Hydration and cramping: how badly was LeBron hurting?

LeBron James is taking a lot of heat for being carried off the court due to leg cramps. It seems that every news outlet and everyone with a Twitter account has an opinion of how this should have been handled and what caused it.

Can cramps really cause enough pain to make you leave the game? And does it really matter what LeBron was or was not guzzling on the sidelines?

First it is important to understand what muscle cramping is. It is an involuntary muscle spasm that is forceful and sustained. Now most of us have experienced a cramp in our day, whether it is while playing a sport or just during normal activity. Most muscle cramps do not cause people to stop an activity. A short break and stretch is all most of us need for the cramp to quickly pass. However, there are varying degrees of muscle cramps and some of them can be intense enough to completely incapacitate you, like it did LeBron. The pain and spasm can be so intense it can make jumping and walking difficult to the point where LeBron could not just suck it up.

Now what if LeBron had come off the court and gulped a few Gatorades, would that have helped?  The literature is not clear on whether or not dehydration will cause cramps. Yes, it is important for you to stay hydrated, especially as hot as it was Thursday night in San Antonio. Because it is difficult to study muscle cramps, it is hard to say whether dehydration would cause cramps.

If dehydration and not having proper electrolytes does cause cramping, then why don't all the muscles in the body cramp?

If there is an electrolyte imbalance it would exist throughout the body, so then why did one side or just his legs cramp and not every muscle in the body?

In 2010, a study published in Medicine & Science in Sports & Exercise, researchers used electrical stimulation to induce muscle cramps in cyclists exercising in the heat and while dehydrated. They found no evidence that it took more or less stimulation to induce muscle cramping whether hydrated or dehydrated.  They concluded that cramping was more a fatigued-related issue then a dehydration issue.

More specific than dehydration, the loss of salt or sodium seems to be the reason the literature most often points to for muscle cramping in excessive heat. There is no doubt that as the body exercises, especially in excessive heat, that it will lose valuable electrolytes. This is where Gatorade has based their claims, that drinking their formulated sports drink will allow for the proper replenishment of these electrolytes and sodium that will cause the muscles not to cramp. The loss of sodium specifically does throw off the muscle imbalance.

Sodium allows the muscles to contract and relax. Without the ability to replenish, the muscles will begin to cramp. It is highly advisable and widely accepted that during periods of long exercise, especially exercise that takes place in excessive heat, drinking a sports drink other than water will help to replenish the electrolytes that are lost during exercise. But it doesn't have to be Gatorade.

What could have been done differently or what can you do if you experience cramps? When you are exercising you need to make sure you have proper nutrition and fluid. Beyond that, if you feel a cramp come on the best thing you can do is massage the area. Start off gently and then get more aggressive as the cramping begins to subside. You may notice as you are massaging the muscle that there is a 'knot' in the muscle. This 'knot' could be one of the reasons that you could be experiencing a cramp.

You can also stretch and foam roll. Both of these things are advisable before and after every exercise which will help prevent the 'knots' that could form in the muscles. If you are exercising and you get a cramp, then you should first massage, then stretch. Stretching right away will not allow the muscle to relax but massaging the area first will allow for some of the muscle spasm to relax before you begin trying to lengthen the muscle by stretching.

So why didn't LeBron just suck it up and get back out there? The bottom line is only the coach and the medical staff knows why. Heat-related cramping (no pun intended) is a sign of the beginning of illnesses such as heat exhaustion and heat stroke. Signs of a more serious injury or illness could have been observed while he was with the medical staff which would have called for him to be taken out of the game.

LeBron James is arguably one of the greatest basketball players of all times Guaranteed, like most athletes, he plays with some degree of pain all the time. While many times professional athletes are perceived as whiners, they are not when it comes to their bodies. They play with more pain in one game then most people will experience in a life time. They don't back down because they had a simple cramp, like most people think.

James has a team of people that look after his nutrition, his training, his body. The decision to take an athlete out of a game, especially one of such importance, is not made by the player alone. If drinking water or any fluid at that point in time was all he needed to do it would have been done. But, hey, at least Gatorade got some good mileage out of it.

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