Let’s Talk About Calf Cramps: Physical Therapists’ Tips and Exercises to Get Relief

Ever woke up with a charley horse in the middle of the night? It can be a rough awakening. But cramps like these — involuntary spasms of the leg muscle — are common. They affect about 40% of people over the age of 50. While calf muscle cramps mostly occur at night, they can happen during the day, too, especially after exercise. 

“Leg cramps are one of the more common complaints I get in my practice. A lot of patients tell me that they wake up in the middle of the night with a sensation that their calves are cramping up and tightening,” says Dipalee Babaria, PT, DPT, a physical therapist at Hinge Health.

While calf muscle cramps are not usually dangerous, there’s no doubt that they can affect your general quality of life — especially if they wake you up from a sound sleep. (Fact: More than  75% of leg cramps happen at night.) But Dr. Babaria says that there are plenty of things you can do to help prevent them, starting with some basic stretches and exercises.

What Are Leg Cramps?

“Leg cramps are an involuntary contraction of the muscle,” says Dr. Babaria. They can be caused by a challenging workout, certain medications, or dehydration. Leg cramps can technically happen in any leg muscle, although it’s usually the calf muscles. Often the pain only happens for a few seconds or minutes.

What Do Leg Cramps Feel Like?

Leg cramps usually feel like a sudden, severe tightness of the calf muscle — or as though the muscle is locked up, says Dr. Babaria. “It’s like the muscle is stuck in this painful position,” she explains. The cramps don’t tend to last long. They feel better when you stretch out your calf muscles. But once they subside, you may also notice an achiness or soreness that persists for several hours.

Calf Muscle Cramps: Triggers and Causes

Anyone can get a painful leg cramp. But there are some reasons you may be more prone to them:

• Age. The older you are, the more likely you will be to start to develop leg cramps. “Your muscles and tendons naturally change with age,” points out Dr. Babaria. “Sometimes, patients come in and ask why they’ve started to develop calf muscle cramps seemingly out of nowhere, when they haven’t changed their workout routine or lifestyle at all. It’s just a normal part of entering the sixth or seventh decade of life.”

• Pregnancy. About half of all pregnant women develop leg cramps, particularly in the third trimester. It’s thought to be due to several different factors, including weight gain, nerve compression, not enough blood flow to the muscle, and possibly even low calcium or magnesium levels.

• Certain medications. Drugs like diuretics, which treat high blood pressure, and inhaled long-acting beta agonists (LABA), which control asthma symptoms, may cause calf cramps. Other drugs, such as birth control pills, antidepressants, and anti-anxiety medications, have also been linked to leg cramps.

• Sitting a lot. People who are sedentary, or sit for a long period of time (say, on an airplane) may notice more leg cramps, says Dr. Babaria. “There’s not enough blood flowing to your legs, which can trigger a cramp,” she explains.

• Dehydration. When you don’t get enough fluid, your body doesn’t get enough electrolytes, such as calcium, magnesium, and potassium. These can all help prevent muscle cramps.

• Intense exercise. Cramps that occur during — or after— exercise are known as exercise-induced muscle cramps. They’re more likely to occur if you exercise outdoors in the heat and become dehydrated, and are caused by working your muscles harder than they’re used to, explains Dr. Babaria.

Here’s the bright spot: These are all things that can be addressed with lifestyle changes — and pretty easily.

Treatment for Leg Cramps

• Stretch. When a cramp strikes, Dr. Babaria recommends that you straighten your leg — and hold it — with your toes flexed upward. This can often ease the cramp quickly. Another option is to stand on the floor with your foot flat and pressed downward firmly. 

• Walk around. Walking helps increase blood flow to the leg, which may help relieve the cramp.

• Take a hot shower or bath. The heat can help calm the contraction, says Dr. Babaria.

• Ice. While heat may be a go-to, sometimes, people respond better to ice, notes Dr. Babaria. Use it to massage and calm down the muscle and ease the contraction.

Your leg cramps should resolve in several minutes, but to prevent them from recurring, Dr. Babaria recommends that you stretch your calves daily. “It’s good to stretch them for a few minutes before you go to bed, because they can encourage the movement of blood flow to the area,” she points out. 

A 2012 study published in the Journal of Physiotherapy found that adults over age 55 who did nightly stretches for six weeks reported significant decreases, not just in nighttime leg cramps but in their severity.

Hinge Health physical therapists suggest these exercises to help with leg cramps. A combo of moves that stretch and strengthen not just your calf muscles, but also your hips and glutes, can go a long way toward improving your symptoms. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Switch Your Sleeping Position

If you sleep on your side or back, keep your legs in a relaxed position, so they don’t get the chance to tighten up and cramp, advises Dr. Babaria. “One way to do this is to sleep with your toes pointed upward, or hang your feet over the bed,” she says.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Grandner, M. A., Winkelman, J. W. (2017). Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLOS ONE. doi:10.1371/journal.pone.0178465

2. Winklerman, J. W. (2022, May). Nocturnal Leg Cramps. UpToDate. https://www.uptodate.com/contents/nocturnal-leg-cramps

3. Muscle Cramps. (2023, August). National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK499895

4. Maughan, R. J., Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.). /doi:10.1007/s40279-019-01162-1

5. Hallegraeff, J. M., van der Schans, C. P., de Ruiter, R., de Greef, M. H. G. (2012). Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. Journal of Physiotherapy, 58(1), 17–22. doi:10.1016/S1836-9553(12)70068-1