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Cramping in Summer Sports: The Sodium Solutionby: E. Randy Eichner, M.D.Team Internist, University of Oklahoma © More from this issue The adult body contains 200 to 250 grams of salt (sodium chloride), which is about a half-pound and more than enough to fill a few salt shakers. But in August football, in five sets of summer tennis or in tropical triathlons, some athletes can lose 25 to 50 grams of salt in sweat. So athletes going hard can lose up to 10 to 25 percent of their total body salt! Massive salt loss like this – along with dehydration and muscle fatigue – leads to cramping. Cramping starts as muscle twitching, often in the arms or legs, and can evolve into painful whole-body muscle cramps that can disable athletes: Picture a football player writhing on the field; a triathlete hobbling to the finish; or a tennis player forced to default. Not All Cramps Are Alike Not all cramps are alike and the causes of cramping are diverse and debated. For example, a writer’s cramp or a calf cramp that can wake you at night is not caused by salty sweating. Nor does salty sweating cause the cramp in an injured thigh muscle when you overuse it. Cramping that can hobble athletes with sickle trait when they run or patients with atherosclerosis when they walk, is caused by low blood flow and not low sodium. Salt Loss: Ancient Mariners Three lines of evidence implicate low sodium in causing heat cramps. First, history. Knowing that stokers on ocean liners mixed sea water with drinking water, a London doctor prevented cramps in industrial stokers using a saline drink. Adding salt in beer or in milk cut cramping in miners and men building the Hoover Dam. And deep in British coal mines in the 1920s, cramping was cut by “salt in water, about the composition of sweat.” Seriously Sweating Sooners The second line of evidence is from research on sodium loss in athletes, much of it by the Gatorade Sports Science Institute (GSSI). This shows that individual athletes, such as NFL players, who suffer heat cramping, are heavy and salty sweaters. In contrast, selected athletes – tennis players, runners, soccer players and football players – who don’t lock up, don’t lose as much sodium in sweat. An ongoing GSSI field study of Oklahoma Sooner football players suggests that crampers lose more sodium than position-matched non-crampers. So growing research ties heat cramping to dehydration and sodium depletion. Proof in the Pudding The third line of evidence is anecdotal proof in the pudding. At the University of Oklahoma, we have cut heat cramping among our athletes by urging them to consume more salt and drink sports drinks that contain sodium. We:
The Plain Water Problem
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