Almost everyone already experienced leg cramps in their life.
Cramps are sudden pain and tightness in the muscles, usually the calf muscles behind the leg,
but can also happen in the front of the leg, in the thigh or the foot.
In this video I will explain what cause muscle cramps, how to treat them when
they happen, and how to prevent them. So, let’s talk about muscle cramps today
In North America, muscle cramps are also known as “Charlie horses”, and “choppers” in Europe.
These are painful contractions of a muscle, usually the calves, hamstrings or the foot.
What cause muscle cramps? In the past, people thought that
cramps were caused by dehydration and depletion of electrolytes. However, recent scientific
studies could not demonstrate these theories. The exact mechanism is still unknown, but there
seems to be an imbalance between contraction and relaxation of the muscle fibers, which is called
the “altered neuromuscular control theory”. That is why all cramps are relieved
by stretching of the muscles. At the end of this video I’ll
demonstrate how to stretch the muscles. There are basically six types of cramps:
pregnancy-related, neurogenic muscle cramps,
muscle cramps associated with a medical condition, exercise-associated muscle cramps,
muscle cramps as side effects of medications, and the nocturnal leg cramps.
First, pregnancy-related leg cramps are very common either before or after delivery. It
seems that the main causes are depletion of magnesium and dehydration. In these cases,
supplementation with magnesium is helpful to reduce the frequency and intensity of cramps.
Stretching of the muscles help to prevent and alleviate an episode of leg cramps.
Second, neurogenic muscle cramps are painful muscle contractions that occur
in people with neurological diseases. They are caused by a problem of the neurons
coordinating the contractions of the muscles. For example, cramps occur in approximately 50% of
patients with ALS (amyotrophic lateral sclerosis), in 64% in patients with polyneuropathy,
and 80% of Charcot Marie Tooth disease. Cramps are also very common in people
with Parkinson’s disease, stroke, multiple sclerosis, spinal stenosis,
carpal tunnel syndrome and radiculopathy. For neurogenic cramps, in addition to regular
stretching, there are some medications that can be prescribed by a physician, they include
quinine sulphate vitamin B complex
diltiazem, and nafronyl oxalate.
It is important to consult a physician before taking any medication. Quinine has been associated
with severe complications of lowering the platelet levels, and is no long available
as a supplement that can be obtained without a doctor’s prescription in the United States.
Third, there are some medical conditions that predispose
the person to more leg cramps. Examples are: liver cirrhosis caused by alcohol or hepatitis C,
people on dialysis due to kidney failure, people with magnesium and calcium deficiencies,
dehydration, diabetes, parathyroid or thyroid dysfunction, and
varicose veins. In these cases,
the most effective way to avoid cramps is by treating the underlying medical condition.
Fourth, is exercise-associated muscle cramps. These are muscle cramps after strenuous exercises,
especially after a period of inactivity. They usually last from 1 to 3 minutes and
generally occur in the thigh or leg. It is important to visit a physician
to make sure there is no underlying metabolic, neurological or endocrine disease.
There are a few things that can be done to prevent exercise-associated muscle cramps:
Stretching prior to exercise. Remember that
stretching is the most effective way to get rid of an episode of cramps.
Despite the lack of empirical evidence, replacement of electrolytes is very common
among athletes. Mainly potassium. It is recommended to use nutritional options
like drinks and food rich in potassium. Here are the top 10 sources of potassium.
Dried Apricots Cooked Lentils
Dried prunes Acorn squash
Raisins Flesh of baked potato
Kidney beans Orange juice
Mature seeds of soybeans Banana
How much potassium does a person need per day? Female adults need 2600 mg per day,
during pregnancy and lactation this increases to 2900 per day
Male adults need 3400 mg per day There are some conditions that
put a person at higher risk of potassium deficiency, such as people with inflammatory
bowel disease and those who use certain medications like diuretics and laxatives.
Third, Massage Massage immediately before an event
could reduce the number of cramps, however, this has not been demonstrated in rigorous studies yet.
Fourth, Neuromuscular re-education to correct muscular imbalances.
There is an interesting study showing that hamstrings cramps can be avoided if the
person does exercises for strengthening and re-education of the gluteus maximus muscle.
Fifth, There are other interesting treatments for exercise-induced cramps that showed some
promising initial results in scientific studies. One of these included drinking
pickle juice when the cramps started, it seems that the duration of the cramps were diminished.
And last, there is some suggestion that hyperventilation strategies work to reduce
the duration of a exercise-associated muscle cramp. The person is instructed
to breath quickly and deeply, 20 to 30 deep breaths per minute when the cramp starts.
The fifth cause of muscle cramps can be side effects of prescribed medication:
Statin for example. These are medications to lower cholesterol, such as atorvastatin,
fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin.
Diuretics to lower blood pressure (“water pills”) such as furosemide and hydrochlorothiazide.
Alzheimer’s disease medication Donepezil Nifedipine, a treatment for
angina and high blood pressure Raloxifene, an osteoporosis treatment
Some asthma medications like Terbutaline and albuterol
Some Parkinson’s disease medication Tolcapone opioids like morphine and
Some antibiotics, antiretrovirals, anticancer and antipsychotic drugs
Sixth and last, when we can’t find a cause or precipitating factor for muscle cramps,
we call this just “idiopathic muscle cramps” or “Nocturnal Leg cramps”.
They are more common in older age. Approximately one-third of individuals over the age of 50 years
have regular nocturnal leg cramps. It seems that these cramps are
associated with shortened muscle length and less physical activity.
The only treatment that we know for idiopathic leg cramps is stretching.
We recommend the person to stretch before going to bed, and when the leg cramps occur.
Another thing that is very helpful to reduce the pain is to walk a few steps before stretching.
Walking is excellent to get rid of cramps, however there are situations that walking is not possible,
like if the person is driving a car or swimming.
These situations can be very dangerous. The person who is prone to muscle cramps
need to stretch the muscles before driving or swimming to avoid any unexpected cramp.
So, for this stretching exercise all you need is a wall, just stay maybe two feet from the wall,
and the affected leg, you're going to support your affected foot on the wall, and then you're
going to move your body forward. Put your hips forward, keep your, keep your both knees straight,
and you notice that if you just keep your, putting your hips forward, you're stretching, and feeling
the stretch on the cuff muscles of this right foot, and then you can do with the other one,
just put the left one there, knees straight, it's really important to keep the knee straight,
and just move your hips forward, forward. Forward, forward, and you'll be noticing, so if you
do this in the middle of the night when you have those leg cramps you all walk first before you
do this just sometimes just by walking, you will notice that the cramps are going away, and then
you find a wall, and just do this exercise this is the stretching of the calf muscles.
If the cramps happen when you are sleeping, you are in bed, and you just want to stretch in bed,
you can try to do this by yourself, keep the knees straight, and try to pull
the toes towards your face, just by doing this you may alleviate, you can also try doing this,
you can also try to help with your hands, pulling this way, if the cramps are happening here,
in the calf, but sometimes if the cramps are happening here, in the front of the leg,
you need to do the opposite, you need to pull down, down, down, down to stretch the
muscle that is having the cramp, the cramps, and sometimes the cramps happening inside of the foot,
so then you need to stretch the muscles inside of your foot, so you can do this, or this,
and if you want to do more efficiently, you can leave a bed sheet on the side of your badge, and
if they are happening in the middle of the night, you can just pull and do the stretch like this,
because then you'll be stretching the whole foot, and leg and calf just keep the knees straight,
the important thing is to keep the knee straight when you are stretching the leg cuff muscles.
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works best for you. Please, don’t forget
that this video is for educational purpose only. If you have a condition that needs medical advice,
please talk to your doctor. And if there is an emergency, go to the nearest emergency department.
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Good bye.