Muscle Cramps

What Your Symptom Is Telling You
Muscle cramps are an "equal opportunity" pain: They don't discriminate between the star athlete and someone who barely moves. You may be competing in a long-distance bike race, taking leisurely laps in the pool or sleeping soundly in bed. Suddenly, a muscle seizes up and grips you in pain. Cramps may also occur after inactivity, such as sitting too long in one place without moving a muscle. Sometimes you can even get a cramp when you're just lying in bed, though researchers cannot define a cause.
A cramp is caused by anything that interferes with the muscle's natural ability to contract and relax. Take a foot spasm, for example. When feet are flexed for propulsion while swimming or when tight bedsheets force your toes downward, the muscle tendons become overstretched and the nerves extending through your foot and into your calf can become hyperexcitable. When this happens, the nerve signals become confused, according to Robert Nirschl, M.D., assistant professor of orthopedic surgery at Georgetown University School of Medicine in Washington, D.C. The result: a painful cramp. "Your muscles may get the message to contract, but not to relax," he explains.
Profuse perspiration can also cause a muscle cramp. Heavy sweating drains your body of important minerals: potassium, sodium, magnesium and calcium. These minerals, called electrolytes, carry electrical charges to the nerves that control a muscle's impulse to contract and relax. Lack of fluids can upset the delicate balance of electrolytes, causing nerve signals to misfire.
If you've actually injured a muscle from overuse, a cramp may go into a continuous contraction, or spasm. While "cramp" and "spasm" are often used interchangeably, a spasm generally means the muscle fibers have "locked up" to protect the injured muscle.
People who have conditions that interfere with blood circulation or muscle metabolism can experience repeated cramps. These conditions include diabetes, rheumatoid arthritis and thyroid disease.
Symptom Relief
Here's how to ease out of the grip of a muscle cramp, no matter what the cause.
Stretch and squeeze. Stretch a cramped leg muscle with one hand and alternately squeeze and release the muscle with the other hand. "This mechanical kneading restores blood flow and generally helps relax the spasm and tightness in seconds," says Dr. Nirschl.
Point your toes back toward your chin. This is a quick way to halt a leg cramp while swimming, according to Harry Daniell, M.D., clinical professor in the Department of Medicine at the University of California, Davis, School of Medicine.
Cool it. If stretching doesn't release a cramp and the muscle's in painful spasm, an ice massage will numb the area, according to Irene von Estorff, M.D., assistant professor of rehabilitation medicine at the New York Hospital-Cornell Medical College in New York City. Rub the ice over the cramped muscle for three to five minutes or until the area is bright red, which indicates that blood cells have returned to heat the cramped muscle. Make sure to keep the ice moving so you don't harm skin tissue.
Or heat it. If ice is too uncomfortable, try heat. Heat improves superficial blood circulation and makes muscles more flexible, so some people find that heat is more soothing for muscle cramps than ice. Try a heating pad for 20 minutes at a time or even a warm shower or bath. Make sure to massage the muscle with your hands following ice or heat.
Pinch your upper lip. Oddly enough, pinching the area above the upper lip with your finger and thumb can make a leg cramp vanish, according to Dr. Nirschl. He's not sure why this works, but there are two possible reasons: The upper lip may be a pressure point that helps relax the muscle. Or, he says, it simply may be that the pain of the pinch distracts you from the pain of the cramp until it releases on its own.
Quench your thirst pronto. "If you're exerting yourself, dripping with sweat and suddenly feel a cramp in your thigh, take a few swigs of water or whatever fluid is handy," says Robert Wortmann, M.D., chairman of the Department of Medicine at East Carolina University School of Medicine in Greenville, North Carolina. If you follow swigging with stretching, the cramp should vanish quickly.
Keep on sipping. "To prevent cramping during a sweaty workout, take three or four normal swallows of water every ten minutes," says Owen Anderson, Ph.D., editor of Running Research News.
Pass up the salt. Whatever you do, avoid taking salt tablets or very salty liquids such as soft drinks when you're perspiring. "Salt actually draws fluid out of muscles and into the stomach," says Dr. Nirschl.
Pack a sports drink on a hot day. If you're going to be sweating profusely during a long hike, you may need to replace potassium and other electrolytes that plain water can't provide. "Sipping electrolyte sports drinks such as Gatorade at regular intervals may be a good idea," says Dr. Nirschl. These replacement drinks also contain glucose, which helps electrolytes get absorbed quicker than plain water. A better idea is to choose a more natural sports drink product that isnt packed with artificial colors, flavors and preservatives.
Do wall push-ups before bedtime. "In a study with 44 people, we found that calf-stretching exercises, performed three times per day for a week, helped cure nocturnal leg cramps," says Dr. Daniell. To perform the calf stretch, he says, stand facing a wall about two feet away. Place your hands on the wall and slowly lean forward, keeping your heels in contact with the floor. Hold the position for ten seconds and relax for five seconds. Do this two more times.
Serve yourself a quinine nightcap. "This age-old remedy seems to work for nocturnal leg cramps," says Dr. Daniell. Possibly, quinine make nerves less excitable. In any case, taking quinine and vitamin E tablets (like Q-vel) or 12 ounces of plain tonic water each night probably won't hurt, and it may help. But talk to your doctor first.
Muscle cramps are an "equal opportunity" pain: They don't discriminate between the star athlete and someone who barely moves. You may be competing in a long-distance bike race, taking leisurely laps in the pool or sleeping soundly in bed. Suddenly, a muscle seizes up and grips you in pain. Cramps may also occur after inactivity, such as sitting too long in one place without moving a muscle. Sometimes you can even get a cramp when you're just lying in bed, though researchers cannot define a cause.
A cramp is caused by anything that interferes with the muscle's natural ability to contract and relax. Take a foot spasm, for example. When feet are flexed for propulsion while swimming or when tight bedsheets force your toes downward, the muscle tendons become overstretched and the nerves extending through your foot and into your calf can become hyperexcitable. When this happens, the nerve signals become confused, according to Robert Nirschl, M.D., assistant professor of orthopedic surgery at Georgetown University School of Medicine in Washington, D.C. The result: a painful cramp. "Your muscles may get the message to contract, but not to relax," he explains.
Profuse perspiration can also cause a muscle cramp. Heavy sweating drains your body of important minerals: potassium, sodium, magnesium and calcium. These minerals, called electrolytes, carry electrical charges to the nerves that control a muscle's impulse to contract and relax. Lack of fluids can upset the delicate balance of electrolytes, causing nerve signals to misfire.
If you've actually injured a muscle from overuse, a cramp may go into a continuous contraction, or spasm. While "cramp" and "spasm" are often used interchangeably, a spasm generally means the muscle fibers have "locked up" to protect the injured muscle.
People who have conditions that interfere with blood circulation or muscle metabolism can experience repeated cramps. These conditions include diabetes, rheumatoid arthritis and thyroid disease.
Symptom Relief
Here's how to ease out of the grip of a muscle cramp, no matter what the cause.
Stretch and squeeze. Stretch a cramped leg muscle with one hand and alternately squeeze and release the muscle with the other hand. "This mechanical kneading restores blood flow and generally helps relax the spasm and tightness in seconds," says Dr. Nirschl.
Point your toes back toward your chin. This is a quick way to halt a leg cramp while swimming, according to Harry Daniell, M.D., clinical professor in the Department of Medicine at the University of California, Davis, School of Medicine.
Cool it. If stretching doesn't release a cramp and the muscle's in painful spasm, an ice massage will numb the area, according to Irene von Estorff, M.D., assistant professor of rehabilitation medicine at the New York Hospital-Cornell Medical College in New York City. Rub the ice over the cramped muscle for three to five minutes or until the area is bright red, which indicates that blood cells have returned to heat the cramped muscle. Make sure to keep the ice moving so you don't harm skin tissue.
Or heat it. If ice is too uncomfortable, try heat. Heat improves superficial blood circulation and makes muscles more flexible, so some people find that heat is more soothing for muscle cramps than ice. Try a heating pad for 20 minutes at a time or even a warm shower or bath. Make sure to massage the muscle with your hands following ice or heat.
Pinch your upper lip. Oddly enough, pinching the area above the upper lip with your finger and thumb can make a leg cramp vanish, according to Dr. Nirschl. He's not sure why this works, but there are two possible reasons: The upper lip may be a pressure point that helps relax the muscle. Or, he says, it simply may be that the pain of the pinch distracts you from the pain of the cramp until it releases on its own.
Quench your thirst pronto. "If you're exerting yourself, dripping with sweat and suddenly feel a cramp in your thigh, take a few swigs of water or whatever fluid is handy," says Robert Wortmann, M.D., chairman of the Department of Medicine at East Carolina University School of Medicine in Greenville, North Carolina. If you follow swigging with stretching, the cramp should vanish quickly.
Keep on sipping. "To prevent cramping during a sweaty workout, take three or four normal swallows of water every ten minutes," says Owen Anderson, Ph.D., editor of Running Research News.
Pass up the salt. Whatever you do, avoid taking salt tablets or very salty liquids such as soft drinks when you're perspiring. "Salt actually draws fluid out of muscles and into the stomach," says Dr. Nirschl.
Pack a sports drink on a hot day. If you're going to be sweating profusely during a long hike, you may need to replace potassium and other electrolytes that plain water can't provide. "Sipping electrolyte sports drinks such as Gatorade at regular intervals may be a good idea," says Dr. Nirschl. These replacement drinks also contain glucose, which helps electrolytes get absorbed quicker than plain water. A better idea is to choose a more natural sports drink product that isnt packed with artificial colors, flavors and preservatives.
Do wall push-ups before bedtime. "In a study with 44 people, we found that calf-stretching exercises, performed three times per day for a week, helped cure nocturnal leg cramps," says Dr. Daniell. To perform the calf stretch, he says, stand facing a wall about two feet away. Place your hands on the wall and slowly lean forward, keeping your heels in contact with the floor. Hold the position for ten seconds and relax for five seconds. Do this two more times.
Serve yourself a quinine nightcap. "This age-old remedy seems to work for nocturnal leg cramps," says Dr. Daniell. Possibly, quinine make nerves less excitable. In any case, taking quinine and vitamin E tablets (like Q-vel) or 12 ounces of plain tonic water each night probably won't hurt, and it may help. But talk to your doctor first.