By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- Muscle cramps are painful, involuntary contractions of a muscle
- Many theories have been made over the years about cause and risks for muscle cramps, including poor warmup, dehydration, and electrolyte imbalances
- New theories about muscle cramps focus on hyper-active nerve stimulus leading to the muscle cramp
- One preventive approach is to fool the nerve into quieting down by drinking a pungent, spicy drink. Two prominent neurobiologists have developed a product called HotShot that may reduce muscle cramps.
I’m pretty sure anyone who’s ever played a sport has had a muscle cramp at some point in their life. Maybe the calf, foot, hamstring, or even the “side ache” which is most likely a cramp in the diaphragm muscle. They are annoying, tough to predict, and tough to prevent. But there is a new theory on preventing muscle cramps that is very interesting: the cramp is actually the result of a hyperactive nerve causing a muscle to contract, and you might be able to fool the nerve into quieting down by drinking a shot of really spicy liquid.
There have been many theories developed over the years about the factors that can increase an athlete’s risk of muscle cramps. For example, some of the common associations are:
- Starting exercise without a proper warmup (might lead to microtears in the muscle, supposedly causing a cramp)
- Electrolyte imbalances
- Supplement use (especially creatine)
With these types of associations, sports medicine professionals have long advocated for athletes to do a proper warmup, make sure you’re adequately hydrated, and consider a sports drink with electrolytes. Other remedies such as drinking pickle juice are also reported to work, but how?
A muscle cramp is a forceful involuntary contraction of the involved muscle. And a muscle is given a signal to contract by the nerve that leads to the muscle. A recent article in the Wall Street Journal details the story of Nobel prize-winning neurobiologist Rod MacKinnon and his colleague Bruce Bean and their quest to end muscle cramps by attacking the problem at the nerve level.
Dr. MacKinnon became interested in the muscle cramp problem many years ago when he had severe upper extremity cramps when kayaking far off the Cape Cod shore.
Dr. MacKinnon and Dr. Bean’s idea: fool the nerve supplying the muscle to calm down by occupying the body’s nervous system elsewhere. Drink a really spicy drink, brain focuses on the spice, and the cramp stops. The actual science is quite a bit more complicated than that, involving complex ion-gating pathways, but hopefully you get the point.
Back to pickle juice. This odd concoction started showing up in the press surrounding endurance athlete habits maybe around 6 or 7 years ago. Originally it was believed that pickle juice might contain the right mix of electrolytes to ward off a cramp. But MacKinnon’s work suggests the mechanism might actually be that the bitter taste produces a stimulus that allows the nerve communicating to the muscle to relax.
Drs. MacKinnon and Bean have developed a product called HotShot that has a very pungent, hot taste and is in the early testing phase. The preliminary results seem to show that the electrical signals that may lead to a cramp are reduced as quickly as 15 minutes from drinking a HotShot and last 6 to 8 hours. Sideline Sports Doc has no relationship with the company or the researchers.
I’d emphasize that this is very early research, so we’ll await more evidence. Does it work for everyone, most people, some people? Does it prevent a cramp? Should it be used only if a cramp comes on? Is only the cramping muscle affected?
It’s a very interesting concept and who knows, maybe sometime soon you’ll be asking for some hot sauce with your leg cramp.