Complaints
Calf cramp
A calf cramp is a sudden, painful and involuntary contraction of your calf muscle. The muscle feels rock hard and your foot sometimes pulls into a pointed position. Cramp often strikes at night or during sport and usually lasts a few seconds to minutes. At De Fysio Man, we find out why your calf cramps and help you get cramps less often.
Calf cramp: what causes it?
During a cramp, a muscle or part of a muscle contracts forcefully without you controlling it. In the calf, this is usually the gastrocnemius. The most widely accepted explanation is a disturbed balance in the nerve signals to the muscle. A tired muscle that contracts in a shortened position in particular then receives too many signals and too little inhibition. That is why cramp often develops when you lie in bed with your feet pointed under the duvet, or at the end of a hard effort.
The idea that cramp is mainly caused by dehydration or a magnesium deficiency is only weakly supported by research, although heavy sweating in hot weather can play a part. Night-time calf cramps are more common in older people, during pregnancy, with prolonged standing or sitting and with little exercise. Certain medicines, such as diuretics and cholesterol-lowering drugs, and conditions such as diabetes, kidney disease or an underactive thyroid can also trigger cramp.
Types of calf cramp
Calf cramp takes different forms, each with its own approach:
- Night-time calf cramp: you wake up with a hard, painful calf. This is the most common form, especially over the age of 50.
- Exercise-related cramp: cramp that comes on during or after sport, often with fatigue, heat or a session that is harder than you are used to.
- Cramp during pregnancy: mainly in the second and third trimester, probably due to changes in circulation and load.
- Cramp as a side effect or signal: cramp linked to medication or an underlying condition. You discuss this with your GP.
How does calf cramp show itself?
Cramp is usually harmless, but annoying if it happens often. Book an appointment if you recognise this:
- A suddenly rock-hard, visibly tensed calf muscle.
- Waking up with pain in the calf, sometimes several times a night.
- A foot that pulls into a pointed position or toes that curl.
- A bruised, stiff-feeling calf that can last for hours after the cramp.
- Cramp during sport that forces you to stop.
- Poor sleep or being afraid to stretch your legs.
Is your calf also swollen, warm and red alongside the cramp, or is the pain constantly present? Then contact your GP the same day, as this may indicate thrombosis. Also see your GP if you have cramp together with muscle weakness, muscles that are getting thinner or muscle twitching, or if the cramp started after beginning a new medicine.
When should you see a physiotherapist for calf cramp?
Occasional cramp is normal and does not need treatment. Physiotherapy is useful if you often have cramp, if it disturbs your sleep or if cramp stops you from finishing your sport. Treatment can also help if your calf stays tense and tender between cramp attacks. We look at muscle tension, strength, fitness and your daily load.
Fewer cramps: our approach
We teach you what to do at the moment of the cramp and then work on a calf that cramps less easily.
Treatment and exercises
- Explanation of cramp and what you can do straight away: pull your foot towards you or stand up and put your weight on the leg.
- Stretching exercises for the calf, including just before going to sleep.
- Trigger point therapy for tender, tense spots in the calf.
- Connective tissue massage to reduce tension and stiffness in the calf.
- Strength training and building fitness, so your calf tires less quickly.
- Advice on sleeping position, a loose duvet at your feet and drinking enough in hot weather.
Cramp during sport
If you mainly get cramp during matches or long training sessions, your calf is often not prepared for that duration or intensity. We build up your training so the calf muscle gains more endurance. A good warm-up and a pace that matches your fitness also make a difference.
Calf cramp, a calf strain and intermittent claudication
Cramp is not the only explanation for sudden calf pain. If the pain lasts for days after the cramp when pushing off and stretching, a calf strain may have developed. If you repeatedly get a cramp-like pain after a fixed walking distance that disappears when you stand still, intermittent claudication may be the cause. In athletes, recurring cramp sometimes goes together with chronic calf pain from overuse. You can read more about the different causes on the page about calf complaints.
When the cramp keeps coming back
If night-time cramp keeps returning often despite stretching and adjustments, discuss this with your GP. They can check whether medicines or an underlying condition play a role and, if needed, consider treatment with medication. In the meantime, we keep guiding you with exercises and treatment of the muscle tension, so your calf stays as relaxed as possible.
How we work at De Fysio Man
1. Intake and assessment
We discuss when the cramp occurs, how often and for how long. We ask about medicines and sport, and assess the tension, strength and length of your calf muscles.
2. Tailored treatment plan
You receive a plan with stretching and strength exercises and treatment of the calf, matched to the moment when you get cramp.
3. Calmer nights
We work towards fewer cramp attacks, better sleep and sport without your calf cramping halfway through.
Frequently asked questions about calf cramp
A cramp attack usually lasts a few seconds to a couple of minutes. Afterwards, the calf can feel bruised for up to a day. With regular stretching and strength exercises, many people notice within a few weeks that the cramp occurs less often.
Research shows that for most people magnesium helps little or not at all against night-time calf cramp. Only with a proven deficiency can supplementation be useful. Stretching exercises and addressing muscle tension and fatigue are usually more effective. Consult your GP before you start taking supplements.
Ordinary calf cramp comes on suddenly, often at night or during sport, and fades within a few minutes. With intermittent claudication, the pain develops each time you walk, after roughly the same distance, and disappears within a few minutes of standing still. The cause is then a narrowing of the arteries in your leg. If you recognise this pattern, have your GP examine it.
No, for calf cramp you can make an appointment at De Fysio Man yourself. Do see your GP first if your calf is swollen and warm, if you also have muscle weakness or if the cramp started after a new medicine. Reimbursement of physiotherapy is through your supplementary insurance; do check the terms of your policy.
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