Magnesium and Sports Performance

Below is the text of a research paper I did for a course in Sports Massage. It explains how magnesium is related to sports performance, and how to raise blood levels of this essential mineral. Hope you enjoy it.

Magnesium, Epsom Salts and Sports Performance;
or, How to become a better athlete just by soaking in the tub

A Paper by Laura A. Sosnowski
Sports Massage class, Fall 2008
Instructor: Stephanie Petersen

Supplementation among athletes at any level has become a booming industry, with most attention and dollars focused on exotic and potentially harmful anabolic steroids. However, perhaps their attention should focus more on the basics of vitamins and minerals, essential elements that are commonly deficient even among apparently well-fed Americans. Specifically, we will examine magnesium deficiency and depletion, and the effects of supplementation on sports performance as well
as overall health.

According to an online reference, the average mixed American diet supplies about 120 mg of
magnesium per 1,000 calories (NationMaster.org, 2003-2005), yet according to revised dietary
guidelines, that intake level can well put most of us into depletion territory.

Magnesium is the eighth most abundant element found within the human body; a 190-lb person possesses approximately 1 oz (23 gr) of magnesium (faqs.org). Yet at least ten percent of us are deficient in magnesium. Most of us do not recognize the signs of magnesium insufficiency until blood levels drop to severe levels; symptoms include personality changes, muscle spasms, tremors, numbness and tingling and in extreme instances, convulsions and delirium (NationMaster.com, 2003-2005).

Magnesium is essential to both bone and muscle health, with the most important muscle in the body,
the heart, especially vulnerable to signs of deficiency.
The body stores about half its magnesium inside the cells of tissues and organs. The other half is
combined with calcium and phosphorus inside bones. A tiny amount—just 1 percent—of the body's
magnesium circulates within the blood at a constant level (Lukaski et al, 2004).

The absorption of orally administered magnesium is unpredictable, but 45 percent is the usual
estimate. Both magnesium hydroxide and magnesium oxide are capable of raising serum magnesium
levels when administered orally (NationMaster.com, 2003-2005).

Research on the effects of supplementation on sports performance or on other performance measures has been frustrating due to inconsistent results; but it is difficult to determine which form of magnesium was used in each study and whether one form is more easily absorbed than another. Different forms of magnesium also vary widely in actual magnesium content. See charts below for details.

Percent Magnesium Content of Oral Supplements
Mg Oxide -- Mg 60 percent
Mg Carbonate -- 45 percent
Mg Hydroxide -- 42 percent
Mg Citrate -- 16 percent
Mg Lactate -- 12 percent
Mg Chloride -- 12 percent
Mg Sulfate -- 10 percent

As you can see, supplements vary widely in levels of actual magnesium content. (Data from National Institutes of Health, Office of Dietary Supplements, 2005.)

What other functions and health conditions are affected by low magnesium levels?

Hypertension – “An observational study with four years of follow-up, found that a lower risk of hypertension was associated with dietary patterns that provided more magnesium, potassium, and dietary fiber... Foods high in magnesium are frequently high in potassium and dietary fiber. This makes it difficult to evaluate the independent effect of magnesium on blood pressure.”

Diabetes – “Magnesium plays an important role in carbohydrate metabolism. It may influence the release and activity of insulin, the hormone that helps control blood glucose (sugar) levels. Low blood levels of magnesium (hypomagnesemia) are frequently seen in individuals with type 2 diabetes. Hypomagnesemia may worsen insulin resistance, a condition that often precedes diabetes, or may be a consequence of insulin resistance.”

Osteoporosis – “Bone health is supported by many factors, most notably calcium and vitamin D.
However, some evidence suggests that magnesium deficiency may be an additional risk factor for
postmenopausal osteoporosis. This may be due to the fact that magnesium deficiency alters calcium
metabolism and the hormones that regulate calcium. Several human studies have suggested that
magnesium supplementation may improve bone mineral density.”

Cardiovascular Disease – “Some observational surveys have associated higher blood levels of
magnesium with lower risk of coronary heart disease. In addition, some dietary surveys have suggested
that a higher magnesium intake may reduce the risk of having a stroke. There is also evidence that low
body stores of magnesium increase the risk of abnormal heart rhythms.” (All four above quotes from
National Institutes of Health page on Magnesium, 2005.)

Mitral Valve Prolapse – “A significant body of evidence [suggests] that magnesium deficiency is at least a symptom of MVP and that many of the symptoms of MVP syndrome are reduced or resolved by magnesium supplementation” (Nelson, 2007).

Some recent sports and exercise studies show that healthy levels of magnesium help human
beings to perform work and exercise with less effort and tire far less quickly. The Henry Lukaski and
Forrest Nielsen studies put a small group of post-menopausal women on a normal but supplemented
diet for 35 days, then on a magnesium depletion diet for 93 days, and then back on a supplemented diet for 49 days. They were put through exercise tests at the end of each dietary phase. The women in a magnesium depleted status required more oxygen to to reach their target heart rate on the exercycle; in other words, their muscles required more oxygen to do the same amount of work (Lukaski, 2002). Related studies show that muscles tire more quickly when in a magnesium-depleted state.

Events that take from one to seven minutes to complete were the most affected. A list of athletic events
in that range include running a mile or the 1500 meters, or swimming several laps of a pool. A 1998
German study tested blood samples of triathletes – athletes who swim 500 meters, bike 20 kilometers,
and run 5 kilometers. Those with magnesium orotate supplementation showed higher blood levels of
oxygen (an increase of 208% compared to an increase of 126% in the controls), while showing better
performance times (Golf et al, 1998).

Modern Americans' levels of dietary magnesium are further impacted negatively by the depletion of magnesium levels in the soil, as a result of intensive agriculture. Rejection of hard water over artificially softened water also leaves us without a common, natural and free source of dissolved magnesium. E.B. Flink, author of "Magnesium Deficiency in Human Subjects: A Personal Historical Perspective," has listed numerous causes of magnesium deficiency. He classifies them into nutritional causes (dietary insufficiency, alcoholism); intestinal causes (diarrhea, malabsorption); excess loss of magnesium through the kidneys (due to disease or the influence of drugs, especially diuretics); endocrine and metabolism causes (hyperthyroidism, pregnancy, excessive lactation, high levels of serum calcium); and genetic and neonatal causes (Myerson, 1989).

Not only is the soil depleted, but our efforts to supplement with calcium has thrown all our
dietary minerals out of balance: “Interestingly, our focus on getting enough calcium is another factor in
decreased magnesium levels. In a delicate dance of balance, calcium depletes magnesium yet calcium
functions best when enough magnesium is present. Studies indicate that taking a calcium supplement
without enough magnesium can increase the shortage of both nutrients. Researchers have found that
many Americans have five times as much calcium as magnesium in their bodies, although the proper
ratio for optimum absorption of both minerals is two to one” (Breyer, 2008).

Liquids with dissolved magnesium may be the most effective way to quickly restore blood levels of this element. An astonishing British study showed that merely taking Epsom salt baths for twelve minutes a day can raise blood levels. And with some evidence that those who drink hard water have the benefit of improved heart health, it is also interesting that Dasani bottled water has some magnesium sulfate added to improve “mouth feel” (NationMaster, 2003-2005).

The above-mentioned British study was conducted by the University of Birmingham with a small group of subjects. Blood levels of magnesium rose by an average of ten parts per million just after one bath, and rose an average of nearly 40 ppm after a week of daily baths. It seems astonishing that a mineral could cross the skin barrier, but I suspect that the sulfur helped to transfer the mineral.

To quote the study:

In other experiments using excised human skin, we found that sulfate does penetrate across the skin barrier. This is quite rapid so probably involves a sulfate transporter protein... To check this, 2
volunteers wore ‘patches’ where solid MgSO4 was applied directly to the skin and sealed with a waterproof plaster. Plasma/urine analysis confirmed that both Mg and sulfate levels had increased so this is potentially a valuable way of ensuring Epsom salts dosage if bathing is not available.
Interestingly, both volunteers, who were > 60 years old, commented without prompting that ‘rheumatic’ pains had disappeared (Waring, 2004).

Using the skin to “inject” magnesium supplements into one's system opens up a whole new range of options. Suggestions listed in one article to combine it with lotion or coconut oil, to sponge bathe in a solution, or to spray it on oneself like a mist, do not seem so far-fetched after all (EnzymeStuff.com, 2002).

One wonders if magnesium depletion is at the root causes of the little understood phenomenon of fibromyalgia, chronic fatigue syndrome, and other modern ills. It is disappointing to note that studies using magnesium to treat CFS have had mixed results (MotherNature.com, 1998-2005).

One can only hope that our craze for calcium will abate, and be replaced with a healthier concern for a natural, organic, and balanced diet, together with the simple self-treatments our grandmothers used.

(A couple other charts were included in the paper, but they do not transfer well to this format. However, please refer to the U.S. Department of Agriculture's Nutrient
Database Web site: http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl. for a chart of foods rich in magnesium. Also, you may look up the chart of recommended daily allowances for all ages at the Office of Dietary Supplements, National Institutes of Health, 2005.)

SOURCES:
Breyer, Melissa, Amazing Health Benefits of Epsom Salt Baths, Care2 Green Living, April 2008, http://
www.care2.com/greenliving/health-benefits-of-epsom-salt-baths.html .
Epsom Salts, EnzymeStuff.com, 2002 -- updated Aug. 2005,
http://www.enzymestuff.com/epsomsalts.htm .
Golf, S.W., Bender, S., and Gruttner, J. On the significance of magnesium in extreme physical
stress, Institute of Clinical Chemistry and Pathobiochemistry, University Medical School, Justus-
Liebig-University, Giessen, Germany, 1998, abstract at http://cat.inist.fr/?
aModele=afficheN&cpsidt=1638288.
Lack Energy? Maybe It's Your Magnesium Levels, USDA, May 2004, http://www.ars.usda.gov/is/AR/
archive/may04/energy0504.htm . (Reprinted from the May 2004 issue of Agricultural Research
magazine.)
Lukaski, Henry C; Nielsen, Forrest H, Dietary magnesium depletion affects metabolic responses during
submaximal exercise in postmenopausal women, The Journal of Nutrition, May, 2002,
http://findarticles.com/p/articles/mi_7229/is_/ai_n30048561?tag=artBody;col1 (abstract), and as PDF
at http://jn.nutrition.org/cgi/reprint/132/5/930.pdf.
Magnesium, Faqs.org, www.faqs.org/sports-science/Je-Mo/Magnesium.html, undated .
Magnesium, NationMaster.com encyclopedia, 2003-2005, http://www.nationmaster.com/encyclopedia/
Magnesium-sulfate .
Magnesium, MotherNature.com, 1995-2008,
http://www.mothernature.com/Library/Ency/Index.cfm/Id/2879002.
Magnesium, Office of Dietary Supplements, National Institutes of Health, Jan. 2005,
http://ods.od.nih.gov/factsheets/magnesium.asp .
Myerson, Ralph, Magnesium maximizes heart health; magnesium appears to be essential for the
integrity of the heart, Better Nutrition, Dec. 1989,
http://findarticles.com/p/articles/mi_m0860/is_n12_v51/ai_8199735.
Nelson, Terry, The dangers of magnesium deficiency in endurance athletes, Organ Internist, Dec. 2007,
http://findarticles.com/p/articles/mi_m0FDL/is_/ai_n24940334 .
Waring, R.H., Report on Absorption of magnesium sulfate (Epsom salts) across the skin, University of
Birmingham, 2004,
http://www.epsomsaltcouncil.org/articles/Report_on_Absorption_of_magnesium_sulfate.pdf .

Massage to Improve Immunity?

Massage is probably the last thing that you would think of when looking for strategies to improve your immune system.

But a specific type of massage, Lymphatic or Lymphatic Drainage Massage (known as LDM), could do just that.
LDM's link to immune functions is clear enough that it is contra-indicated with those who have had an organ transplant. Transplant patients must take immune-suppressing medications for the rest of their lives, so anything that boosts immune function is not desired.

I will be writing about the research behind Lymphatic Massage and other issues, but more research needs to be done to show exactly how strong the connection is and what patients benefit the most. We need long-term studies done, with followup reports over the course of a decade (at least) not just a few months.

Sports Fitness: Get Buff in 6 Min./Day?

Read an interesting article in the New York Times about a study done on rats regarding changes in muscle tissue with two groups of rats. One group was worked in lengthy swimming sessions, two sessions of three hours each. Another group was worked more intensely for shorter bouts: each session was about twenty seconds with a ten-second rest, but while carrying a weight. The two groups of rats had very similar changes in muscle tissue despite the very different training regimens.
Rats have similar muscle tissue to that of humans, so the researchers extrapolated that humans did not necessarily have to exercise for hours in order to develop endurance.
You can read the story about the study at http://well.blogs.nytimes.com/2009/06/24/can-you-get-fit-in-six-minutes-a-week/?em
My concern is that athletes who go full bore into an intense weight-training session are probably more likely to get injured. Start with those stretching and limbering exercises first before intense bouts. Muscles need to be warmed up adequately before you stress them with anything that intense.

Avoid these 8 Acupuncture Points to Avoid Miscarriage

Pregnancy massage is one massage modality that is experiencing high growth. In fact, it is often one of the most-requested services at any massage clinic or individual business. However, there are some areas that should not receive deep pressure due to the chance of causing a miscarriage.

Chinese medicine has held that these eight acupuncture or acupressure points are key to avoiding miscarriage; conversely, practitioners may press them with the intent of causing delivery in an overdue pregnancy.

The eight points are:
1 - Kidney 1 is on the sole of the foot, about on the midline vertically, and just below the level of the ball of the foot.
2 - Large Intestine 4 is located between thumb and forefinger, in the fleshy part just above the knuckle of the first finger.
3 - Spleen 6 is located 2-3 inches above the ankle bone, on the inside of the leg.
4 - Spleen 10 is located about three inches above the knees, on the inside of the leg.
5 - Liver 3 is located between the first and second tarsal bones on top of the foot, about an inch past the gap between the toes (going toward the ankle).
6 - Bladder 67 is is on the outside edge of the nail on the little toes.
7 and 8 - The uterus reflex and the ovary reflex are located on either side of the heel, one on the inside surface and one on the outside surface. They are just below the ankle bone, and between the ankle bone and the Achilles tendon.

Just casual or accidental pressure on these points will not cause a miscarriage. It requires deep sustained pressure and also the actual INTENT on the part of the practitioner to effect a miscarriage using these points.

In fact, I have known of some healthcare workers who have used these points intentionally and with good results in cases of coworkers, etc. who were overdue and desperately wanted to deliver. One person claims three out of four women who ask for this service have gotten the desired result, and gone into labor within a few hours of a session of pressing these points.

Method: Press on the points indicated with a firm pressure, for 20-30 seconds, release, and press again. You may have to press each point two or even three times like this. If the pressure is too painful due to swelling in the ankles or legs, then just work on the bottom of the foot and the hand. And again, the intent on the part of the therapist or friend is a key part of the technique.

On the other hand, if you are a massage therapist and you have a pregnant client with some normal lymphatic swelling in the feet and legs in pregnancy, you may still lightly massage those areas. Lymphatic drainage is a light form of massage, and can help the woman by reducing swelling without damaging lymph vessels. There need be no fear that light treatment of this kind is going to accidentally induce early labor.

Which Muscles are Involved in Occupational Syndromes?

Golfer's Elbow: Triceps Brachii and Flexor Carpi Radialis. Triceps Brachii muscle extends forearm at the elbow. Flexor Carpi Radialis flexes the hand at the wrist. Flexor Carpi Radialis flexes the hand at the wrist. Do stretching exercises; try to touch opposite sides of room with outstretched arms, stretch arms overhead, etc. Pretend one hand is a ring-shaped squeegee, and squeeze arm from elbow to hand; repeat 3 or more times. It may be helpful to ice the inside of the forearm, from the elbow to mid-arm, followed by a heating pad or hot towel. Same with inside of wrist. Lifting moderate weights and doing pushups will help keep biceps and triceps in balance.

Tennis Elbow: Supinator and Triceps Brachii muscles. Triceps Brachii muscle extends forearm at the elbow. Supinator causes thumb joint pain, elbow pain, pain turning door knobs. Supinator muscle causes the rolling motion of elbow as your turn hand from palm down to palm up. It may be helpful to ice the inside of the elbow joint followed by a heating pad or hot towel. Pushing against resistance in the OPPOSITE direction will help keep Supinator from going into spasm during tennis matches. Lifting moderate weights and doing pushups will help keep biceps and triceps in balance.

Hairdressers: Pronator Teres and Flexor Carpi Radialis. Pronator Teres muscle causes the rolling motion of elbow as your turn hand from palm up to palm down; it also helps flex elbow. Flexor Carpi Radialis flexes the hand at the wrist. Do stretching exercises; try to touch opposite sides of room with outstretched arms, stretch arms overhead, etc. Pretend one hand is a ring-shaped squeegee, and squeeze arm from elbow to hand; repeat 3 or more times. It may be helpful to ice the inside of the forearm, from the elbow to mid-arm, followed by a heating pad or hot towel. Same with inside of wrist.

Video Gamer's Thumb: aka weeder's thumb; Adductor Pollicis, causing pain with writing or with a pincer movement. The Adductor helps your hand grip small objects, and also allows you to touch thumb to other fingers. Exercise the hand muscles by inserting fingers into a rubber band, and trying to stretch the rubber band by spreading the fingers.
I hope these tips will be helpful to you. Cheers :) Laura

Frozen Shoulder Syndrome Can Be Caused by the Way You Sleep

Having suffered from this condition myself, I can tell you firsthand how suddenly Frozen Shoulder can strike and how miserable it makes you feel. All you know is, you cannot lift your arm above your shoulder, and there is no comfortable position in which to lie down.

It took me some time before I finally tried to look up what was wrong with me. I found a Chinese medicine webpage that said it was often called Fifty Year Shoulder, because that was the age at which the condition usually struck. It recommended warming herbs in foods to improve circulation, and use of a heating pad.

OK, the heating pad helped somewhat, tho I cannot say the cinnamon et al helped any.
Finally I wound up at a massage therapist who was pretty good with trigger points. He began by releasing some trigger points or adhesions in the supraspinatus and infraspinatus. Those are two of the rotator cuff muscles, and they are located on the dorsal side of the shoulder blade. They help you lift the arm and roll the arm forward.

Rotator cuffs are not built to do heavy lifting; that is the job for the biceps and triceps and pecs. Rotator cuffs are meant to stabilize the shoulder joint. They help keep the shoulder down while the other muscles lift the elbow up with its payload.

So anyway, this was an improvement. Another session worked on stretching the tight pec muscles. That hurt, but I was so much better within the week. The therapist lifted my arm up and back as I lay on the massage table, and manually stretched the pec muscle by pushing away from the arm. Then she lay the arm across my chest and gently pushed toward the opposite shoulder.

You can pull your arm across your own chest, and hook the other arm around it to help press it towards your chest. Hold for a couple breaths, and allow the arm and shoulder to relax into it.
After three weeks of the onset of frozen shoulder, you can proceed with Post-Isometric Release techniques.

Stand or lie on your back, whichever you prefer. Raise the arm above you as far as your current range of motion allows. Push in the OPPOSITE direction; HOLD for 5 seconds and release. You should be able to move your arm a bit further than before. You may repeat the exercise at the new limit of your range of motion.

Repeat this series for every angle of movement for your arm. Up, to the side, across the chest, forward, back. Make circles with your arms, slowly, with your arms straight out at the side. Make the circles bigger.

Stand in a corner. Put your forearms on either wall, hands pointing up. Lean into the corner. You may feel a stretch in the pecs and in the upper back.

Lastly, hold your arms out to the side. Roll the shoulder forward so that your hands turn palm up. Rotate the arms back again. Roll both shoulders forward and back for a minute or two, then roll one shoulder forward while rolling the other one back. This helps correct the hunched shoulders that so many of us get from working at a computer all day.

Now, ask yourself how you lie in bed at night. Do you lie on your side, and do you let the shoulder flop forward? Ask yourself what you are training your muscles to do by your habitual ways of sitting, standing and lying.

Lying with the shoulders flopped forward is straining your supraspinatus and infraspinatus muscles because they are being stretched for too many hours. It also is training your pec muscles to shorten up in front. Eventually your shoulder will cry out, I can't do this anymore and cramp up into the Frozen Shoulder syndrome.

Lying in this position will also tend to hunch the back. And you are probably much too young to have a Dowager's Hump on your back.

So please, try to train yourself to lie on your back when you sleep.
Sweet dreams :) Laura

Do You Have Tight Ass Syndrome?

Competitive cyclists are prone to a condition facetiously labeled Tight Ass Syndrome. It frequently occurs after a hard effort like a time trial or trying to accelerate on an incline.

It is fairly easy to relieve this cramp by having the patient lie prone on the massage table and sinking an elbow into the glutes, both gluteus maximus and gluteus medius. The pressure causes a reflexive response that dilates the blood vessels and melts the fascia in the myofascial tissues. The immediate release allows the therapist to proceed with neuromuscular therapy techniques on both a prone and side-lying patient.

Cyclists and other sufferers should perform the following stretches while lying on their backs. Bring the knee up and pull it in the direction of the opposite shoulder. Hold for 2 or 3 seconds, or a breath, and let the leg lie down flat. Repeat ten times.

I might add that the patient can use a stretchy band or towel passed under the foot to help lift and guide the leg, if it is painful to lift it. This also helps to achieve a greater angle of stretch once the muscles begin to relax and lengthen.
Best Wishes :) Laura