Objective: To discuss the causes, prevention and treatment of exercise associated muscle cramps (EAMC) according to the level of evidence of the available literature, in order to present some evidence-based guidelines for athletes, coaches and health professionals. News: Since it appears fundamental for sports medicine physicians and sports health professionals to be able to manage and prevent EAMC, although pathophysiology and causes of EAMC are discussed, clear understanding of EAMC causes seems important in order to treat and prevent EAMC. Perspectives and projects: The present review evaluated the available literature on EAMC based on their level of evidence to present some evidence-based guidelines for sports professionals. Fifty articles were selected: 24 after full-text reading and 26 articles after screening selected articles references. Level of evidence was from 1 (n = 3), 2 (n = 8), 3 (n = 10), 4 (n = 13), and 5 (n = 16). Conclusions: The "Altered neuromuscular control theory" seems to be the most scientifically acceptable theory, and suggests that EAMC are caused by an imbalance between increased afferent activity (e.g. muscle spindle, Ia) and decreased inhibitory afferent activity (e.g. Golgi tendon organs, Ib) which leads to increased a-motor neuron activity and muscle cramping, especially with muscle contraction in a shortened position. EAMC prevention measures should take into account the preparation of muscle to exercise (adapted training) and the respect of muscle fatigue during exercise (warm-up before exercise, well-controlled effort and rest during exercise). EAMC treatments should be non-pharmacological and should play a role on neuromuscular control (rest and/or stretching).
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