Take that, muscle cramps!

Here are the best ways to stop painful cramps — and prevent them from returning.

Published: October, 2018

Image: © ChesiireCat/Getty Images

A muscle cramp always feels like a surprise. The involuntary contraction strikes without warning, whether it’s a charley horse in the middle of night or a back spasm as you reach for an everyday object. But don’t let that cramp throw you for a loop. “When it suddenly strikes, don’t exercise or tighten the muscle. Just gently stretch it to your tolerance. That helps to relax the muscle and relieve the uncontrolled contraction,” says Madhuri Kale, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital.

What causes cramps?

Exercising without properly warming up the muscles can lead to cramps. Cramps also occur when a muscle is not able to relax properly (such as from a deficiency of magnesium or potassium in your diet) or when it becomes irritated by a buildup of lactic acid (which can happen if you don’t rest your muscle after it has exercised a lot). Dehydration can worsen both of these problems. Kale says older adults often don’t drink enough water at night because they want to avoid having to go the bathroom, and they end up dehydrated.

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Muscle spasms are the sudden, intense and uncontrollable contraction of muscles. They’re painful and frustrating, and can stop athletes in their tracks or jolt someone awake in the middle of the night. Also called a muscle cramp or charley horse, a muscle spasm happens when the muscle is fatigued and becomes unable to relax. Stretching is the best remedy, and regular exercise and maintaining a healthy lifestyle can help prevent muscle spasms from occurring.

Cramping during the menses phase of menstruation causes similar discomfort as muscle cramps but for a different reason. Doctors may suggest certain medications or contraceptives to minimize period cramping, although extreme or persistent cramping could be a sign of a more serious health issue.

What causes exercise cramps?

Muscle cramps during exercise can be debilitating, so it’s hardly surprising that people go to great lengths to avoid them. The sports world is full of “secrets” for avoiding cramps, from Epsom salt baths to drinking pickle juice or mustard, most of which are ineffective.

So, what causes muscle cramps during or after exercise? Researchers have hypothesized that exercise cramps might be caused by electrolyte imbalance or dehydration, but that’s primarily based on anecdotal evidence. Many experts agree that the strongest scientific evidence points to muscle cramps being caused by a miscommunication between the tendon that controls the muscle and the nervous system. According to a 2009 review by Dr. Martin Schwellnus, a professor and sports medicine physician at the University of Pretoria in South Africa, the miscommunication that causes exercise-associated muscle cramps (EAMC) is most likely the result of muscle fatigue.

Muscles constantly communicate with the nervous system, telling it whether they are stretched or contracted. When a muscle becomes fatigued, the signals between the tendon and the central nervous system essentially become confused. Instead of signaling for the muscle to contract, and then relax, the central nervous system sends more signals for the muscle to keep contracting. The signal to relax doesn’t get through and the muscle cramps.

If you tend to get muscle cramps, you may have a genetic predisposition based on the type of collagen in your tendons, according to research by Malcolm Collins, a professor of exercise science and sports medicine at the University of Cape Town in South Africa. You’re also more likely to suffer cramping during exercise if you’ve experienced it before, and if you’ve had injuries to the tendons or ligaments, according to Schwellnus’ 2009 review.

The best way to relieve cramps? Forcefully stretch the cramping muscle. This stops the muscle from contracting and allows the relaxation signals to be received.

The simplest way to avoid cramps during and after exercise is to avoid overexertion. Several studies have found that athletes who cramped were often running faster than their normal speeds. Exercising in hot or humid conditions is more tiring and will cause muscles to fatigue faster. Staying hydrated and making sure your body is properly conditioned for exercise will also help stave off the fatigue that causes cramps.

Forcefully stretching the cramping muscle is the best way to stop the painful muscle spasm. (Image credit: )

Cramps during sleep

For many people, muscle cramps come not during exercise, but in the middle of the night, and the pain can be excruciating. About 30% of American adults experience occasional nocturnal leg cramps, and about 6% experience them more than 15 times a month, according to a 2017 study published in the journal PLOS One.

The condition is more common in older adults and in people with other health issues, such as hypertension, diabetes or poor cardiovascular health. People who have other sleep problems are also more likely to suffer from leg cramps during sleep.

Once cramps hit, they can be relieved by stretching the muscle. To prevent nocturnal cramping, stretching leg muscles before bed has been shown to help, and there are some prescription medications that have varying levels of effectiveness in preventing and treating cramps. But the best treatment is an improvement in overall health.

Doctors once recommended quinine (the chemical that gives tonic water its bitterness) for nocturnal leg cramps, but because of the drug’s potentially serious side effects, the FDA warned doctors not to prescribe it for nighttime leg cramps in 2010. The amount of quinine in tonic water isn’t enough to cause health problems for most people, but it’s also not enough to prevent leg cramps.

One thing that may help prevent nighttime cramping is untucking the sheets and blankets at the foot of the bed to give your feet room to relax in an upward position. If your feet are pointed all night, your calf muscles are contracted, and that could cause a cramp.

Period cramps

Unlike exercise-associated or nocturnal cramps, period cramps aren’t related to overall health or physical exertion. Instead, they are a painful and sometimes debilitating side effect of the uterus contracting to expel the tissue that built up to support a potential pregnancy as part of the menstrual cycle.

Period cramps are the result of a different mechanism than muscle cramps and therefore require a different treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil, Motrin or Aleve alleviate cramps by directly and indirectly decreasing the muscle contractions in the uterus, according to Medline Plus. For people whose period cramps aren’t calmed by pain medication, oral contraceptives may be the solution because they limit the growth of the uterine lining in the first place. With less uterine lining to shed, the risk of cramping decreases.

If period cramps are very painful and don’t respond to pain medication or hormonal contraceptives, they may be the result of an underlying medical condition such as endometriosis or uterine fibroids. At that point, a doctor will need to do more tests to find the cause.

Additional resources:

  • Read more about the symptoms and causes of muscle cramps, from the Mayo Clinic.
  • Learn more about similar topics in sports medicine on the American Medical Society for Sports Medicine’s website, Sports Medicine Today.
  • Watch this video explaining muscle cramps from Physiotutors.

This article is for informational purposes only, and is not meant to offer medical advice.

Take a multivitamin pill to get zinc and magnesium. Massage the muscles. Drink plenty of water. Be sure to get enough electrolytes like sodium and potassium. Stretch before you start to exercise. No, stretch as soon as you finish. See a nutritionist to correct imbalances in your diet. See a trainer to be sure you are moving correctly.

Of course, Dr. Marks said, medical conditions can lead to cramps, including narrowed blood vessels, usually from atherosclerosis, or compression of a nerve, as happens in spinal stenosis. Cramps also can arise from hypothyroidism. And they can be a side effect of medications like diuretics, used to lower blood pressure, which can lead to a potassium deficiency that can cause cramps.

But, he and others said, those conditions do not explain the vast majority of cramps.

“You are left with the fact that cramping usually occurs in healthy people without any underlying disease,” Dr. Marks said.

There are three leading hypotheses about how to treat cramps and how to prevent them.

There’s the dehydration proposal: you just need more fluid. But, Dr. Schwellnus said, he studied athletes who cramped and found that they were no more dehydrated before or after a race than those who did not have cramps.

Then there’s the electrolyte hypothesis: what you really need is sodium and potassium.

Michael F. Bergeron, who directs the environmental physiology laboratory at the Medical College of Georgia, said the electrolyte hypothesis applies to a specific type of cramp that is related to excessive sweating. It occurs, he said, when the fluid that bathes the connection between muscle and nerve is depleted of sodium and potassium, which was lost through sweat. The nerve then becomes hypersensitive, Dr. Bergeron said.

“Usually you feel little twitches first,” he explained. “They last for 20 to 30 minutes and if you don’t do anything you can be in full-blown cramps.” Those cramps, he continued can move from place to place on your body, from one leg to the next, to your arms, stomach, even your fingers or your face.

The solution, Dr. Bergeron said, is to drink salty fluids like Gatorade (the company sponsors his research). He said he had prevented cramps in tennis players this way.

Causes of muscle twitches and how to relieve them

Muscle twitching, also known as fasciculation, has many common causes. These include:


Share on PinterestStrain or overuse of a muscle can cause twitches.

When a person exercises vigorously or for a long period, they may experience muscle twitching.

Research suggests this muscle twitching may happen after exercise for two reasons:

  • Firstly, exercise can lead to muscle fatigue. Muscle fatigue triggers twitching and cramping in overworked muscle fibers.
  • Secondly, exercise may cause an electrolyte imbalance through sweating. Electrolytes play a role in muscle contraction. An electrolyte loss within muscle fibers may trigger twitching.

The arms and legs are common places to experience muscle twitching that overexertion causes. The most worked muscles are most likely to twitch, which can include the calf, thigh, or biceps, depending on the exercise.

Not getting enough sleep

Brain chemicals, or neurotransmitters, play a role in transmitting information from the brain to the nerves that control muscle contraction.

Sleep deprivation may affect how neurotransmitter receptors work. This means excess neurotransmitters may build up in the brain.

The impact that a lack of sleep has on neurotransmitters function may lead to muscle twitching.

A common place to experience muscle twitching from tiredness is in the eyelid.


Drinking too much coffee, tea, or energy drinks that contain caffeine may cause muscle twitching.

Caffeine is a stimulant. When a person has too much of it, caffeine can stimulate muscle twitching anywhere in the body.

Calcium deficiency

The body needs calcium to support proper muscle function. Having a calcium deficiency may cause muscle twitching. Calcium deficiency is known as hypocalcemia.

People can get calcium from dairy products, soya beans, tofu, nuts, and leafy greens.

Magnesium deficiency

Magnesium also plays a role in keeping the nerves and muscles healthy. Magnesium helps to transport calcium across cell membranes to support nerve and muscle function.

Having a magnesium deficiency may cause muscle twitching anywhere in the body, including the face. Magnesium deficiency is known as hypomagnesemia.

Causes of magnesium deficiency include:

  • poor diet
  • drinking too much alcohol
  • diarrhea

If people do not address a magnesium deficiency, it may increase their risk of cardiovascular disease.

Vitamin D deficiency

Nerves need vitamin D to carry messages to and from the brain to the body’s muscles. Having a vitamin D deficiency may cause muscle weakness and twitching.

Causes of vitamin D deficiency include lack of exposure to sunshine and poor diet.


Muscle mass is up to 75 percent water. Water also helps to carry nutrients and minerals to muscles to support their function.

When a person does not drink enough water, they may develop dehydration. Having dehydration may cause muscle twitching.

Stress and anxiety

Experiencing psychological stress or high anxiety levels may prompt excess muscle tension. This complication can lead to muscles twitching.

Muscle twitches caused by stress can occur anywhere in the body.

Certain medications

Certain medications can lead to involuntary muscle twitching. This reaction may be a side effect or due to interactions with other drugs.

People can discuss side effects and drug interactions with the doctor when taking a new medication.


Theories for the Cause of EAMC

The dehydration–electrolyte imbalance theory is the most common among health care professionals.56 Proponents state that because the body does not store enough water for exercise46 and athletes do not ingest enough water to replace the amounts they lose during exercise,23 EAMC are the result of fluid and electrolyte depletion, which results in the sensitization of select nerve terminals.34 The resulting contracture of the interstitial space increases the mechanical pressure on select motor nerve endings and finally results in EAMC.8,34 Exercise in hot and humid conditions exacerbates the amount of fluid and electrolytes lost, thereby facilitating cramps.

Support for the dehydration–electrolyte imbalance theory comes mainly from research classified as level 4 and 5 evidence. Miners develop cramps because of their sweat losses while working in hot and humid conditions.41,60 More recently, researchers observed that the majority of cramping (95%, 87 of 92) occurred in hot months—specifically, when football players exercised in environmental conditions in which the risk of developing heat illness was “high” or “extreme.”16 Other evidence for this theory comes from case studies and other observational work in which large sweat losses occurred in exercising athletes.6,7,54 Some health professionals postulate that sweat glands are unable to reabsorb sodium at “high” sweat rates.20 The prevailing belief is that EAMC are a warning sign of dehydration–electrolyte imbalance.21

The dehydration–electrolyte imbalance theory does not, however, explain EAMC in athletes exercising in cool,29 temperature-controlled environments.6 For example, Maughan38 reported that marathoners (18%, 15 of 82) still developed EAMC even though the ambient temperature was 10 to 12°C. Thus, it is unlikely that a hot and humid environment is required for the development of EAMC, although they may occur more frequently under conditions of elevated ambient temperatures.16

Regarding fluid losses in crampers and noncrampers, plasma volume losses in runners with EAMC (5.2%) were not significantly different from those of runners without EAMC (4.4%), nor were losses in blood volume (1.7% vs 1.3%) or body weight.38 Moreover, sweat rate and sodium/fluid losses are often not different in athletes who develop EAMC.2,22,54,57 Finally, a correlation between body weight losses and EAMC has not been established in several groups of athletes.32,52,57

The treatment for EAMC also fails to support the dehydration–electrolyte imbalance theory. If EAMC were due to dehydration, the simple cure would be fluid replacement. However, when carbohydrate-electrolyte fluids were ingested at a rate that matched sweat loss, EAMC still occurred in 69% of athletes (9 of 13).30 Moreover, athletes who develop EAMC often ingest similar amounts of fluid during exercise as do their noncramping counterparts.54 Oral fluid ingestion may be ineffective, and intravenous fluid may provide a faster delivery for athletes suffering from acute EAMC.22 It is interesting that stretching the affected muscle almost immediately relieves EAMC51 and yet has no effect on the fluid conditions of the body.

Overall, the dehydration–electrolyte imbalance theory has limitations: First, inferences of cause and effect cannot be made from observational data (eg, field studies); causation may be inferred only from meta-analyses and randomized, experimental research designs (evidence levels 1 and 2, respectively).45 Second, although EAMC may appear in the presence of significant electrolyte and/or fluid losses during exercise, numerous other variables associated with exercise may be factors (eg, accumulation of metabolites, intensity of exercise, and acclimatization). Because athletes who experience EAMC often have significant fluid deficits,54 restoring body fluids is an appropriate precautionary measure against the development of more serious forms of heat illness (eg, exertional hyponatremia, heat stroke).

The neuromuscular theory of EAMC proposes that muscle overload and neuromuscular fatigue cause an imbalance between excitatory impulses from muscle spindles and inhibitory impulses from Golgi tendon organs (GTOs). These localized EAMC tend to occur when the muscle is contracting in an already-shortened position.51 The reduced tension in the muscle tendon likely reduces the inhibitory feedback from GTO afferents, thereby predisposing the muscle to cramp from the imbalance between inhibitory and excitatory drives to the alpha motor neuron.33 This enhanced excitability at the spinal level results in an increase in alpha motor neuron discharge to the muscle fibers, producing a localized muscle cramp.51

Study designs that examine the plausibility of the neuromuscular system’s role in EAMC are stronger than those for dehydration (levels 3 to 5): animal,28,42 exercising humans,43,51 and stretching for EAMC.27,52 These varying models and treatment observations are more consistent with the neuromuscular theory than with the dehydration–electrolyte imbalance theory.

In felines, muscle spindle42 and GTO28 activity were measured following neuromuscular fatigue induced by supramaximal stimulation (100 Hz). Fifty percent of type Ia (25 of 49) and 55% of IIa (18 of 33) muscle spindle afferents increased their resting discharge following fatiguing electrical stimulation.42 Similarly, feline GTO discharge rate was lowered and delayed with fatigue induced with a similar protocol.28 Thus, neuromuscular fatigue appeared to decrease the inhibition from the GTO and increase the excitatory stimuli from muscle spindles. These effects may result in a heightened excitatory state at the spinal level.

In humans, EAMC occurs more frequently at the end of competitions and physical work32,38,41 and when the muscle contracts while it is already shortened.51 Stretching, the primary treatment for acute EAMC,56 is thought to relieve EAMC via autogenic inhibition. Stretching increases the tension in the muscle’s tendon, resulting in GTO activation and an increase in inhibition of the alpha motor neuron, which may restore the physiological relationship between excitatory and inhibitory impulses to the alpha motor neuron.50

The neuromuscular theory also has limitations. The report of altered muscle spindle and GTO activity relies on difficult methodologies that have produced inconsistent results. The majority of GTO Ib afferents (5 of 8, 63%) have only a slight decline or no change in firing in response to stretching of a fatigued muscle.26 Neuromuscular fatigue often induces muscle afferent fatigue with supramaximal electrical stimulation (eg, 100 Hz).28,42 Normal human muscle recruitment patterns indicate stimulation frequencies much lower (eg, < 30 Hz) than those used to induce fatigue in animal studies (eg, 100 Hz).48 Low electrical stimulation frequencies closer to normal recruitment patterns (eg, 16 to 32 Hz) have successfully induced cramps in humans.39,53,55 Thus, the frequencies used to support the neuromuscular theory28,42 do not match normal neuromuscular signaling in humans. Finally, it is unclear how fatigued a muscle needs to become for an EAMC to occur or whether the neuromuscular fatigue is occurring peripherally (ie, in the muscle) and/or centrally (in the spinal cord or brain). Moreover, it is unlikely that neuromuscular fatigue induced with electrical stimulation is the same as fatigue induced with volitional muscle contractions, given that larger diameter motor neurons/units are stimulated first with electrical stimulation and last with volitional contractions.10,24 Muscle fatigue is a continuum rather than an absolute condition. It is likely that the degree of fatigue required to elicit cramping is unique to each athlete.

Because EAMC occur in a variety of situations, environmental conditions, and populations, it is unlikely that a single factor (eg, dehydration, electrolyte imbalance, or neuromuscular factors) is responsible for causing them directly. It is more likely that EAMC are due to a combination of factors that simultaneously occur under specific physiological circumstances in each athlete.

What Causes Muscle Rigidity?

There are muscles all over your body. When you need to move a particular part of your body, your brain sends a nerve signal to the muscles located in that body part. This causes the muscles to tighten, or contract.

Muscles can contract a little bit or a lot, depending on the type of signal the brain sends. After contracting, the muscles relax until the next time you need to use them.

Muscle rigidity happens when a muscle or a group of muscles stays contracted or partly contracted for an extended period. The brain continues to send nerve signals telling the muscle to contract even when the muscle is no longer needed for movement.

This can sometimes last for several hours or days. The longer your muscle remains contracted, the more pain you’ll feel.

Muscle rigidity is often triggered by stress.

Stress can adversely affect your body’s nervous system — including your nerves — and how they function.

Your nervous system may respond to stress by putting additional pressure on the blood vessels, which results in reduced blood flow to the muscles. This can cause muscle tension and pain.

Certain medications, such as statins, can also cause muscle rigidity. Some medical conditions may also contribute to it. These include:

  • amyotrophic lateral sclerosis, which is a progressive neurodegenerative disease that causes nerve problems and a loss of control of voluntary muscles
  • chronic exertional compartment syndrome, which is an exercise-induced muscle and nerve condition that causes pain and swelling
  • chronic fatigue syndrome, which is a condition that causes extreme fatigue, sleep abnormalities, and muscle pain
  • claudication, which is a condition in which cramping occurs due to a lack of blood flow to the muscles, usually in the legs
  • dehydration, which is a condition that develops as a result of not drinking enough water
  • delayed-onset muscle soreness, which is a condition characterized by muscle pain and stiffness that develops hours or days after very strenuous exercise
  • dystonia, which is a condition that causes random and involuntary muscle contractions
  • fibromyalgia, which is a chronic disorder that can cause muscle soreness, pain, and rigidity
  • lupus, which is a chronic inflammatory disease that can cause pain and stiffness in the joints
  • Lyme disease and Rocky Mountain spotted fever, which are tick-borne illnesses that can cause nerve damage
  • myofascial pain syndrome, which is a chronic disorder in which pressure on sensitive points in the muscles causes pain
  • Parkinson’s disease, which is a progressive neurological disease that affects movement
  • polymyalgia rheumatica, which is a chronic inflammatory disease that can cause muscle pain and stiffness, especially in the shoulders
  • repetitive strain injury, which is an injury to the muscles or nerves as a result of muscle overuse
  • rheumatoid arthritis, which is a chronic inflammatory disorder affecting the joints, especially those in the hands and feet
  • bacterial and viral infections
  • pinched nerves

You’ve probably experienced a muscle spasm or cramp — that sharp stabbing pain in a muscle that wakens you from a deep sleep or trips up your run.

A cramp is a sudden contraction or tightening of a muscle that usually lasts a few seconds to a few minutes. Cramps are caused by muscle spasms – involuntary contractions of one or more muscles. Muscle cramps and spasms are most often experienced in the leg. However, hand or foot spasms, as well as cramps in the feet, arms and abdomen are also common.

For immediate relief, stretch the muscle gently and massage it to help the muscle relax. Applying heat to the cramp when the spasm begins can also help.

“Muscle cramps and spasms are often a part of the body’s normal stress response,” says Rio Dickens-Celestin, MD, a primary care physician at Scripps Clinic Carmel Valley. “As a physician, I try to figure out what is triggering the pain.”

“In instances where extra help is needed, a course of anti-inflammatory medications, acetaminophen or muscle relaxants can often be effective,” says Dr. Dickens-Celestin. “Identifying and addressing the underlying cause, however, is the best long-term approach.”

You don’t have to be a marathoner to be painfully familiar with the pangs of muscle cramps. The young, old, active, and sedentary alike are all susceptible to cramps—and they can come when you least expect it—creeping up on you during a sun salutation or disrupting a good night’s sleep.

“Muscle cramping is basically an over-activation or contraction of a muscle,” says Houman Danesh, M.D. and director of Mount Sinai’s Integrative Pain Management. “And although it can happen anywhere, it usually occurs in the calf since that muscle uses the most energy in the body.”

(Hit the reset button—and burn fat like crazy with The Body Clock Diet!)

But while it’s easy to know when you’re having a muscle cramp, it can be harder to figure out why you’re experiencing one. We talked to Danesh about the surprising reasons why you might be cramping.

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“The way muscles are activated involves a balance of electric signals and ions,” Danesh explains. “Dehydration changes the pool of signals. So changing that signal, the body doesn’t know if the signal is coming from the brain or just because there’s an electrical imbalance around the cell.” With all this confusion, your muscles have difficulty processing the right signals. And that overactivity results in pain. Luckily getting rid of this cramp doesn’t have to cramp your style. Hydrate, hydrate, hydrate!

Here’s a great hack to ensure you’re drinking enough water:

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There’s nothing more annoying than having a crooked piece of art hanging in your apartment. Well, maybe except for that arm or back cramp you got while trying to hang it just right for an hour. According to Danesh, it’s common to get a muscle strain after holding a position for a prolonged period of time. “Doing something your body isn’t trained to do constantly activates a muscle and breaks it down a little bit,” he says. “That breakdown usually causes a buildup of lactic acid which can trigger to muscle to go into spasms.” Luckily, this kind of cramp typically goes away with time. Give it a few hours, but if it’s interfering to the extent that it won’t let you sleep through the night, you should probably talk to a doctor.

RELATED: 7 Reasons You Can’t Seem To Tone Up Your Muscles

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Some also refer to this unpleasant phenomenon as a “pinched nerve.” There’s a series of nerves going all the way from your brain down your spinal cord, and according to Danesh, “anything can cause a nerve to be pinched from a herniated disk to arthritis to putting yourself in a weird position, which will irritate the nerve.” (Don’t push those yoga poses if your body says no!) “Thankfully the body is a miraculous healing system,” he says. Usually a regular dose of anti-inflammatories will relieve the pain. But again, if that first line of defense doesn’t get the job done in a few days, to the doctor you go.

RELATED: This Man’s Gruesome Leg Cramp Looks Like It’s About To Burst Out Of His Skin

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“Pregnancy causes a whole slew of changes throughout the body,” says Danesh. And the hormonal shifts can lead to muscle cramps. According to the Mayo Clinic, these cramps usually occur in the calf or foot region, typically flaring up at night during the second and third trimester. It isn’t always clear why this is happening, but you can try to curb the pain by drinking water, stretching, and taking magnesium supplements (just get the go ahead from your doc first).

RELATED: ‘Why I Love Foam Rolling In The Nude’

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Another possible reason for muscle cramps is an inadequate blood supply—which literally means you aren’t getting enough blood flow to your legs or arms. “That’s usually due to a buildup of cholesterol in your blood, but it could also be due to a pinched artery by an ovarian mass or tumor,” Danesh says, although he continues that this more serious cramping would probably be noticeable (a.k.a. not just your average cramp). You should be on the lookout if you have high cholesterol and chat with a doctor. Danesh also says that if a runner notices she’s getting a muscle cramp consistently at the same mile marker during training, that could also be a sign of compartment syndrome—which impedes blood flow—and she should see a doctor ASAP.

Summit Medical Group Web Site

You can begin stretching your hip muscles right away by doing the first 2 exercises. Make sure you feel just a mild discomfort during the stretches and not sharp pain. You may do the last 3 exercises when the pain is gone.

  • Hip flexor stretch: Kneel and then put one leg forward. Keep your foot flat on the floor. Flatten your lower back and lean your hips forward slightly until you feel a stretch at the front of your hip. Try to keep your body upright as you do this. Hold this position for 15 to 30 seconds. Repeat 3 times with each leg.
  • Quadriceps stretch: Stand at an arm’s length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don’t arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.
  • Heel slide: Sit on a firm surface with your legs straight in front of you. Slowly slide the heel of the foot on your injured side toward your buttock by pulling your knee toward your chest as you slide the heel. Return to the starting position. Do 2 sets of 15.
  • Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.
  • Resisted hip flexion: Stand facing away from a door. Tie a loop in one end of a piece of elastic tubing and put it around the ankle on your injured side. Tie a knot in the other end of the tubing and shut the knot in the door near the floor. Tighten the front of your thigh muscle and bring the leg with the tubing forward, keeping your leg straight. Return to the starting position. Do 2 sets of 15.

How Long Does It Take to Recover From a Hip Flexor Injury?

Anyone can suffer from a hip flexor injury, although they are most common in cyclists, dancers, soccer players, and martial artists. The hip flexors are a group of muscles that enable the hip joint to bend the knee toward the chest and make it possible to bend forward at the waist.1 Many activities, including kicking, running, and jumping, engage the hip flexors.

With overuse, overstretching, or sudden contraction, the hip flexor muscles may be injured, resulting in pain and limiting mobility.2 Knowing how to treat a hip flexor injury may help you reduce the amount of time it takes to recover.

What Is a Hip Flexor Injury?

A hip flexor injury may occur when one or more of the hip flexor muscles are torn. Although several muscles make up the hip flexor group, the psoas major and iliacus, together known as the iliopsoas, are the two that are most often injured. When a small number of fibers are torn, the injury is relatively minor and does not significantly impact function, although it may still be painful. If the muscle tears completely, the injury is much more severe and may result in a major loss of function in the leg.

What Causes a Hip Flexor Injury?

Overuse, weakness in the supporting muscles, muscle imbalances, and falls or overextension may injure the hip flexors. Prolonged sitting can also increase the risk of an injury, because it forces the hip flexor muscles to stay in a contracted position for long periods of time. This shortens the muscle, increasing the risk of injury. Regular stretching may help counteract the risk.3

What Are the Symptoms of a Hip Flexor Injury?

When one or more of the hip flexor muscles are torn, you typically feel pain in the front of the hip or in the groin area. You might also experience swelling, bruising, muscle spasms, tenderness, and difficulty executing normal range of motion. Hip flexor injuries often affect your gait and may make it difficult to walk without pain.4

How Long Does It Take to Recover from a Hip Flexor Injury?

Depending on the severity of the injury, it may take 1-6 weeks for a hip flexor injury to heal. Minor injuries typically require 1-3 weeks of recovery time, while more severe muscle tears can take 4-6 weeks or longer.5 Untreated severe injuries may take even longer or cause chronic pain.

What Helps a Hip Flexor Injury Heal?

After resting for a few days immediately after the injury, you may be able to employ some of the following treatment methods to help you recover as quickly as possible:

  • Advanced exercises: Stretching the hip flexors, hamstrings, quadriceps, and calf muscles may help prevent future injury and loosen the tight muscles that contribute to hip flexor pain.6
  • Physical therapy: In addition to progressive stretches, a physical therapist may provide appropriate strengthening exercises, massage, biomechanical correction, and other treatment methods to help you recover safely and avoid reinjury.
  • Cold therapy: Using a cold therapy system may help reduce inflammation deep in the damaged tissues and relieve hip flexor pain.7
  • Compression: Compression may help reduce swelling, potentially increasing mobility and reducing pain. Active compression may further help to reduce swelling.8
  • Medication: Pain-relieving medications may temporarily help with pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may also help with inflammation. Talk to a doctor before taking any new medication, especially if you have any underlying medical conditions. Don’t use medication to push through pain or do exercises that you can’t otherwise comfortably perform.9


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