Database: MEDLINE <1966 to May Week 4 2002>
Search Strategy: (Muscle cramps)
------------------------------------------------------------------------------1
Muscle Cramp/dt, rh, su, th [Drug Therapy, Rehabilitation, Surgery,
Therapy] (466)
2
*Muscle Cramp/dt, rh, su, th (254)
3
limit 2 to (human and english language) (181)
4
exp sports/ or exp athletic injuries/ (49186)
5
3 and 4 (0)
6
1 and 4 (11)
7
exp exertion/ and 1 (19)
8
6 or 7 (27)
9
limit 8 to english language (25)
10
muscle cramp/ (1365)
11
4 or exp exertion/ (111575)
12
*muscle cramp/ and 11 (58)
13
exp *sports/ or exp *athletic injuries/ or exp *exertion/ (74502)
14
12 and 13 (34)
15
limit 14 to english language (30)
16
9 or 15 (45)
17
from 16 keep 1-45 (45)
18
from 17 keep 1-45 (45)
***************************
<1>
Unique Identifier
7484689
Medline Identifier
96048951
Authors
Riley JD. Antony SJ.
Institution
East Carolina University School of Medicine, Greenville, North
Carolina, USA.
Title
Leg cramps: differential diagnosis and management. [see comments.].
[Review] [25 refs]
Comments
Comment in: Am Fam Physician. 1996 May 15;53(7):2284 ; 8638504
Source
American Family Physician. 52(6):1794-8, 1995 Nov 1.
Abstract
Leg cramps are a common problem, especially in the elderly. The
differential diagnosis is extensive and includes the following
conditions: true cramps, such as those related to heat, hemodialysis and
electrolyte disturbances, as well as idiopathic cramps (the most common
type); contractures occurring in conditions such as metabolic myopathies
and thyroid disease; tetany, which is usually related to electrolyte
disturbances, and dystonias, such as occupational cramps and those
related to antipsychotic medications. Other leg problems that are not
cramps, such as restless legs syndrome and periodic leg movements, also
must be distinguished. The etiology of idiopathic leg cramps is not
clear. Treatments for leg cramps include stretching exercises, quinine
sulfate and vitamin E, but no treatment is conclusively effective.
Nonetheless, in many patients relief of symptoms is achieved with one or
more of these treatments. [References: 25]
<2>
Unique Identifier
6741897
Medline Identifier
84253668
Authors
Smith NJ.
Title
The prevention of heat disorders in sports.
Source
American Journal of Diseases of Children. 138(8):786-90, 1984 Aug.
<3>
Unique Identifier
5938206
Medline Identifier
66144193
Authors
De Vries HA.
Title
Quantitative electromyographic investigation of the spasm theory of
muscle pain.
Source
American Journal of Physical Medicine. 45(3):119-34, 1966 Jun.
<4>
Unique Identifier
8638753
Medline Identifier
96203371
Authors
Ogletree JW. Antognini JF. Gronert GA.
Institution
Nix Sports Medicine Clinic, San Antonio, Texas.
Title
Postexercise muscle cramping associated with positive malignant
hyperthermia contracture testing.
Source
American Journal of Sports Medicine. 24(1):49-51, 1996 Jan-Feb.
<5>
Unique Identifier
10496591
Medline Identifier
99424910
Authors
Noakes TD.
Title
Postexercise increase in nitric oxide in football players with muscle
cramps. [letter; comment.].
Comments
Comment on: Am J Sports Med. 1998 Nov-Dec;26(6):820-4 ; 9850785
Source
American Journal of Sports Medicine. 27(5):688-9, 1999 Sep-Oct.
<6>
Unique Identifier
9850785
Medline Identifier
99067771
Authors
Maddali S. Rodeo SA. Barnes R. Warren RF. Murrell GA.
Institution
Hospital for Special Surgery, New York, New York, USA.
Title
Postexercise increase in nitric oxide in football players with muscle
cramps. [see comments.].
Comments
Comment in: Am J Sports Med. 1999 Sep-Oct;27(5):688-9 ; 10496591
Source
American Journal of Sports Medicine. 26(6):820-4, 1998 Nov-Dec.
Abstract
Nitric oxide, a free radical inter- and intracellular messenger
molecule, is important in exercise physiology. This study tested the
hypothesis that serum nitric oxide concentrations change after strenuous
exercise with severe generalized muscle cramps. The study group consisted
of 77 professional football players in preseason training. All players'
concentrations of serum nitrite and of other serum chemicals were
determined during their preseason evaluations and compared with the
concentrations in 40 serum samples taken from 25 of those same players
who required intravenous rehydration for severe generalized muscle cramps
after a training session. Player weight and percentage of body fat were
significantly higher in players who received intravenous fluids than in
players who did not. The serum of players requiring intravenous hydration
showed evidence of skeletal muscle breakdown (increases in lactate
dehydrogenase, creatinine phosphokinase, aspartate aminotransferase, and
alanine aminotransferase) and of dehydration (elevations in protein,
blood urea nitrogen, and cholesterol). The major finding, however, was a
nearly 300% increase in serum nitrite concentrations in players requiring
rehydration. There were no correlations between concentrations of nitrate
and of any of the other serum chemicals. These data support the
hypothesis that large amounts of nitric oxide are synthesized in
professional football players after strenuous exercise with severe muscle
cramps. The study design did not allow us to determine whether this
increase in nitric oxide was due to exercise or muscle cramps or both,
but it does provide a basis for evaluating these relationships.
<7>
Unique Identifier
7059300
Medline Identifier
82134491
Authors
Ajax ET.
Title
Trapshooter's cramp.
Source
Archives of Neurology.
39(2):131-2, 1982 Feb.
<8>
Unique Identifier
10217378
Medline Identifier
99231730
Authors
Sinzinger H. Schmid P. O'Grady J.
Title
Two different types of exercise-induced muscle pain without myopathy
and CK-elevation during HMG-Co-enzyme-A-reductase inhibitor treatment.
Source
Atherosclerosis. 143(2):459-60, 1999 Apr.
<9>
Unique Identifier
3219108
Medline Identifier
89117532
Authors
Bye AM. Kan AE.
Institution
Department of Neurology, Children's Hospital, Camperdown, New South
Wales, Australia.
Title
Cramps following exercise.
Source
Australian Paediatric Journal. 24(4):258-9, 1988 Aug.
Abstract
A 13-year old boy presented with a 10-year history of severe muscle
cramps experienced an hour after prolonged exercise. There was no history
of exercise intolerance or myoglobinuria. A muscle biopsy showed a lipid
myopathy and a deficiency of muscle carnitine palmityl transferase. He
has responded to a high carbohydrate, low fat diet with added
carbohydrate intake preceding extensive exercise. Diagnosis of this
entity before an episode of rhabdomyolysis is unusual.
<10>
Unique Identifier
9773179
Medline Identifier
98446356
Authors
Herfel R. Stone CK. Koury SI. Blake JJ.
Institution
Department of Emergency Medicine, University of Kentucky College of
Medicine, Lexington 40536, USA.
Title
Iatrogenic acute hyponatraemia in a college athlete.
Source
British Journal of Sports Medicine. 32(3):257-8, 1998 Sep.
Abstract
Hyponatraemia is one of the most common electrolyte abnormalities,
leading to significant morbidity and mortality. In the most basic sense,
hyponatraemia can be due to sodium loss or fluid excess. The
extracellular fluid status is used to clinically divide hyponatraemia
into three categories to help to determine both the cause and treatment
required. Hyponatraemic patients can be categorised on the basis of their
fluid status as hypovolaemic, euvolaemic, or hypervolaemic. Another
distinction to make in evaluating hyponatraemia is whether the onset was
acute or chronic in nature. The case presented here is iatrogenic acute
hypervolaemic hyponatraemia in a college athlete. The patient presented
in respiratory distress with an altered mental status after the
administration of hypotonic fluids for treatment of muscle cramps.
Treatment included intubation, water restriction, and furosemide, to
which he responded favourably. Hyponatraemia should be in the
differential diagnosis for patients presenting after intravenous fluid
administration.
<11>
Unique Identifier
9865408
Medline Identifier
99081006
Authors
Yeung SS. Yeung EW. Wong TW.
Institution
Department of Rehabilitation Sciences, The Hong Kong Polytechnic
University, Hung Hom, Kowloon.
Title
Provision of physiotherapy at the Tsing Ma Bridge international
marathon and 10 km race in Hong Kong.
Source
British Journal of Sports Medicine. 32(4):336-7, 1998 Dec.
Abstract
This report examines the delivery of sports physiotherapy at the Tsing
Ma Bridge marathon and 10 km race in Hong Kong. The incidence, type of
injury encountered, and treatment modalities selected are examined. The
report also highlights the flexibility required when planning the
provision of such a service.
<12>
Unique Identifier
6441612
Medline Identifier
85123476
Authors
MacDonald R.
Title
Physiotherapy management of marathon musculo-skeletal casualties.
Source
British Journal of Sports Medicine. 18(4):283-5, 1984 Dec.
<13>
Unique Identifier
3926148
Medline Identifier
85253810
Authors
Norris FH. Smith RA. Denys EH.
Title
Motor neurone disease: towards better care.
Source
British Medical Journal Clinical Research Ed.. 291(6490):259-62, 1985
Jul 27.
Abstract
Even in the most severe forms of motor neurone disease--progressive
bulbar palsy and amyotrophic lateral sclerosis--the symptoms and
disabilities from progressive paralysis may be relieved in many patients
by various symptomatic treatments. Quality of life may be improved even
in the terminal stage, when narcotic administration should be considered.
The physician's proper role is to offer and carefully supervise these
treatments, not withhold them. Home care is recommended even for the most
severely paralysed, though hospice care may be a good alternative. The
underlying principle--to alleviate symptoms--applies to the management of
all progressive incurable diseases.
<14>
Unique Identifier
6301765
Medline Identifier
83181661
Authors
Smith R. Hughes RL. Borensztajn J. Segura RP. Sahgal V.
Title
Focal muscle cramps in a young man. Possible myopathy with tubular
aggregates.
Source
Chest. 83(5):795-800, 1983 May.
<15>
Unique Identifier
8223790
Medline Identifier
94039306
Authors
Minetti C. Tanji K. Chang HW. Medori R. Cordone G. DiMauro S.
Bonilla E.
Institution
Department of Neurology, College of Physicians and Surgeons of Columbia
University, New York, NY 10032.
Title
Dystrophinopathy in two young boys with exercise-induced cramps and
myoglobinuria.
Source
European Journal of Pediatrics. 152(10):848-51, 1993 Oct.
Abstract
Two young boys were referred for evaluation of metabolic myopathy
because of elevated serum levels of creatine kinase, cramps and
pigmenturia. Immunohistochemical studies of dystrophin in muscle biopsies
showed reduced intensity of the stain with a patchy and discontinuous
pattern in most fibers. In both patients dystrophin was undetectable by
immunoblotting. DNA analysis of the dystrophin gene was not informative
in one patient; in the other it revealed an in-frame deletion comprising
exons 3-6. These observations suggest that the two patients are affected
with an unusual phenotype of Becker muscular dystrophy. Dystrophin
analysis should be included in the evaluation of patients with childhoodonset of recurrent myoglobinuria.
<16>
Unique Identifier
11417373
Medline Identifier
21311047
Authors
Kanaan N. Sawaya R.
Institution
Department of Family Medicine, American University of Beirut Medical
Center, Beirut, Lebanon.
Title
Nocturnal leg cramps. Clinically mysterious and painful--but
manageable. [Review] [22 refs]
Source
Geriatrics. 56(6):34, 39-42, 2001 Jun.
Abstract
Nocturnal leg cramps are common occurrences among older, generally
healthy adults. Although there are many known causes--endocrinologic,
neurologic, and vascular disorders, treatment with certain drugs, and
occupational factors--a significant portion of cases are idiopathic.
History, physical exam, and laboratory testing can provide clues for
distinguishing between cramps with identifiable causes and idiopathic
cases. For nonidiopathic cases, management consists of treating the
underlying cause whenever possible. A nonpharmacologic approach
(massaging and stretching) is the recommended first-line treatment for
idiopathic cases. Quinine sulfate also appears to offer safe and
effective symptom management of idiopathic cases, although its efficacy
has not been definitively established in clinical trials. [References:
22]
<17>
Unique Identifier
8653105
Medline Identifier
96241651
Authors
Bergeron MF.
Institution
Department of Health Science, College of Health, University of North
Florida, Jacksonville 32224-2645, USA.
Title
Heat cramps during tennis: a case report.
Source
International Journal of Sport Nutrition. 6(1):62-8, 1996 Mar.
Abstract
A 17-year-old, nationally ranked, male tennis player (AH) had been
experiencing heat cramps during tennis match play. His medical history
and previous physical exams were unremarkable, and his in-office blood
chemistry profiles were normal. On-court evaluation and an analysis of a
3-day dietary record revealed that AH's sweat rate was extensive (2.5
L.hr-1) and that his potential daily on-court sweat sodium losses (89.8
mmol.hr of play-1) could readily exceed his average daily intake of
sodium (87.0-174.0 mmol.day-1). The combined effects of excessive and
repeated fluid and sodium losses likely predisposed AH to heat cramps
during play. AH was ultimately able to eliminate heat cramps during
competition and training by increasing his daily dietary intake of
sodium.
<18>
Unique Identifier
8653100
Medline Identifier
96241646
Authors
Clarkson PM.
Title
The elusive cramp.
Source
International Journal of Sport Nutrition.
<19>
Unique Identifier
10967873
Medline Identifier
20423582
Authors
Sandys P.
Title
6(1):1-2, 1996 Mar.
Restless leg syndrome--mechanical and cramps (Aug '99). [letter;
comment.].
Comments
Comment on: Ir Med J. 1999 Aug;92(5):362-3 ; 10522076
Source
Irish Medical Journal. 92(7):440, 1999 Nov-Dec.
<20>
Unique Identifier
10967873
Medline Identifier
20423582
Authors
Sandys P.
Title
Restless leg syndrome--mechanical and cramps (Aug '99).
Source
Irish Medical Journal. 92(7):440, 1999 Nov-Dec.
<21>
Unique Identifier
5035312
Medline Identifier
72210412
Authors
Jusic A. Dogan S. Stojanovic V.
Title
Hereditary persistent distal cramps.
Source
Journal of Neurology, Neurosurgery & Psychiatry.
Jun.
35(3):379-84, 1972
<22>
Unique Identifier
6981686
Medline Identifier
83009164
Authors
Mills KR. Newham DJ. Edwards RH.
Title
Severe muscle cramps relieved by transcutaneous nerve stimulation: a
case report.
Source
Journal of Neurology, Neurosurgery & Psychiatry. 45(6):539-42, 1982
Jun.
Abstract
The case is described of a 51-year-old man with a 21 year history of
severe, long-lasting and widespread muscle cramps. Physical examination
revealed muscle hypertrophy and fasciculation; electromyography showed
spontaneously active motor units which disappeared during sleep. Cramps
could be aborted by ice or mechanical vibration but the most effective
management was achieved using transcutaenous nerve stimulation.
<23>
Unique Identifier
2976810
Medline Identifier
89177297
Authors
Taylor DJ. Brosnan MJ. Arnold DL. Bore PJ. Styles P. Walton J.
Radda GK.
Institution
MRC Biochemical and Clinical Magnetic Resonance Unit, University of
Oxford, UK.
Title
Ca2+-ATPase deficiency in a patient with an exertional muscle pain
syndrome.
Source
Journal of Neurology, Neurosurgery & Psychiatry. 51(11):1425-33, 1988
Nov.
Abstract
31P Magnetic resonance spectroscopy studies were carried out in vivo on
skeletal muscle of a patient with verapamil-responsive, chronic,
progressive post-exertional muscle pain. A sister suffered from a similar
complaint. The results showed that the muscle: (1) decreased its high
energy phosphate content more rapidly than normal during exercise,
indicating either increased utilisation or decreased production of ATP;
(2) acidified more rapidly than normal during exercise suggesting an
increased glycolytic rate; (3) continued in some studies to acidify
markedly during the first minute after exercise, indicating that
glycolysis remained active into the recovery period; (4) had
phosphocreatine and ADP recovery rates consistent with normal rates of
oxidative phosphorylation. On the basis of these results, it was proposed
that the patient suffers from a defect in Ca2+ handling in the muscle.
Subsequently, direct measurement of Ca2+-ATPase activity in the
sarcoplasmic reticulum fraction from a muscle biopsy sample showed that
the activity of this enzyme was reduced by about 90%.
<24>
Unique Identifier
1331336
Medline Identifier
93057594
Authors
Isaacs H. Badenhorst ME.
Institution
Department of Physiology, Witwatersrand University Medical School,
Johannesburg, South Africa.
Title
Internalised capillaries, neuromyopathy and myalgia.
Source
Journal of Neurology, Neurosurgery & Psychiatry. 55(10):921-4, 1992
Oct.
Abstract
Internalised capillaries are described in the muscle fibres of two
adult males who complained of exertional myalgia. In one patient,
"bundles" of internalised capillaries were found in 2% of the Type 1
fibres and many of the Type 1 fibres exhibited non-specific
cytoarchitectural changes. The other had hereditary motor and sensory
neuropathy (HMSN) Type 2 and his muscle biopsy exhibited the more
conventional single and double internalised capillaries in 3% of the
muscle fibres in addition to the anticipated neuropathic changes.
Electron microscopy revealed the presence of paracrystalline inclusions
in the mitochondria of muscle of both patients. Dystrophin was normal on
both immunogold/silver staining and immunoblotting. Sixty five of 77
recorded patients with evidence of internalisation of capillaries have
been males and 10 are known to have complained of muscle cramps or severe
myalgia. An ischaemic pathogenetic predisposition is proposed as a
possible stimulus to the capillary internalisation, formation of
paracrystalline mitochondrial inclusions and myalgia.
<25>
Unique Identifier
7830383
Medline Identifier
95131528
Authors
Miles MP. Clarkson PM.
Institution
Department of Exercise Science, University of Massachusetts, Amherst.
Title
Exercise-induced muscle pain, soreness, and cramps. [Review] [94 refs]
Source
Journal of Sports Medicine & Physical Fitness. 34(3):203-16, 1994 Sep.
Abstract
The three types of pain related to exercise are 1) pain experienced
during or immediately following exercise, 2) delayed onset muscle
soreness, and 3) pain induced by muscle cramps. Each is characterized by
a different time course and different etiology. Pain perceived during
exercise is considered to result from a combination of factors including
acids, ions, proteins, and hormones. Although it is commonly believed
that lactic acid is responsible for this pain, evidence suggests that it
is not the only factor. However, no single factor has ever been
identified. Delayed onset muscle soreness develops 24-48 hours after
strenuous exercise biased toward eccentric (muscle lengthening) muscle
actions or strenuous endurance events like a marathon. Soreness is
accompanied by a prolonged strength loss, a reduced range of motion, and
elevated levels of creatine kinase in the blood. These are taken as
indirect indicators of muscle damage, and biopsy analysis has documented
damage to the contractile elements. The exact cause of the soreness
response is not known but thought to involve an inflammatory reaction to
the damage. Muscle cramps are sudden, intense, electrically active
contractions elicited by motor neuron hyperexcitability. Although it is
commonly assumed that cramps during exercise are the result of fluid
electrolyte imbalance induced by sweating, two studies have not supported
this. Moreover, participants in occupations that require chronic use of a
muscle but do not elicit profuse sweating, such as musicians, often
experience cramps. Fluid electrolyte imbalance may cause cramps if there
is profuse prolonged sweating such as that found in working in a hot
environment. Thus, despite the common occurrence of pain associated with
exercise, the exact cause of these pains remains a mystery. [References:
94]
<26>
Unique Identifier
11832881
Medline Identifier
21822375
Authors
Dickhuth HH. Rocker K. Niess A. Horstmann T. Mayer F. Striegel H.
Institution
Medical Clinic and Polyclinic, Department of Sports Medicine,
University of Tubingen, Tubingen, Germany. hans.herman.dickhuth@unituebingen.de
Title
Exercise-induced, persistent and generalized muscle cramps. A case
report.
Source
Journal of Sports Medicine & Physical Fitness. 42(1):92-4, 2002 Mar.
Abstract
We are reporting on a 46-year-old man who has suffered of muscle cramps
for 4 years, occurring immediately after jogging and playing tennis and
lasting for 7-8 hours. Repeated neurological, orthopedic, internal
medical and endocrinological examinations showed no pathological
findings. Physiotherapy, supplementation of fluids and electrolytes had
no effect, nor did medication therapy with muscle relaxants. During
spiroergometry without medication, there was an overproportional increase
of heart rate and respiratory rate with delayed pCO2 increase after
exercise with otherwise normal blood gas levels. This reaction was
considerably reduced during spiroergometry under beta-blockade
(metoprolol 100 mg); at the same time, the muscle cramps could no longer
be induced. Both excessive respiratory regulation and direct
hyperadrenergic stimulation should be discussed as the primary cause of
the muscle cramps. According to recent findings, b-blockers with
intrinsic sympathocomimetic activity should be avoided in therapy.
<27>
Unique Identifier
3735481
Medline Identifier
86281812
Authors
Maughan RJ.
Title
Exercise-induced muscle cramp: a prospective biochemical study in
marathon runners.
Source
Journal of Sports Sciences. 4(1):31-4, 1986 Spring.
Abstract
Exercise-induced muscle cramp has been considered to result from
disturbances of fluid and electrolyte balance resulting from excessive
sweat loss. Serum biochemical and haematological measurements were made
on 82 male marathon runners before and after a 42.2-km race. Fifteen
(18%) of the runners reported an attack of muscle cramp which occurred
after 35 +/- 6 km (mean +/- S.D.) had been covered. These subjects were
not different from the others in terms of racing performance or training
status. Serum electrolyte concentrations, including sodium and potassium,
were not different between those suffering from cramp and those not so
affected either before or after the race, although a significant (P less
than 0.001) increase in serum sodium concentrations occurred in both
groups. Serum bicarbonate concentrations fell to the same extent (from 28
to 24 mmol l-1) in both groups. Significant decreases in plasma volume,
calculated from the changes in circulating haemoglobin and haematocrit,
occurred in both groups of subjects, but there was no difference in the
extent of the haemoconcentration. The results suggest that exerciseinduced muscle cramp may not be associated with gross disturbances of
fluid and electrolyte balance.
<28>
Unique Identifier
9232553
Medline Identifier
97376443
Authors
Schwellnus MP. Derman EW. Noakes TD.
Institution
MRC/UCT Bioenergetics of Exercise Research Unit, University of Cape
Town Medical School, Newlands, South Africa.
Title
Aetiology of skeletal muscle 'cramps' during exercise: a novel
hypothesis. [Review] [45 refs]
Source
Journal of Sports Sciences. 15(3):277-85, 1997 Jun.
Abstract
The aetiology of exercise-associated muscle cramps (EAMC), defined as
'painful, spasmodic, involuntary contractions of skeletal muscle during
or immediately after physical exercise', has not been well investigated
and is therefore not well understood. This review focuses on the
physiological basis for skeletal muscle relaxation, a historical
perspective and analysis of the commonly postulated causes of EAMC, and
known facts about EAMC from recent clinical studies. Historically, the
causes of EAMC have been proposed as (1) inherited abnormalities of
substrate metabolism ('metabolic theory') (2) abnormalities of fluid
balance ('dehydration theory'), (3) abnormalities of serum electrolyte
concentrations ('electrolyte theory') and (4) extreme environmental
conditions of heat or cold ('environmental theory'). Detailed analyses of
the available scientific literature including data from recent studies do
not support these hypothesis for the causes of EAMC. In a recent study,
electromyographic (EMG) data obtained from runners during EAMC revealed
that baseline activity is increased (between spasms of cramping) and that
a reduction in the baseline EMG activity correlates well with clinical
recovery. Furthermore, during acute EAMC the EMG activity is high, and
passive stretching is effective in reducing EMG activity. This relieves
the cramp probably by invoking the inverse stretch reflex. In two animal
studies, abnormal reflex activity of the muscle spindle (increased
activity) and the Golgi tendon organ (decreased activity) has been
observed in fatigued muscle. We hypothesize that EAMC is caused by
sustained abnormal spinal reflex activity which appears to be secondary
to muscle fatigue. Local muscle fatigue is therefore responsible for
increased muscle spindle afferent and decreased Golgi tendon organ
afferent activity. Muscles which cross two joints can more easily be
placed in shortened positions during exercise and would therefore
decrease the Golgi tendon organ afferent activity. In addition, sustained
abnormal reflex activity would explain increased baseline EMG activity
between acute bouts of cramping. Finally, passive stretching invokes
afferent activity from the Golgi tendon organ, thereby relieving the
cramp and decreasing EMG activity. [References: 45]
<29>
Unique Identifier
3610693
Medline Identifier
87279229
Authors
Molea D. Murcek B. Blanken C. Burns R. Chila A. Howell J.
Title
Evaluation of two manipulative techniques in the treatment of
postexercise muscle soreness.
Source
Journal of the American Osteopathic Association. 87(7):477-83, 1987
Jul.
<30>
Unique Identifier
5826040
Medline Identifier
66001832
Authors
Balthrop E.
Title
Heat cramps secondary to skin diving.
Source
Journal of the Florida Medical Association.
<31>
Unique Identifier
7086808
Medline Identifier
82216655
Authors
52(10):714, 1965 Oct.
Joekes AM.
Title
Cramp: a review.
Source
Journal of the Royal Society of Medicine.
75(7):546-9, 1982 Jul.
<32>
Unique Identifier
8935851
Medline Identifier
97089943
Authors
Miller JM.
Title
A simple alternative to quinine for nocturnal muscle cramps.
Source
Maryland Medical Journal. 45(5):383, 1996 May.
<33>
Unique Identifier
10694128
Medline Identifier
20155820
Authors
Morton DP. Callister R.
Institution
Discipline of Human Physiology, Faculty of Medicine and Health
Sciences, The University of Newcastle, Callaghan, NSW, Australia.
darren.morton@avondale.edu.au
Title
Characteristics and etiology of exercise-related transient abdominal
pain.
Source
Medicine & Science in Sports & Exercise. 32(2):432-8, 2000 Feb.
Abstract
PURPOSE AND METHODS: In order to investigate the characteristics of the
exercise-related transient abdominal pain (ETAP) commonly referred to as
"stitch," a questionnaire was administered to a total of 965 regular
sporting participants involved in six sports. RESULTS: The percentage of
respondents claiming to have experienced ETAP within the past year for
the respective sports were: running (69%, N = 439), swimming (75%, N =
103), cycling (32%, N = 76), aerobics (52%, N = 126), basketball (47%, N
= 121), and horse riding (62%, N = 100). ETAP appears to be most
prevalent in activities that involve repetitive torso movement, either
vertical translation or longitudinal rotation. ETAP appears to be a
single condition, common in its manifestation to most sufferers, and was
described by respondents as a well-localized pain (79%), mostly
experienced in the right or left lumbar regions of the abdomen (78%). The
sensation of ETAP may be related to the severity of pain with less
intense ETAP being described as cramping, aching, or pulling, and greater
severity ETAP as sharp or stabbing in nature. Fourteen percent of
respondents indicated that they experience shoulder tip pain (STP), which
being the diaphragmatic-referred site could suggest irritation of the
diaphragm. Respondents claiming to have experienced ETAP were more likely
to report STP (r = 0.14, P < 0.01). CONCLUSIONS: The findings of the
present study provide perspective on previously suggested etiologies of
ETAP, which include diaphragmatic ischemia and stress on the visceral
"ligaments," and form the basis for examining alternative etiologies such
as cramp of the musculature and irritation of the parietal peritoneum.
<34>
Unique Identifier
10495640
Medline Identifier
99425640
Authors
Riggs JE. Schochet SS Jr. Webb RW.
Institution
West Virginia University School of Medicine, Morgantown, USA.
Title
Exertional myalgia syndrome associated with diminished serum ammonia
elevation in ischemic exercise testing.
Source
Military Medicine. 164(9):663-5, 1999 Sep.
Abstract
A 36-year-old man with chronic severe exertional myalgias had a normal
serum lactate elevation and diminished serum ammonia elevation on an
ischemic forearm exercise test (IFET). The IFET is commonly performed in
the evaluation of patients with complaints of exertional myalgias,
cramps, and rhabdomyolysis. The finding of a normal serum lactate
elevation and a diminished serum ammonia elevation after ischemic
exercise is usually considered indicative of myoadenylate deaminase
deficiency. However, myoadenylate deaminase activity was normal in this
man's muscle biopsy specimen. This case suggests that a diminished serum
ammonia elevation in the IFET is not always indicative of myoadenylate
deaminase deficiency, a disorder of ammonia production. A diminished
serum ammonia elevation in the IFET could also reflect an impairment of
net ammonia efflux from muscle into blood.
<35>
Unique Identifier
1484526
Medline Identifier
93133187
Authors
Sachdev P.
Institution
Neuropsychiatric Institute, Prince Henry Hospital, Little Bay, Sydney,
Australia.
Title
Golfers' cramp: clinical characteristics and evidence against it being
an anxiety disorder.
Source
Movement Disorders. 7(4):326-32, 1992 Oct.
Abstract
The clinical characteristics of 20 golfers suffering from golfers'
cramp or the "yips" are described. The typical description is that of a
middle-aged golfer who has played competitive golf since his teens and
develops the problem during a tournament in the form of a jerk, spasm, or
freezing of movement while putting or chipping, with the rest of the game
being relatively unaffected. The problem generally takes a chronic
fluctuating course, and a number of 'trick' strategies are partially or
fully successful. In this study, the subjects were compared with a
matched group of 20 unaffected golfers on a number of indices of
psychopathology; no significant differences emerged. The more severely
affected golfers also did not differ significantly from the mildly
affected ones, except on the subjective report of anxiety. These data
support the argument that golfers' cramp is not an anxiety disorder or a
neurosis. The important role of anxiety and arousal in its manifestation
is, nevertheless, recognized and its pathophysiology speculated upon.
<36>
Unique Identifier
10091625
Medline Identifier
99190046
Authors
Chen R. Karp BI. Goldstein SR. Bara-Jimenez W. Yaseen Z. Hallett
M.
Institution
Human Motor Control Section, National Institute of Neurological
Disorders and Stroke, Bethesda, Maryland 20892-1428, USA.
Title
Effect of muscle activity immediately after botulinum toxin injection
for writer's cramp.
Source
Movement Disorders. 14(2):307-12, 1999 Mar.
Abstract
Animal and human studies have shown that nerve stimulation enhances
some effects of botulinum toxin (btx A) injection. Voluntary muscle
activity might work similarly and would focus the effect of an injection
into the active muscles. We studied the effects of exercise immediately
after btx A injection in eight patients with writer's cramp with
established response to btx A over two injection cycles with a singleblinded, randomized, crossover design. Immediately after the first study
injection, they were randomly assigned to write continuously for 30 min
or have their hand and forearm immobilized for 30 min. Following the
second injection, they were assigned the alternate condition. Patients
were assessed just before each injection, and at 2 weeks, 6 weeks, and 3
months post-injection. Assessment included objective strength testing,
self-reported rating of benefit and weakness, and blinded evaluation of
videotapes and writing samples of the patients writing a standard
passage. Strength testing showed that the maximum weakness occurred at 2
weeks post-injection, but the benefit was maximum at 6 weeks postinjection. The "write" condition resulted in greater reduction in
strength than the "rest" condition. Btx A treatment led to improvement in
self-reported ratings, writer's cramp rating scale scores by blinded
raters, and reduction in writing time, but the differences between the
"write" and "rest" conditions were not significant. We conclude that
voluntary muscle activity immediately after btx A injection leads to
greater reduction in muscle strength. Our findings raise the possibility
that voluntary muscle activation may allow reduction of btx A doses and
favorably alter the balance of benefit and side effects of btx A
injections.
<37>
Unique Identifier
7753132
Medline Identifier
95272636
Authors
Vital C. Coquet M. Mazat JP.
Title
Mitochondrial abnormalities on the muscle biopsy of a cycling champion.
[letter; comment.].
Comments
Comment on: Muscle Nerve. 1994 Mar;17(3):305-12 ; 8107707
Source
Muscle & Nerve. 18(6):673-4, 1995 Jun.
<38>
Unique Identifier
6543911
Medline Identifier
86014189
Authors
Sufit RL. Peters HA.
Title
Nifedipine relieves exercise-exacerbated myalgias.
Source
Muscle & Nerve. 7(8):647-9, 1984 Oct.
Abstract
Three women with exercise-exacerbated myalgias refractory to usual
medications are described who responded favorably when the calcium
channel blocker, nifedipine, was administered. The side effects were
dose-related and prevented complete resolution of the symptoms. Three
potential mechanisms of action are suggested for these effects.
<39>
Unique Identifier
9486871
Medline Identifier
98146292
Authors
Operti MG. Vincent MF. Brucher JM. van den Berghe G.
Institution
Laboratory of Physiological Chemistry, International Institute of
Cellular and Molecular Pathology, UCL 75.39, Brussels, Belgium.
Title
Enzymes of the purine nucleotide cycle in muscle of patients with
exercise intolerance.
Source
Muscle & Nerve. 21(3):401-3, 1998 Mar.
Abstract
The activities of adenylosuccinate synthetase, adenylosuccinate lyase,
and adenosine monophosphate deaminase were measured in muscle from
patients suffering from fatigue and cramps following exercise. Results
denote the existence of secondary deficiencies of adenylosuccinate
synthetase and/or adenylosuccinate lyase in subjects with congenital or
acquired myopathies. They also suggest that searches are warranted for
primary deficiencies of adenylosuccinate synthetase as a cause of
exercise intolerance.
<40>
Unique Identifier
9447613
Medline Identifier
98108874
Authors
Wolfe GI. Burns DK. Krampitz D. Barohn RJ.
Institution
Department of Neurology, University of Texas Southwestern Medical
Center, Dallas 75235-8897, USA.
Title
Cylindrical spirals of myofilamentous origin associated with exertional
cramps and rhabdomyolysis.
Source
Neuromuscular Disorders. 7(8):536-8, 1997 Dec.
Abstract
We describe the presence of cylindrical spirals on muscle biopsy from a
31-year-old man who developed rhabodomyolysis following a long run. He
had a prior history of exertional cramps and myoglobinuria. His maternal
grandfather had similar symptoms. Transmission electron micrographs
demonstrated continuity between the lamellae of the cylindrical spirals
and native myofilaments. Whether these unusual structures confer a
derangement in myofilament function is uncertain.
<41>
Unique Identifier
3638656
Medline Identifier
86313018
Authors
Walker M.
Title
When the going gets hot.
Source
Nursing Times. 82(32):44-7, 1986 Aug 6-12.
<42>
Unique Identifier
1531894
Medline Identifier
92179825
Authors
Farrell JP. Drye CD.
Institution
Redwood Orthopaedic Physical Therapy, Inc., Castro Valley, California
94546.
Title
Back school programs. The young patient. [Review] [35 refs]
Source
Occupational Medicine. 7(1):55-66, 1992 Jan-Mar.
Abstract
CC's treatment goals were all met with the exception of eliminating the
AMNT sign. Slump-sit right knee extension (-15 degrees), right SLR (80
degrees coupled with dorsiflexion), and lumbar flexion (85% coupled with
neck flexion) all continued to reproduce right buttock cramping and pain.
Currently he is playing basketball without restriction, performing an
individualized exercise program that emphasizes lower extremity muscle
stretching, AMNT stretching, and advanced truncal stabilization
exercises. He has a very good understanding of body mechanics and an
awareness of safe SFP during activities of daily living and on the
basketball court. His motivation, along with the motivation of parents,
coaches, athletic trainer, and physical therapist, greatly assisted CC in
returning to competitive basketball. CC is intermittently evaluated to
monitor the AMNT sign and the effectiveness of the home exercise program.
Currently CC's AMNT appears to regress if he is not monitored on a
monthly basis; thus he warrants intermittent treatment. Monitoring of the
patient is an integral aspect of long-term management of chronic
discogenic disease that is often neglected. It can be hypothesized that
monitoring may prevent serious complications in the future for many
patients. CC is a patient who needed specific therapeutic intervention
beyond rest, general instructions about body mechanics and exercise,
modalities, and traditional back school. The history of this patient's
problem revealed that rest and general exercises had failed, thus
necessitating specific therapeutic treatment. This patient is an
excellent example of how physical therapy in the form of manual therapy,
specific therapeutic exercise, education through repetition of functional
tasks, and the team approach to patient care can lead to a successful
treatment outcome. [References: 35]
<43>
Unique Identifier
3081922
Medline Identifier
86149947
Authors
Jaffe R.
Title
Sports medicine emergencies.
Source
Primary Care; Clinics in Office Practice. 13(1):207-15, 1986 Mar.
Abstract
With the high interest in fitness and sporting activities at present,
all primary care physicians must be prepared to treat emergencies in
sports medicine. Basic knowledge, reference material, equipment, and
supplies are mandatory (see Tables 1 and 2). Unique situations may
require additional items.
<44>
Unique Identifier
9722865
Medline Identifier
98390089
Authors
Evans GF. Haller RG. Wyrick PS. Parkey RW. Fleckenstein JL.
Investigator: Blomqvist CG.
Institution
Department of Radiology, University of Texas Southwestern Medical
Center, Dallas 75235-8896, USA.
Investigator Affiliation: U TX SW Med Ctr, Dallas
Title
Submaximal delayed-onset muscle soreness: correlations between MR
imaging findings and clinical measures.
Source
Radiology. 208(3):815-20, 1998 Sep.
Abstract
PURPOSE: To assess correlations between muscle edema on magnetic
resonance (MR) images and clinical indexes of muscle injury in delayedonset muscle soreness (DOMS) produced by submaximal exercise protocols.
MATERIALS AND METHODS: Sixteen subjects performed 36 elbow flexions
("biceps curls") at one of two submaximal workloads that emphasized
eccentric contractions. Changes in MR imaging findings, plasma levels of
creatine kinase, and pain scores were correlated. RESULTS: Both exercise
protocols produced DOMS in all subjects. The best correlation was between
change in creatine kinase level and volume of muscle edema on MR images,
regardless of the workload. Correlations tended to be better with the
easier exercise protocol. CONCLUSION: Whereas many previous studies of
DOMS focused on intense exercise protocols to ensure positive results,
the present investigation showed that submaximal workloads are adequate
to produce DOMS and that correlations between conventionally measured
indexes of injury may be enhanced at lighter exercise intensities.
<45>
Unique Identifier
8784961
Medline Identifier
96379441
Authors
Bentley S.
Title
Exercise-induced muscle cramp. Proposed mechanisms and management.
[Review] [28 refs]
Source
Sports Medicine. 21(6):409-20, 1996 Jun.
Abstract
Muscle cramp is a common, painful, physiological disturbance of
skeletal muscle. Many athletes are regularly frustrated by exerciseinduced muscle cramp yet the pathogenesis remains speculative with little
scientific research on the subject. This has resulted in a perpetuation
of myths as to the cause and treatment of it. There is a need for
scientifically based protocols for the management of athletes who suffer
exercise-related muscle cramp. This article reviews the literature and
neurophysiology of muscle cramp occurring during exercise. Disturbances
at various levels of the central and peripheral nervous system and
skeletal muscle are likely to be involved in the mechanism of cramp and
may explain the diverse range of conditions in which cramp occurs. The
activity of the motor neuron is subject to a multitude of influences
including peripheral receptor sensory input, spinal reflexes, inhibitory
interneurons in the spinal cord, synaptic and neurotransmitter modulation
and descending CNS input. The muscle spindle and golgi tendon organ
proprioceptors are fundamental to the control of muscle length and tone
and the maintenance of posture. Disturbance in the activity of these
receptors may occur through faulty posture, shortened muscle length,
intense exercise and exercise to fatigue, resulting in increased motor
neuron activity and motor unit recruitment. The relaxation phase of
muscle contraction is prolonged in a fatigued muscle, raising the
likelihood of fused summation of action potentials if motor neuron
activity delivers a sustained high firing frequency. Treatment of cramp
is directed at reducing muscle spindle and motor neuron activity by
reflex inhibition and afferent stimulation. There are no proven
strategies for the prevention of exercise-induced muscle cramp but
regular muscle stretching using post-isometric relaxation techniques,
correction of muscle balance and posture, adequate conditioning for the
activity, mental preparation for competition and avoiding provocative
drugs may be beneficial. Other strategies such as incorporating
plyometrics or eccentric muscle strengthening into training programmes,
maintaining adequate carbohydrate reserves during competition or treating
myofascial trigger points are speculative and require investigation.
[References: 28]