Muscle Cramps

Dr. Paul MackareyIf you have been to a Lackawanna Trail High School football game in the past few weeks you might be wondering why running back, Josh Dixon, has not been on the field very much in the second half of the game. His father Brad recently contacted me, asking for advice. Josh has suffered from severe muscle cramps in both calves that were controllable in the first half of play with stretching and massage. However, after the halftime break his problems worsened. He was unable to play with and consistency in the second half. The cramps were so painful that he could not run two plays in a row. However, I am happy to say that he is improving each week. This problem is also common in endurance athletes. Participants in yesterdays Steamtown Marathon will surely relate to this column.

A muscle cramp is defined as an involuntary contraction or spasm of a muscle that will not relax. The tight muscle spasm is painful and debilitating. It can involve all or part of the muscle and groups of muscles. The most common muscles affected by muscle cramps are: gastrocnemius (back of lower leg/calf), hamstring (back of thigh), and quadriceps (front of thigh). Cramps can also occur in the abdomen, rib cage, feet, hands, and arms. They can last a few seconds or 15+ minutes. They can occur once or multiple times. It can cause a very tight spasm or small little twitches.


Although the exact cause may be unknown at this time, there are several theories why muscle cramps occur. According to the American Academy of Orthopaedic Surgeons, when a muscle is flexible and conditioned, the muscle fibers are capable of changing length rapidly and repeatedly without stress on the tissue. Also, overall poor conditioning or overexertion of a specific muscle leads to poor oxygen/carbon dioxide exchange and build up of lactic acid and cause a muscle spasm. Also, this process can alter muscle spindle reflex activity and stimulate the spinal cord to send a message to the muscle to contract. If uncontrolled this leads to cramps and spasm.
Muscle cramps are more common in hot weather due to loss of body fluids, salts, minerals, potassium, magnesium and calcium. This leads to an electrolyte imbalance which can cause a muscle to spasm.

Common Causes of Muscle Cramps

  • Tight muscles
  • Imbalance in strength/length between two cooperative muscles
  • General Fatigue
  • Overexertion in extreme heat
  • Dehydration – electrolyte imbalance
  • Medications/Supplements– some medications and supplements can increase risk of muscle cramps

High Risk Factors For Muscle Cramps

  • Infants & young children
  • 65+ years old
  • Obesity
  • Deconditioned Athletes in mid-40’s
  • Smoking
  • Medication/Supplements
  • Endurance Athletes

Treat and Prevent Muscle Cramps

First Aid

  • Cramps usually do not require a physician visit
  • Stop the activity
  • Stretch or elongate the muscle
  • Deeply massage the muscle while on stretch
  • Heat the muscle if tightness continues
  • Cold to muscle if sore later in day or next day


  • Exercise regularly and stay conditioned for your sport
  • Reduce caffeine intake
  • Hydrate regularly – especially in warm conditions – Use sports drinks, drink all day BEFORE the activity as well as during/after
  • Stretch – AFTER you warm up – concentrate on the vulnerable muscles – stretch slowly, hold for 10 seconds, slowly release, and repeat
    • Hamstring – feel pull in back of thigh
      • Lying on floor in doorway, extend one knee and rest heel on wall
      • Standing – lock knees and touch shins/toes
    • Calf – feel pull in back of knee and lower leg
      • Stand and lean into wall with one leg back while keeping your heel down
    • Quad – feel pull in front of thigh
      • Stand, grab onto foot, bring heel to buttocks while extending hip
      • Repeat while sitting on ground
  • Consider:
    • Diet, vitamins, tonic water, sports drinks
    • Heel lifts for calf cramps when unable to adequately stretch calf
    • Compression shorts for hamstring or quad cramps

See you family physician if cramps persist or worsen. There are other medical reasons for persistent cramps and spasms.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliate faculty member at the University of  Scranton, PT Dept.