How to avoid cramping

I started a 6 month chemo therapy program for lymphoma in March, 2021. This consisted of 6 monthly 2 day cycles of chemo (first day 6 hours on the drip and the next day 1.5 hours). I cycled or did the stairs all but 2 days of my 6 month program because (a) I wanted to remain somewhat active during the program, (b) I had goals during and after my treatment and, (c) I was interested in seeing how the chemo affected me. Staying active helped and I achieved most of my goals. My experiment was very interesting - I was about 70% normal for the days of and day following chemo, then a significant drop in capacity for the next 4-5 days (to about 20% ability), then gradually improving to back to about 70% ability before the start of the next cycle - that held true for all 6 cycles.

My goals during and after chemo (trust me, this is relevant [tangentially?] to the cramping article) were (a) do the Death Ride at the end of cycle 4, (b) cycle Mt. Evans and Pikes Peak (14,000' peaks) on the same day in the 5th cycle, (c) travel to Saudi Arabia to ride the hardest cycling mountain range in the world at the end of my treatment, (d) do an Everest 2 months after my final treatment and (e) do Mauna Kea for my 65th birthday and when I would be cleared by my oncologist as being in remission.

Check to all but the Death Ride, but that wasn't my fault - forest fires caused the DR to be canceled the day before the ride. However, we made lemonade by driving to Owens Valley all night and riding White Mountain and Horseshoe Meadows the next day. Then I did Evans/Pikes, Everest, Saudi and Mauna Kea.

It was during the Everesting attempt that Clarence King saved me. An Everest is a stupid attempt (if you are 64 and just finishing chemo treatment anyway) to climb 29,032' (the height of Mt. Everest) in 24 hours. I hydrated and stretched before the start and took electrolytes throughout. In spite of my best efforts, at about the half-way point I could feel the cramps coming on and knew there would be no way to press on for 10 more hours and another 15,000' with cramps. Clarence was riding with us and I mentioned my concern to him and he told me that coconut water is a miracle cure for cramps and he had several boxes of it in his car. Clarence gave me several boxes of coconut water which I drank throughout the night and was able to Everest within 24 hours - that would not have happened without the coconut water.

My next cramping experience with in the Asir Mountains, Saudi Arabia - it is hot there (duh) and the mountain roads are the steepest set in the world - Rdom has one mile at 26% (2.5 miles at 20.3%), Al Jaadah 2.5 miles at 18% ( 5 miles at 16.4%) and Bani Amr (5 miles at 18%). The inevitable cramping came on early in the trip and amazingly I was able to find coconut water in the Asir Mountains and that did the trick - I was able to complete all of the climbs without being shut down by cramps.

To avoid cramps, I use electrolyte tablets (my preference are Nuun tabs (electrolyte replacement), but there are many varieties out there). However, if I fail to prevent them and they start, I have two remedies. The first is the most convenient but least pleasant...I keep a couple of sachets of ketchup with me (I actually carry them in an old Nuun tab tube). If cramps start, I take one or two of those (washed down with some water). It's a convenient way to get vinegar "on the run" and more palatable than straight vinegar sachets! https://pubmed.ncbi.nlm.nih.gov/32459412

My second...and preferred source is beetroot pickle juice (i.e. the remaining pickle "juice" once you've eaten all of the beetroot). I actually keep the jars after I finish the beetroot and keep them in the fridge so I have a decent source come summertime! A couple of tablespoons of that is great for cramps! And it suits the frugality of my Scottish upbringing since it's a free by-product of eating beetroot! And I just grab a couple of sachets of ketchup from any fastfood chain!

My keys to avoiding cramping...

Once it starts, it is difficult to recover... It takes hours of rehydration plus nutrition and rest to reset from a cramp. Prevention is key. I am a big fan of electrolyte tablets. Ratio is important. Be sure to follow the instructions with regards to the amount of water needed to add to your tab. I don't like taking electrolyte pills, it is too easy to get water overloaded with this method (I gained 10 lbs of water weight on a ride by doing this method, not good). Finally, avoiding the bonk is crucial. 100 to 150 kcal per hr of simple sugar is mandatory. I also suggest taking an hour to eat real food on rides approaching 8 hrs in total length.

I have most certainly experienced cramps. In fact, I cramped up pretty bad at mile 58 of the Levi Fondo, with just about 70 miles left to go. It was a dog fight between my legs and my psyche the rest of the way. Since that time I really tapped into my inner scientist to find a cure for me. As you know, electrolyte balance is highly variable with each athlete, often dictated by genetics, heat, humidity, sun, effort, etc. For me, I really had to experiment with different salt solutions with manufacturers and the frequency with which I hydrated on rides. First learning tool was to recognize that you almost can't drink enough while you are churning 180-250 Watts on a bike at age 53 - you just can't. The other is, not all salt solutions are the same. The differences between Nuun, LMNT, The Right Stuff, Precision Hydration, etc. are small, yet significant. In the end, I ended up going with LMNT brand as it has a higher volume of Magnesium than the others, and doesn't include glucose much, so I get my carbs from other sources. The other avenue I went with is the use of either real food and G-Blocks from Cliff. All of these combos have stopped my cramping, including having none of it during the Death Ride, or France Tour de France routes immediately thereafter.

As far as cramping, it's a very interesting topic. There's tons of studies on cramping going back decades, and nobody has really been able to figure out why cramping occurs. It's likely there are many causes, including going too deep (muscle fatigue for which they are not trained), dehydration, magnesium, and electrolytes (salt). Cramping also affects different individuals differently, some people never cramp, some cramp all the time. Furthermore, cramping in a weekend warrior who suffers from cramping during their century ride is likely caused by a different reason (lack of muscle training, and build up of lactic acid) than a cyclist training every day (more likely to suffer from chronic electrolyte depletion). What is known is that maintaining hydration, electrolytes, and salt helps some people, some of the time. And so staying hydrated during the ride is important, and salt and electrolytes help retain water. For the daily rider, increasing salt intake on a daily basis may help long term. The goal would be to replenish normal salt levels in the body given the daily losses.

So, each person is going to respond differently to different remedies, and it requires trial and error. I'm fortunately not somebody who cramps, I've only cramped once and that was after an 18,000' 8 hour session on the trainer, I got way behind on electrolytes. I've found for me personally that SaltStick capsules, one tablet taken as directed on the bottle, just makes me feel better on the ride. They contain salt as well as magnesium, some calcium, and some vitamin D that is there to help with the calcium absorption. In looking at the reviews online some people swear by them, others state they don't work...so, it's back to the original conundrum of each person having to try different regimens and finding out what works for them and trying to pinpoint the reason they cramped and targeting that to avoid it in the future.

Coconut water is also my go-to, but is not available everywhere we travel. If not available then I substitute some kind of coconut milk (which seems to include part of the "meat" pureed).

My recipe is to fill my water bottles up about 1/3 full of the coco water and finish with water. On top of that I also add a scoop of endurance power (in my case Hammer Perpeteum). But I think the best recipe will be athlete-dependent. My advice is to try coconut water mixed with your normal mixture of electrolyte or endurance powder and experiment to see what works.

Btw, I did 102 miles today, in just short of 6 hours, starting with two bottles 1/3 full of coconut water plus my normal mixture. Filled one of the bottles with water half way through the ride. My first and only little cramp twinge was at mile 100 in my right calf and only for a couple of seconds. Off the bike now and no cramps whatsoever.