It is a scenario familiar to many runners: you are hitting your goal paces and feeling great, when suddenly, calf cramps stop you in your tracks. Running cramps are physically painful – and mentally demoralizing when they strike during a race. This article will discuss what causes muscle cramps while running, how to prevent cramps while running, and how to get rid of cramps while running.
Common Types of Running Cramps
There are various types of cramping from running that you can experience. Muscle cramps (particularly calf cramps) stomach cramps, and side stitches can all happen while running. While all unpleasant, the causes of these types of cramps are different.
Exercise-associated muscle cramps are temporary but intense and painful. Muscle cramps when running occur when a muscle contracts involuntarily. These cramps are severe enough to throw off your running gait, cause you to slow down, or cause you to stop entirely. Muscle cramps when running often occur in muscles used during the particular exercise, especially those that span multiple joints (the calf, quadriceps, hamstring, etc).
Calf cramps are one of the most common types of muscle cramps when running. The causes can be similar, with a few added factors. If a runner has a forced forefoot strike or a toe strike, they might be holding their calf in a shortened position during the whole running gait. As described below, the shortened muscle position can lead to overuse and increase the risk of cramping.
Gastrointestinal cramps typically occur in the abdomen or pelvic area. You can have stomach cramps or bowel cramps. You may have stomach cramps from eating too soon before running. High exercise intensity slows intestinal motility, which can cause cramping. Dehydration is another culprit of GI cramps when running, due to its impact on gastric emptying. Food intolerances or medical issues such as IBS or IBD can also trigger stomach cramps when running.
Side stitches can occur in the stomach area, but they are different than stomach cramps. While the causes of side stitches are poorly understood, some theories suggest that they are caused by poor posture impairing diaphragm expansion.
The advice below will address muscle cramps (including cramping calves while running). However, stomach cramps involve different causes and treatments. Typically, allowing yourself enough time to digest and staying well hydrated will reduce the risk of cramping due to GI upset.
Why Do I Get Cramps When I Run?
We do not fully understand why muscle cramps occur. Muscle cramping during exercise can be difficult to replicate in laboratory settings (if often requires electrical induction vs exercise induction), which complicates the study of muscle cramping. For example, dehydration does not trigger exercise-associated muscle cramps in a lab setting, but athlete nerves or muscle overuse may be different in that controlled setting compared to during the final miles of a marathon.
Over the years, people have formulated theories for potential causes of muscle cramps:
- Heightened neuromuscular excitability
- Muscle fatigue/overuse, especially if the muscle is in a shortened position (such as the calf while running)
- Dehydration/imbalanced electrolytes
- Low muscle glycogen from inadequate fueling, low carbohydrate diet, or even poor sleep
- Genetics or muscle fiber typology (may be more common in fast-twitch muscle fibers)
- Race day nerves
- Pushing too hard for your fitness
More than likely, cramping is multifactorial. As outlined in a 2022 review in the Journal of Athletic Training, the multifactorial theory points to the interaction of various factors. The variables include environment (heat/humidity), exercise duration and intensity, hypohydration, sodium levels, low muscle glycogen, a higher percentage of fast-twitch muscle fibers (genetic), lack of sleep, medical conditions or medications, neuromuscular excitability, and muscles contracting in shortened positions.
No matter the triggers, cramping occurs when neuromuscular activity alters. When you develop a muscle cramp, the process starts when muscle damage occurs simultaneously to muscle fatigue and potentially elevated muscle temperature. In this scenario, the excitatory activity of the muscle spindle increases while the inhibitory activity of the Golgi tendon organ decreases. Meanwhile, central nervous system activity alters. This all cascades, leading to spinal alpha motor neuron activity increasing and then muscle cell membrane activity increasing. As a result, you develop a muscle cramp.
How to Prevent Cramps While Running
Train Appropriately for Your Race
If overuse and fatigue are two factors for muscle cramping, then being adequately prepared for your race can help prevent cramps while running. For most runners, there are three big training variables to consider: overall training volume, longest long run, and goal pace training.
For example, if you experienced cramping in past marathons, you may benefit from increasing your overall weekly volume, completing two to three 20-22 mile long runs, and incorporating goal marathon pace workouts into your training. Half marathons may benefit from long runs that exceed race distance (14-16 mile long runs) and goal pace workouts.
Replace Sodium and Carbohydrates
For a while, people believed that low sodium/electrolytes caused muscle cramps because of how sodium impacted electrical signals in the muscles. However, research indicates that sodium is not the only cause. Another culprit may be low muscle glycogen, because of how it contributes to muscle fatigue in a manner that alters neuromuscular function.
Some athletes may be more likely to have muscle cramps when they experience an imbalance of fluid and electrolytes. A 2019 review in Sports Medicine suggests that some athletes who are prone to cramping may experience it if they have high sweat loss without replacing sodium. But the sodium may not be the only reason that sports drinks help some cramp-prone athletes.
As noted in the 2019 and 2022 reviews, researchers concluded that a 2% carbohydrate-electrolyte drink beverage decreased electrically-induced muscle cramp susceptibility in studies. Sports drinks with carbohydrates have a glycogen-sparing effect, so muscle fatigue is less likely to occur. Possibly, it’s the combination of sodium and carbohydrates that prevents cramping in athletes, rather than just sodium alone. If you take salt tablets, then be sure you are still taking gels to replace carbohydrates.
Other electrolytes, such as magnesium, are not lost in large quantities in your sweat. Most sports drinks more than adequately replace the magnesium lost in your sweat. Since large doses of magnesium can cause gastrointestinal upset, it is not recommended to supplement magnesium during runs beyond what is in your sports drink.
However, a pre-race IV will not help reduce the risk of muscle cramps. Instead, rely on a fueling strategy that replaces lost sodium and carbohydrates during the race.
Related: A Guide to Electrolytes for Runners
Do Lower Body Strength Training
The above-cited 2022 review suggested that neuromuscular training may reduce the likelihood of muscle cramping on race day. Specifically, the researchers suggested once-per-week lower-body strength training in the three months before a race. Runners who completed weekly strength training were only 25% likely to experience muscle cramping, compared to 46% of runners who did not.
If you are prone to muscle cramps, it is worth incorporating strength training at least three months out from your race (even better, to include it regularly). Strength routines for runners do not have to be long or aggressive. 20-30 minutes once per week is long enough to reap the benefits without being too sore or tired for running.
Calm Race Day Nerves
Heightened nervous system activity from race day nerves may increase the risk of muscle cramping. Calming race day nerves may be a beneficial approach in preventing muscle cramps while running – and even if it doesn’t help with cramps, lower nerves will help with performance.
Meditation, positive self-talk, and deep breathing before a race can help some runners lower nervous system activity. For others, calming race day nerves may involve racing more often. This sort of exposure therapy reinforces that racing is not that scary. I often encourage athletes to stay off social media and do relaxing activities such as puzzles or reading before a race starts.
If you are prone to cramps and experience bad pre-race nerves, it may be worth monitoring your caffeine intake before a race. Caffeine is a performance booster. However, it is also a nervous system stimulant. While more research is needed, it is possible too much caffeine could be a tipping point for a cramp-prone athlete. Additionally, individual response to caffeine varies. Some runners experience adverse responses, such as worsened anxiety.
How to Get Rid of Cramps While Running
Even if you do everything to prevent muscle cramps, they can still occur. Some factors behind muscle cramps, such a medications and genetics, make it difficult to prevent them all of the time. If cramps happen to you, there are things you can do to get rid of cramps while running.
Stop and Stretch
Stretching is not an effective prevention strategy for cramps. However, if you experience a muscle cramp during a race, one of the most effective treatments is static stretching. If you are racing, it is worth the time to pull over and stretch the affected muscle for 30-60 seconds.
Stretching stimulates the Golgi tendon organ (GTO) – the inhibitory proprioceptor in your muscle. As discussed above, decreased inhibitory activity in the muscle is part of the cascade of events leading to cramping. By increasing the inhibitory action of the affected muscle via stretching, you can often reduce the severity of or resolve the cramping.
Importantly, you need to stretch the muscle long enough to stimulate the GTO. A few short seconds will not be enough, nor will dynamic stretches. Instead, you really want to hold that stretch for as close to a minute as you can.
Take a Pickle Juice Shot
Pickle juice may stop muscle cramps when they occur. It’s not the sodium though – it’s how ingredients such as vinegar affect neural activity. According to the 2022 review, pickle juice is an agonist to the transient receptor potential (TRP) receptors in the back of the mouth. Ingesting pickle juice triggers an oropharyngeal reflex that may stop active muscle cramping. Typically, the response is quick – within a couple of minutes if it works.
While the evidence is not as strong, other TRP agonists such as mustard or capsaicin may have a similar effect. None of these will work as a prevention against muscle cramps, though.
Trail/ultra races may have mustard and pickle juice at aid stations. If you are running a road race, you may instead want to carry packaged pickle juice shots.
Take a Salt Tablet
The research literature is not strong in supporting this measure – but many athletes report that sodium ingestion does help their muscle cramps. It is a low-risk approach, so if you get a muscle cramp, it does not hurt to try taking in more sports drink or a salt tablet. But since this approach isn’t heavily supported by the evidence, try it in conjunction with stretching.
Post-Run Recovery from Muscle Cramps
If you experience muscle cramps during a run or race, or they persist after you finish, there are post-run measures you can take to help treat the cramps.
Yes, rest! Most of the literature suggests placing yourself in a comfortable position. If you are stopping mid-race or have cramps upon finishing, seek out the medical tent. Rest allows the neuromuscular activity to calm down.
Massage the Muscle
Whether the cramp is continuing or has passed, massage can help the affected muscle. Massage aids in relieving pain and altering the neural signals that a muscle sends. It can stop the pain-spasm-pain cycle, which is especially important if cramping continues after you stop running.
More Advice on Avoiding Running Cramps
Muscle cramps are complex and not fully understood. Because so many factors may contribute to the development of muscle cramps, the management of cramping can become an individual case study. It may take trial and error to find what works. For example, strength training alone may not help, but strength training, enough carbs and sodium in the race, and calming your nerves all may help.