Beyond sleep, I do think that cold-water immersions do have merit, especially right after exercise and especially when it’s hot out. The sooner you can cool your body down after exercise in the heat the sooner you can go from a catabolic state back to an anabolic state. When you’re really hot after exercise, your metabolic rate stays high, as do all of the catabolic hormones that help maintain blood glucose during exercise. So bringing down your core temp with cold water immersion can reverse that process. In addition, the cold-water immersion may also help to inhibit the inflammatory response associated with exercise helping you to recover faster. Beyond cold-water immersion post exercise, it may also help to make sure that you are cool right before bed as this can help initiate sleep.

Finally, make sure that you are eating a proper meal immediately after exercise and that you are drinking plenty during and after exercise. The quicker you refuel and rehydrate post exercise the faster you’ll recover. Sometimes, it’s just as simple as drinking enough electrolyte solution after a ride to make up for the loss in body weight to ensure proper recovery. At the Tour de France, I’ll normally have riders drink 2 to 2.5 liters of a high salt, high sugar solution within the first hour of finishing a ride along with about 1000 to 1500 calories of real food.

- Allen

First, there’s a substantial amount of literature out there suggesting that cramps have nothing to do with fluid or electrolyte balance but have everything to do with basic fatigue either within the muscle or our nervous system that causes a simple but uncontrollable “knee jerk” reflex to be initiated.

- Schwellnus, M. P., Derman, E. W., & Noakes, T. D. (2001). Aetiology of skeletal muscle cramps during exercise: a novel hypothesis. Journal of sports sciences, 15(3), 277-285.

- SULZER, N. U., SCHWELLNUS, M. P., & NOAKES, T. D. (2005). Serum electrolytes in Ironman triathletes with exercise-associated muscle cramping. Medicine & Science in Sports & Exercise, 37(7), 1081.

So you’re right that your cramps probably don’t correspond to hot days or changes in your fluid and electrolyte balance. That being said, this isn’t an excuse to not watch your fluid and electrolyte intake since you’ll have more serious problems than just a cramp if you don’t stay properly hydrated during a race. Moreover, there is evidence that while an electrolyte disturbance or dehydration may not be the sole cause of cramping, drinking a carbohydrate-electrolyte solution can help delay the onset of exercise induced muscle cramps.

- Jung, A. P., Bishop, P. A., Al-Nawwas, A., & Dale, R. B. (2005). Influence of hydration and electrolyte supplementation on incidence and time to onset of exercise-associated muscle cramps. Journal of Athletic Training, 40(2), 71.

- Bergeron, M. F. (2008). Muscle Cramps during Exercise-Is It Fatigue or Electrolyte Deficit? Current Sports Medicine Reports, 7(4), S50.

Because, cramping may be entirely due to fatiguing muscles the best thing an athlete can do is to get fitter – to get to a point where the stimulus that causes the cramp is pushed back. The fact that most cramps happen in races when athletes are pushing themselves to novel and higher levels of duration and intensity may be a strong indicator that the body just wasn’t prepared for the effort. Thus, working harder in training or simulating efforts that cause cramps might be a worthwhile strategy to prevent cramps in the future.

Still cramps happen, regardless of how hard we train or how prepared we are and because these cramps may be more neurological in etiology, scientists and coaches have tried developing novel strategies for dealing with them. The most interesting in the last year or so has been the idea of drinking pickle juice during a cramp. There has always been anecdotal evidence that drinking pickle juice can relieve cramps in some athletes. So to test that hypothesis, Miller et. al., simulated cramps in dehydrated subjects through an electrical shock then immediately following the induced cramp gave subjects 1 ml of pickle juice per kilogram of body weight (70 ml for a 70 kg or 154 lb person) or plain deionized water. Amazingly, the pickle juice and not water immediately stopped the electrically induced cramp. Though the mechanism for this was not explored, the authors think it may be due to a neurally mediated reflex. Pickle juice is essentially acetic acid, so vinegar may work as well, though no one to my knowledge has ever tested that. Moreover, I’ve never known any athlete to try pickle juice for cramping, so I don’t know if it actually works. But some research is out there and if you ever try it, I’d love to know if it works for you.

- Miller, K. C., Mack, G. W., Knight, K. L., Hopkins, J. T., Draper, D. O., Fields, P. J. et al. (2010). Reflex inhibition of electrically induced muscle cramps in hypohydrated humans. Med Sci Sports Exerc, 42(5), 953-961.

- Miller, K. C., Mack, G., & Knight, K. L. (2009). Electrolyte and plasma changes after ingestion of pickle juice, water, and a common carbohydrate-electrolyte solution. J Athl Train, 44(5), 454-461.

- Miller, K. C., & Knight, K. L. (2009). Electrical stimulation cramp threshold frequency correlates well with the occurrence of skeletal muscle cramps. Muscle & nerve, 39(3), 364-368.

- Dale, R. B., Leaver-Dunn, D., & Bishop, P. (2003). A Compositional Analysis of a Common Acetic Acid Solution With Practical Implications for Ingestion. J Athl Train, 38(1), 57-61.

What I do know helps is contracting the opposite muscle of the cramp. So in your case, try contracting your hamstring when your quad is cramping. When a muscle is contracting the nervous signal to the opposing or contralateral muscle is cut off. The idea here is that if the cramp is neural in nature, contracting the opposite muscle will hopefully cut off the signal causing the cramp. Of course, stretching and massage the cramp may also help.

One thing I wonder is whether or not you are getting the cramps more in one leg over the other. If this is the case, this may be a sign of a weaker leg or some sort of asymmetry on the bicycle putting more strain one leg. If both legs are cramping equally, I think this is just a case of fatigue. Finally, because these cramps are occurring in your quad, I also wonder if you are sitting fairly forward on the saddle putting more stress on those muscles rather than your gluts. Or it may just be that your quads are the weak link in the chain. Regardless, keep on training hard, keep on stretching, and see if you can simulate the cramps in training so you can not only adapt to a new level but so you can test some pickle juice for me.

- Allen

Answer:
Your “Hot Foot” is not uncommon amongst cyclists and I think you are on the right track in terms of figuring out a solution. My experience is that you would be helped with shoes that are wider in the front. Moreover, you may simply benefit from shoes that are ½ a size or 1 size larger. As long as the heal cup is tight and you are getting enough support over the top of your foot, having some wiggle room in your toe box can really help with comfort without sacrificing power transfer. This defies the typical convention that cycling shoes need to be tight, but a bigger shoe is something that I have seen really help a lot of cyclists. Beyond a slightly larger shoe, you might be a candidate for custom insoles to help distribute pressure across your foot more evenly. While a custom solution from a trained professional would be the best solution, I know some cyclists who have cut out pieces of Techno Gel from Dr. Scholl’s footpads and made little donuts that they place in their shoe to take the pressure off a hot spot. I’ve also seen athletes cut out little holes in the soles of their shoes or on the side of their shoes to relieve pressure points. While all of the above solutions might give you some relief, there may be some underlying foot pathology that needs to be addressed. So I really do recommend that you also see a podiatrist to make sure there isn’t something else there beyond an uncomfortable shoe that is causing your discomfort. A simple x-ray and a thorough exam by a doctor may reveal something more there and I highly recommend you have it checked out just to be safe. Best of luck and keep on icing and taking care of that foot.

- Allen

1. Schedule a light massage for after your rides if you have the time and can bear the expense. At this point, I don’t recommend deep massage unless you’re already accustomed to it as a very deep massage may initial do more harm than good. If you don’t have access to a massage therapist or can’t bear the expense, then I suggest self massage with something like “The Stick” (www.thestick.com) or your own hands.

2. Make sure that you get plenty to eat immediately after your ride and that you eat enough during your ride. A lot of the fatigue and inability for riders to recovery during stage races is due to a lack of carbohydrate in their diet and not timing food intake immediately after their workouts. At this point, don’t be shy about stuffing yourself with real wholesome meals with lots of nutrient and energy density.

3. Sleep more. The kind of effort you are putting on yourself will require more sleep. If you are having trouble sleeping, that might be a sign you are a bit over-reached, so do what you can to get more rest. Some suggestions to this end include; a) taking a cool bath right before bed to bring down your core temp and help initiate sleep, b) use ear plugs (my favorites are the “Hearos” brand), c) use an eye mask to keep out excess light.

4. If you know someone with a Normatec MVP (www.normatecsports.com/) then borrow it and use it. We had great success with the device with helping athletes recover from hard work. In addition, you can look into borrowing a Game Ready (www.gameready.com). The Game Ready’s are normally prescription only, but can be found in a lot of physical therapy offices and are great for icing and compressing sore sports or nagging injuries.

5. Stay hydrated. Make sure you weigh yourself before and after you get on the bike and goal to bring back your body weight with adequate hydration. On the bike, I recommend the “exercise” sports drink from www.secretdrinkmix.com and off the bike, I recommend the “anytime” hydration drink which is very similar to but less expensive than Pedialyte.

6. Continue to use the ice water baths, stretch, and go for a walk to help keep the legs loose.

I hope these suggestions help. Keep on fighting and keep us posted.

- Allen