Day 13: Fasting cramps, muscle injuries and electrolytes

I may have said this a few time already, but I suppose every time it happens has to be the "hardest day of Ramadan" so far...today has been the hardest day of Ramadan so far. 

I knew from my first PE lesson this morning that something wasn't quite right. I was trying to enjoy some leisurely 3v2 basketball, boys vs staff, but my legs were absolutely dead. I felt like I had run a half-marathon before coming to work. Muscles all over my body were entering in to cramp spasms under hardly any exertion and I started to feel quite weird in the head; like brain fog.

I still played on having fun with the kids though, and in a few subsequent lessons too, but it was definitely taking it out of me significantly more than it had done last week when it was sunny and quite warm (for Scotland at least). My favourite part of the morning was trying to put down 80 cones in a rectangular with straight lines for a problem solving game I call minesweeper. It genuinely took me 20 minutes! There were cones everywhere.

The muscle cramps actually started on Saturday evening when I was enjoying Iftar at Zenab's. I was just sat enjoying my scran and the conversation when my hamstring jumped in to spasm and I had a bit of a struggle on my hands trying to straighten it out! The awkward moment passed quickly, but the pain in my hamstring actually didn't.

Annoyingly, I haven't been consistently following my usual stretching routine since Ramadan began. The disrupted sleeping and eating hours have seen me struggle to go the extra mile to squeeze every health activity in that I would like to do, and stretching and injury rehab (sorry to my new therapist in advance of my first appointment next week) have been a struggle to engage with. With this in mind, I can't say for sure what is causing me to feel cramps all over my body at the most random times; as I was writing this, I got cramp in my lat muscle after reaching round to scratch my back! Based on a few books I have read this year, I have a few considerations to share, before reaching out to you the reader, to see if there are any other experiences specific to fasting and muscle cramps that you can share.

When it dawned on me that my muscle cramping could be related to fasting I did the obvious thing; I googled "muscle cramp ramadan" to see what popped up. Within the top three searches I found what seemed to be the perfect research article based on muscle injuries during Ramadan (Chamari et al, 2013).

Prior to any specific Ramadan discussion, the paper discusses many of the contributing factors specific to muscular injuries in football players. These include, but are not limited to, a busy schedule, fatigue, depleted glycogen stores, hypohydration and reduced quality of sleep. I am sure most of these contributing factors will feel quite familiar to anyone who is currently observing fasting during Ramadan. 

Chamari et al (2013) make reference to another research paper by Chaouachi et al (2009), who previously suggested that an intense training schedule, altered carbohdyrate intake, disrupted hydration and sleep patterns may place Muslim athletes at greater risk of injury during Ramadan. Another paper by Chamari et al (2012) was cited as the only research paper of its kind specifically collecting data and evaluating the muscle injuries in elite soccer players during the month of Ramadan. 

The 2012 (Chamari et al) paper involved the researchers collecting data over the course of two months in two consecutive seasons. The results presented within this paper showed that incidences of muscle injuries (spasms/cramps, tears, worse) increased dramatically during Ramadan, compared to the weeks before and after the holy month. Suggestions were made as to why these elite football players were experiencing higher rates of injury, including fatigue, disrupted hormones and elevated inflammatory response. 

I could have just ended today's post here, having cited sufficient research to make my case that there is a link between muscle fatigue, muscle spasms/cramps and Ramadan. However, the research presented above does not exactly relate to my personal situation. Despite my childhood ambitions of becoming an elite footballer, winning Overton St. Helen's Primary School Footballer of the Year for 1998, I am not an elite footballer.

Usually, whenever I experience an unexpected injury or disruption to my physical wellbeing, I look towards my nutritional intake to try and assess why and what's changed in my eating habits. I am often of the belief that the majority of physical problems we experience on a day-to-day basis are caused by too much, or too little of something in our diet. If my muscles are cramping, and I'm not an elite footballer, and I haven't over-exerted myself, I'm most likely experiencing a micronutrient deficiency. 

This thought process took me back to the carnivorous books that I have read already this year, specifically Michelle Hurn's 'The Dietitian's Dilemma' and Paul Saladino's 'The Carnivore Code'. Both of these books made reference to a loss of sodium in diet when tranisitioning from a typically high carbohydrate diet (as actively promoted by the UK and US Governments for the past 30/40 years) to a low/no carbohydrate diet. I checked in with Michelle Hurn (@runeatmeatrepeat) via Instagram this afternoon (UK time) and asked her what she thought of my current situation with reference to fasting.

Despite making clear that she could not give advice per se, nor is she an expert in fasting, Michelle explained that when the body and brain are using fat and ketones for fuel we can use up electrolytes far quicker than when relying more heavily on glycogen stores from carbohydrate intake. Michelle's suggestion, as stated in her book, is to increase salt intake and consume an electrolyte drink to counter this. Thank you so much Michelle for sharing your knowledge with me today and every other time I have interrupted your day via DM!

As a result, I am preparing a highly salted ribeye steak (or two) cooked in salted butter for my second meal tonight before bed and will be looking in to quick and easy homemade electrolyte drinks to make for as long as I'm experiencing my muscle cramps!

If you have any experience of increased muscle injuries, muscle cramps/spasms and muscle fatigue during Ramadan, please share your experiences with me in the comments section below, or get in touch on Instagram (@JCDCoaching).

References

Karim Chamari, Alexandre Dellal and Monoem Haddad (2012) 'Injury rates in professional soccer players during Ramadan'

Karim Chamari, Alexandre Dellal and Monoem Haddad (2013) 'Muscle Injuries in Professional Soccer Players During the Month of Ramadan'

Anis Chaouachi, Aaron J Coutts, Karim Chamari, Del P Wong, Mustapha Chaouachi, Moktar Chtara, Rachida Roky, Mohamed Amri (2009) 'Effect of Ramadan intermittent fasting on aerobic and anaerobic performance and perception of fatigue in male elite judo athletes'