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Do you suffer from Night Cramps? – Bedtime Stretching Could be the Answer…

13/02/2017

It’s fair to say that at some point, each of us will experience a lower limb muscle cramp of some type. Often affecting the calf muscle or the Hamstrings, the exact cause of nocturnal leg cramps is unknown or ‘idiopathic’. Some possible contributing factors to muscle cramping are believed to include:

  • Nerve excitability due to electrolyte imbalance
  • Diuretic use
  • Certain medications
  • Muscle and tendon shortening either from too little or too much physical activity

While leg cramps can affect anyone at any age, statistically pregnant women and those over 55 are more likely to suffer from nocturnal leg cramping. Research suggests that up to half of the older population over 55 suffer nocturnal leg cramping, with yet a greater proportion experiencing nocturnal leg pains. However, is there anything we can do to manage these cramps/pains?

Magnesium Supplements

For those experiencing leg cramps, the general consensus has been to take Magnesium supplements. Interestingly however, to date there is very little evidence to suggest that Magnesium supplements are effective in reducing the incidence or severity of nocturnal leg cramps in the older population¹. The majority of evidence that shows benefits of Magnesium supplementation is in the pregnancy population, who are more likely to suffer from electrolyte imbalance due to increased diuresis as gestation advances. This type of cramping is unlikely to be representative of the idiopathic or spontaneously occurring cramping seen in the older population.

The only other substance that has been investigated to reduce nocturnal leg cramping/pain, has been quinine (found in Tonic Water) although it may have side effects if taken in large doses, limiting its therapeutic potential benefit.

Stretching

A study from the Netherlands² found that simple Hamstring and Calf stretches performed each night before bed significantly reduced both the frequency of nocturnal leg cramps and the severity of night time leg pain. This particular study examined 88 older adults (> 55 years old), however our experience in managing younger people with nocturnal leg cramping/pain suggests similar results can be achieved with this population also.

These results were very encouraging as they provide evidence for a quick and easy therapy for this irritating condition. With such a high proportion of older adults affected, chances are we all know someone who can benefit from these findings. The stretches are easy to do, don’t cost a cent and best of all – do not have any side effects!

So, if night cramps/pain is an issue for you, why not try doing 2 x 30sec holds of the 2 stretches below:

calf hamstring

To get the most benefit, evidence suggests that you should stretch until a slight tightness/discomfort is felt in the target muscles. You should have a 10 second rest between sets of each stretch and avoid holding your breath during the stretch.

Remember, there are many potential causes for nocturnal cramping and leg pain so if your pain persists or worsens, it is important to see your physiotherapist. There may be more significant inflammatory causes for your pain which can be assessed and treated by your Physio.

Further reading:

  1. Garrison S. R., Allan G. M., Sekhon R. K., Musini V. M. & Khan K.M. 2012. Magnesium for skeletal muscle cramps. Cochrane Database of Systematic Reviews, 9. Art. No.: CD009402. DOI: 10.1002/14651858.CD009402.pub2.
  2. Hallegraeff J. M., van der Schans, C.P., de Ruiter, R. & de Greef, M. 2012. Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults. Journal of Physiotherapy, 58; 17-22.

 

Vatche Douzmanian

Physiotherapist

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