An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps

Exercise-associated muscle cramps (EAMCs) are common and frustrating for athletes and the physically active. We critically appraised the EAMC literature to provide evidencebased treatment and prevention recommendations. Although the pathophysiology of EAMCs appears controversial, recent evidence suggests that EAMCs are due to a confluence of unique intrinsic and extrinsic factors rather than a singular cause. The treatment of acute EAMCs continues to include self-applied or clinician-guided gentle static stretching until symptoms abate. Once the painful EAMCs are alleviated, the clinician can continue treatment on the sidelines by focusing on patient-specific risk factors that may have contributed to the onset of EAMCs. For EAMC prevention, clinicians should obtain a thorough medical history and then identify any unique risk factors. Individualizing EAMC prevention strategies will likely be more effective than generalized advice (eg, drink more fluids).