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Includes Expert Content
Leg cramps after excercise
Jammnbabe1966 posted:
I wanted to ask a question i am 47 years old and i have been exercising for the last two weeks on and off and i started waking up in the night or when i wake up in the morning with bad leg cramps from my calf and some times my upper hips and legs what can i do to help with the cramps or am i not giving enough of something like maybe the right vitamins to prevent these cramps please advise thanks Lisa
Rich Weil, MEd, CDE responded:
Hi Jammnbabe,

Nocturnal (nighttime) cramping is common but the precise cause is not always easy to determine. It can be due to medications, nutritional deficiencies such as electrolytes), dehydration, poor circulation, and other factors. It could just be overuse from your workouts too. I suggest that you speak with your doctor about it to rule out medical reasons (ask your doctor about taking quinine for nocturnal cramping as this is an often overlooked treatment)

WebMD has some excellent resources regarding cramps.

And here are hydration guidelines.

Hydration guidelines should be individualized for each person. The goal is to prevent excessive weight loss (>2% of body weight). You should weigh yourself before and after exercise to see how much fluid you lose through sweat. One liter of water weighs 2.25 pounds. Depending on the amount of exercise, temperature and humidity, body weight, and other factors, you can lose anywhere from approximately .4 to 1.8 liters per hour.

Pre-exercise hydration (if needed):

1) 0.5 liters per hour for a 180-pound person several hours (3-4 hours) prior to exercise.

2) Consuming beverages with sodium and/or small amounts of salted snacks or sodium-containing foods at meals will help to stimulate thirst and retain the consumed fluids.

During exercise:

1) Suggested starting points for marathon runners is 0.4 to 0.8 liters per hour, but again, it should be individualized based on body weight loss.

2) No more than 10% carbohydrate in the beverage, and 7% has generally been considered close to optimal. Carbohydrate consumption is generally recommended only after one hour of exertion.

3) Electrolyte repletion (sodium and potassium) can help sustain electrolyte balance during exercise. Particularly when

a) there is inadequate access to meals or meals are not eaten;

b) physical activity exceeds 4 hours in duration;

c) during the initial days of hot weather.

Under these conditions, adding modest amounts of salt (0.3 to 0.7 g/L) can offset salt loss
in sweat and minimize medical events associated with electrolyte imbalances (eg, muscle cramps, hyponatremia).


1) Drink approximately 0.5 liters of water for every pound of body weight lost.

2) Consuming beverages and snacks with sodium will help expedite rapid and complete
recovery by stimulating thirst and fluid retention

Good luck.
Rich Weil, MEd, CDE responded:
Hi Jamm

Nocturnal cramping (and daytime cramping) is common but the precise cause is not always easy to determine. It can be due to medications, nutritional deficiencies, poor circulation, dehydration, and other factors. Your doctor can help rule out medical issues (and ask your doctor about quinine as treatment as this can sometimes help nocturnal cramping).

Here are some excellent WebMD resources.

And here are exercise and hydration guidelines from the American College of Sports Medicine and the National Athletic Trainers' Association are the following:

1. Pre-Hydration: Drink 17 to 20 fl oz of water or a sports drink 2 to 3 hours before exercise to enable fluid absorption and allow urine output to return toward normal levels. 7 to 10 ounces of water or a sports drink 10 to 20 minutes before exercise.

2. During exercise fluid replacement should approximate sweat and urine losses and at least maintain hydration at less than 2% body weight reduction. This generally requires 7 to 10 ounces every 10 to 20 minutes during exercise. More than 2% loss of body weight will affect performance, particularly endurance performance.

3. CHO concentrations greater than 8% increase the rate of CHO delivery to the body but compromise the rate of fluid emptying from the stomach and absorbed from the intestine. Fruit juices, CHO gels, sodas, and some sports drinks have CHO concentrations greater than 8% and are not recommended during an exercise session as the sole beverage. Excessive CHO can cause gas, upset stomach, and diarrhea. Carbohydrate consumption at a rate of app 30-60 grams per hour has been shown to maintain blood glucose levels and sustain exercise performance

4. Post-exercise hydration should aim to correct any fluid loss accumulated during exercise. Rehydration should contain water to restore hydration status, carbohydrates to replenish glycogen stores, and electrolytes to speed rehydration. A liter of water weighs app 2.25 pounds. You should weigh yourself nude before and after exercise to determine how much fluid you lose so you know how much to replace.

5. Include CHOs in the rehydration beverage during exercise if the session lasts longer than 45 to 50 minutes or is intense. Drinking 1 liter of a 6% CHO drink per hour of exercise will be adequate.

6. Inclusion of sodium in fluid-replacement beverages or salted snacks should be considered to help stimulate thirst and retain fluids under the following conditions:
a. inadequate access to meals or meals not eaten;
b. physical activity exceeding 4 hours in duration;
c. during the initial days of hot weather.

Under these conditions, adding modest amounts of salt (0.3 to 0.7 g/L) can offset salt loss in sweat and minimize medical events associated with electrolyte imbalances (eg, muscle cramps, hyponatremia). Adding a modest amount of salt
(0.3 to 0.7 g/L) to all hydration beverages would be acceptable to stimulate thirst, increase voluntary fluid intake, and decrease the risk of hyponatremia (low sodium levels) and should cause no harm.

Take care,

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