Treatment of Deltoid Muscle Cramping During Exercise
For acute deltoid cramping during exercise, immediately stop the activity and perform gentle passive stretching of the deltoid muscle until symptoms resolve, then address underlying risk factors including hydration status and sodium balance. 1, 2
Immediate Management
Stop exercise immediately when cramping occurs and rest the affected deltoid muscle. 1
Apply gentle passive stretching to the cramped deltoid muscle, which is the most effective immediate treatment for exercise-associated muscle cramps (EAMC). 1, 2 This can be achieved by:
- Gently pulling the affected arm across the body (for posterior deltoid)
- Extending the arm behind the back (for anterior deltoid)
- Holding the stretch until the painful spasm subsides 2
Hydration and Electrolyte Replacement
Once the acute cramp is relieved, focus on correcting potential contributing factors:
Assess and correct sodium deficits, particularly if exercise duration exceeds 1 hour. 3 Athletes experiencing muscle cramping should:
- Consume fluids containing 1.5 g/L of sodium (increased from the standard 0.5-0.7 g/L recommendation) 3
- This is critical because sodium deficits can prompt muscle cramping in prolonged exercise, and athletes training in heat have higher sodium requirements than the general population 3
Rehydrate appropriately by consuming fluids to replace 100-150% of body mass lost during exercise. 4
Include carbohydrates in the hydration regimen: 30-60 g/h for exercise lasting longer than 1 hour. 3
Risk Factor Identification
The most important risk factors for EAMC are:
- Previous history of muscle cramping (strongest predictor) 1
- Higher relative exercise intensity or duration compared to normal training 1
- Exercising in hot and humid conditions 1
- Premature muscle fatigue 1
Prevention Strategies
Reduce the risk of premature muscle fatigue, which is the key to preventing future episodes. 1 This involves:
- Adequate conditioning specific to the activity being performed 5
- Gradual progression of exercise intensity and duration to allow the body to adapt 3, 4
- Regular stretching using post-isometric relaxation techniques, particularly targeting the deltoid muscle 5
- Correction of muscle imbalances and posture abnormalities that may increase motor neuron activity 5
Maintain proper hydration status before exercise by drinking 6 mL of fluid per kg of body mass every 2-3 hours to start exercise euhydrated. 3
Ensure adequate sodium intake before, during, and after exercise, particularly for "heavy sweaters" who may lose large volumes of sodium. 3
Include proper warm-up with stretching and low-level activities before intense exercise. 4
Post-Exercise Recovery
Consume protein (0.2-0.4 g/kg/h) with carbohydrates (0.8 g/kg/h) within the first hour after exercise to maximize protein synthesis and enhance recovery. 4
Include sodium in recovery hydration regimens to maintain total body water balance. 4
Common Pitfalls to Avoid
Do not return to intense exercise too soon, as this can exacerbate muscle dysfunction and increase cramping risk. 4
Avoid exercising when air temperature exceeds 70°F without adjusting pace, as heat stress significantly increases cramping risk. 3 Be alert for signs of heat injury including headache, dizziness, nausea, and cramps. 3
Do not ignore proper hydration and nutrition, as this delays recovery and increases future cramping risk. 4
Avoid exercising to complete fatigue, as the relaxation phase of muscle contraction is prolonged in fatigued muscle, raising the likelihood of sustained motor neuron firing that triggers cramps. 5
Individualization Based on Specific Risk Factors
Since recent evidence suggests EAMCs result from a confluence of unique intrinsic and extrinsic factors rather than a single cause, identify patient-specific risk factors through thorough history including:
- Previous cramping episodes and their circumstances 2
- Training intensity relative to conditioning level 1
- Environmental conditions during exercise 1
- Hydration and nutrition practices 3
- Muscle imbalances or postural abnormalities 5
Tailor prevention strategies to the identified risk factors rather than applying generalized advice, as individualized approaches are more effective. 2