How To Prevent Cramping with Physiotherapist Matt Donnelly

This episode of the Get Fast podcast is brought to you by Trivalo Coaching, where we help triathletes and cyclists like you train smarter to race faster. You are joined, as always, on every podcast by your hosts. We have former Australian Ironman champion, Jared Donnelly, and I am Jordan Donnelly. On this episode of the podcast, we are really excited because we have another member of the Donnelly family joining us. We have the middle brother of the Donnelly family, Matt. Matt Donnelly is a physiotherapist. He's been working as a physiotherapist for the last 10 years or 8 to 10 years. And he is an in house physiotherapist at Trivello Coaching and he is currently studying a postgraduate study in musculoskeletal physiotherapy. And most importantly, we actually turned to Matt and Matt provides us with a lot of research articles and knowledge on athletic performance injury. And today's topic, which we're really excited to dive into, is cramping. Cramping is something that is a really big problem for a lot of endurance athletes. It's something that causes a lot of confusion and clarity can really help with this issue. And it's a pretty crazy topic to talk about, as you'll find out in the episode. But I absolutely loved this episode because the conversations that we have, Matt, outside of the podcast have been really helpful for you and I, dad, in terms of our own personal experience with cramping. And we want the listeners to be able to hear the same thing if they're experiencing cramps themselves. So what did you like about the episode?

Yeah, look, Matt always brings really good theory to the table and he's a person who's always been a very well read. Even when I was a little boy, he was reading while you guys were playing games, he was in the corner reading and finding out about stuff. And you know, before the Internet came along, Matt was the Internet in our family. He could answer almost everything. And it's been something that's been valuable to me and to yourself in all aspects of training and exercise, asking Matt for advice on certain things because he does do so much research and he's had so many experiences with different sorts of athletes over the journey that he's been a physio. And yeah, that to me was what I really enjoyed about this episode was him really cutting out all the myths, giving us clarity on what is happening with cramping, what's causing it and what are the things we could possibly try. But there's no evidence to Say that these are solutions. These things work for you and I. We've got strategies, and Matt's helped us to formulate these over the journey. And I'm really grateful to him for his knowledge and his expertise in this area. And. And it really made me quite shocked to see that, you know, we really don't understand cramping from a scientific point of view very much at all. And that's Matt's real summary, is that there's so much more to learn in this field because no one's got a good grasp of what's actually happening.

Absolutely. So without further ado, we'll let you get into the episode. It was a really good one, and like you said, Matt is the academic of the family, so we can't wait for you to hear this one. It was a beauty. Without further ado, here is Matt. So, Matt, another member of the Donnelly family, joins us on the podcast. We're slowly ticking it off. I think slowly we're going to get every member of the family on here at one point or another. Welcome to the podcast. Start by introducing yourself a little bit and your background with sport and physiotherapy.

Yeah, sure. Thanks for having me on, guys. So I've been a physio for the last eight years, working in and out of different hospital organizations based around Melbourne. Obviously grew up loving cross country and athletics and all the other sports that dad got us to do. Growing up, really interested in muscle injuries and muscle stuff. There's lots of different fields you can get into in physio, but I'm definitely the stereotypical physio that everybody thinks of when they think of physio. So I deal with muscle injuries, bone injuries, tendon injuries, and I'm actually doing a bit of study back at uni, doing some postgrad, studying muscle stuff, which is pretty exciting.

Awesome. So one of the main topics we wanted to talk about today is cramping, and there are a wide range of topics we could talk about with musculoskeletal injury and performance, but often we find ourselves, us three, talking about cramping, and it's a really common issue in endurance sports, so we're going to dive straight into that because it's a pretty wild topic and it's, as you would say, relatively. Everything's kind of relatively unproven with cramping. So what. Why don't you start off by talking to us about what cramping is?

Well, as its basic definition, there's actually three types of cramping that are talked about. In literature. So there's obviously the unexplained night cramping, and there's some cramping that's associated with different diseases like diabetes and things. But the one that I'm really interested in, we're going to talk about today is exercise associated muscle cramp, which is its own specific thing they talk about in the scientific research. And so they define that as a painful or involuntary contraction of muscle which occurs immediately after or during exercise. And there's a little bit to unpack there, if you don't mind me going into it in a bit more detail.

Absolutely.

So to start off with, like, it's really important to understand how do muscle contractions work in the first place? So it's not actually something we think about in a lot of detail. But if you're taking a stride when you're running or pushing through the bike, your brain has to send individual signals to every single muscle in your leg to do that action. And it's not something you're doing constantly, consciously, it's happening constantly at an unconscious level. But there are neural signals going from your brain to your muscles. And so it's thought that cramping is associated with an alteration of those signals or those signals not quite working the way they're meant to.

Would that be the muscle sending messages back to the brain, or is it the brain depicting something happening in the muscle activity?

It's both. So there's that constant feedback loop that they need to communicate with each other and talk to each other. And there's two different types of signal pathways that happen. There's the excitatory impulses which tell your muscles to contract, and then there's the inhibitory impulses which tell them don't contract that much. Because if you're thinking about running, you're not contracting your calves, hamstrings and quads 100%. With every stride it's balanced. You've got a, um, depending on how fast you want to run or what pace you want to run it, you're going to contract your muscle to a certain extent, but it's not going to be that hundred percent maximal possible force you can possibly produce, because you have to have that balance when you're doing a task as well, between the muscles that propel you forward and the muscles that control you and stop you from going out of control. So, for example, if you think about when you're running and you straighten your knee to take that next stride forwards, obviously your quads have to contract, but at the same time your Hamstrings have to contract to make sure that your knee doesn't go flying out uncontrollably in front of you. So there has to be that balance between the two muscles. And so it's that neural drive that's coming from your brain, how to define how much each muscle contracts or relaxes. And it's actually a really fine balance. And that's something that we train over many, many, many years to get better at a skill.

So getting back to the question of what is cramping? So there's many reasons why the muscle and the brain decide to stop you from exercising. And cramping is the end result, isn't it?

Yeah. There's lots of different factors that can contribute to cramps. And there's a lot of myths around what causes cramps as well.

Just before we get to the myths, can we just establish what is the cramping?

Yeah, it's the involuntary contraction. So it's when the neural signals get mixed up and your muscle spasms and contracts at full force when it's not meant to and you're not wanting to.

Great. So that little spasm that I, for example, get whilst I've done a big day session and I can sit on the couch and I can just see my. My calves involuntarily twitching and that is generally the precursor to what's going to happen in the next five minutes, which is I'm going to get a massive cramp in my car.

Yep.

Is that sort of some of the pathway indicated?

Yes. Well, because cramps can happen up to eight hours after a really intense exercise session, they can happen right at the end. And in fact, they're most common towards the end of a race or towards the end of a footy match or a soccer match or something, they never happen at start. And depending on the person, because your genetics can influence how severe they are or how intense they are, you can still, hours after you finish the race, have cramping depending on the person and depending what you've done.

So, Matt, that establishes what cramping is. It's involuntary muscle contraction. And if you've ever had a cramp, then you know it's totally involuntary because you jerk and it really shocks you. So based on the fact that you're saying it's a neurological almost malfunction, it's your muscle cramping when or your brain telling your muscle cramping when it shouldn't, why do we think it's so nutrition based, then? Start by telling me what are the causes of cramping because a lot of the perception out there is nutrition, I.

Guess I've been probably jumping a little bit ahead. So if we're taking the pure definition of cramping, it's just that it's an involuntary contraction and it's as simple as that. And that's as clear as the research gets. And from there it gets really, really murky and there's actually not a lot of clarity around it. So the theory that I've been talking about so far is the neuromuscular fatigue theory, which is probably the one that's got the most evidence behind it for what causes muscle cramping. The other theories are a bit more well known. So the idea that dehydration causes cramping, which is pretty well refuted by now, and the second theory, which is all about electrolytes and electrolyte imbalances causing cramps. And again, that has a lot of very weak evidence surrounding it. And certainly when I've listened to sports doctors giving lectures and presentations, dehydration and electrolytes causing cramp is pretty out now. They're really thinking that neuromuscular fatigue is what causes cramps nowadays. Although there is lots more research that needs to be done in this field. And there's lots of things that they still don't know about cramping, which is.

Surprising because anecdotally, if you speak to a lot of endurance athletes, they will have felt that when they replace their electrolytes or their salt level, the cramps seem to go away. And so that might be where that conception comes from. Yeah, perhaps.

But certainly when they've tried to do that in randomized control trials, they found it makes absolutely no difference.

So what are you saying, Matt? That it's the muscle just getting fatigued from the same action over and over again that can't sustain it due to what other factors?

Yeah, and fatigue in of itself is a really interesting thought to unpack because what contributes to fatigue? What things make fatigue worse? So, for example, we know that exercising in a hot, humid conditions is going to make you more fatigued. We know that stress and psychological well being is going to lead to increased fatigue if it's in the negative spectrum. We know that increased exercise intensity or duration is going to lead to more fatigue. Inadequate conditioning or inadequate preparation before a race is going to lead to further conditioning and faster fatigue. And it's really all those factors put together that make your fatigue faster in a race than you might otherwise do.

So just to be a little bit controversial, so, you know, if you didn't drink or fuel in an endurance sport, you're going to tell me that that'll be okay and it's not a contributing factor to cramping?

Well, because we're talking about, obviously you need fuel to exercise and you need nutrition and water and fluid to exercise. And that's totally separate issue to cramping because if you haven't got the energy stores to run and it doesn't matter if you're cramping or not, you won't finish the race. And there's no way you can get through an ironman without adequate nutrition and adequate hydration. However, those things don't have any impact on cramping.

So that's a really good point to make. And we're not sitting here saying that you don't need to fuel and have the right nutrition and a lot of electrolyte level, the right hydration level. That's not what we're saying. And, and that has to be made, really. The evidence is saying that that's not the link to cramp, but that's obvious that you need that in endurance.

Yeah, yeah. Because if you could think about. And even you can break down fatigue into peripheral fatigue or central fatigue. So peripheral fatigue being obviously your muscles are working hard, they're producing chemicals, they're burning glycogen, they're breaking down other different bits and pieces producing lactic acid. So in order to help manage that, you need adequate glycogen stores, you need adequate energy levels. You're obviously sweating constantly during a race. And you've raced in Hawaii before. You know how brutal the heat can be. Don't tell me you could have done that without having a drink of water once during that race.

The hydration is just so important and so is the fueling. They're two separate entities anyway. But just getting back to the cramping. So, so the repeated continuous, such as running exercise, such as running, such as screaming, such as pedaling, you know, you just, you're using the same muscle groups repeatedly in endurance sport. And I know myself if I go high explosive efforts repeatedly in 10 minutes, I could possibly bring on a cramp. And it doesn't have to be endurance. That's.

Yep.

That's one of the things I'm really interested in because I have been in a short hard or high intensity criterium and within the 10 minute mark, I've sustained a cramp.

Yeah. And in the research they've done, and they've actually done a couple of studies in ironman athletes, which is awesome. It's cramping is associated with higher intensity exercise. And even it's really interesting if you took athletes that say they did a faster race time than their previous PB were more likely to cramp, or athletes that maybe had come into the event a bit under conditioned compared to what they normally would be were more likely to cramp. The other thing that a history of cramping made you more likely to cramp as well. So there's probably some people out there who are maybe a bit more genetically disposed to cramping than others. Even things like your height and weight may have an impact from one study they looked at. Or if you've had previous injuries or if you've had previous tendon or muscle issues, then that might increase your risk as well. But the main thing is that association between high intensity exercise and fatigue leading to cramp.

So a weakness in the muscle and unable to be doing repeated efforts at high intensity is going to expose a weakened muscle. Is that one of the things you're saying?

Yeah. Well, to contract a muscle you need adequate neural drive. You need to get those messages from your brain to your muscle. And the more rehabbed or trained a muscle is, the more efficient those signals are going to go from your brain to your muscle. It's that idea of neuroplasticity, being able to train your brain to do stuff. And the more you train your brain to do something, the better it gets at spitting out those signals repeatedly. It's why the things like the 10,000 hour rule exist, how the more you practice something, the better you get at it. So someone who's practiced running a triathlon for years and years and years worth of training, their muscles are going to be finely tuned to receiving those inputs from their brain about what they're meant to be doing. Now I would consider you, Jared, a very finely tuned athlete. But you still cramp when you do stuff that pushes you beyond your limits. Like when you raced, what was the event you did? 250ks in one day?

Yeah. How can you forget, Matt?

I couldn't remember the name. What was it called?

You were sitting in the car for seven hours behind me.

I was. I remember the race vividly. I just mental blanked on the name. So yeah, when you were racing Warrnambool, yes, you are incredibly fit athlete, but how many times a year do you ride? 270km?

Yeah, not a great deal. But the point you were making before is I've never ridden the first hour and a half at my highest intensity. And that was the reason. And you've hit it on the, on the head. You know, I sustained massive cramps at 100K because my first hundred K was riding with, you know, the NRS Elite Riders of Australia. And I'm a 60 year old trying to ride my tempo, which is going to cause some issues. And it clearly did. So it's a really good example you've given.

But on that note, I mean, you agree that dad is a highly trained athlete and you called him Jared before and we can call him dad on this podcast, but he is a highly trained athlete. So why is he still getting, you know, calf cramps when it's not? I mean, Warrnambool is an extreme example, but dad, you would just do an endurance ride or something and, or do a criterium and get calf gramps that night on the couch.

So yeah, it can, there's. I would say it's linked back to the fatigue element as well. And just because you're used to training doesn't mean that particular session you didn't push yourself maybe beyond what you have done recently. Maybe your accumulated fatigue from the last couple of weeks of training has built up because, you know, that training load does contribute to overall fatigue. And that's why we train in blocks rather than just smash you harder and harder and harder for 12 months straight. You need to have rest breaks, know you. You need to have periods where you settle down your training a bit. The other thing to consider, sorry, dad. Is age. As you get older, you're more likely to cramp.

Oh, that's crap. I cramped as a 27 year old cramping. The same. The history thing you said before. Genetic history of cramping. I'm intrigued about that.

That was my next question as well, because is there in the literature a strong link genetically? Because the experience dad talks about with his calf, I mean, I sent you a video of my calf doing the exact same thing. Matt, I don't really want to hear that it's genetic.

Yeah, it's not very strongly proven. It's more that. Because the way they do these research things is they make people fill out pages and pages worth of surveys and they found that people who have a history of cramping are more likely to cramp. And so the people that cramped their whole lives are more likely to cramp after an event. Which you would conclude means that there's got to be some kind of genetic involvement. What that is or what it looks like. I haven't found any concrete answers how that works. So it's obviously still a work in progress, but it does seem to be that if you cramp lots before, you're probably predisposed to cramping lots in the future. Unfortunately.

That brings us to a really good point. Part of the conversation that I really just want to clarify this, and you've said this to me many times in conversations, man, I just want to really make this point, is that you said before, you know, we can establish what cramping is as a definition. It's involuntary muscle contraction. But apart from that, everything gets pretty murky. And I think that's a really important point to reiterate, is that the rest we really don't really know, do we?

No, not at all. So there's lots of really good research that's coming out. And so this is where this neuromuscular fatigue argument is coming from, that this is probably the best evidence we have so far. But I think what people. And this always surprised me when I'm doing research or I'm doing further study is there's so many areas of the human body that we just don't know enough about. And even the leaps and bounds we've taken in medicine in the past 20 years versus the last two centuries of medical research, like, we're always learning stuff, we're always learning new things. And so this is our best guess so far. But it might be proven to be total crap in 50 years. We don't know. But I think there's definitely some merit in the arguments that people are putting forward for this theory, and I think it makes sense in practice. So I'm really happy to talk about it more now and talk about how we can use it to examine our training, examine our race days, and use that as a bit of an idea of what we can do about it.

It's so interesting, this whole area, and especially when I've been a history of a cramper, and it's, you know, it's nothing more frustrating and infuriating to be. To be well prepared in every aspect of your race, preparation and for you to be prevented from executing what you want to do because of a cramp. And it's debilitating. You can't continue. You know, there's been examples of people having to pull out because of cramping. And, you know, one of the things, you know, you experience with me and you and I have talked about this a lot, and we've experimented on myself in training since those events was. We'll talk about that in a minute. You know, how do we prevent cramp? But we've experimented already with, with changing a few things, the neuromuscular pathway from the brain to the muscle. But the thing I'm sort of saying here is, you know, there's things that we can, we can control and there's things that we can't. And it seems like the cramping is something that's really out of our control and we can only concentrate on nutrition, electrolyte being fitter, training at higher intensity than the event would probably require. And that's one of the things that I found out. If we just keep taking the Warrnambool as an example, and if I use Kona, the year where I was possibly going to finish in the top five or six and cramp got me with literally 3k to go, you know, the intensity of that event was above what I'd been doing ever in my life before. So that. That's an example of the same with the Warrnambool. The intensity of that event was above what I trained at. And so what I'm trying to get across is there are things we can do about it. We don't have evidence that tell us that that's right or wrong. But from the experimenting that I'm doing, it definitely is proving to me that there's training above what the expectation and the level of intensity of the race is going to prevent that from. From rearing its head when it really matters.

Well, it comes back to common sense training principles. So if you know that you've got to have a certain level of fitness to complete a big race or do well in a big race, then you need to train for that level. And if you're not prepared for an event when it comes up and you try and push yourself harder than you possibly can, you're going to struggle. So, for example, the Puffing Billy Fun run, which is 14k, is really popular fun run for lots of people to do, but it's 14Ks of hills. And so if you're not for an amateur athlete who doesn't run a lot, if the longest distance you've ever run is 5k and you try and enter that event, you're going to struggle. There's just no way of getting around that. And so when it comes to this other stuff, like you're doing other big races, your preparation is so important.

So let's circle that back to now that we know that there's lack of evidence for exactly what causes it. What do we know? And you said this before, what do we know? Are Actual myths. And you said that there are some things that evidence shows dehydration really strongly doesn't, doesn't cause it. And we know that.

So, for example, the idea that electrolyte loss causes cramp is pretty well debunked as a theory. And so sport drinks and electrolyte drinks might help you recover your energy levels, but they're going to do absolutely nothing for cramping.

Stop you there. That is a necessary part of an endurance or any sporting activity. You need to continually replace those things as you're losing them. So we're not saying not to do that in your event or in your training. We're saying it just doesn't relate to cramping.

That's the only thing that's right. And things they've looked into other supplements like magnesium. So for example, bananas are really popular. High home idea for treating cramp. Also has no evidence. Might be really good again for restoring your energy levels at a halftime break at a footy game. Having something to get your energy levels going again. Or bananas are still an incredibly popular snack in elite tennis matches around the world and even in the Australian Open when we used to work there. But is it going to do anything for cramping? The research says no.

Pickle juice is another one we've experimented with.

Yeah, I was reading about that again. Yeah, Not a lot of evidence to suggest that it's going to be helpful.

Anecdotally though, there is. There is so much experience of athletes literally getting the pickle juice to touch their lips and this is the theory behind it anyway. And their cramp goes away. So.

Well, it's really interesting. I was reading a nutrition article from this year and I was thinking. Because originally they were thinking that pickle juice was related to certain proteins and things they were looking at and electrolyte related things. But they're actually thinking it wasn't necessarily the electrolytes. It might have been a very, very specific acid that happens to be in pickle juice and happens to be in a couple of other products. And that may or may not help. They couldn't really find conclusive evidence either way. So that's why that one is a little bit more interesting than your electrolyte drinks. But again, it has nothing to do with electrolytes. It might have to do with some other random chemical that they're still looking into. But yeah, your Gatorades and your power aids aren't going to do anything for Grant.

So we talked about the brain sending messages and that cycle between the muscle, the brain and working backwards and forwards and basically talking to each other. You and I have trialed this and we're suggesting that the research is telling us about changing the pathway where we're trying to stop the brain to send a message to the muscle to cramp, because the brain is sending a message saying, you've overdone it. I'm going to stop you from getting injured by giving you a crank. And we're experimenting that with trying to break that pathway.

I'll unpack that a little bit more. So, for example, when we think of pain and when we think of fatigue, we think of them in terms of protective mechanisms and we think of them in terms of, okay, if I were to push myself to my absolute maximal limit, completely ignoring pain, there's a risk I might hurt myself, I might do a muscle injury, I might do a tendon injury or something. So we sometimes need a healthy amount of sensory input from our body telling us what's going on and saying, ah, this is, I'm stuffed, I probably shouldn't push this hard, otherwise I'm gonna hurt myself or otherwise I'm gonna do some damage. And it's really interesting because pain isn't necessarily associated with actual damage. It can be associated with potential damage or resembling tissue damage. So there's this constant back and forth with your brain trying to figure out, is this too much or is this okay? And so if you've analyzed the situation and you're looking at yourself going, yes, I'm cramping, but otherwise, the Warrnambool race is a really good example. You cramped in the first hundred kilometers and you said, okay, clearly I'm overdoing it. I'm pushing way too hard. I can't keep this up for another hundred and seventy kilometres. I need to back off a bit. And so you dropped off the back of those young guys who are in the elite teams from around the world, and your race became much more manageable. And so that warning signal that's going off in your brain saying this is too much, this is unsustainable, backs off because you've made adjustments, you've adapted to your environment. And even if we're thinking about how you can respond to those situations, you can. There's two extremes of response. There's the people who they push through no matter what, and they try and tough it out. And sometimes that can be helpful and sometimes that can be really harmful as well. And then there's the other extreme of people who they get a slight twinge of pain or a slight twinge of fatigue and they'll completely back out of the race or they'll completely stop training. And that may or may not be helpful as well. So the two extremes of thought in response to pain and fatigue, that it's more beneficial to have a middle ground where you're looking at the contributing factors and going, ah, what's going on here? I'm fatigued, I'm really hot. I'm training or exercising way harder than I ever have. Maybe I do need to make some adjustments. Maybe I do need to slow down. What is it happening in the context of the day? Is this the biggest race of your life and you probably you'll happily push through and risk things happening because this is the thing you've been dreaming of, this is the thing you've been hoping and working towards? Or are you cramping on a Monday afternoon recovery ride? Then maybe you don't need to push yourself that hard or you're cramping in the first session of preseason training of leading up to competition season. The context around your decision making makes a big impact as well. About all right, should I listen to my body back off a bit or am I okay to keep going? And it'll change situation to situation, and even how you're feeling in yourself is going to impact those decisions as well. And we know that our psychological mood has a huge impact on pain and lots of other factors that go on in your brain. So stress as well has a really big impact. So putting all those together, all those really complex factors that make up not just how our muscles work, but how our whole body works is really important to understanding what to do in a given situation.

I resonate with that to the most extreme level possible, because in my own experience with cramping, and I'm similar to that, I've really struggled with cramping in a lot of different scenarios and really experimented a lot with you and dad on different things, just like you've experimented a lot, dad and I. It's probably a myth that you've just debunked there, Matt, which is that once you cramp, that's it, like your body's done. That's what I used to believe, and I don't think that's necessarily true at all, because in situations you can relax your body and you can stop that process of the muscles over firing and cramping. And for me personally, I used to think once my body cramped, that was it, I was done. I wasn't going to recover, I wasn't going to be able to perform anymore. But the moment I. The one thing that actually helped me. Again, this is totally anecdotal, but I tried a lot of things, especially in footy games. I used to cramp in the third quarter of every footy game. And every game I tried something different. I tried different nutrition levels, different hydration levels, different tactics. Eventually, the only thing that stopped it was just relaxing and not feeling so psychologically stressed about the cramp. And if the cramp came on, not thinking that that was it, game done, and just relaxing through the cramp, and then I'll be able to play out the fourth quarter. And I think, dad, you've had a similar experience like that experience with Warrnambool. You know, for a lot of people, cramping at 100k mark would mean race over. And you said, no, I'm gonna have to finish the race. So you chose a different tactic. Yeah, I really resonate with that hard.

And Matt's talked me through a lot of those things. And I've been experimenting on some of our endurance Saturdays during winter, during COVID where we've been doing the example I'm going to give you, we started doing an endurance ride on the trainer indoor. And to ride more than two hours on the indoor trainer in the last 10 years, you would say, someone's gone mad. Um, but, you know, I eventually went from two hours to three to four to five to six. So. So I've done six hours on an indoor trainer at reasonably high intensity and getting various levels of cramp throughout that period of four months on a Saturday. And. And Matt suggested that I try things where I'm breaking the thought pattern from my head to my muscles. And that's what I concentrated on a bit what you were talking about, Jordan. You know, I could feel the cramps coming on at certain parts during that Saturday endurance ride. And in that endurance ride, it had lots of high intensity in amongst the endurance. We did races, we had a rest, and we did another race, and we do heel repeats. And the thing that really helped me was to try almost like examples I'll give is if I use smelling salts so that my brain stopped concentrating on the cramp. It took away my thought process about my muscles going to cramp, or I started chewing a little bit of whatever I had, But I don't ever eat any food. So again, that's a foreign example to the brain. And it's saying, what are you doing now you're eating? Or the pickle juice? You know, you've got this sour taste on your Mouth and the brain stops concentrating on the cramp pathway, was more concentrating on what the hell I'm doing to myself. It's tricking, almost tricking itself into, well.

What you're talking about. There is something that goes on in a lot of pain research and a lot of pain practical pain strategies. Now, in terms of using this stuff for cramp, it's completely hypothetical. Like you said, we're trying stuff, we're giving it a go. But these specific practical strategies haven't got a lot of evidence that I've seen behind them. But I'm more making links between, well, if this works in this scenario, how about we try it here and see what happens? And I'm the first to admit that it's not going to work for everyone. But for example, if we're talking about pain, one of the things that we use in some of the chronic pain clinics I've worked in is the idea that your brain can only concentrate on so many things at once and you can only consciously concentrate on so many things at once. And so a really powerful technique we use with managing pain is mindfulness. So if you're constantly thinking about, my knee sore, my knee sore, my knee sore, my knee sore. Jordan, how's your knee feeling?

Yeah, you focus on how sore it is.

Yeah, exactly. And if you're constantly focused on that, do you reckon that's going to make you relaxed or stressed?

Absolutely stressed, yep.

And then combine that with, this is the biggest race day of your life. How's your stress levels?

Yeah, yeah, through the roof.

So one of the things we can do is like, try and selectively draw your attention elsewhere. So, for example, if you're competing in the biggest event of your life, a once in a lifetime achievement. So, for example, Hawaii in Kona. Dad, what are some of the other incredible things about racing in Kona that you could tell us about, apart from the agonizing pain of muscle cramping?

Yeah, just being, you know, the elite event, the World cup of triathlon sort of thing, you know, the World cup of soccer, you know, it's so grateful to be there, to be, to be selected, to qualify. There's so many good things experiencing racing against the best in the world, in age group or professionalism. The myth, the myth of Kona itself, the lava fields. There's so many other things about that race that, you know, concentrating on winning the race and doing your best performance is one definite thing in my mind. But I did have a sense of gratefulness to be able to be in that, in that unbelievably big race.

And even if we go even more specific, looking at other senses, like, I'm sure if you cast your memory back, you could probably tell me some of the things you saw on the running track when you were running out in Hawaii, in some of the incredible sights. And like, Hawaii is beautiful. So you must have had distinct sounds and smells and things you could see and look at as you were running on the pavement.

Yeah. You would expect someone normal to answer. Yes, but all I was focused on was what the pace I was running at was and how my body was coping. And I'm just continually asking myself, feedback, is this pace sustainable? So I understand what you're saying. I do remember seeing Dave Scott and Mark Allen running the other direction in front of me and thinking, far out. I'm not that far behind these guys at the turnaround and things like that. I distinctly remember. But they're all race, race sort of things.

Yeah, but even that's an interesting example of selective attention and what you choose to focus on when there's so much happening around you. And so the theory we use in chronic pain is that by deliberately becoming more mindful of a particular aspect, so we use breathing control as one really obvious conscious thing we do to draw our attention away from different areas of our body or away from areas of pain can be really powerful to helping people relax and calm down. And even if it doesn't necessarily change their pain, it helps them feel better about it and helps them feel a bit more comfortable in managing it moving forward. So I'd be. And that's something that you've been trying in relation to cramp. And like I said, this is totally experimental, but it's really interesting concepts to think about. So have you found it has any impact at all when you're going through a race and you're cramping or.

Doesn't make a difference in my training sessions, definitely I can actually relax better and think about other things and not concentrate on the upcoming cramp that I can start. I can tell where it's coming, you know, And I think what we've said, both of us have said, you know, the anxiety levels build because I can already feel the twitches coming. So that's when I'm consciously trying to distract my brain and it seems to work. Um, but if I was in a competitive race situation, I'm not sure I would be so calm and so able to quickly, you know, just relax myself and take the stress away from the situation.

Yeah. Probably the biggest thing that helps Cramping, and this is the thing that has the most evidence behind it is static stretching. So you found on the bike, when you can stand up and do some calf stretches or other stretches on the bike, that helps really relieve things. And that actually has one of the strongest research behind it. So that's why you see AFL footballers when they're on the field and they start cramping up, they immediately jump into a stretch. And what that does is it helps override some of the mixed up neural signals you're getting. Because obviously when you're cramping, your muscles shorten and contract. And so helping to lengthen your muscles actually sends a different signal from your muscle to your brain, vice versa, and it helps kind of interrupt that process. So this, the most well supported treatment for cramps is static stretching.

And look, I agree with that. And obviously you have to do a stretch anyway because you've got to unlock the cramp, so you can't. And I have tried to keep going with cramp locked and I've ended up tearing my calf muscle, which is not ideal, without trying to stretch it out. But I've been experimenting with, and I know from some of the high intensity sessions that I do, I get cramped at night in bed. Later on, I don't get cramp in the race, I get it in bed. And if I haven't given myself the right fueling nutrition, so I'm talking about drinks and food after the high intensity event that I've done, whether it's a Thursday night race or a Saturday endurance day, if I haven't looked after myself really well post exercise, I will get the cramp, no problem. But if I do all those things, like walk afterwards, get the blood flow around, eat the right fuel, drink the right hydration, and the third thing I do is I rub an exterior magnesium cream onto my calves and I also take magnesium powder post event. And the results have been remarkable. That's just the test on myself.

Yeah. And from, and from what we've been talking about, a lot of those things that you try have no basis in evidence whatsoever. So whilst the overall package works for you individually, the research doesn't support a lot of those things in helping manage cramps.

But what I can say, Matt, is if I don't do those things, I will cramp all night. And the minute I do one of those things, I can go back to sleep. That to me is it's a result.

Yeah. And this is why cramps are so hotly contested and there's so much debate about what's going on. And it really does summarize that we don't know everything about cramping.

What I would it could be a placebo that I've rubbed the cream on and now I feel better.

Yeah. Or even if we break it down further and we look at the different elements of fatigue. So all of those things you've just suggested do help address fatigue. So, for example, adequate nutrition after a race will help address overall fatigue. Adequate warm down helps settle down your muscles, helps keeps the blood flow moving, helps move some of the buildup of chemicals that are produced by the muscles when you're exercising helps keep everything moving. So we know that a warm up and a cool down are really important factors for racing and for events and for exercising in general. So all those different factors you've said could be helpful. But again, I just want to link it back to the research into cramping specifically. Hasn't got a lot of association with some of the stuff that you've spoken about.

Do you have anything to finish off? And I'll actually add to that point, dad, is for me, the post nutrition has no impact on whether I keep cramping or not. I keep cramping during the night, whether I fuel myself to the tee. So that's my personal experience. So to finish off, Matt, do you have any final recommendations for what people could experiment or try? I mean, we've tried some wacky things ourselves with purposefully turning the muscles on and off and that kind of thing. Do you have anything else that people can try to manage it?

I guess the research in terms of preventing cramps, there's not a lot in the research that I found when you do get a cramp, static stretching is the best thing for it. But in terms of stopping them from coming on at all, I haven't found anything in my reading that has said you should or shouldn't do this. In the lead up to it, I'd probably say overall, considering the link between pushing yourself harder than you've trained and cramping or high intensity exercise, the best thing you can do is train and train appropriately and train to your level and plan and prepare so you can perform at the level that you want to perform to. So if you know that you've got a big event coming up, then being as consistent and as diligent as you can with your preparation in your exercise and your training is probably going to be the best thing that contributes to you having a good race on the day.

Perfect. That's a nice little subtle reiteration of our motto there. I appreciate you putting that in. I think that's good. A pretty perfect way to finish this podcast. Is there anything else you want to touch on, dad, before we go?

No, I just really wrapped that. Matt's been able to give us so much really scientific based information and there's so many myths about cramping out there. And Matt and I have talked long and hard about this many times on some of my walks. That's gone for 45 minutes on, what about this? What about trying this? And you know, we're experimenting all the time and so are the researchers. And there will be a time when we have a lot more knowledge about what to do about cramping and A, how to prevent it in the first place and then B, when you get it, what to do about it, and then post. You know, there's so many areas that we're still learning about, and that's what the message across to everybody who's listening is. There is no one fix here. It's. It's not what is available. And if it was, they would be, you know, doing very well in their careers.

Yeah, they'd be incredibly wealthy.

Yes.

And I'll just reiterate on that point as well. I am no expert on this. All the opinions we've expressed today are mine. And just from the reading that I've done. And so if anyone else has got other stuff that they've heard about cramp, that'd be a great discussion to have and that'd be a great thing to.

Have a talk about.

But these are just my opinions from what I've read and from what the research I've come across says. So that's the best we've got so far. And I'm sure there'll be plenty more research done into cramp in the future.

And that's why we appreciate you coming on, Matt, because you always provide a lot of clarity and a lot of well thought out opinions. We know that you don't form these opinions lightly. You do it from research and just pretty good critical thinking skills. So we appreciate you coming on. And as we get more evidence or if any more research comes out into any of these topics, I'm sure we'll get you back on the podcast to provide an update to the listeners. But I'm sure they will appreciate at least some clarity around that. And, you know, if from our own experiences, dad, you found a little bit of a concoction that works for you. For me, like I said, the best thing that works for me is relaxing and being able to be mindful like Matt said and relax my body, that's actually been the most effective for me. So maybe for the athletes out there it's time for you to experiment and find what works for you. That's it for this episode.

I just kind of said one more thing, Jordan. I just think we really need to keep that link between fatigue and cramping and once we in our mind reconcile that fatigue does contribute a lot to cramping then that will inspire everybody to be more intent on the training sessions that are put in front of them. And the goal is to not cramp if you are a cramper. So concentrating on, you know, testing your body to get those fatigue levels and stress yourself so you get close to that with the intensity in training is going to put you in good stead come race day.

Perfect. That's a great way to finish. Thanks very much for listening and we'll see you next time.