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

Exercise-associated muscle cramps (EAMC) are common and frustrating for athletes and the physically active. We critically-appraised the EAMC literature to provide evidence-based treatment and prevention recommendations. While the pathophysiology of EAMC appears controversial, recent evidence suggests EAMC are due to a confluence of unique intrinsic and extrinsic factors rather than a singular etiology. The treatment of acute EAMC continues to include self-application or clinician-guided gentle static stretching until EAMC abatement. Once the painful EAMC are alleviated, clinicians can continue treatment on the sidelines by focusing on patient-specific risk factors that the clinician believes may have contributed to the genesis of EAMC. For EAMC prevention, clinicians should first perform a thorough medical history followed by identification of the patients' unique risk factors that could have coalesced to elicit EAMC. Individualizing EAMC prevention strategies will likely be more effective than generalized advice (e.g., drink more fluids).