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Postexercise Increase in Nitric Oxide in Football Players with Muscle Cramps

Sirish Maddali, MD, Scott A. Rodeo, MD, Ronnie Barnes, ATC, Russell F. Warren, MD and George A. C. Murrell, MBBS, DPhil

Hospital for Special Surgery, New York, New York

Presented at the 22nd annual meeting of the AOSSM, Lake Buena Vista, Florida, June 1996, at which it received a 3M Basic Science Award.

Address correspondence and reprint requests to Professor George A. C. Murrell, Orthopaedic Research Institute and Sports Medicine and Shoulder Service, St. George Hospital Campus, University of New South Wales, Sydney, 2217, Australia

Nitric oxide, a free radical inter- and intracellular messenger molecule, is important in exercise physiology. This study tested the hypothesis that serum nitric oxide concentrations change after strenuous exercise with severe generalized muscle cramps. The study group consisted of 77 professional football players in preseason training. All players’ concentrations of serum nitrite and of other serum chemicals were determined during their preseason evaluations and compared with the concentrations in 40 serum samples taken from 25 of those same players who required intravenous rehydration for severe generalized muscle cramps after a training session. Player weight and percentage of body fat were significantly higher in players who received intravenous fluids than in players who did not. The serum of players requiring intravenous hydration showed evidence of skeletal muscle breakdown (increases in lactate dehydrogenase, creatinine phosphokinase, aspartate aminotransferase, and alanine aminotransferase) and of dehydration (elevations in protein, blood urea nitrogen, and cholesterol). The major finding, however, was a nearly 300% increase in serum nitrite concentrations in players requiring rehydration. There were no correlations between concentrations of nitrate and of any of the other serum chemicals. These data support the hypothesis that large amounts of nitric oxide are synthesized in professional football players after strenuous exercise with severe muscle cramps. The study design did not allow us to determine whether this increase in nitric oxide was due to exercise or muscle cramps or both, but it does provide a basis for evaluating these relationships.

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