How to Stop Leg Cramps at Night?

How to stop leg cramps at night?

We might have experienced nocturnal leg cramp or night leg cramp at least once in our lifetime. But when it occurs regularly, then it becomes a matter of concern. Research suggests it increases with age and becomes very common above 50 years or older. 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)¹. 

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 will explain all the tips and exercises you need to do to prevent this cramp. Also, I will share a very effective way to minimize discomfort when you have cramps. So let’s get started.

How to stop leg cramps at night?

That sudden pain in your calf muscle at night can become unbearable and feels like the leg and foot muscles are locked. This is how night leg cramps feels 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 cramp is purely mechanical, which means it is not due to the symptoms of any diseases². 

However, it might be secondary to diseases like Arthritis or medicines like diuretics. But still, it is purely mechanical and can be prevented by simple foot positioning during sleeping and stretching exercises 10 to 15 minutes before bed.

Let’s start with positioning.

Foot positioning to prevent cramps

If you follow a simple way neutral positioning of the foot² 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.

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.

But this plantar flexion movement can also be produced with the contraction of calf muscle. This can happen when sitting with leg hanging, the foot comes to plantar flexed position with the weight of foot.

This also happens when sleeping in prone and supine position as you can see in this figure.

But, in this resting plantarflexed foot posture, the calf muscle is already shortened. So, any involuntary contraction of the 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 a 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 sleepers, it is even easier to obtain this foot position. As you can see, the figure places your foot at the edge of the bed/ mattress so the foot remains neutral.

Stretching exercises

Research indicates that stretching exercises before bed⁴ are practical in treating night cramps. Just follow these simple stretching protocols just before bed for 10 minutes daily.

This protocol involves stretching of calf muscles and hamstring muscles. It is straightforward, and anyone can perform it very quickly.

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” theory³, according to which modern way of sitting or use of toilets is devoid of squatting posture which our ancestors used to do. 

Squatting posture gives 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 and lack of exercise.

The first exercise is stretching the calf muscle in standing.

Stand in front of the wall at a distance of 1 meter. To stretch the right side of muscle, move your left leg forward lean your body over the wall and try to stretch gently 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 to stretch the calf of the left leg.

Hold this position for a minimum of 10 seconds, take 5 5-second gap and then repeat it on the other leg for 10 to 15 times.

Also read: Varicose Veins Cause| 5 Best Exercises for Spider Veins

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.

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 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) 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, walk inside the bedroom.

Final word

In addition to these exercises and tip, one must integrate other effective calf muscle stretching exercises into their routine.

Keep Reading: Muscle pain after workout: Causes, remedies

Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.