Every one of us might have experienced nocturnal leg cramp or night leg cramp at least once in our lifetime. But when it occurs on a regular basis then it becomes a matter of concern.
In fact, research suggests that it increases with age and age above 50 years or more it becomes very common.
Out of every nocturnal muscle cramp cases, 24% to 25% of them reported mild cramps (5 times per month) and 5% of them reported moderate to severe cramps (15 times per month).
Research also associate it with a sedentary lifestyle in the person of age 60 years and above, it also increases with shorter sleep duration, disturbed sleep, and depression symptoms.
In this article, I am going to break down all the tips and exercises that you need to do to prevent this kind of cramps. Also, I am going to share a very effective way to minimize discomfort right when you have cramps.
So let’s get started.
How to stop leg cramps at night?
That sudden pain in your calf muscle in the middle of the night can become unbearable and feels like the muscle of leg and foot is locked. This is how night leg cramps feel like.
To define it, leg cramps are episodes of pain usually lasting up to few minutes caused by sudden intense involuntary contraction of muscles for muscles group.
Nocturnal leg cramps happen in the sleep of the night and involve the calf muscles and the small muscles of the foot and are common and troublesome in older people. Even after cramps subside, there may be residual discomfort and tenderness that may persist for hours afterward.
Research has found that this type of night leg cramps is purely mechanical, which means it is not due to the symptoms of any diseases.
However, it might be secondary to diseases like Arthritis or medicines like diuretics. But still, it is purely mechanical and it can be prevented by simple foot positioning during sleeping and stretching exercises 10 to 15 minutes before going to bed.
Let’s start with positioning.
Foot positioning to prevent cramps
If you follow a simple way neutral positioning of the foot using a pillow during sleeping, it can help reduce episodes of cramps during. These positionings are very effective if you practice regularly and there’s a logic behind this strategy.
To understand this we need to understand the mechanism of nocturnal leg cramps.
Mechanism of nocturnal leg cramps
The calf muscle (gastrocnemius muscles) are the bulky muscles present on the back of our lower leg. These are heavy-duty muscles and are known as second heart of the body.
The contraction of this muscle causes the foot to move downward. This movement is termed as plantar flexion.
Confused! let me simplify this.
Try standing on your toes, observe that this action is actually brought about by movement of the foot downward i.e plantar flexion movement of the foot. This is the result of the action of the calf muscle.
Plantar flexion of foot
But this plantar flexion movement can also be produced with the contraction of the calf muscle. This can happen when sitting with leg hanging, the foot comes to the plantarflexed position with the weight of the foot.
This also happens when sleeping in the prone and supine positions as you can see in this figure.
But, in this resting plantarflexed posture of the foot, the calf muscle is already in a shortened state. So any involuntary contraction of calf muscle in this particular position results in cramps and unbearable pain.
So, positioning the foot in a neutral position can minimize cramps to some level.
Foot positioning in supine
We can use a pillow to position the foot in neutral position in a habitual supine sleeper. Just place the pillow near the foot and rest the foot against the pillow.
Foot positioning in prone
For habitual prone sleeper, it is even easier to obtain this foot position. As you can see it the figure just place your foot at the edge of the bed/ mattress so as the foot remains hanging in neutral position.
Research indicates that stretching exercises just before going to the bed is very effective in the treatment of night cramps. Just follow these simple stretching protocol just before bed for 10 minutes daily.
This protocol involves stretching of calf muscles and hamstring muscles. It is very simple and anyone can perform it very easily.
Calf muscle stretching in standing
Lack of stretching in the calf muscle is thought to be the primary cause of night cramps. One of the study talks of “squatting” theory, according to which modern way of sitting or use of toilets is devoid of squatting posture which our ancestors used to do.
Actually squatting posture gives a good stretching to Tendo Achilles and calf muscles, and lack of stretching of this muscle has been linked to night leg cramps.
Another study points out that a sedentary lifestyle and lack of exercise in person of 60 years age can cause an increase in cases of night leg cramps. This can be due to the weak calf and leg muscles due to the lack of exercise.
The first exercise is stretching of calf muscle in standing.
For this stand in front of the wall at a distance of 1 meter. To stretch the right side of muscle move your left leg forward and lean your body over the wall and try to achieve a gentle stretch on the right side calf muscles.
Likewise to stretch the left side calf muscle, move the left right leg forward and lean your body on the wall so as to stretch the calf of the left leg.
Hold this position for minimum of 10 seconds, take 5 seconds gap and then repeat it on the other leg repeat it for 10 to 15 times.
Hamstring stretching in standing
Stand in front of a chair or a stool and place one of your leg over it while maintaining your knee in complete straight position. Now bend yourself forward and you would feel a nice stretch on back of your thigh and leg.
Hold this position for a minimum of 10 seconds, take 5 seconds gap, and then repeat it on the other leg repeat it for 10 to 15 times.
Both calf and hamstring stretching
Very simple exercise, sit on the bed in a long sitting position and try to hold the great toe with your hands. Simultaneously bend your head towards the knee, this will also give a nice stretching on your hamstring and calf muscles simultaneously.
What to do during a cramp
Nocturnal leg cramps occur all of sudden in the night with an intense bout of pain giving a feeling of the muscle being locked, the foot also becomes contracted. The best thing I would suggest at this point is to stay calm and relax and do not try to perform any kind of foot movement.
Next is, tell your partner to hold the foot and bend the foot upward (dorsiflexion movement) so as to give a gentle stretch on the calf muscle.
If you are sleeping alone, try to rest your foot against the wall of the raised part of the edge of the bed and push it to have a self calf stretching. This will immediately relieve the cramp and you will get relief. After the brief episode of cramps subsides take a short walk inside the bedroom.
In addition to these exercises and tip, one need to integrate other effective calf muscle stretching exercises to their routine.
See More of Dr. Sunit:
- Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS One. 2017;12(6):e0178465. Published 2017 Jun 6. doi:10.1371/journal.pone.0178465
- Weiner IH, Weiner HL. Nocturnal Leg Muscle Cramps. JAMA. 1980;244(20):2332–2333. doi:10.1001/jama.1980.03310200066033
- Butler JV, Mulkerrin EC, O’Keeffe STNocturnal leg cramps in older peoplePostgraduate Medical Journal 2002;78:596-598.
- Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial: https://doi.org/10.1016/S1836-9553(12)70068-1
Dr. Sunit Sanjay Ekka
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