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Spasms, Cramps, and Charley Horses…..Oh My!

Have you ever woken in the middle of the night to that horrible cramping pain in your foot with your poor toes all curled up?

Or have you been in the middle of a great jog when all of sudden you are hit with a charley horse in your calf or hamstring? I think most of us have experienced a muscle cramp, spasm, or charley horse at one point in time but do you happen to know why you get muscle spasms? For the purpose of this discussion I would like to stick to the type of muscle spasms that affect muscles called “skeletal muscles.” Skeletal muscles include all of our muscles that attach to bone that we typically have voluntary control over; such as the muscles of our hands, feet, arms, and legs. As a PT I have heard many people share their thoughts on why we get muscle spasms. I have heard people say things like, “I need to eat more bananas,” or “I need to drink more water.”

I recently overheard Andy, PTA and gym supervisor of Back in Motion’s Portland office, working with a patient.  He was supervising the patient doing an exercise when she developed a muscle spasm in her leg. Andy immediately had the patient do some gentle stretching which helped alleviate the pain, but as soon as she began the exercise again, the spasms came back. They moved onto a new exercise and the spasm did not return. This spurred a conversation between the two about the root cause of muscle spasms. Andy quickly provided her with a sound logical explanation regarding muscle fatigue and possible dehydration. Here are some of the more common causes of muscle spasms:

  • Overuse or muscle fatigue

    • Doing too many repetitions of an activity, doing it too quickly, or doing it with poor mechanics can place abnormal demand on the muscle.
  • Dehydration

    • Muscles need hydration to create a proper contraction. If the nerves to the muscles are deprived of water and sodium they can become over sensitive and involuntarily contract or spasm.
  • Electrolyte imbalance

    • Muscles need the right balance of glucose, sodium, potassium, calcium, and magnesium to produce an effective contraction.
  • Atherosclerosis

    • Narrowing of arteries reduce blood flow to muscles which alters the oxygenation, hydration, and electrolyte supply.
  • Chronic Pain

    • Sends impulses to the brain that tell muscles to contract and guard against further injury.
  • Pinched nerves

    • This can alter signals to the muscle causing them to be painful and cramp.
  • Side effect of medication

Related: Manage Pain through Desensitization

Here are some ways you can manage your pain if you are experiencing a muscle spasm.

Put some weight on it: if it is your calf or foot try standing up. If it is a muscle in your hand or arm try putting your hand on a table or wall and leaning some body weight into it.

  • Self-massage/trigger point pressure: this can counteract the muscle spasm and help bring blood flow to the muscle increasing oxygen and electrolytes. Apply direct pressure to the sorest part of the muscle spasm and hold for 60-90 seconds and release. Thera-canes and thera-hooks can be good tools for doing this technique.
  • Gentle stretching: This can counteract the effects of the spasm by elongating the contracted muscle tissue. Common stretches include wrist stretches, hamstring stretches, and calf stretches.



  • Ice/heat: Heat is typically better for muscle spasms because heat can be relaxing and also increase blood flow to the muscle spasm.  Some people respond better to ice because it reduces the pain which can reduce the muscle spasm; but be careful, ice can be an irritant and cause the spasms to worsen in some people.
Related: What is Dry Needling

If you have a muscle spasm that concerns you, happens frequently or does not go away, it is always a good idea to contact your physician. Your physician will be able to help determine the severity of the condition and make the appropriate recommendations. Sometimes physical therapy is recommended, at which point someone like myself would do a thorough examination and determine if we could help. I had a patient 2 years ago that had been suffering from calf cramps for years. I did therapeutic massage combined with exercises and his leg cramping was gone in just a few short weeks. Another patient I treated recently for cramping in the lower legs merely had over corrected a foot issue with great sneakers plus orthotics and within 3 days of me removing the orthotics from the shoes, the lower leg spasms were gone.

Anyone can attend a free 30-minute consultation at Back in Motion® without a prescription from a physician and the physical therapist can determine if it is within their scope of practice to treat that patient’s condition. Maine is considered a “direct access” state, which means if the therapist believes they can address the concern, the staff at Back in Motion® will contact your physician for you regarding a prescription for physical therapy. So please, do not hesitate to schedule a visit if you suffer from muscle cramps, spasms, or charley horses.

By Mike Moras, DPT

Back in Motion® Physical Therapy – Portland, Maine



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