Episode Title: Unraveling the Mystery of Muscle Cramping with Jeff Sankoff

Guest:
Today's guest is Jeff Sankoff, an emergency physician and seasoned triathlete with over 50 finishes at the 70.3 distance, six Ironman completions, and six 70.3 World Championships under his belt. Jeff is also the host of the Tri-Doc Podcast and a coach who specializes in guiding triathletes, runners, and cyclists through his Tri-Doc coaching business. His unique combination of medical expertise and extensive experience in endurance sports makes him the perfect guest to discuss the complexities of muscle cramping.

Episode Summary:
In this episode, Brodie Sharpe and Jeff Sankoff delve into the elusive and often frustrating topic of muscle cramping. Jeff shares his personal experiences with cramping, particularly during his endurance races, and discusses the scientific theories behind what causes muscle cramps. The conversation covers potential causes such as dehydration, electrolyte imbalances, and the newer theory of neuromuscular imbalances. They also touch on the related condition of hyponatremia, exploring its dangers and how to prevent it during long endurance events. Throughout the discussion, Jeff emphasizes the multifactorial nature of cramping and the importance of personalized strategies for prevention and treatment.

Key Talking Points:

• Personal Experiences with Cramping: Jeff shares how cramping has affected his races, sometimes costing him podium finishes, and the frustration of managing cramps throughout his athletic career.
• Causes of Muscle Cramping: Exploration of the two main theories behind muscle cramping: dehydration/electrolyte imbalance and neuromuscular dysfunction due to an imbalance between excitatory and inhibitory nerve impulses.
• Hyponatremia: Understanding the dangers of hyponatremia, how it can be mistaken for heat stroke, and the importance of balancing water and electrolyte intake during long endurance events.
• Prevention and Treatment: Discussion on the effectiveness of various cramp remedies, such as electrolyte supplements, spicy drinks like pickle juice, and the importance of training at race intensity to prevent cramps.
• The Role of Fitness and Strength Training: How better fitness and strength in targeted muscle groups might reduce the risk of cramping during high-intensity efforts.

Key Takeaways for Runners:

• Experimentation is Key: If you’re prone to cramping, try different strategies such as electrolyte replacement or spicy liquids to find what works best for you.
• Listen to Your Body: Pay attention to how your body reacts in different conditions and intensities. Adjust your training and race strategies accordingly to minimize the risk of cramping.
• Stay Hydrated, but Smartly: In hot conditions, ensure you're not just drinking plain water but also replenishing your sodium levels to avoid hyponatremia.
• Strength Training: Incorporate strength training into your routine to enhance muscle endurance and potentially reduce the risk of cramping during races.
• Know the Warning Signs of Hyponatremia: Be aware of the symptoms like confusion and imbalance, and ensure you're adequately replacing sodium if you’re sweating heavily during long races.

Where to Find Jeff Sankoff:

• Website: Tri-Doc Coaching
• Instagram: @tridoccoaching
• Podcast: The Tri-Doc Podcast available on Apple Podcasts, Stitcher, Spotify, and more.

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