Help! I have a “Charley Horse”

Have you ever awoken in excruciating pain for what seems like no reason at all?  Is your foot cramping,  causing your toes to curl painfully under…  or is there a hard painful knot on the back of your calf causing you to clutch at the back of your leg? I have a “Charley Horse”!

The excruciating “Charley Horse” is actually a muscle cramp, an involuntary stiffening of a muscle or muscles that often occurs at night and without warning.

What do you do when you have a “Charley Horse”?

Don’t Stretch the muscle! …  YET

Immediately when we experience a cramp we need to Isometrically Contract the antagonist muscle. What this means is that we contract (without any movement of the joints) the opposite muscle to the one that is cramping.

For example when our calf cramps we need to contract the muscles on the front of our lower leg, and we need to do this without stretching the calf itself.

An easy way to do this, while still in bed, is to place the affected leg (in this photo the right leg is affected)  straight out and with the opposite foot prevent the foot on the affected side from drawing back towards your nose. The resistance of your feet against each other will keep the affected calf from stretching, and the resulting contraction of the antagonist muscle will relax the cramped calf muscles. This is called Reciprocal Inhibition and describes the process of muscles on one side of a joint relaxing to accommodate contraction on the other side of that joint.

Our initial reflex will be to stretch the muscle. We don’t want to do this since stretching an already forcefully and involuntarily contracted muscle could result in damage to that muscle. Stretching is good, but only when the cramp has resolved!

Heat, such as a hot pack or a warm bath, and Massage are great to incorporate when there is a cramp. This will promote blood circulation to the area and help the muscles to relax. It can also help by diminishing and altering our pain perception.

Now that the “Charley Horse” has resolved you can and should stretch!
The muscles have stopped cramping so you will not risk injuring the tissue. Incorporate stretches primarily for your calf muscles (gastrocnemius and soleus) and your foot and toes. You can see examples of these stretches on my plantar fasciitis blog post here.  Do these stretches regularly to ease the pain of the recent cramp as well as to prevent future cramps.

What are some other preventative measures?

Stay adequately Hydrated

Speak to your MD about:

• Diet and Supplementation for Vitamin and Mineral Deficiency (sodium, calcium, potassium, magnesium)
• Medications that you’re taking that may have diuretic effects
• Possible parathyroid dysfunction

Avoid over training, Muscle Fatigue, and sudden increase or dramatic change in activity

Monitor Sleep Positions to avoid contraction/shortening of the posterior muscles in the legs and the bottom of the feet.

• If you sleep on your stomach place a pillow under your shins or let your feet dangle off the end of the bed.
• If you sleep on your back avoid a heavy blanket pressing your toes down toward the bed.

The “Charley Horse” is a common occurrence that we can do our best to prevent and control, but there is still some mystery as to why it happens. While not a dangerous condition in itself, it could be a symptom of underlying health issues. Please seek the advice of a MD if you have any concerns.