Muscle cramps that strike during sports can be painful, disruptive, and incredibly frustrating—especially when they’ve been happening for years and common fixes like hydration and supplements don’t seem to help. Many active adults and athletes assume cramps are simply the result of dehydration, but the reality is often more complex. In this Q&A, Dr. Jason Spangler, fellowship-trained sports medicine physician at Center for Sports Medicine & Orthopaedics in Cleveland, explains why exercise-induced muscle cramping occurs, what may be contributing to it, and how proper training, conditioning, and medical evaluation can help bring lasting relief.
Q: I’m having serious issues with muscle cramping during sports for several years. It usually starts in my thighs or calves and can spread to my feet when it gets bad. I’ve never had a cramp outside of exercise. I’ve tried every supplement I can think of, stay well-hydrated, and drink electrolytes, but nothing seems to help. What could be going on?
A: Muscle cramping during exercise is a frustrating and surprisingly common problem, even among well-conditioned athletes. While dehydration and electrolyte imbalances are often blamed, research shows these are not the only or even the most common causes.
Cramps often occur when muscles become fatigued or overstimulated. Over time, nerves that control the muscle can misfire, triggering a painful, involuntary contraction. This tends to happen more frequently during high-intensity or long-duration activity, especially in hot conditions or when your body is not accustomed to the workload.
If your bloodwork is normal and hydration has not helped, it may be worth focusing on training and neuromuscular conditioning. Make sure to warm up and stretch regularly, especially the muscle groups most affected. Gradually build intensity and avoid sudden increases in duration or load. Address posture or gait issues, as tightness in the hips or hamstrings can increase cramp risk. Review any medications or supplements that might affect muscle excitability, such as stimulants or diuretics. In some cases, nerve compression or a metabolic muscle disorder may play a role. Keep in mind that adequate hydration prior to activity is equally important as hydration during activity, if not more so!
If cramps persist despite conditioning changes, ask your physician about seeing a neurologist or sports medicine specialist. At the first sign of cramping, gentle stretching and massage can often bring quick relief.
To schedule an appointment with Dr. Spangler, call (423) 624-2696 or click here to schedule online. CSMO – Cleveland’s Urgent + Ortho walk in care is available Monday – Saturday.
Jason Spanger, DO
Fellowship Trained Sports Medicine Physician
