Muscle Cramps

Yesterday in my Pilates mat class, one of the participants developed a cramp in her foot. After her agony subsided, she asked “What causes muscle cramps and why do I get them so frequently in my feet?”

We’ve all experienced a muscle cramp, sometimes known as a “charley horse” (wonder where that term came from?), and can attest that cramps can be downright painful! If we’re lucky we might experience the milder form of an annoying twitch or muscle spasm.

Muscle cramps commonly involved the skeletal muscles, or those which we have voluntary control over. When the fibers of a muscle involuntarily contract a spasm occurs. If only a few fibers contract and the spasms are short lived, just a twinge or twitch, you’ve lucked out. However, if the spasm is forceful and prolonged then it becomes a cramp. A cramp can be defined as an involuntary, forcibly contracted muscle that does not relax. The pain can be abrupt and intense in the involved muscle with visible hardening or a knot when palpated. The most common sites of muscle cramps seem to be the calf, thigh and arch of the foot. A muscle cramp may resolve in a few seconds, but may last up to a few minutes or longer. There are different theories on the cause of muscle cramps, but the exact reason why a cramp develops is uncertain. Factors that may lead to muscle cramping include muscle fatigue, lack of flexibility, exercising in the heat and imbalances in the electrolytes in the blood.

There are four types of muscle cramps that involve the skeletal muscles: “True” cramps, tetany, contractures and dystonic cramps. “True” cramps are the most common and may involve some fibers or all of a muscle and even a group of muscles that act together. It is generally agreed an over firing of the nerves that stimulate the muscles are the primary cause of “true” cramps. Vigorous exercise and repetitive movements can result in cramping during the activity or much later. An injury or sudden blunt trauma to the muscle, such as getting hit with a baseball, can cause a persistent muscle spasm,. Holding a position for a prolonged time can also cause muscle fatigue and cramping. Muscle cramps may occur at rest or during the night when the muscle is shortened by an awkward sleeping position. For example simply lying with the toe pointed downward can cause shortening and a cramp in the calf muscle.

Whether the cause of the cramp is dehydration, injury to a muscle, vigorous exercise, repetitive movement, or holding a prolonged position, stretching can prevent or stop most cramps when they occur. Gently massaging the muscle or using a warm compress can help the muscle to relax and the cramp to subside.

For the common calf cramp, walking around then slowly stretching the calf by pressing the heel down and leaning forward (“runners stretch”) can be effective.
A cramp in the flexor muscles of the hand known as writer’s cramp, can be relieved by opening and closing the fingers several times then extending and pressing them flat on a table for a prolonged stretch. If the cramp is associated with dehydration from vigorous activity then it’s essential to replace fluids and electrolytes (sodium and potassium). In the case of my fellow Pilates participant with cramps in her foot arch, learning to have a relaxed toe point by pulling the big toe slightly back may be the trick to working out without the interruption of foot cramps.