“What could be causing the cramps in my calves?”

A cramp is technically anything that interferes with the muscle’s normal ability to contract and relax and results in temporary discomfort, whereas a spasm is more prolonged and due to a muscle “locking up.” Like most medical conditions, there can be many causes.

Football players and other types of athletes often develop cramps due to dehydration, which results in the loss of valuable electrolytes like sodium and potassium. That’s why “sports drinks” are so popular. When children complain of discomfort in this area it’s usually associated with growth (“Growing Pains”), or over activity.

Night cramps are common especially as we age (“Restless Leg Syndrome”). Calf cramps are also common with medications such as cholesterol lowering drugs. Neurological problems and many other (sometimes serious) medical conditions, such as Intermittent Claudication, are also causes.

Claudication is a vascular problem that can best be understood in terms of supply and demand. When active, the calf requires more blood, and if your arterial system can’t supply the amount of blood needed, pain develops. When you stop and the blood flow catches up to the demand, pain usually stops. This is similar to what happens when you have a heart attack and is certainly something that necessitates a physician’s consultation as soon as possible.

But even subtle changes, like excessive outer heel wear on your walking or running shoes can cause your calves to suddenly hurt. Inadvertently stepping in a hole or any sudden pull on the muscle can also cause discomfort.

However, the most common cause of calf cramps is tight muscles. This can be associated with overactivity and is most often seen with improper stretching. A great many people do stretch, but never realize they are doing so improperly.

Calf pain is also very common among those with arthritis. The body’s response to pain, whether it’s due to an injury or disease, is muscle spasm and guarding. So those who have painful joints almost always have associated muscles tightening. Often this protective mechanism can cause more discomfort than the arthritis itself. Unfortunately, this component of the arthritic process is often neglected.

Once your calf muscle tightens it may progress and make stretching it quite difficult. In addition, tight calf muscles can lead to many other problems. These include pain in the fronts of the legs (shin splints) as well as arch and heel pain.

Warm compresses, good stretching and rest often helps. A heel lift on the side that is tight can also offer some temporary relief. In severe cases I use a painless (a freeze spray is used first) injection of a local anesthetic in a new trigger point, that almost always immediately relieves the pain and stops the progression of this condition.

So as you can see, there can be many causes for your calf cramps. In most instances, learning how to stretch properly can usually eliminate your discomfort quite quickly. If discomfort continues, it’s probably best to have a medical evaluation.

 

— A former reconstructive foot and ankle surgeon and past clinical instructor of Medicine at Emory, Dr. Pack practices at MCG in Greensboro. He works with patients who have arthritis and wish to decrease joint symptoms and remain active without medication or surgery. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist, and helped the UGA Golf Team (2005 NCAA national champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at (706) 454-0040.