Has a muscle cramp ever woken you up in the middle of the night? Or stopped you in your tracks in the middle of an activity? If you’re like most people, chances are your answer is “yes.” Muscle cramps, or “charley horses” as they are sometimes called, are extremely common and occur when muscles involuntarily contract and cannot relax. While it is not known exactly why muscle cramps develop, there are some proven methods for preventing and treating them.

“Cramps can affect any muscle under your control,” explains Patrick F. Leary, DO FAOASM, a sports medicine specialist in Erie, Pa. Dr. Leary adds that “cramps can involve part or all of a muscle, or several muscles in a group.” The most notorious sites for cramps are the calves, thighs, and arch of the foot. Cramps in the hands, arms, abdomen, and along the rib cage are also very common.

“When a person experiences a muscle cramp, the muscle that is cramping feels harder than normal to the touch or may even show visible signs of twitching,” Dr. Leary says. The intensity of muscle cramps range from feeling like mild twitches to excruciating pain.

Unfortunately, cramps can occur anywhere, anytime to anyone. “No one is immune,” explains Dr. Leary. “You could be young or old, very active or normally very sedentary, and you could develop a muscle cramp doing just about anything.” However, Dr. Leary adds that-infants, the elderly, the overweight, and athletes are at the greatest risk for muscle cramps.

Some common causes of muscle cramps, according to Dr. Leary, are insufficient stretching before exercise, exercising in the heat, and muscle fatigue. Athletes who become fatigued and dehydrated while participating in warm-weather sports frequently develop muscle cramps. “Imbalances in the levels of electrolytes in the blood, such as sodium, potassium, chloride, calcium and phosphate, can also lead to muscle cramps,” he adds. Sodium is the primary electrolyte in sweat. Total body salt deficiency is a reason for heat cramps. Proper hydration before, during and after exercise is the key to preventing cramps. Normal cravings for salty foods usually will accommodate the nutritional replacement.

The good news is that muscle cramps usually go away within minutes and typically do not warrant medical attention. “You can usually treat muscle cramps with self-care measures,” says Dr. Leary. Here are a few of the methods:
• Stop doing whatever activity triggered the cramp.
• Gently stretch and massage the cramping muscle, holding it in stretched position until the cramp stops.
• For a calf cramp, put your weight on your cramped leg and bend your knee slightly. If you're unable to stand, try pulling the top of your foot on the affected side toward your head while your leg is in a straightened position. This will also help ease a back thigh (hamstring) cramp.
• For a front thigh (quadriceps) cramp, use a chair to steady yourself and try pulling your foot on the affected side toward your buttock.
• Apply heat to tense/tight muscles, or cold to sore/tender muscles.

Dr. Leary warns that if cramps are severe, happen frequently, respond poorly to simple treatments, or are not related to obvious causes like strenuous exercise, you should see your doctor. “They could be a symptom of problems with circulation, nerves, metabolism, hormones, medications, or nutrition,” he says. Supplements, Anabolic Steroids and creatine have been implicated in the development of cramping.

To prevent muscle cramps, Dr. Leary advises to work toward better overall fitness. “It is important to do regular flexibility exercises before and after you work out to stretch muscle groups most prone to cramping.” He adds that it’s also a good idea to avoid dehydration. “Your aim should be to drink plenty of liquids, generally at least six glasses of water or other beverages daily.” The exact amount depends on what you eat, your gender, your level of activity, the weather, your health, your age and any medications you may be taking. “Fluids help your muscles contract and relax and keep muscle cells hydrated and less irritable,” Dr. Leary explains. When you’re exercising, it’s best to drink fluids before, during, and after the activity. Cramping can be so severe that IV solutions are needed to alleviate the deficits.

Though a muscle cramp is common, it is still a real pain. If you think your muscle cramps are too frequent and severe to be normal, it is best to see your doctor for an evaluation. Prevention is the key.

Dr. Leary is the Director of Sports Medicine for the Lake Erie College of Osteopathic Medicine. Primary Care Sports Medicine combined with the manual medicine skills of Osteopathy make for a natural fit on the sidelines, in the classroom and in the wellness clinic. Dr. Patrick F.Leary is a sports medicine specialist who currently practices at the Saint Vincent Sports Medicine and Restorative Care in Erie, Pennsylvania. He has a faculty appointment at the Lake Erie College of Osteopathic Medicine and is certified in Family Medicine, Sports Medicine and Geriatrics. He is Director of Sports Medicine at LECOM and Team Physician for Edinboro University of Pennsylvania. Previously, Dr. Leary served as Team Physician at the University of Notre Dame where he did his undergraduate work. Dr. Leary is a Fellow of the American Osteopathic Academy of Sports Medicine and the American College of Osteopathic Family Physicians.