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Last updated April 18,2017, originally published March 30, 2014
By Sam Pothecary, Contributing Columnist
Painful, frustrating, and sometimes infuriating to get rid of, muscle
cramping can be a hefty irritation. Estimated that almost everyone will
experience a muscle cramp at some point in their life, they are a very
Some groups are more likely than others to suffer from muscle
cramping, whilst certain activities can also increase the risk of
contracting cramps. Those who do not exercise regularly are more
likely to suffer cramping when they become active. Also, people with
arterial blockage in their legs (peripheral artery disease) experience
cramping or pain in the calves when they try to walk.
Even though there is not one perfect cure for muscle cramping, there
are a number of medicines and natural treatments that can assist in
stopping them, as well as a number of prevention measures to avoid
getting cramps altogether. So, here we will explore the causes of the
problem, and the best ways to stop cramming from taking a grip of
What Is Muscle Cramping?
No single accepted definition of muscle cramp exists and many
classifications of muscle cramps have been attempted. However, it is
usually defined as 'an involuntarily and forcibly contracted muscle that
does not relax', the definition offered by Jewell and Young in their
2002 study: Interventions for leg cramps in pregnancy. It often occurs
when a muscle involuntarily contracts in a "spasm", which is forceful
The muscle cramping is usually brief, and lasts anywhere from a few
seconds to a quarter of an hour, with some rare cases lasting beyond
this point. The pain that is associated with cramp usually goes once the
cramp has relaxed, however in cases of a prolonged cramp there can
be a lasting ache on the muscle.
The cramp can develop in a single part of the muscle, the entire muscle,
or several muscles that usually act together, and all of our muscles can
cramp. Cramps will usually occur in muscles that are under our
voluntary control (skeletal muscles), but they can also occur in
involuntary muscles of our various organs. Most commonly muscles of
our lower limbs are those that will be affected by cramp, such as our
calf or thigh muscles and small muscles of the foot. However, as
mentioned they can affect any muscle in the body, and it is not
uncommon for people to experience cramps in their hands and their
stomach, as noted by Dr. Daniel Gornel, MD, MPH, senior health
consultant to the Los Angeles County Department of Health Services.
Who's Most at Risk?
As already stated, almost everybody will experience muscle cramping at
some point in there life, be in during a stroll in the park, while playing
sport, or sleeping. In fact, during sleep is one of the most likely times
that you could experience cramps. The results of Allen and Kirby's 2012
study, Nocturnal leg cramps, showed that 60% of adults have
experienced nocturnal cramps at some point in their life.
However, there are some groups in which cramping is more common.
Children regularly suffer from cramping as a result of the strain of the
Athletes and individuals working under hot conditions are also known
to experience increased levels of cramping. In addition to this, women
during pregnancy are at a higher risk of suffering from cramps, as
Jennifer. G. Hensley found in her 2009 study," Leg cramps and restless
legs syndrome during pregnancy", that up to 30% of women can be
affected by leg cramps during pregnancy.
In addition to these groups, people that suffer from metabolic
disorders are at increased risk for cramps. The National Institute for
Health Care and Excellence (NICE CKS) found that 50% of patients
with uremia and 20 – 50% of patients with hypothyroidism complain of
muscle cramps. Other medical conditions that may increase the risk of
cramp include: atherosclerosis and sciatica.
But, to fully understand who is at risk from this unpleasant annoyance,
it is important to examine the causes of the problem.
The exact cause of muscle cramping is not known, but there are many
risk factors that may increase the likelihood of suffering from cramp.
The Mayo Clinic writes that "overuse of a muscle, dehydration, muscle
strain or simply holding a position for a prolonged period of time may
result in a muscle cramp." They also state that the cramps may be
related to an underlying medical condition, such as: inadequate blood
supply, nerve compression, or mineral depletion.
What Kind of Cramp Do You Have?
A common type of cramp is "paraphysiological cramp," which is cramp
that occurs in healthy people in response to a physiological stimulus.
This type of cramp often occurs during sport, unaccustomed exercise,
or throughout pregnancy. Parisi, Pierelli, Valente and others, write in
their 2003 study, "Muscular cramps: proposals for a new classification",
that these types of cramps result from hydro-electrolyte imbalance
following repeated and chronic use of the same muscle group,
producing increased excitation of the neuromuscular nerve endings.
Certain Drugs Can Make You Cramp
It has also been argued that certain drugs can increase the likelihood of
cramp. Some of the drugs that have been implicated include: donepezil,
raloxifene, salbutamol, terbutaline, nifedipine, phenothiazines,
penicillamine and nicotinic acid.
Be Careful About Your Diet, Conditioning and Shoes
Other possible causes include: tight muscles, poor physical condition,
poor muscle tone, inadequate diet, reduced blood supply and wearing
tight boots or high-heeled shoes for lengthy periods.
Treatment and Prevention
As most muscle cramps resolve after a short period of time, there has
not been a huge amount of research done on how to best treat cramp.
However, there are a number of ways in which you can alleviate the
pain, as well a number of preventative measures that can be taken to
reduce the risk of suffering from muscle cramps.
First, Stretch and Massage
The most effective treatment of cramp once it has set in on one of your
muscles is to stretch and massage the affected muscle.
Try and sustain a stretch in the affected area and then lightly massage
the area until the cramp subsides.
If the cramp is in your leg or your foot, standing up and walking
around can often achieve stretching of the muscle, as noted by
Schwellnus, Drew and Collins, in their 2008 study, "Muscle cramping in
athletes – risk factors, clinical assessment, and management".
Use a Warm Towel
Another home remedy trick, to relieve the pain of a cramp, is to apply
heat or cold to the cramping muscle. In this instance, simply use a
warm towel or heating pad on tense or tight muscles. Or use ice or an
icepack to massage the cramped muscle. Additionally, taking a warm
bath or using a stream of hot water on the cramped muscle can also
Drink, Drink, Drink and Eat a Banana
It could also be equally important to rehydrate yourself to help alleviate
the cramp. Dr. Gornel states: "If the cramp is associated with fluid loss,
as is often the case with vigorous physical activity, fluid and electrolyte
(especially sodium and potassium) replacement is essential."
Eating a banana, especially during rests breaks as you exercise, can
keep your potassium levels high.
Alternatively to self-help treatments, some medications have been
proven to help treat muscle cramps. However, medicines are not
generally needed to treat an ordinary cramp that is active, because
most cramps subside before the time that medicines would be able to
have an effect.
Quinine sulfate has been the most frequently used drug for the
treatment of muscle cramps. Quinine acts by decreasing the excitability
of the muscles. In a 2010 study, by El-Tawil, Al Musa, Valli, Lunn and
Weber, titled: Quinine for muscle cramps, they found that there was
moderate evidence that quinine significantly reduces cramp frequency,
intensity and cramp days. However, the use of Quinine for muscle
cramps, is not generally recommended due to the poor benefit-to-risk
ratio, as Quinine has an extensive side-effect profile.
Other than Quinine, some muscle relaxant medications can be used in
the short-term to relax muscle cramps. These medications include:
cyclobenzaprine, orphenadrine and baclofen.
Additionally, if the cramps are associated with specific medical
conditions, sometimes, additional medications can be specifically
As with many conditions, muscle cramping is best avoided altogether by
adopting appropriate prevention strategies before the cramp begins.
The first clear strategy for preventing muscle cramp is to avoid
dehydration. Here, it is important to drink plenty of liquids every day.
The logic behind this, is that fluids help your muscles relax and keep
muscle cells hydrated and less irritable. If you are in the process of
physical exertion, drink fluids at regular intervals, and continue once
you have finished.
Stretching your muscles regularly will also help to prevent cramp,
especially if you are going to be partaking in a physical activity. Stretch
before and after you use any muscle for an extended period. Allen and
Kirby noted, that if you suffer from cramps at night, an effective
method of preventing this is to stretch your muscles before you go to
Other suggestions include: increasing your level of physical fitness,
make sure that your diet is nutritionally adequate, and introduce plenty
of fruits and vegetables, regular massaging and properly fitted shoes.
If you experience regular muscle cramping and/or if your cramps last
longer than a few minutes, you may have an undiagnosed medical
condition that requires treatment. In this situation you would be wise
to consult a doctor.
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