Foot Cramps?
Ready to Kiss Foot Cramps Goodbye?
Most of us are familiar with that moment of panicked recognition when a sudden tightening of a muscle becomes a full-blown muscle cramp. The pain is enough to jolt most of us out of our beds or chairs in a desperate attempt to stretch the muscle and alleviate the cramp. Sometimes cramping occurs during exercise, other times it wakes us up from a peaceful sleep. For those of you experiencing foot cramps you might be wondering why it’s happening and what you can do about it.
WHAT IS HAPPENING DURING A MUSCLE CRAMP?
Practical Neurology reports the “conventional definition of a muscle cramp is a painful contraction of a muscle or muscle group, relieved by contraction of antagonist muscles.” It is induced by a hyperexcitable and involuntary sustained muscle contraction. It is usually localized to a single muscle group, a single muscle, or a few muscle fibers and can last from a few seconds to a few minutes. Often palpating the cramping muscle(s) will reveal a “knot”. Soreness can persist following the cessation of the muscle cramp even into the next day.
Myogenic, “originating in muscle tissue,” causes of cramping as outlined above and below need to be distinguished from neurogenic, “originating from the nerve” causes of cramping which are not discussed in this article. Neurogenic causes of cramping originate from dysfunction or injury in either the central or peripheral nerves. Examples of neurogenic origins of cramping include spasticity, dystonia, tetany, and myotonia.
WHAT CAN CAUSE FOOT CRAMPS?
Myogenic foot muscle cramps are thought to have several causes. According to Harvard Health, exercise habits, diet, and medical conditions can all contribute to muscle cramps. Poor blood flow in the lower leg and foot muscles caused by narrowing of the arteries (called atherosclerosis) can predispose one to foot cramps or lower leg cramps. In some cases acute narrowing of the arteries caused by cold temperature on a foot that has snuck out from under the bed covers can cause sudden cramping.
Diets low in magnesium or potassium can lead to a deficiency in these minerals and may interfere with a muscle’s ability to relax properly. Because high levels of magnesium or potassium can have significant side effects including causing cardiac abnormalities, it is important to consult with your physician before supplementing with either magnesium or potassium. Dehydration is another condition that may explain cramping so drinking enough water, especially if you have been exercising in hot weather, is important.
Exercising without properly warming up or cooling down may also increase the likelihood of developing foot cramps. Newer clinical research also suggests muscle strength, flexibility, and foot biomechanics may play a role in developing foot cramps which we will explore further in the next section.
PHYSICAL THERAPISTS TACKLE FOOT CRAMPS
If you have optimized your hydration levels, learned to rest appropriately between bouts of exercise, and blood mineral levels are in the normal range but are still experiencing either nocturnal or exercise-related foot cramps, physical therapy may be able to help.
Warming up muscles properly prior to exercise may be helpful in decreasing foot cramps. Your physical therapist can teach you proper warm-up exercises for the feet and ankles to help prepare the foot muscles for the demands of the upcoming exercise and activity. Dynamic stretches which involve tightening and relaxation of the muscles as they move the joints through their range of motion are a great way to warm up. Walking on your toes, walking on your heels, and actively rolling your ankles through their full range of motion are some examples of dynamic warm ups for the foot muscles.
Static foot and ankle stretching prior to exercise, where a muscle is lengthened and held in this position for a long period of time, has been the subject of much debate over the years as research has suggested it may increase the risk of injury before strength and power-related activity. For recreational athletes, short duration static stretches (<60s) are likely safe when integrated within a dynamic warm up routine but should be applied with caution by high performance athletes prior to intense strength and power activities (Chaabene et al., 2019). Your PT can personalize a static and dynamic warm up for your feet depending on the type of sport or exercise you are doing. Static stretching before bed, however, may reduce the incidence of nighttime foot cramps.
McKay et al. (2021) explored the relationship between nighttime and exercise-induced cramps with several factors. Their research found a correlation between overall decreased body flexibility and increased incidence of nocturnal cramping. They also found that those with decreased toe flexor strength and fallen arches were more likely to experience foot cramps during exercise. Finally, those who passed the toe flexor strength assessments and were able to walk their age and gender-predicted distance or greater on the Six Minute Walk Test were less likely to have either type of muscle cramp.
These findings suggest that a program of proper foot strength and mobility training and overall lower extremity muscle strength, power, flexibility and endurance exercises may decrease the likelihood of both night-time and exercise-induced foot cramps. A case report submitted to the International Journal of Physical Therapy in 2019 (Addison Williams Andrews & Richard Pine) outlined a physical therapy program consisting of addressing soft tissue extensibility, joint mobility, muscle strength and lower limb biomechanics. In this case the subject was experiencing bilateral lower limb muscle cramping lasting several minutes three to four times per night. This multifaceted approach helped to decrease the frequency of cramping to one episode a week on average lasting less than a minute.
AN INDIVIDUALIZED PROGRAM IS BEST
Now that we have reviewed some of the causes of foot cramps and some of the solutions, it’s time to get started treating your foot cramps. When you schedule an appointment at Evolve PT your physical therapist can assess your foot and lower body structure, strength, and flexibility and identify which factors may be contributing to your foot cramps. If you are ready to take your exercise and activity to the next level or sleep through the night without foot cramps, let our therapists create a program just for you so you can kiss those cramps goodbye.
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