Muscle cramps may be sign of blood clots

2014-11-28 12:00:05 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the blog.

The Browns offensive lineman Jason Pinkston has been dealing with blood clots in his lungs. The Browns offensive lineman Jason Pinkston has been dealing with blood clots in his lungs.

Itís that time of year for high-intensity training and long practices on the field. With that comes dehydration and the dreaded muscle cramps.

But beware, itís not always muscle cramps from fatigue, heat and humidity. In recent years, weíve heard about several cases of blood clots, even in young athletes.

Last week, I had the chance to speak with WAKR morning show host Ray Horner about this topic. We discussed the symptoms of blood clots and how they differ from the run-of-the-mill charley horse. We also talked about how kids can prevent the routine muscle cramp.

Below is an audio file and transcript of our discussion. Originally aired on 1590 WAKR-AM on Aug. 11, 2014.

HORNER: Dr. Joe Congeni with us, Sports Medicine Center at Akron Childrenís Hospital. What did you bring with you today?

DR. CONGENI: I just wanted to talk about one other thing. You know, the No. 1 complaint this time of year when we go to 2-a-days in soccer practice and football practice and training and everything is cramping. But, you also saw that cramping isnít always just muscle cramps from fatigue and heat and humidity.

You saw this week that Jason Pinkston really unfortunately had to give up the game of football. It looks like he probably wonít be back. He had a re-occurrence of blood clots.

Dr. Joe Congeni Dr. Joe Congeni

So blood clots are really a rare thing, and when youíre looking at young athletes you think, ah, come on, you know this is something that occurs in older people, generally. But weíve seen just in our community at least 3 cases of young athletes in the last year or 2 that had blood clots, and significant blood clots where they go from the legs to the lungs. Thatís called a pulmonary embolism.

One of the really important things is we need to know what are those things that can cause serious effects, even death. A PE, a pulmonary embolism, is something that can cause death.

So, these people feel like a charley horse or a cramping in their legs, but itís a little bit of a different pattern. They have a lot of warmth to it, and other things.

Then if they start having any respiratory complaints, like problems breathing, coughing and problems catching their breath, they really need to be studied and make sure they donít have blood clots, like in the Jason Pinkston (former Cleveland Browns player) case, like in the Anderson Varej„o (Cleveland Cavaliers) case.

There are a couple of examples, and weíve had a couple of other local college athletes and other things where there have been blood clots, rather than just run-of-the-mill cramping.

HORNER: Well, thatís interesting. I just had a cramp in my hamstring the other day, but we have to be aware of other symptoms, right?

DR. CONGENI: There are other things that occur with blood clots for sure. And so, you know, rapid heart rate, passing out, discoloration is really a different thing that youíll see. A bluish or a pale discoloration with it is a blood clot, instead of a routine cramp.

Yes, this is the time of year weíre gonna get tons of cramps. When I go out to 2-a-days later this week, thatís all Iím gonna hear about. A lot of kids are getting them over and over again. I mean, you know, by definition, coaches are having athletes exercise to fatigue. This is the time of year youíre trying to push your teams to get Ďem in the best shape they can be in. All over this town every kid is exercising to pretty near fatigue.

When you do that the muscles after a period of time are just gonna give out, and theyíre gonna lock up and cramp up. And so, you know, the routine is daily weighs to see if youíre losing too much weight. Make sure that youíre keeping up with your fluids. Look at the meds. Avoid the supplements. There are certain supplements that add to the muscle cramping.

So, 99 percent of the time itís gonna be the routine muscle cramping from pushing your body to muscle fatigue. But, there are those rare ones, and just beware of things like blood clots that have a totally different picture. And people that are having recurring cramping and it just doesnít seem right, get them to a medical doctor or somebody to evaluate them.

HORNER: Just for our parents side, because as Joe mentioned, there are so many young athletes out there right now with the soccer, the volleyball, cross country and football practices, these kids come home with cramps.

Is water still the best, or are these sports drinks ó the Powerades, the Gatorades ó are those equally as good? But, stay away from the energy drinks, right?

DR. CONGENI: So, if you are exercising over an hour, which the vast majority of these late summer practices are over an hour, it isnít a bad thing to have some electrolytes in there, too. So, youíre exactly right.

Energy drinks? No, thatís caffeine.

HORNER: Thatís sucking the water out.

DR. CONGENI: Thatís actually sucking the water out. Itís dehydrating our athletes more.

Uh, creatine? Sucking the water out ó I like the term youíre using ó and dehydrating kids more. Protein supplements? Sucking the water out. Alcohol? Definitely dehydrating.

On the side of hydrating well, water and good hydration before you play, but probably electrolytes isnít a bad thing and lightly salting your meals.

Now, what about when we go to pickle juice and things like that? Well, thatís later on after kids have been cramping already, but salting your foods, making sure that you have some electrolytes, making sure you have some potassium, even calcium is a big one here, too.

Now people are even saying vitamin D in calcium. So, making sure youíre drinking enough milk, yogurt and cheese and things like that with vitamin D and calcium . So, probably not just water alone with these kids practicing over an hour a day.

Weigh yourself daily. See how much weight youíre losing. Make sure youíre keeping up with hydration. Stretch your muscles beforehand and then also keep an eye on the electrolytes and stay away from the supplements that, as you said, suck the fluid out of the muscles.

HORNER: It was good stuff you had there, Joe, as far as the diet. When these kids come home from practicing all day, yogurtís not a bad idea to have on the dinner table, you also mentioned a glass of milk. What other good things should parents maybe cook when these kids are out working hard?

DR. CONGENI: Well, itís a good time to replenish carbohydrates. Itís a good time for protein replenishment, too. And, they might need to sneak in more than 3 meals a day, too.

This is a time that theyíre really gonna be burning up a lot of calories and Ö the 3 meals a day are necessary. This is a time you canít get away with skipping breakfast, which so many athletes do; skip breakfast and theyíre down to†2†meals a day. This is 3 meals a day with probably snacks in between. And then, make sure youíre hydrating at every meal.

Remember, we say it all the time, your thirst mechanism is not going to keep up enough. , weíve gone back to actually salting the foods is beneficial.

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