DEAR DOCTOR: I love swimming and doing water exercises in the pool. The problem is that I tend to get painful cramps in my legs and feet. Is there anything I can do to avoid them? Does my age (I'm 69) have anything to do with this?
DEAR READER: Muscle cramps in the legs -- the calf and thigh, as well as the feet -- are a fact of life for some of us who exercise. And while there are many theories as to why they occur (many of them presented quite forcefully as fact), the truth is, we don't really know the cause. It does appear that cramps, or muscle spasms, can become more common as we age. That's particularly true of leg cramps that occur at night, during sleep. For others, as you have discovered, they can intrude into the activities of daily life.
What's happening is that, due to a nerve malfunction, the muscle fibers suddenly contract and don't release. Unless you've ever lived through a muscle spasm (sometimes it's called a charley horse), you can't understand just how helpless you feel and how painful it is. And while the spasm itself typically ends relatively quickly, that area of the muscle may feel tender for a day or so.
If you decide to check in with your family doctor regarding the onset of these muscle spasms, he or she will most likely begin with a physical examination of the area involved. Your doctor will also collect the information needed to rule out any underlying disease or condition that could be the cause of the spasms. This includes diabetes, kidney disease, heavy drinking or alcoholism, and peripheral artery disease. The latter, which Dr. Ashley covered in a recent column, is a condition in which certain arteries, including those in the legs, become narrow. Pregnant women are also prone to muscle cramps, particularly in the final months before delivery.
Other factors in persistent leg cramps can include a pinched nerve, flat feet, muscle fatigue from overuse and an imbalance of essential minerals such as calcium and magnesium. Muscle cramps can also be a side effect of certain medications, such as diuretics and statins.
We see two potential factors associated with muscle spasms in your situation. One is muscle overuse, and the other is cold temperature. Do the cramps occur in the later stages of your workouts? If so, try taking a break before you reach that danger zone. Hop out of the pool, get something to drink, warm up your legs with a quick walk. Do some stretches and massage the muscles before getting back into the pool.
Another area of agreement around muscle spasms is the importance of potassium, calcium and magnesium in neural health. Dark leafy greens are a good source of magnesium. Potassium-rich foods include sweet potatoes, bananas, broccoli, halibut, cantaloupe and orange juice.
When a cramp does occur, gently massage the affected area and gradually stretch the muscle. It's possible for a cramp to last up to a minute or more, so be patient. And if the cramps are severe enough to interfere with daily life, please do get in touch with your doctor.
(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)
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