Chances are we’ve all experienced the painful effects of a muscle cramp. Some can be mild and annoying and others can stop us dead in our tracks. Whether we’re out for a jog in the morning, sitting at our desks at work, or sound asleep in the middle of the night, muscle cramps can strike suddenly and without warning. So what exactly causes a muscle cramp? What are some of the risk factors that predispose us to cramps? And what can be done to break a cramp when it occurs?

A cramp is an involuntary and sustained muscle contraction that can last anywhere from a few seconds to a couple of minutes. Commonly referred to as a “Charley Horse,” these sudden and painful spasms cause a noticeable hardening and bulging of the affected muscle(s), and can at times leave some residual soreness once they’ve passed. It’s not uncommon for a cramp to strike multiple times before it’s completely resolved. Let’s take a look at the different types of cramps and what’s behind them.

Types and Causes

Muscle cramps can occur anywhere in the body. True cramps, as differentiated from tetany, dystonic cramps, or even smooth muscle cramps (i.e. menstrual cramps), are cramps that affect voluntary skeletal muscles. Some commonly affected areas include the hands, ribcage, abdomen, thighs, calves, and foot muscles.

Cramping that occurs during or after exercise or physical activity is considered a fairly normal occurrence. Muscle fatigue and over-exertion, such as in writer’s cramp or long distance running, are the likely culprits in cases such as these. But more often than not, the exact cause may be hard to identify since there are so many contributing factors. Here are some other leading causes:

  • Chronic muscle tension
  • Poor circulation
  • Dehydration
  • Overuse
  • Injury
  • Vitamin deficiencies
  • Drug side effects
  • An overly facilitated nervous system
  • Myofascial trigger points
  • Restless Leg Syndrome
  • Insufficient stretching before or after exercise
  • Increased levels of lactic acids and metabolites
  • Medical conditions such as: diabetes, cirrhosis of the liver, thyroid disorders, kidney disease, MS

A muscle spasm can develop in any of the voluntary muscle groups as a protective mechanism against further injury.

Repetitive use of certain muscles can lead to muscle fatigue, which in turn can cause cramping.

Resting cramps, such as those that occur while we’re sitting or lying down in awkward positions, are more likely to occur as we age.

Dehydration, either from a lack of proper hydration or excessive perspiration, can increase the chances of cramping due to sodium depletion; so can diuretics, which are medications that promote urination.

Severe vitamin deficiencies have also been associated with muscle cramping. B1, B5, B6, magnesium, potassium, and calcium are all important for proper muscle functioning.

Leg Cramps

Leg cramps, such those that affect the front and back of the thigh, as well as the calf and foot muscles, are usually at the top of the list of afflicted areas. Cramps that occur while walking or running can be the result of poor circulation caused by muscle tension in the lower leg. The gastroc/soleus complex, the two prominent muscles of the lower leg, is an integral part of the venous return to the heart. The soleus muscle in particular has the unique distinction of being called the “body’s second heart.” The reason for this is that the soleus contracts both while shortening and lengthening, making it very efficient at pumping blood back to the heart. If the muscle is chronically tight and shortened due to trigger points or poor conditioning, it can impede blood flow and therefore be an indirect cause of calf cramps.

Muscle tension on the top of the foot, whether due to tight footwear or trigger points in the interosseus muscles, can cause numbness, swelling and cramps on the top of the foot. The poor circulation resulting from this is likely to promote trigger points in the area.

Nocturnal leg cramps can also be the result of trigger points in the lower leg muscles. Vitamin deficiencies, such as magnesium and potassium, can be a significant factor in such cases. Calf cramps that occur in the later stages of pregnancy may be considered normal to some, but can often be the result of a calcium deficiency.

Poor circulation can lead to decreased levels of oxygen to the muscles. In some cases a condition known as claudication, which causes pain and/or cramping in the lower leg or thigh, is a result of inadequate blood flow to the leg. The pain is typically felt while walking or running, when oxygen is needed the most. It subsides while at rest and is sometimes referred to as “intermittent claudication” for that reason. Claudication can be a symptom of a more serious condition known as peripheral artery disease (PAD). Atherosclerosis, which is hardening of the arteries due to high cholesterol and an accumulation of plaque in the arteries, often begins in the arteries furthest from the heart. The pain associated with claudication however does not necessarily come from a muscle cramp, but from an accumulation of lactic acid and other chemical byproducts held in the tissue.

Cramp Relief

There are a few things that can be done when we’re in the throes of a cramp. Most of us will gently massage and/or stretch the affected muscle until the cramp subsides. This is an instinctual reaction to an acute attack of pain. And for most of us, is all that it takes. Here are some alternate ways of breaking a cramp.

Sustained compression: Hold the cramped muscle with steady pressure until it subsides. This is an especially good technique when dealing with multiple cramps.

Ice/Heat Application: The numbness caused by icing a cramped muscle will inhibit nerve impulses and help to break the cramp. Although it may take longer, it will aid in reducing post cramp soreness and may be a good option when a muscle cramps multiple times. Heat is also a great way of soothing and relaxing cramped muscles. A twenty-minute soak in a warm bath with Epsom salt or applying moist heat compresses should suffice.

Reciprocal Inhibition: Muscles work in opposition to each other. In order for one muscle group to contract, the opposing muscle group must relax. For example, in order for the calf muscles to flex, the shin muscles must relax and give to a certain degreee. This neuromuscular technique uses the inhibition naturally created in the opposing muscle group to stop the cramp. If the cramp occurs in the calf muscles, place the opposite (non-cramping) foot on top of the cramping foot to provide resistance, and try to lift your toes against the resistance. Flexing the shin muscles of the cramping leg against resistance will create reciprocal inhibition in the calf muscles. Although this technique is a bit more involved and requires some forethought, the relief it provides is often immediate and well worth the practice.

Muscle Spindle Approximation: This other neuromuscular technique uses a set of proprioceptive cells found in the belly of a muscle to provide relief. This technique is ideally suited for large, graspable muscles such as the quadriceps, hamstrings, and abdominals. Grasp either end of the cramping muscle and squeeze the ends together. If the quadriceps are cramping, grasp just above the knee with one hand and just below the pelvis with the other hand and bring the ends together.

Stretching: Although stretching is one of the most common ways of breaking a cramp, caution should be used as stretching during a severe cramp can make it worse. For lower leg/calf cramps, gently point the toes up and down until the cramp subsides. Stretching before and after exercise is an excellent way of reducing your chances of getting a cramp. For those who suffer from nighttime cramps, some gentle stretches before going to bed should be part of your routine.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.