Prophylactic stretching does not reduce cramp susceptibility
Corresponding Author
Kevin C. Miller PhD, ATC
School of Rehabilitation and Medical Sciences, Central Michigan University, 1208 Health Professions Building, Mount Pleasant, Michigan, 48859 USA
Correspondence to: K.C. Miller; e-mail: [email protected]Search for more papers by this authorJames D. Harsen DPT
School of Rehabilitation and Medical Sciences, Central Michigan University, 1208 Health Professions Building, Mount Pleasant, Michigan, 48859 USA
Search for more papers by this authorBlaine C. Long PhD, ATC
School of Rehabilitation and Medical Sciences, Central Michigan University, 1208 Health Professions Building, Mount Pleasant, Michigan, 48859 USA
Search for more papers by this authorCorresponding Author
Kevin C. Miller PhD, ATC
School of Rehabilitation and Medical Sciences, Central Michigan University, 1208 Health Professions Building, Mount Pleasant, Michigan, 48859 USA
Correspondence to: K.C. Miller; e-mail: [email protected]Search for more papers by this authorJames D. Harsen DPT
School of Rehabilitation and Medical Sciences, Central Michigan University, 1208 Health Professions Building, Mount Pleasant, Michigan, 48859 USA
Search for more papers by this authorBlaine C. Long PhD, ATC
School of Rehabilitation and Medical Sciences, Central Michigan University, 1208 Health Professions Building, Mount Pleasant, Michigan, 48859 USA
Search for more papers by this authorThis study was supported by the Central Michigan University Office of Research and Graduate Studies.
ABSTRACT
Introduction: Some clinicians advocate stretching to prevent muscle cramps. It is unknown whether static or proprioceptive neuromuscular facilitation (PNF) stretching increases cramp threshold frequency (TFc), a quantitative measure of cramp susceptibility. Methods: Fifteen individuals completed this randomized, counterbalanced, cross-over study. We measured passive hallux range of motion (ROM) and then performed 3 minutes of either static stretching, PNF stretching (hold–relax—with agonist contraction), or no stretching. ROM was reassessed and TFc was measured. Results: PNF stretching increased hallux extension (pre-PNF 81 ± 11°, post-PNF 90 ± 10°; P < 0.05) but not hallux flexion (pre-PNF 40 ± 7°, post-PNF 40 ± 7°; P > 0.05). Static stretching increased hallux extension (pre-static 80 ± 11°, post-static 88 ± 9°; P < 0.05) but not hallux flexion (pre-static 38 ± 9°, post-static 39 ± 8°; P > 0.05). No ROM changes occurred with no stretching (P > 0.05). TFc was unaffected by stretching (no stretching 18 ± 7 Hz, PNF 16 ± 4 Hz, static 16 ± 5 Hz; P = 0.37). Discussion: Static and PNF stretching increased hallux extension, but neither increased TFc. Acute stretching may not prevent muscle cramping. Muscle Nerve 57: 473–477, 2018
REFERENCES
- 1Sulzer N, Schwellnus M, Noakes T. Serum electrolytes in Ironman triathletes with exercise associated muscle cramping. Med Sci Sports Exerc 2005; 37: 1081–1085.
- 2Cooper E, Ferrara M, Broglio S. Exertional heat illness and environmental conditions during a single football season in the Southeast. J Athl Train 2006; 41: 332–336.
- 3Norris F, Gasteiger E, Chatfield P. An electromyographic study of induced and spontaneous muscle cramps. Electroencephalogr Clin Neurophysiol 1956; 9: 139–147.
- 4Bergeron M. Muscle cramps during exercise—is it fatigue or electrolyte deficit? Curr Sports Med Rep 2008; 7(suppl): S50–S55.
- 5Schwellnus M. Cause of exercise associated muscle cramps (EAMC)—altered neuromuscular control, dehydration, or electrolyte depletion? Br J Sports Med 2009; 43: 401–408.
- 6Miller KC. Rethinking the cause of exercise-associated muscle cramping: moving beyond dehydration and electrolyte losses. Curr Sports Med Rep 2015; 14: 353–354.
10.1249/JSR.0000000000000183 Google Scholar
- 7Miller KC, Knight KL, Mack GW, Hopkins JT, Draper DO, Fields PJ, et al. Three percent hypohydration does not affect the threshold frequency of electrically-induced muscle cramps. Med Sci Sports Exerc 2010; 42: 2056–2063.
- 8Braulick K, Miller K, Albrecht J, Tucker J, Deal J. Significant and serious dehydration does not affect skeletal muscle cramp threshold frequency. Br J Sports Med 2012; 47: 710–714.
- 9Minetto M, Holobar A, Botter A, Ravenni R, Farina D. Mechanisms of cramp contractions: peripheral or central generation. J Physiol 2011; 23: 5759–5773.
- 10Ross B. Muscle cramp and the Hoffmann reflex. XXth World Congress in Sports Medicine Handbook, Melbourne, Australia; 1974. p 67–70.
- 11Khan S, Burne J. Reflex inhibition of normal cramp following electrical stimulation of the muscle tendon. J Neurophysiol 2007; 98: 1102–1107.
- 12Schwellnus M, Drew N, Collins M. Increased running speed and previous cramps rather than dehydration or serum sodium changes predict exercise associated muscle cramping: a prospective cohort study in 210 Ironman triathletes. Br J Sports Med 2011; 45: 650–656.
- 13Schwellnus M, Nicol J, Laubscher R, Noakes T. Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping (EAMC) in distance runners. Br J Sports Med 2004; 38: 488–492.
- 14Summers KM, Snodgrass SJ, Callister R. Predictors of calf cramping in rugby league. J Strength Cond Res 2014; 28: 774–783.
- 15Wagner T, Behnia N, Ancheta W, Shen R, Farrokhi S, Powers C. Strengthening and neuromuscular reeducation of the gluteus maximus in a triathlete with exercise associated cramping of the hamstrings. J Orthop Sports Phys Ther 2010; 40: 112–119.
- 16Dickhuth H, Rocker K, Niess A, Horstmann T, Mayer F, Striegel H. Exercise-induced, persistent and generalized muscle cramps. J Sports Med Phys Fitness 2002; 42: 92–94.
- 17Hoffman M, Fogard K. Factors related to successful completion of a 161-km ultramarathon. Int J Sports Physiol Perform 2011; 6: 25–37.
- 18Stone MB, Edwards JE, Stemmans CL, Ingersoll CD, Palmieri RM, Krause BA. Certified athletic trainers' perceptions of exercise associated muscle cramps. J Sport Rehabil 2003; 12: 333–342.
- 19Daniell H, Pentrack J. A revised stretch for preventing nocturnal cramps and a plausible mechanism for its benefit. J Physiother 2013; 59: 138.
- 20Konrad A, Stafilidis S, Tilp M. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties. Scand J Med Sports [Epub ahead of print].
- 21Sharman M, Cresswell A, Riek S. Proprioceptive neuromuscular facilitation stretching. Sports Med 2006; 36: 929–939.
- 22Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab 2016; 41: 1–11.
- 23Schwellnus M, Derman E, Noakes T. Aetiology of skeletal muscle ‘cramps’ during exercise: a novel hypothesis. J Sports Sci 1997; 15: 277–285.
- 24Bertolasi L, De Grandis D, Bongiovanni L, Zanette G, Gasperini M. The influence of muscular lengthening on cramps. Ann Neurol 1993; 33: 176–180.
- 25Helin P. Physiotherapy and electromyography in muscle cramp. Br J Sports Med 1985; 19: 230–231.
- 26Guissard N, Duchateau J. Effect of static stretch training on neural and mechanical properties of the human plantar-flexor muscles. Muscle Nerve 2004; 29: 248–255.
- 27Guissard N, Duchateau J, Hainaut K. Mechanisms of decreased motoneurone excitation during passive muscle stretching. Exp Brain Res 2001; 137: 163–169.
- 28Hallegraeff J, van der Schans C, de Ruiter R, de Greef M. Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. J Physiol 2013; 58: 17–22.
- 29Stone M, Edwards J, Babington J, Ingersoll C, Palmieri R. Reliability of an electrical method to induce muscle cramp. Muscle Nerve 2003; 27: 122–123.
- 30Miller KC, Knight KL. Electrical stimulation cramp threshold frequency correlates well with the occurrence of skeletal muscle cramps. Muscle Nerve 2009; 39: 364–368.
- 31Serrao M, Arendt-Nielsen L, Ge H, Pierelli F, Sandrini G, Farina D. Experimental muscle pain decreases the frequency threshold of electrically elicited muscle cramps. Exp Brain Res 2007; 182: 301–308.
- 32Miller KC, Knight KL, Wilding SW, Stone MB. Duration of electrically induced muscle cramp increased by increasing stimulation frequency. J Sport Rehabil 2012; 21: 182–185.
- 33Miller KC, Knight KL. Initial electrical stimulation frequency's effect on cramp threshold frequency and force. J Athl Train 2012; 47: 643–647.
- 34Stone M, Edwards J, Huxel K, Cordova M, Ingersoll C, Babington J. Threshold frequency of an electrically induced cramp increases following a repeated, localized fatiguing exercise. J Sports Sci 2010; 28: 399–405.
- 35Miller KC, Long BC, Edwards JE. Muscle cramp susceptibility increases following a volitionally-induced muscle cramp. Muscle Nerve [Epub ahead of print].
- 36Miller KC, Knight KL. Pain and soreness associated with a percutaneous electrical stimulation muscle cramping protocol. Muscle Nerve 2007; 36: 711–714.
- 37Ross B, Thomas C. Human motor unit activity during induced muscle cramp. Brain 1995; 118: 983–993.
- 38Miller KC, Burne JA. Golgi tendon organ reflex inhibition following manually-applied acute static stretching J Sports Sci 2014; 32: 1491–1497.
- 39Shang G, Collins M, Schwellnus M. Factors associated with a self-reported history of exercise-associated muscle cramps in Ironman triathletes: a case-control study. Clin J Sport Med 2011; 21: 204–210.
- 40Blyton F, Chuter V, Burns J. Unknotting night-time muscle cramp: a survey of patient experience, help-seeking behaviour and perceived treatment effectiveness. J Foot Ankle Res 2012; 5: 1–8.
- 41Houk J, Singer J, Henneman E. Adequate stimulus for tendon organs with observations on mechanics of ankle joint. J Neurophysiol 1971; 34: 1051–1065.
- 42Khan S, Burne J. Afferents contributing to autogenic inhibition of gastrocnemius following electrical stimulation of its tendon. Brain Res 2009; 1282: 28–37.
- 43Burne J, Lippold O. Reflex inhibition following electrical stimulation over muscle tendons in man. Brain 1996; 119: 1107–1114.
- 44Guissard N, Duchateau J. Neural aspects of muscle stretching. Exerc Sport Sci Rev 2006; 34: 154–158.
Citing Literature
