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30.06.2019 Feature Article

Exercise Associated Muscle Cramps and Skin Hives

...How To Avoid Muscle Cramps and Skin itch, during Exercise
Exercise Associated Muscle Cramps and Skin Hives
JUN 30, 2019 FEATURE ARTICLE

EXERCISE ASSOCIATED SKIN ITCH AND MUSCLE CRAMP
Doctor! I like running but my body starts to itch anytime I run; I do get muscle cramps after exercise.

Can you help?
Muscle Cramps and Skin Itch are common Exercise Related complaints.

  1. Exercise Associated Muscle cramps (EAMC)

DEFIINITION: Cramps that occur in skeletal muscles during or shortly after exercise in healthy individuals are termed Exercise Associated Muscle Cramps (EAMC).

EAMC usually involves a single group of muscle fibers, especially the Hamstrings, the Quadriceps, the Calves, toes, and the muscles of the Belly wall.

Pathophysiology
Muscles contractions and relaxations depend on the balance between the factors that stimulate muscle contractions and factors that relax muscles.

When a group of muscles are overused or strained, a state of local muscle-fatigue sets in, and this state increases the activity of the factors that stimulate muscle contractions, and decreased the activity of factors that relax muscles.

Dehydration and low body mineral salts, especially low Potassium/Sodium, may hasten the onset of EAMC.

SYMPTOMS/SIGNS OF EAMC.
Local muscle spasms result in: Acute Pain, stiffness, a knot or bulge in the muscle and muscle-soreness. The muscle spasms may occur during and/or after Exercise.

After exercise, the “cramp-prone state” may last for 8 hours, and even days, in some people.

PREVENTION OF EAMC

  1. Always do stretching exercises before (as part of the Warm-Up) and after prolonged muscle use
  1. Ingest fluids containing salts: Potassium, Magnesium and Sodium about 1 hour before exercise, and every 15-30 minutes during exercise.
  1. Kinesio Taping helps relieve muscle pain by lifting the skin to allow improved blood flow.

TREATMENT OF EAMC
Stretching is the primary treatment for acute EAMC. Stretching increases the tension in the muscle’s tendons and that inhibit the factors that stimulate muscle contractions. After stretching, apply warm pads over the area. Simple Massaging the affected muscles also help.

  1. EXERCISE INDUCED SKIN ITCH

Hives that occur in some people when they exercise are called Cholinergic Urticaria or Heat Bumps.

Pathophysiology
As we burn calories during exercise, our bodies get warmer and sweat. Chemicals and materials on the skin dissolve in the sweat to trigger the release of Histamine (and other chemicals) that produce Hives in some people

RISK FACTORS
Cholinergic Urticaria occurs commonly in persons with a history of

. Asthma.
. Allergic Rhinitis (itchy eyes, nose and throats)
. Atopic Eczema
. Urticaria
Apart from exercise which, is the commonest event associated with cholinergic urticaria, Cholinergic Urticaria may occur with other conditions that increase the core body temperature, and sweating as observed in:

. Hot weather conditions
. Ingesting Hot or Spicy Foods
. Sauna and Hot water showers/baths and Hot-water emersions

. Emotional Stress: being Angry/Upset
SYMPTOMS OF CHOLINERGIC URTICARIA
The hives develop quickly, with the onset of sweat and may last for about 30 minutes. In other persons, it may take 60 minutes or more for the rash to clear on its own.

The Trunk, Thighs, and Arms are the usual areas where the hives develops. The symptoms include

. Itching or tingling start/ Burning/ Warmth/Irritation occurs before the onset of Rash

. Small hives (red skin bumps) then appear.
. Swelling occurs as the hives become larger
In severe cases, the hives may be associated with: Headache. Abdominal pain. Diarrhea. Nausea, Difficulty breathing

TREATMENT OF CHOLINERGIC URTICARIA
Take antihistamines daily:
`` . Cetirizine/Levocetirizine
. Loratadine/Desloratadine
Another useful medication is:
. Danazol (a synthetic androgen useful in allergic skin reactions). Danazol improves the levels of anti-chymotrypsin (anti-chymotrypsin levels are usually low in persons with cholinergic urticaria)

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Alex Sarkodie MD
Alex Sarkodie MD, © 2019

Alex Sarkodie,MBChB has over 30 years experience in the field of Medicine Author column: AlexSarkodie

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