00:00It might be actually. So cramps are really interesting because despite, you know, this
00:07vast global medical research community that we have, we don't know what causes cramps.
00:13Some people think it's an electrolyte imbalance, sodium, magnesium, we'll come back to magnesium
00:17later. Certainly high humidity is a risk, dehydration some people think is the problem.
00:23Other people think there's an imbalance going on in the spinal column between messages that
00:28are going to the muscles to say contract and messages that are saying relax. And then you
00:33get an over contraction message coming from the spinal column, which actually causes this
00:38really painful contraction. And anybody waking up in the middle of the night knows how painful
00:42that can be. And so they've tried lots of things. They've tried magnesium. Magnesium is commonly
00:49taken by people to prevent cramps. And there's really not much evidence that magnesium has
00:55much benefit. And the problem with magnesium is it often goes along with other things
01:00like B6. And we now know that B6, vitamin B6 is a risk. So it's hard to get pure magnesium.
01:07But nonetheless, there's not a lot of evidence there. So then there's pickle juice. So pickle
01:11juice started off with drinking the brine of kosher pickled cucumbers.
01:18Kosher pickles. So the thing about kosher pickles is that they're very pickled. There's not much
01:23sugar in them. So it's fairly much a pure pickle with a low pH. In other words, it's reasonably
01:30acid with vinegar, acetic acid. And there is evidence. So people, for example, with liver
01:36cirrhosis are very prone to cramps. Again, we don't know why. And there's been a randomised
01:41trial showing that pickle juice actually does help to relieve the cramps in people with liver
01:46cirrhosis. And anecdotally, in sports, it does seem to relieve the cramps. Now, there's
01:53a great theory as to how this happens. And it's that when you take pickle juice, you know,
01:59you know, you're... Yeah, it's tart. It's bitter. It hits you at the back of the back of your throat.
02:04And this is the key, is the thought is that what that does is it gets to your brain and your
02:10spinal cord and reprograms this imbalance between relaxation and contraction or has an... or interferes
02:20with the receptors, the lock and key mechanisms in the muscles and the nerves, which then relax the
02:26muscles. And it's thought that chili might do the same thing or wasabi. So it's nothing special about
02:31pickle juice. It's just that you get this really strong reaction at the back of the throat, which
02:36then gets this neurological reaction. Okay. So there might be something to it. The problem with pickle
02:40juice, if you get cramps at home, is there's a lot of salt often in pickle juice. So if you're
02:46taking it, glug, glug, glugging it all the time, it might be a problem. But maybe if you've got a
02:51little bit by the bedside for the occasional cramp, maybe. Okay, a bit of pickle juice, a bit of chili
02:55and maybe a bit of, I don't know, sodium. Or wasabi. Or wasabi. Okay. All right.
03:01Just keep your... Keep it handy. Your sashimi to one side. Yeah. Yeah. Okay. So staying in the sport
03:06theme, I want to talk to you about swimming now, because I don't know about you, but my mum always
03:10used to say, you know, don't eat before you go swimming because you'll get a cramp. Is there
03:13anything to that? What more do we sort of know about cramping? We first came across this researching
03:18it for What's That Rash? in a Boy Scout manual from 1908 saying, you know, and the theory was
03:24that you, they were saying that you should not swim for an hour and a half. So there's all sorts of advice
03:29you got from your granny or your mum. And the theory is that when you've eaten, all
03:33the blood goes to your tummy, your abdomen, your gastrointestinal tract to digest the food
03:38and you haven't got money, you know, you haven't got anything left for your muscles, so you're
03:42going to get cramps. And then the cramps were defined in different ways because the cramp that
03:46your granny was really worried about was really what they called a stitch, where you might bend
03:51over and you get this pain in the abdomen or muscles. There's no evidence for either. In the
03:56national drowning data and also data from internationally, there's no relationship found in the national
04:04drowning data between eating beforehand as a risk factor and drowning. What is a risk
04:10factor for drowning is alcohol and other drugs. 20 or 30% of people have alcohol or other drugs
04:16in their blood. But it's pretty safe to go into the water. There is another theory as to why
04:22this is effective is that your mum and dad would have had lunch and wanted to have a snooze without
04:29worrying about you in the water. Yes, that's a very good theory. I like that one. So then what is a
04:34stitch? What causes a stitch? Again, the global resources of medical science have not actually
04:40answered this, but it's thought to be a combined pressure from the lungs on the diaphragm and also
04:47pressure from underneath. But what causes it in the first place? It could be just simply like muscle
04:51cramps anywhere else. You've been doing too many abdo exercises or, you know, so there's overstress on
04:58the muscles of the abdomen, but nobody knows. Norman Swan, always good to chat. Thank you. Even if I don't know.
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