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Have you ever experienced a "charley horse"? If yes, you probably still remember the sudden, tight and intense pain caused by a muscle locked in spasm. A cramp is an involuntary and forcibly contracted muscle that does not relax. Cramps can affect any muscle under your voluntary control (skeletal muscle). Muscles that span two joints are most prone to cramping. Cramps can involve part or all of a muscle, or several muscles in a group. The most commonly affected muscle groups are:
Back of lower leg/calf (gastrocnemius).
Back of thigh (hamstrings).
Front of thigh (quadriceps).
Cramps in the feet, hands, arms, abdomen and along the rib cage are also very common. Muscle cramps range in intensity from a slight tic to agonizing pain. A cramping muscle may feel hard to the touch and/or appear visibly distorted or twitch beneath the skin. A cramp can last a few seconds to 15 minutes or longer. It might recur multiple times before it goes away.
Why cramps happen
Although the exact cause of muscle cramps is unknown (idiopathic), some researchers believe inadequate stretching and muscle fatigue leads to abnormalities in mechanisms that control muscle contraction. Other factors may also be involved, including exercising or working in intense heat, dehydration and depletion of salt and minerals (electrolytes).
Stretching and muscle fatigue: Muscles are bundles of fibers that contract and expand to produce movement. A regular program of stretching lengthens muscle fibers so they can contract and tighten more vigorously when you exercise. When your body is poorly conditioned, you are more likely to experience muscle fatigue, which can alter spinal neural reflex activity. Overexertion depletes a muscle's oxygen supply, leading to build up of waste product and spasm. When a cramp begins, the spinal cord stimulates the muscle to keep contracting.
Heat, dehydration and electrolyte depletion: Muscle cramps are more likely when you exercise in hot weather because sweat drains your body's fluids, salt and minerals (i.e., potassium, magnesium and calcium). Loss of these nutrients may also cause a muscle to spasm.
Who gets cramps
Just about everyone will experience a muscle cramp sometime in life. It can happen while you play tennis or golf, bowl, swim or do any exercise. It can also happen while you sit, walk or even just sleep. Sometimes the slightest movement that shortens a muscle can trigger a cramp.
Some people are pre-disposed to muscle cramps and get them regularly with any physical exertion. Those at greatest risk for cramps and other ailments related to excess heat include infants and young children, people over age 65, and those who are ill, overweight, overexert during work or exercise, or take drugs or certain medications. Muscle cramps are very common among endurance athletes (i.e., marathon runners and triathletes) and older people who perform strenuous physical activities.
Athletes are more likely to get cramps in the preseason when the body is not conditioned and therefore more subject to fatigue. Cramps often develop near the end of intense or prolonged exercise, or the night after.
Older people are more susceptible to muscle cramps due to normal muscle loss (atrophy) that begins in the mid-40s and accelerates with inactivity. As you age, your muscles cannot work as hard or as quickly as they used to. The body also loses some of its sense of thirst and its ability to sense and respond to changes in temperature.
Treatment and Prevention
Cramps usually go away on their own without seeing a doctor. Self-care:
Stop doing whatever activity triggered the cramp.
Gently stretch and massage the cramping muscle, holding it in stretched position until the cramp stops.
Apply heat to tense/tight muscles, or cold to sore/tender muscles.
To avoid future cramps, work toward better overall fitness. Do regular flexibility exercises before and after you work out to stretch muscle groups most prone to cramping. Always warm up before stretching.
Calf Muscle Stretch: In a standing lunge with both feet pointed forward, straighten the rear leg. (Repeat with opposite leg.)
Hamstring Muscle Stretch: Sit with one leg folded in and the other straight out, foot upright and toes and ankle relaxed. Lean forward slightly, touch foot of straightened leg. (Repeat with opposite leg.)
Quadriceps Muscle Stretch: While standing, hold top of foot with opposite hand and gently pull heel toward buttocks. (Repeat with opposite leg.)
Hold each stretch briefly, then release. Never stretch to the point of pain.
To prevent cramps, you should also keep your body adequately hydrated. Children especially often do not drink enough liquids to replenish fluid lost during exercise. Some tips:
Drink water at regular intervals, before you get thirsty.
Drink more than your thirst requires.
Drink fruit juice or a sports beverage if you are working in heat or sweating for more than an hour.
When to see the doctor
Although most muscle cramps are benign, sometimes they can indicate a serious medical condition. See your doctor if cramps are severe, happen frequently, respond poorly to simple treatments or are not related to obvious causes like strenuous exercise. You could have problems with circulation, nerves, metabolism, hormones, medications or nutrition. Muscle cramps may be a minor part of many conditions such as Lou Gehrig's disease (amyotrophic lateral sclerosis), spinal nerve irritation or compression (radiculopathy), hardening of the arteries, narrowing of the spinal canal (stenosis), thyroid disease, chronic infections and cirrhosis of the liver.
Give the doctor your medical history including details about allergies, illnesses, injuries, surgeries, and medications. How long have you experienced cramps? Is there a family history of the problem? Do your cramps occur only after exercise, or do they happen while at rest? Does stretching relieve the cramps? Do you have muscle weakness or other symptoms? Your doctor may want to take a routine blood test to rule out diseases.
Anyone who watches sports knows that a "pulled hamstring" is a troublesome condition for athletes. The "hamstring" is actually a group of three muscles that help to straighten (extend) the leg at the hip and bend (flex) the leg at the knee. The "pull" is a strain or tear in the muscles or tendons.
Anyone can experience this injury:
An adolescent athlete who is still growing.
A professional athlete involved in football, soccer, skating, or running.
Older athletes whose exercise program is primarily walking.
Hamstring injuries are easier to prevent than to cure. But to understand what causes a hamstring injury, you first have to know how muscles work.
How muscles work
All muscles work in pairs to perform a task. One set of muscles contracts to exert force, while the other set of muscles relaxes. The hamstring muscles, located at the back of the thigh, work with the quadriceps muscle group, in the front of the thigh. When you want to bend your leg, the hamstring muscles contract and the quadriceps muscles relax. Conversely, when you want to straighten your leg, the quadriceps muscles contract and the hamstring muscles relax.
If one muscle group is considerably stronger than its opposing muscle group, the imbalance can lead to a strain. This frequently happens with the hamstring muscles. The quadriceps muscles are usually much more powerful, so the hamstring may become fatigued faster than the quadriceps. A fatigued muscle cannot relax as easily when its opposite muscle contracts, leading to strains.
Strains and tears
Muscle strains are overuse injuries that result when the muscle is stretched without being properly warmed up. It's like pulling a rubber band too long. Eventually, the rubber band will either lose its shape or tear apart. The same options apply to muscles.
In young people, a different dynamic applies. Bones and muscles do not grow at the same speed. If the youth is experiencing a growth spurt, the bones may grow faster than the muscles. The growing bone pulls the muscle tight, and a sudden jump, stretch or impact can tear the muscle away from its connection to the bone.
Often the muscle pulls a piece of bone with it, an injury called an avulsion. If the hamstring tears near the hip, where it attaches to the pelvis, it may pull a piece of the lower part of the hip (ischium) away. This is a serious injury that may require surgery to reattach the muscle.
Recognizing hamstring injury
An injury to the hamstring is usually readily apparent.
Mild strains may involve a simple tightening of the muscle that you can feel.
More severe injuries may result in a sharp pain in the back of the thigh, usually in full stride.
A rupture or tear may leave you unable to stand or walk. The muscle may be tender to the touch, and it may be painful to stretch your leg. Within a few days after a tear, the area may appear very bruised.
Treating hamstring injury
Remember RICE, and you will know the immediate treatment protocol for many sports-related injuries, including hamstring pulls or strains.
Rest the affect area.
Ice the injury.
Compress the injury (Apply a bandage or other compressive device)
Elevate the injury
If the muscle is completely torn, surgery may be necessary to repair and reattach it. No treatment is complete without proper rehabilitation to strengthen and stretch the muscle.
Preventing hamstring injury
The best way to prevent a hamstring injury is to stretch, both before and after an activity. Weak or tight hamstrings can contribute to low back pain, so doing exercises to strengthen and stretch the hamstrings may also reduce your risk of low back pain.
Sit down and straighten your left leg. The sole of your right foot should rest next to the inside of your straightened leg. Lean slightly forward and touch your foot with your fingers. Keep your left foot upright with the ankle and toes relaxed. Hold for 30 seconds. Repeat with right leg.
Hamstring Muscle Strain
Muscle Cramps
Why Cramps Happen
Who Gets Cramps?
When to See a Doctor
When to See a Doctor
How Muscles Work
Recognizing Hamstring Injury
Treatment
Prevention
Prevention
Treatment
