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Health & Exercise Forum

Muscle Cramps

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Sep 3, 2012


Dr. Mackarey's Health & Exercise ForumThis weekend marked the beginning of high school football in NEPA! While a warm September may be a wonderful time of year to watch football from the bleachers, it often plays havoc on athletes as they suffer from severe muscle cramping. This year was not exception as many players limped off the field in pain and many concerned players, parents and grandparents repeatedly ask me about the problem. What exactly is a muscle cramp? Why does it happen? How can it be prevented?

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.

Theory: The Cause of Muscle Cramps

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

Treatment and Prevention of 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

Stretches to Prevent Muscle Cramps

  • 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

Additional Suggestions for Preventing Muscle Cramps:

  • 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 in the Scranton Times-Tribune.

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:

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 associate professor of clinical medicine at TCMC.