And then one more thing that I forgot to mention with treatment for leg cramps, oftentimes if you do, if you stop to stretch, especially if you're not in a race, if you're just out on a normal run, doing some exaggerated running drills like marches or butt kicks can really be helpful for us as some karaoke. Can help to open up your muscles and your joints and get that stretch in them again that can be a helpful thing to allow the muscle to relax as well All

Kevin:

right So one time i'm in high school and we finished a workout And my toe is odd that you said your fourth toe because that was the one that was happening on me I had finished the workout. We're sprawled out on the track because it was a really hard workout in early fall. So plenty warm and my foot cramped up on me So like all of my little toes were just curled over and I couldn't straighten them back out and it was getting really Just more and more painful. And I start like making this sound at my coach comes over. He goes, Brown, what's wrong? I said, my, my foot, something's wrong with it. And he just, he rips my shoe off. Doesn't undo lace or anything. Just rips my shoe off. And you can see that my toes are slowly completely beyond my control. Just starting to cramp up. So my foot is going into a fist. And with no hesitation, my coach grabs all four of my toes and just yanks them back towards my shin and then down and then up and then down and then up. I screamed the entire time. He drops my foot back on the ground. He goes, now it's better. But it was the foot, the toe example of make the, that muscle move through its widest range of motion. And I literally, I got up and was able to walk. Like I went on a jog cooldown afterwards. It's Because it was like the muscle was on the verge of seizing up and it was like no Let's stretch that muscle through its full range of motion and allow it to be like no. No, I can move Let's get blood flow to the area and then everything was fine

Angie:

God bless your coach for grabbing your sweaty foot like your high school boys sweaty foot

Kevin:

He had three high school boys sons older than me I think he'd gone through plenty,

Angie:

but this is the same thing to do You know, like I remember I used to get a lot of cramps specifically like calf cramps and foot cramps when I was pregnant and There was one time that I got, do you remember that one calf cramp I got with the first pregnancy when I was probably eight and a half months pregnant. So I was huge. I was laying in bed and it woke me up at night and I couldn't move. Like I normally, if you get a calf cramp or a Charlie horse you're supposed to flex your foot. Like you're supposed to, you don't point your toe, you flex your foot and pull your toes back towards your head. I couldn't do it. Like this cramp was so bad. That my foot was just frozen and I was like, I like hit you and I was like, Kevin, push me off the bed. Push me off the bed. Cause I couldn't even move. Like I was so big and like I had this huge belly. I had to get off the bed so that I could put enough pressure on my foot to break it out of that position so that I could get my heel down and get myself into that calf stretch position.

Kevin:

Yeah. Your calf hurt for three days after that. It really

Angie:

did. That was The most intense cramp I've ever had in my life.

Kevin:

I do remember that. Like literally your calf hurt for days afterwards and yes you made me, I'm like, I can do this. I can push your foot back. And you're like, no, you couldn't. I couldn't. I couldn't do it. You couldn't do it. You're like, put me on the floor. Yeah. I

Angie:

was like, I asked you to help me first and you couldn't budget. Like it was not

Kevin:

move your

Angie:

foot. It was such an intense cramp. But then yes, I was like, get me off the bed. So yeah, that would be another way for you to do that is like to stop, to stretch, to do some exaggerated range of motion types of drills some dynamic mobility, very helpful in these cases to help with the treatment of muscle cramps. Okay. So going into prevention, we've already talked about some of these, so we'll just briefly touch on some of the ones that we've already talked about to prevent muscle cramps. One of the biggest things you need to look at is your hydration level. Okay, that includes water and electrolytes. Do not wait until you're thirsty to drink water and this accounts for during your day and also on your runs. Okay, if you're thirsty, you're already dehydrated. So you need to be drinking a lot of water throughout the day. You also need to stay hydrated on your runs, like especially on any longer runs. Or in hotter temperatures, super important because cramping is just one step on the way to heat exhaustion and heat stroke, okay? So cramping is something to be definitely taken seriously, especially in the heat. So make sure you're getting enough water, make sure you're getting electrolytes like Kevin mentioned, especially if you're a salty sweater. Electrolytes, cramping is often due to an electrolyte imbalance, okay? Dehydration, yes, but it's, it, the dehydration leads to an electrolyte imbalance is ultimately what causes that cramping, okay? Another way that you can prevent side stitches and cramping is the way that you fuel before and during a run. Now, this also includes the timing of your meals and the timing of your water. So a lot of times I'll ask kids cause one of my first questions when our kids are getting cramps is, have you drank any water? And they're like, yeah, I just, I drank a lot of water right before the race. And I'm like how? Soon before the race. I'm like, oh, I chugged a bottle of water right before we went to the starting line I was like, that was a terrible idea You know because now you have all this water in your stomach and guess what your stomach's right next to your diaphragm So there's sloshing liquid that's just flopping around in your stomach. That's another big cause for Muscle cramping is specifically side stitches. So over drinking right before a race That's why it's important for you to be hydrating all throughout the day and spread it out so that you're well hydrated Before you go out for your race or before you go out for your run and you're not just trying to like chug You know Things before you run to try to make up for it

Kevin:

Yeah And then fueling goes along with this because depending on what it is that you're fueling with so many of those Gels and shoes different things they consume with water if you don't consume with water that is a side stitch waiting to happen It really you

Angie:

know what we actually forgot about GI cramping

Kevin:

Yeah, like

Angie:

lower abdominal cramping a lot of people get that during running as well

Kevin:

Yeah, 100%. And that goes right in with this. If you don't consume with water, you're going to have GI issues. If you consume it with too much water. This is why it whatever you're planning on using. If you're racing something longer, like a half marathon or a marathon. If you're planning on taking in fuel, you're Figure out either what they're passing out at aid stations and make sure you're good with that or figure out how to carry your own fuel and practice this extensively on your runs leading up to the race because you need to make sure that you figured out how to take that fuel in and the water levels that you need to take it in with so that you're getting appropriate calories you I mean, it's hard to overdo calories on, on one gel or chew or whatever the thing is, even if you take it in with sports drink, it's just, it's not going to be too many calories for your body to absorb, but you want to make sure that you can handle all the load at a single time.

Angie:

Yeah. Because when you're having cramping in your lower abdominal area, that's often not muscular cramping. It can be like, there can be some like pelvic floor and lower abdominal cramping that happen, but happens, but. GI cramping is more likely the cause in that. Scenario with the, if it's in that location and that is always due to some sort of electrolyte imbalance and dehydration of going on.

Kevin:

Yeah, exactly. So many of these gels out there now also have electrolytes added to them. So find, so there's so many products out there, find what works for you and don't give up on fueling during a run because you got a side stitch, find something else, try a different one. There's so many out there.

Angie:

Yeah, let's talk about breathing now. So breathing can be used both as treatment and prevention. Breathing exercises since we are talking about it right now in prevention, learning how to breathe better is going to completely transform your running. I know that this is something that when I was a newer runner, I definitely had to spend very conscious time trying to improve my running. And one of the ways that I did that was by To do what's called rhythmic breathing. Rhythmic breathing means that I'm My inhale matches my exhale. So for example the number of steps, the way that I did it when I started was I would inhale for four steps and then exhale for four steps and then try to make my inhale match my exhale. And there are times when you're running faster that they aren't going to necessarily match, but you're going to want to try to keep them as even or as rhythmic as possible. So if the 4 4 seems too difficult, you can move to 3 3's or even 2 2's where you're inhaling for 3 steps, exhaling for 3 steps, inhaling for 2, exhaling for 2. And when I'm doing higher end speed, that's what I'll have to do. I'll try to, just decrease both and not try to decrease one and not the other so that they become more uneven.

Kevin:

But this is especially a good trick if you're newer at running or you really suffer extensively with side stitches. Once you've been running for a long time, breathing does just become a whole heck of a lot more natural. And in that case, if you get a side stitch, flipping over to rhythmic breathing is one that has odd numbers can really help. Because sometimes if you're doing something like 4 4, and you always start breathing in as your left foot hits the ground, and always breathing out as your left foot hits the ground, could cause side stitches on that side. So if you go 3 3, or they're not perfectly matched, you go like 4 4. four, three, or three, two, so that it ends up being an odd number. You're always going to start breathing in with a different foot hitting the ground, and that can also help undo stitches.

Angie:

I love that. That's great advice. The other thing you're going to want to practice outside of your running so that you can do it. During your run is diaphragmatic breathing. So that means those deep belly breaths, a lot of runners and a lot of just people in general tend to breathe more with their chest muscles, their accessory muscles, and they don't do as much breathing with their diaphragm. They don't let their bellies expand when they're out running or when they're just. sitting around and breathing. They tend to breathe more with those chest muscles, and that can put you at higher risk for muscle cramping because you're not getting as much oxygen in as when you take in those really deep diaphragmatic breaths. So practicing diaphragmatic breathing and really strengthening your diaphragm using your breathing just, Intentional breathing. Like you can do this during meditation. You can do this while you're driving like you start taking deeper breaths and trying to inhale for five, six, seven, eight counts and then exhale for the same amount of counts. Don't do it while you're driving if you're new to it because you can get lightheaded at times. So I'm actually going to reverse that don't try to challenge yourself or hold your breath while you're driving But if you're at home sitting in a safe place, then that's a good time to do it Let's

Kevin:

see if I can hold my breath for this entire stoplight Maybe not the safest move. Diaphragmatic is such a funny looking word when you have it typed out But yeah, that's a good one on really making sure that you do it But you put a good point here at the beginning when you said practice this not running so that you can do it when you are running. Because if you get really good at this as you're laying down, then you can do it as you're standing up. And then again, diaphragmatic breathing is a good way to try and take control and focus on breathing. If you've developed a side stitch in the middle of a run, of a race of whatever it is, of really over exaggerating belly breathing. Can sometimes help relieve that, especially if you can catch it early. Yeah,

Angie:

that's what I tend to do now. Like the, I still sometimes do the digging, the fingers dig, but I really just try to take really deep breaths to try to breathe into that area. And if

Kevin:

you catch the side stitch early, I feel like diaphragmatic breathing is a good fix. If you're already into it and it's a knife in your side, you might have to start digging fingers.

Angie:

Yeah. So moving on to some other ways to prevent running cramps sleep. Okay. If you're not getting enough sleep your muscles aren't recovering well enough Which means that they are tired and they're weaker because during your workouts You're breaking your muscles down during rest and sleep and recovery is when your muscles build back stronger So if you're not getting adequate sleep and your body's not recovering then your muscles are staying More in that broken down state and so they're weaker when you're going out to work Running or lifting or whatever it is you're doing. Okay, so making sure to get enough sleep will definitely decrease the incidence of muscle cramping

Kevin:

This works perfectly with your next point here, is tight muscles are often just weak muscles. And whether it's a weak muscle because you were lifting earlier or because you weren't getting enough sleep, you haven't been fueling properly, whatever is causing a weak muscle is likely that muscle is going to overreact when it's needed. to be used and it's going to tighten itself up and tightening up is going to lead to more cramping unnecessarily.

Angie:

Think about it. When you're tired, you are a lot more reactive to people around you. And that's how your muscles are too.

Kevin:

Oh, good metaphor.

Angie:

Think about it. Like when you're tired, you're, you just don't have the same level of patience and you tend to be like, Reactive and kind of spasmy, emotionally spasmy, but it's true though. So this is one of the reasons that muscle strengthening is a really important way for you to prevent muscle cramping as well, because those tight muscles are often weak muscles that spasm, you're often putting a load on them. That's too great that they're not ready for. So by doing that. Undergoing muscle strengthening by strengthening your muscles strength training weightlifting and making those muscles stronger you're going to decrease the chances of muscle cramps as long as You are fueling appropriately and getting the most the right amount of recovery because if you're weight lifting and doing strength training But you're not Refueling and you're not allowing the rest and recovery, you're just breaking the body down and making them weaker and that's just going to lead to more muscle cramping. Okay, so make sure that you understand when I say muscle strengthening, I don't just mean do add more strength training, just continue to do more like for your muscles to get stronger. It's a combination of strength training, applying that load, fueling your body appropriately so that it can build back stronger and allowing enough recovery for it to do so as well.

Kevin:

All right. And one of the other big ones here is making sure that you're warmed up appropriately. If you're going out to do some sort of speed work, making sure that there is an appropriate warmup that includes like some easy jogging, some drill work, some mobility work so that your muscles are actually prepared to do the activity that you are asking them to do. You've got to prime the muscles to make sure that they can go. Like you wouldn't, Start a car in the middle of winter in like snowy conditions, start the car and immediately hit the gas pedal. Like you've got to actually let the engine warm up or the car is not going to perform properly. The same thing happens with your body. If you go, we were talking about being in high heels all day and then trying to immediately run. That's too big of an adjustment for your muscles. If you go from sitting all day and immediately try and go run without much of a warmup, It's going to be difficult for your body to perform optimally. Whether you're coming out of dress shoes, out of sitting all the time, out of being asleep and laying down, it's hard to call on all of your muscles to actively move properly and in like in a good unison in a cooperative manner. And the muscles are just not going to be working optimally, which means you're more likely to cramp along the way.

Angie:

Yes. So hopefully this episode gave you lots of ways that you can treat and prevent muscle cramping. So if you found it helpful, please take a couple of seconds to just leave us a review or share this episode with a friend so that we can help more runners out on the road to stay running happy and feel better and just run their life. So this has been the Real Life Runners podcast, episode number 380. Thanks for spending this time with us today. Now get out there and run your life.