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 Professor Paula Drosescu MD PhD
Societatea Romana de Medicina Sportiva



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Symptoms
    The pain of a muscle cramp is intense, localized, and often debilitating Coming on quickly, it may last for minutes and fade gradually. Contractures develop more slowly, over days or weeks, and may be permanent if untreated. Fasciculations may occur at rest or after muscle contraction, and may last several minutes.  

Diagnosis

    Abnormal contractions are diagnosed through a careful medical history, physical and neurological examination, and electromyography of the affected muscles. Electromyography records electrical activity in the muscle during rest and movement.  

Treatment
    Most cases of simple cramps require no treatment other than patience and stretching. Gently and gradually stretching and massaging the affected muscle may ease the pain and hasten recovery.
    More prolonged or regular cramps may be treated with drugs. Fluid and salt replacement, either orally or intravenously, is used to treat dehydration. Treatment of metabolic or neurologic disease, where possible, may help relieve symptoms.

Alternative treatment
Cramps may be treated or prevented with Gingko (Ginkgo biloba) or Japanese quince (Chaenomeles speciosa). Supplements of vitamin E, niacin, calcium, and magnesium may also help. Taken at bedtime, they may help to reduce the likelihood of night cramps.  

Prognosis
Occasional cramps are common, and have no special medical significance.  

Prevention
Eating a healthy diet with appropriate levels of minerals, and getting regular exercise to build up energy reserves in muscle may reduce the likelihood of developing cramps. Avoiding exercising in extreme heat helps prevent heat cramps. Heat cramps can also be avoided by taking water and salt before prolonged exercise in extreme heat. Taking a warm bath before bedtime may increase circulation to the legs and reduce the incidence of nighttime leg cramps.  

References
1.Bly JL, Jones RC, Richardson JE. Impact of worksite health promotion on health care costs and utilization: evaluation of Johnson & Johnson's Live for Life program. JAMA. 1986; 256:3235-3240.
2.ACSM position stand on osteoporosis and exercise: American College of Sports Medicine. Med Sci Sports Exerc. 1995; 27:1-7.
3.Adamo KB and Graham TE. Comparison of traditional measurements with macroglycogen and proglycogen analysis of muscle glycogen. J. Appl. Physiol. 1998, 84: 908-913.
4.Adamopoulos S, Coats AJ, Brunotte F, Arnolda L, Meyer T, Thompson CH, Dunn JF, Stratton J, Kemp GJ, Radda GK, et al. Physical training improves skeletal muscle metabolism in patients with chronic heart failure. J Am Coll Cardiol. 1993; 21:1101-1106.
5.Braith RW, Pollock ML, Lowenthal DT, Graves JE, Limacher MC. Moderate- and high-intensity exercise lowers blood pressure in normotensive subjects 60 to 79 years of age. Am J Cardiol. 1994; 73:1124-1128.
6.Hăulică I., Fiziologia umană, Editura Medicală, Bucureşti, 1989
7.Mogoş Ghe, Mică enciclopedie de Boli interne, Editura {tiinţifică şi Enciclopedică, Bucureşti, 1988
8.Păun R, Tratat de medicină internă, vol. I-IV Ed. Medicală, Bucureşti, 1986.
9.Ploug, T., H. Galbo, T. Ohkuwa, J. Tranum-Jensen, and J. Vinten. Kinetics of glucose transport in rat skeletal muscle membrane vesicles: effects of insulin and contractions. Am. J. Physiol. 262 (Endocrinol. Metab. 25): E700-E711, 1992.
10.Schwartz, R. S., W. P. Shuman, V. Larson, K. C. Cain, G. W. Fellingham, J. C. Beard, S. E. Kahn, J. R. Stratton, M. D. Cerqueira, and I. B. Abrass. The effect of intensive endurance exercise training on body fat distribution in young and older men. Metabolism 40: 545-551, 1991.
Zorzano, A., T. W. Balon, M. N. Goodman, and N. B. Ruderman. Glycogen depletion and increased insulin sensitivity and responsiveness in muscle after exercise. Am. J. Physiol. 251 (Endocrinol. Metab. 14): E664-E669, 1986.

Professor Paula Drosescu, MD. PhD
Faculty of Physical Education and Sports
“Al. I. Cuza” University Iasi
December 2, 2009
Medical Cabinet Alternative Iasi
Associate Certified Coach ICF
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