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Muscle Cramping - You Asked Us?

Hi Julie and All -
Any suggestions? In my morning class with many older adults, I have a couple that are getting foot cramps. One guy says he gets them when he is on the noodle, bicycling. They all tell me they eat bananas and drink H20. Any suggestions?.
Thanks. Dawn B –Michigan

Dear Dawn:
Muscle Cramping in different parts of the body such as in the calves, hamstrings, lower back and the feet can be an extremely painful condition and is a frequent “bugbear” in an older adult class. Unfortunately, older people are more susceptible to muscle cramps due to normal muscle loss (atrophy). Cramping can start as early as the late-40s and accelerates with age and inactivity.

Often the participants who get muscle cramps are the very people who need to exercise and this can really put a damper on their enthusiasm to come to the program and they drop out. Cramping problems can usually be helped with adjustments to exercise within the class if you stop the activity, do some gentle stretching and massage the affected area. However it must be realized that recurrent cramping can be signs of much deeper problems.

What can you do within the class?
The answer could be as simple as re-training foot mechanics Maybe you need to go back over some basic movement such as teaching the correct use of the feet when walking: - heel-ball-toe on the forward movement and toe-ball-heel on the backward phase. When working in the shallow end check to see that the participants are in the correct depth. Sometimes participants like to work too deep where buoyancy or depth does not allow them to bring the heels down to finish the movement. They may spend half the class balancing on their toes. Make sure to do a lot of easy travel patterns for mobility rather than allowing participants to bounce around in one spot for any length of time. When bicycling, or doing other suspended work on a noodle, cue for correct ankle/foot movement to engage the water correctly.

Footwear:
Are the participants wearing shoes? People who work in bare feet often use the toes to grip the pool floor for traction or curl them up when suspended on a noodle as the foot bicycles around. . This keep the muscles of the toes “in gear” for a great part of the program leading to fatigue, overuse and possible cramping. Shoes offer a more stable base of support by allowing the feet to remain in a comfortable position throughout the program. Shoes provide traction or “grip” to the pool bottom and more “push” in both shallow and deep water. Shoes are important for participants that need stability. The more stable a person is, the more comfortable and happy he/she will be in your class.

No specific known cause:
Regarding the larger picture - there does not appear to be one specific cause of muscle cramping. Research on the subject includes general theories regarding abnormality in the mechanics that control muscle contraction, muscle fatigue, inadequate stretching, or poor overall conditioning. Other factors include dehydration, depletion of electrolytes -salts and minerals i.e. potassium, magnesium and calcium. Another contributing condition is temperature- such as working in an overheated environment or working out in hot weather.
When cramping happens frequently and becomes severe there could be other factors at the root of the problem. For instance:
• Is the participant on medication? Do they have allergies? Have they had any recent surgery? How long has the person experienced cramps?
• Do cramps occur only while exercising, or do they happen while at rest?
• Does stretching relieve the cramps?
• Is there any family history of muscle weakness or other symptoms?

Look at life outside the class:
Many older adults take one or more medications daily. Often medication for High Blood Pressure is combined with a diuretic which will deplete the electrolytes. They may also be taking medication (over the counter or prescribed by a doctor) for the pain of Arthritis, depression, or antibiotics for an infection. Many people self medicate with vitamin and/or mineral supplements. If they are taking more than one medication do they understand why, when and how to take each medication? In cases where additional medication is added on a short term basis, for allergies or for an illness, are these add on medications compatible with what is already being taken?.

If cramps are severe, happen frequently, respond poorly to simple treatments, and are not really caused by exercise the participant should check with their Doctor. They could have problems with poor circulation, a nervous-system problem, imbalance of metabolism and/or hormones or be attributed to numerous chronic illnesses. These can run the gamut from Lou Gehrig's disease, spinal nerve irritation or compression, hardening of the arteries, narrowing of the spinal canal (Stenosis), thyroid disease, chronic infections, and cirrhosis of the liver.

Remain within your level of expertise:
As fitness professionals we must stay within the limits of our expertise and stick to offering generic advice that might help - such as eating bananas for potassium, drinking water to stay hydrated and working at your own pace. In other words - eat right and exercise to stay fit and be comfortable. Make it perfectly clear that you CANNOT offer medical advice and that it is best that each affected person check with a professional. A nutritionist is the best person to check with for dietary advice; tell participants taking medication to check with their pharmacist to go over any medications that are being taken to check for compatibility. If the cramping problem persists they should visit the doctor for a routine check up which should include a blood test to rule out disease.

Good Luck!
Drusilla Leitch
WaterART Grand Master Trainer

If you would like to submit an article or comments – please do. “By contributing, you're sharing your expertise and experience. By sharing newsletters to your participants, featuring your own writing, you can enhance your own professional credibility with your participants, your facility, and your peers.”

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