Explained: Rajesh Ramesh limped at World Relays, why do athletes suffer from cramps?

Cramps returned, and quarter-miler Rajesh Ramesh hobbled at the World Relay Championships on Sunday morning, raising a critical question of why he is prone to injury, preciously cramps.

On August 27, 2023, Ramesh, now 25, ran the race of his life. Running the final leg in the men's 4x400m relay race, he created a buzz at the World Athletics Championships in Budapest.

He pulled himself up in a position where he was whispering at the neck of the USA's Justin Robinson in the first semifinal.

Though the USA eventually pipped India to win the heat in 2:58.47 seconds, Ramesh's blistering race enabled India to set a new national record and break an Asian feat, set previously by Japan.

The Indian team clocked 2:59.05s to beat the Japanese record of 2:59.51s. Their previous national record stood at 3:00.25s.

But after running such a terrific race, Ramesh was nowhere to be seen on the team bus on their way back to the hotel in Budapest.

Ramesh had to be carried off on a stretcher immediately after the race as he had suffered from cramps. It was the first time the young athlete was facing such a situation.

“I vomited for the next one hour. My cramps had hit me so badly that I needed to be taken off on a stretcher. I haven’t felt anything like this before. It took me two hours to feel okay,” the ticket collector at the Tiruchchirappalli railway station had said back then.

While athletes may feel uneasy, especially if the sweltering conditions prevail at the venue, and suffer from cramps after running high-intensity races, the final burst affected Ramesh. He had to take a break.

"He was being carried off. We asked him if he was okay. He just kept saying lactic, lactic (build-up of acid in the muscles during intense exercise),” Amoj Jacob, one of the members of the Indian relay team, recalled.

Lactic acid had built up in his muscles when he picked up the pace while chasing the highest possible finish. The Indian team exited the World Championships with a commendable fifth-place finish.

Ramesh would make a comeback at the Asian Games in Hangzhou to win the 4x400m gold medal with Amoj, Muhammed Anas Yahiya, and Muhammad Ajaml.

However, the injury made a comeback to haunt him as he opened his season at the World Relay Championships in the Bahamas in pursuit of a spot in the Paris Olympics.

Ramesh hobbled

On Sunday, Ramesh, making a comeback from an injury, was tasked with the anchor's role at the World Championships at the Thomas A. Robinson National Stadium in Nassau, Bahamas. This time, he could not even finish his leg.

After Muhammad Anas ran the first leg in 45.93s, Ramesh, running for the second time today after competing in the mixed relay event where he clocked a decent 46.79s, was seen hobbling at the first bend of his 400m lap, leading to India's withdrawal from the heat.

Ramesh could barely put his left leg forward after picking up the pace; he was writhing in pain as he bent and held his thigh muscle in despair. He was in the third position in the race when he picked up the injury.

India eventually ceded a chance to secure a Paris Olympics quota place as Ramesh left the field limping. In its statement, the Athletics Federation of India (AFI) revealed that Ramesh suffered from cramps in his leg muscles.

“The men’s 4x400m relay team had a good start. Muhammad Anas clocked 45.93 seconds in the first leg, but the second runner - Rajesh Ramesh - fell due to cramps in leg muscles at the first bend,” the AFI stated in the statement.

What is surprising here was Ramesh was preferred despite India having reigning national 400m champion Noah Nirmal Tom in the squad. Nirmal Tom won the 400m gold at the Indian Open 400m Competition in March.

Reasoning cramps

While it is difficult to decipher exactly what led to this injury, multiple factors may lead to cramps.

"Environmental conditions play a big role," Dr Sudeep Satpathy, a sports medicine physician, told The Bridge.

"This is a multifactorial problem. Changes in electrolyte balance, temperature, and then his fitness and conditioning level, and hydration level may lead to cramps. When there is a sudden change of momentum and the athlete tries to press to pick up the pace at the curve, the chances are high of suffering from cramps," Dr Satpathy added. 

In the Bahamas, the weather is humid and sultry even though the temperature in the evening was quite low as the humidity level went up, a situation much different from the Indian conditions, at the time of the event.

The Indian relay team will get a second chance to qualify for the Paris Olympics on Monday. Thus, it will be interesting to see who replaces Ramesh and how he fits into the team of Muhammed Anas Yahiya, Muhammad Ajmal, and Amoj.

India has four reserved quartermilers in the contingent in Arokia Rajiv, Nirmal Tom, Yashas Palaksha, and Avinash Krishna Kumar for the World Relay Championships.