July 2020

Is cramping cramping your style? In this article, we explain how cramping and hydration go hand in hand and what you can do to avoid issues.

Several factors contribute to cramping. Many athletes have increased their training intensity and volumes but possibly overlooked their nutritional needs to meet their supplementary training requirements.

Go back to the root cause

Dehydration may contribute to cramping in athletes along with imbalances in electrolytes and muscle fatigue.

There are a number of reasons why we may get more dehydrated. In the heat, we lose more sweat and are more prone to dehydration through both sodium and water loss. We also get dehydrated in winter. We often reduce our consumption of salads packed with magnesium-rich leafy vegetables over the cooler months and our natural inclination to drink fluids may also be reduced and our thirst mechanism sluggish over winter.

Coffee, alcohol, and some drugs (such as oral contraceptives) may also accelerate the excretion or reduce the absorption of water and electrolytes such as magnesium and calcium. Not all athletes realize they require 20% more magnesium than a sedentary person.

The adrenal gland churns through sodium, vitamin C, and magnesium when we are stressed. It is pretty rare to find a person who can honestly say they are stress-free, especially in the current environment.

How to stop cramping- a reminder of the basics

Increasing magnesium-rich foods such as spinach, broccoli, squash, peanuts, cashews, almonds, oats, brown rice and cocoa (quality chocolate can be beneficial!) pumpkin seeds, chia seeds, and yogurt may help reduce cramping in athletes. These foods may also ward off more advanced issues linked to magnesium deficiency such as fatigue, immune, bone, or cardiovascular issues.

Most athletes grossly underestimate their daily fluid needs when taking into account fluid losses from training. Endurance athletes are notorious for skipping hydration opportunities during a session (especially long-distance runners) despite large sweat losses. Many athletes are shocked at how many liters of fluid they lose in a single session and ignore the increased risk of nausea, vomiting, diarrhea, and other gastrointestinal problems due to dehydration. However, excessive fluid intake also causes issues such as hyponatremia (low sodium concentration in the blood). Therefore, knowing your sweat rate is the best way to determine how much you should be drinking during and post-exercise.

Calculating your sweat rate can be completed at home by following these simple steps:

1. Weigh yourself just before an intense one-hour session

2. Complete your session and record any fluids you had during the session

3. After your workout towel dry yourself

4. Weigh yourself again in the same clothing you had on for the session

5. The difference between the two weight measurements equates to the fluid lost per hour i.e. 1 liter = 1 kg of fluid lost. If you had fluids during your session deduct this amount i.e. 1kg of minus 200ml of fluid ingested during the run = 800ml of fluid lost.

Companies such as The Sweat Lab provide home-based sweat tests you can order online here

Post exercise rehydration

During recovery, you will continue to lose fluids through sweating and urination. Plan to replace 125-150% of this fluid deficit over the next 2-6 hours. Sip a small amount of fluids constantly over a few hours rather than sculling large amounts at once.

Make sure your daily total fluid intake includes both your exercise-associated requirements and physiological needs. Although we are led to believe 8 glasses is sufficient as a basic requirement, national health associations are now suggesting that 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) of fluids a day for women is more appropriate for adults living in temperate climates. Typically 20-30% of your hydration needs are obtained through water-containing foods and the remainder through liquids.

Athletes with a limited intake of dietary sodium (strictly whole foods diet) may benefit from adding a small pinch of sea salt to evening meals or drink bottles (except athletes with elevated blood pressure).

In some cases where magnesium depletion is significant, a magnesium supplement and adequate electrolytes may be beneficial. As with all supplements, it is best to speak with a health professional to avoid the pitfalls of self-prescribing such as gastrointestinal issues and interactions. Athletes with a history of iron or zinc deficiency should be mindful of magnesium forms. Magnesium citrate is often found in supplements as it is well absorbed and specific to muscles however long-term use may interfere with the carrier protein (ceruloplasmin) and contribute to future mineral insufficiency.

Five quick tips for boosting your overall fluid intake:

1. Keep a pot of warm herbal tea or lemon and ginger in your workspace and sip continuously

2. Enjoy a cup of bone broth, miso or soup as a snack or with dinner.

3. Increase your fluid through foods. Enjoy more “wet” dishes such as soups, casseroles or Vietnamese style Pho bowls and enjoy snacks with high water content such as cucumbers, watermelon, oranges and apples.

4. Add warming herbs and spices such as cinnamon and turmeric to your favourite smoothies or juices (made with room temperature water or warm milk and fresh fruits instead of frozen).

5. Stick to a hydration plan during training sessions and keep a record of total intake daily in your training app or journal.

About the Author Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

Tart cherries have been used for decades to treat gout and osteoarthritis, but they also contain phytochemicals which stimulate melatonin, enhance sleep, recovery and sports performance and reduce inflammation.

Tart cherries contain the phytochemicals anthocyanins, flavonoids, flavanols and phenolic acids. Tart Cherries have a higher content of anthocyanins than sweet cherries and contain potassium, calcium, iron, magnesium, vitamins A, C, B6, E, and folic acid. Some sources suggest cherries have 19 times as much vitamin A & beta carotene as strawberries and blueberries!!

Evidence supports tart cherries

A 2016 study involving soccer players found tart cherry juice is efficacious in accelerating recovery following prolonged, repeat sprint activity, movement patterns often seen in soccer, AFL and rugby. The study also supports evidence that polyphenol-rich foods such as tart cherry juice are effective in accelerating recovery following various types of strenuous exercise.

A 2010 study involving recreational male and female runners competing in the London marathon, who supplemented tart cherry juice twice daily for 5 days prior and 2 days after the marathon showed improvements in muscle strength recovery, reduction of inflammatory markers and uric acid. The athlete’s total antioxidant status was 10% greater, while oxidative stress was lower in comparison to placebo.

Studies involving trained cyclists have also shown significant benefits when using Montmorency tart cherry concentrate on reduced oxidative stress, inflammation and muscle damage across 3 days of 109 minutes of road cycling racing when used twice daily for seven consecutive days. They concluded tart cherry juice has direct application for athletes competing in scenario’s where back-to-back performances are required.

How tart cherries help

Tart cherry juice may reduce pain and accelerate recovery after exercise and decreases blood markers of inflammation/oxidative stress in both strength and endurance exercise.

1. Reduces creatine kinase (CK) a pathology marker for muscle damage and breakdown

2. Reduces inflammation -shown in studies by reductions in interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), interleukin-1-beta (IL-1-β) and C-reactive protein (CRP),

3. Reduces oxidative stress- it’s ORAC rating of 12,800 is one of the highest in the world.

4. Increases tryptophan, melatonin levels and improves sleep quality.

How to use Tart Cherry Juice for recovery and sleep

Tart cherry juice is unlikely to have beneficial effects during the adaptation/build stage of training, but when there is competition or intense training or multiday tournaments it may improve recovery. Examples of such competitions include: a rugby or AFL tournament, a marathon, a multiday cycling event, triathlon or an ultramarathon.

It is unlikely to be beneficial for consistent use where adaptation to the training stimulus is the athletes’ priority.

General recommendations found in the literature suggest having 30ml of tart cherry juice concentrate in 100ml of water twice daily. This equates to 60-90 cherries per serving.

Tart Cherry juice represents a more convenient way to ingest a large quantity of these polyphenolic compounds without associated side effects such as stomach pain or diarrhoea.

Take the 30ml in water first thing in the morning and in the evening. The evening dose is typically suggested one hour before bed to help facilitate quality sleep, which is of course an athlete’s primary innate recovery tool.

This protocol is suggested for 2-3 days post an event or strenuous training session.

We still need further research and larger studies involving athletes to substantiate claims that a preloading phase of 4-5 days prior to competition is required. It is unlikely that the compounds responsible for its benefits stay in your body long enough to accumulate over many days. Therefore, it remains questionable as to whether the loading phase is really necessary.

What to look out for and where to purchase?

There are many brands of tart cherry juice available online, in health food shops and in supermarkets.

Montmorency and Balaton TC varieties have both been studied; however, most researchers have used Montmorency brands (more predominant and widely available commercially to athletes).

Check the label on the bottle states the juice specifically contains either of these varieties.

The beneficial compounds (anthocyanins) in tart cherries are reduced with heat. Therefore it is important to source tart cherry products that are cold pressed if you wish to maximise the anthocyanin levels and possible benefits. There are a few companies who do this, so check before you purchase.

As a general rule most juices contain around 25 grams of sugar per 250mls but just remember you should only be having 30mls at a time. Low sugar options are available that contain stevia or vanilla extract but generally speaking the sugar content (3 grams per serve) is not an issue for most athletes.

You can expect to pay around $26-28 Aus for organic start cherry juice (450-950ml). The cheaper juices found in chemists or supermarkets are less likely to be cold-pressed.

We hope this information may inspire you to try something new that you may not have otherwise considered. As with all things, moderation and targeted use is more likely to yield desired benefits than overconsumption.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References:

Bell, P.G.; Walshe, I.H.; Davison, G.W.; Stevenson, E.; Howatson, G. (2014).Montmorency Cherries Reduce the Oxidative Stress and Inflammatory Responses to Repeated Days High-Intensity Stochastic Cycling. Nutrients, 6, 829-843.

Bell, P. G., Stevenson, E., Davison, G. W., & Howatson, G. (2016). The effects of montmorency tart cherry concentrate supplementation on recovery following prolonged, intermittent exercise. Nutrients, 8(7), 441.

Howatson G, McHugh MP, Hill JA, et al. (2010). Influence of tart cherry juice on indices of recovery following marathon running. Scand. J. Med. Sci. Sports 20:843–52.

McCormick, R., Peeling, P., Binnie, M., Dawson, B., & Sim, M. (2016). Effect of tart cherry juice on recovery and next day performance in well-trained Water Polo players. Journal of the International Society of Sports Nutrition, 13(1), 41.

Szalóki-Dorkó, L., Végvári, G., Ladányi, M., Ficzek, G., & Stéger-Máté, M. (2015). Degradation of anthocyanin content in sour cherry juice during heat treatment. Food technology and biotechnology, 53(3), 354-360.

Vitale, K. C., Hueglin, S., & Broad, E. (2017). Tart cherry juice in athletes: a literature review and commentary. Current Sports Medicine Reports, 16(4), 230-239.

Supplementation by athletes can be a minefield to navigate for the unwary. Whilst there may be significant value in taking additional nutrients, most of us share the view that it should always be a ‘food first’ policy. Maintaining a balanced nutrient–dense diet, is the key foundation for sports performance regardless of the level of competition.

Foods ingested in their natural format contain a package of bioavailable nutrients that help the body absorb key nutrients in ratios that are more easily assimilated than many supplements, and no volume of supplements can make-up for a poor diet. Athletes undertaking regular hard training sessions, may however benefit from taking supplements to maintain nutrient sufficiency and to maintain optimal health.

Supplementation by athletes should ideally focus on only high-quality supplements that are more likely to contain nutrients in beneficial ratios and bioavailable forms. Unfortunately, supplements may not contain all the active ingredients and compounds found in nature. Poor quality (and often cheaper) supplements may contain artificial forms of nutrients that are more difficult for the body to absorb. Retail products may also be formulated in doses below the therapeutic range required for health benefits. The storage and manufacturing processes of some supplements may also be questionable. Investigations of cheaper supplements such as fish oil may be rancid! Supplementation by athletes does have its place. It just isn’t practical to expect anyone to eat 2 buckets of spinach a day! Some nutrients are difficult to obtain purely from food sources when an athlete has high demands, digestion issues, illness, dietary restrictions or nutrient depletion. Iron, iodine, vitamin C and vitamin B12 are just some of the nutrients that fall into this category.

A 2015 study showed up to 70% of athletes use some form of supplement. This study by Outram and Stewart (2015) also revealed between 10-15% of supplements contained banned substances and over 80% did not contain what the label said. Competing athletes are typically aware of known banned substances but some are unaware of the considerable risk of accidental or inadvertent doping through using supplements.

If you are taking supplements and likely to be drug tested either in or out of competition in the future, the general guidelines below may be helpful. Some athletes are currently not in competition but still need to be aware there is no guarantee that taking “at risk” supplements will be out of your system when testing and competition resume.

Avoid imports
Imported supplements purchased online may sometimes appear to be cheaper but come at a huge cost to your sporting career. There are a number of issues to consider. Product quality can be difficult to ascertain due to being produced under different standards and labelling laws from those imposed on us from the Therapeutic Goods Association (TGA) in Australia. All ingredients may not be listed on the label of an imported product and this may put athletes at significant risk of testing positive to a banned substance. In the USA, dietary supplements are classified as a subcategory of food, exempting manufacturers from providing pre-market evidence of product safety and efficacy. The U.S. Food and Drug Administration (FDA) cannot inspect supplements until after the products have entered the marketplace and some disreputable manufacturers have spiked products with drugs such as anabolic steroids and amphetamines.

Know your banned substances
Always check labels and know the banned substance list for your specific sport both in and out of competition. The list of banned drugs and substances can be found on the ASADA website and substances can be checked here. If you are likely to be competing internationally, it would be wise to also look at the WADA guidelines here. Just because the substance does not appear on the prohibited list, does not mean it is 100% ok to ingest. The rules change frequently and supplements and other over the counter drugs may have different names from what appears on the list. Substances such as Bupropion, caffeine, nicotine and phenylephrine are included in the WADA 2020 Monitoring Program and their status may change at any time. If in doubt, avoid the substance.

Health foods and natural products
Some health food products and herbal medicines should still be avoided even if they are not on the banned list if you are unable to be assured of their purity and quality. For example, maca powder taken to support hormone function, energy and sports performance is one natural food product that is at risk of contamination. Tribulus is another product to be weary of. The Australian Institute of Sport (AIS) states “these products do not appear on the WADA list and are thus not specifically banned. However, they are often found in multi-ingredient products that contain banned ingredients or are at high risk of being contaminated. Therefore, they are not recommended for use.” See the AIS Supplement Group D list here .

Supplementation by athletes -Consider certified
Common sports supplements such as magnesium, probiotics, vitamin C, protein powders, creatinine etc. are now being batch tested and certified. Human and Supplement Testing Australia (HASTA) is an Australian commercial product testing organisation for WADA and has a certification scheme. Certifying a product involves not just multiple batch testing, but verification of the manufacturing quality controls that are in place and site inspections. If a product has been “HASTA Certified” it means that every batch has been tested for over 200 WADA prohibited substances.

Informed Sport also conduct supplementation testing on international sports nutrition brands. You can read more about the Informed Sport certification process here and HASTA process here

The same supplements should not be more expensive than usual just because they are batch tested.

Are there any guarantees?
No. Supplements screened by Hasta and Informed Sport cannot offer a 100% guarantee that an athlete will not test positive, but they are significantly less risky than other supplements. As batch testing is very expensive, limited supplements are available despite some manufacturers having large product ranges. If you have purchased a Hasta certified product, always check your supplement bottle has been batch tested. If your supplement does not come with a Hasta certificate, you are unable to safely assume it has been batch tested.

Are certified products better quality?
Unfortunately no. Companies that can afford to undertake the rigorous and expensive certification process may have some products included. Smaller companies that produce high quality products, may not be on the list. Just because a product is certified, does not mean they are suitable for you. Athletes still need to choose supplements with bioavailable forms of nutrients and take sufficient amounts to reach therapeutic levels and health benefits. There are Hasta certified products from reputable companies that I recommend frequently but it may be difficult for an athlete to choose suitable options if they just scroll through the list of supplement options.

Therefore, if you are a competing athlete, we suggest always checking with a qualified practitioner before self-prescribing any supplement, even if it appears to be batch tested or packaged as ‘food grade’ at the health food shop. Batch tested supplements are available through the Athlete Sanctuary.

We hope you found this information useful. If you would like further guidance with your supplementation protocol or health concerns, please get in touch.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

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