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Muscle fibers, fatigue and cramps

Learn it here, then practice it on the patient.

Not all muscle fibers are the same: some are built for endurance and others for quick, strong bursts. The way a fiber makes its energy decides how long it can work before it tires.

Energy sources

Muscle uses a small stock of ATP and creatine phosphate for the first seconds of effort. After that it breaks down glucose, without oxygen for fast but short work and with oxygen for long, steady work.

Fiber types

Slow oxidative (type I) fibers are red, rich in mitochondria and myoglobin, and resist fatigue. Fast glycolytic (type IIx) fibers are pale, strong and tire quickly; fast oxidative (type IIa) fibers sit in between.

Fatigue

Fatigue comes from falling energy stores, buildup of metabolic byproducts and changes in ion levels inside the fiber. Rest and oxygen let the muscle refill its stores.

Cramps

A cramp is a sudden, painful, involuntary contraction. Common triggers are overuse, dehydration and low potassium, magnesium or calcium; gentle stretching usually relieves it.

Fiber typeBuilt forTires
Type I (slow oxidative)Posture, walking, enduranceSlowly
Type IIa (fast oxidative)Running, repeated effortModerately
Type IIx (fast glycolytic)Sprints, liftingQuickly

At the bedside

Ask about cramps when you review electrolytes or diuretic use, since low potassium or magnesium can cause both cramps and heart rhythm problems. Low calcium may show as hand spasms or tingling around the mouth.

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Written by Making Synapses. Topic reference: OpenStax, Anatomy and Physiology 2e (no text adapted).