Why Do I Cramp, And How Can I Avoid And Treat It?

By Scott Niekerk

Contrary to the information recently published in the science section of the NY Times, “cramping” is not really a mystery in my clinical experience.

What is a cramp?

First we must understand this. According to Wikipedia: Cramps are unpleasant, often painful, sensations caused by contraction or over shortening of muscles. Cramps can be caused by cold, overexertion or low calcium level in blood. Illness or poisoning can also cause cramps, particularly in the stomach, which is referred to as colic; but this is a whole different issue, as is menstrual cramps.

Reasons for cramps:

There are three basic causes of cramping:

1. Electrolyte imbalance, mainly low blood calcium, but also imbalances of sodium and magnesium. Worsened by dehydration.

2. Overuse syndrome: such as someone who never exercises, running 2 miles, will likely have cramping during or after doing this. Too much too soon! This is different to delayed onset muscle soreness

3. Reduced flexibility. Tight muscles and fascia (connective tissue) cause poor oxygenation of the tissue, referred to as ischemia, and can lead to cramping.


It is first important to understand the cause, see 3 above reasons.

1. Treatment of item 1, electrolyte imbalance. This can be diagnosed by blood test. Hydrating by drinking water. Magnesium deficiency is an epidemic, so supplementing with a high quality mineral powder or nutritional supplement which supplies required electrolytes. Gatorade and sports drinks have lots of sugar, so should be avoided. Diet: Foods with high sources of potassium include, in order from highest to lowest: avocados, potatoes, bananas, broccoli, orange juice, soybeans and apricots, although it is also common in most fruits, vegetables and meats. All these will help prevent cramps. We carry IntraMAX liquid supplement in our office which is very good.

Leg cramps may also be due to vitamin D deficiency which is thought to be another epidemic in the northern hemisphere. Vit D is needed for calcium absorption. Due to change in diet, shunning milk because of high cholesterol content, or, in children, preference for soft drinks, and decreased sun exposure, vitamin D deficiency is widespread. Correcting this deficiency will in many cases also eliminate, or reduce, frequency of leg cramps

2. For overuse, remember moderation is always the key. Start and progress any exercise program slowly, preferably under guidance of a trained professional such as a Physical Therapist or trainer. Moist heat can help for item 1 and 2.

3. Flexibility can be resolved by stretching. First aid for any cramp is gentle and gradual elongation of the shortening tissue. If it is the foot or calf, standing up usually will do the trick. To prevent future cramps, a twice daily routing of stretching that and connecting areas is important. Bodywork, especially MyoFascial Release is very helpful in addressing fascial restrictions (tight connective tissue) in the body. Applying topical creams like Topricin, Traumeel, Hylarub and arnica – homeopathic anti-inflammatory can be a useful adjunct. Creams like BenGay, Tiger Balm and Icy Hot should be avoided at all costs!

This article is original material written by Scott van Niekerk, physical therapist and owner of Wholistic physical Therapy in Brewster, NY. We are a Holistic Treatment center, with physical therapists specialized in Myofascial Release, as taught by John Barnes.

Please visit our website http://wholisticphysicaltherapy.com for more information on how we can help you be FREE of pain and stiffness, to have your life back!

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