How to combat night pains and cramps

Leg cramps and pain of a night time is a reasonably common occurrence, particularly in the older population. Research suggests that between 38 and 50% of those over 55 suffer nocturnal leg cramping, with a significant number more experiencing nocturnal leg pain. At the other end of the life cycle, many adolescents suffer “growing pains” at night. A study from the Netherlands (Hallegraef et. al. 2012) 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). In my experience as a physio, I have found that the outcomes of the study can effectively prevent nocturnal leg cramping/pain in younger people too. The exact cause of nocturnal leg cramps is unknown, with a number of possible causes hypothesised: nerve excitability due to electrolyte imbalance, diuretics, steroid use, and muscle and tendon shortening (as a result of either too little or too much physical activity). There has been some research suggesting that taking quinine (e.g. in tonic water) can be moderately effective in reducing nocturnal leg cramping/pain, although it does have side effects. There is really no research to back taking many of the other supplements people try (Magnesium, Vitamin B, Calcium, Vitamin E etc.)

The results of the Hallegraef study though were very encouraging. The stretches are easy to do, and there are of course no side effects. So, if night cramps/pain is an issue for you, why not try doing 3x30 second holds of the two stretches below:

Hamstring stretch
A hamstring stretch can be performed a number of ways. Choose a stretch that is most comfortable for you to manoeuvre into. For older people, stand with feet hip width apart perhaps near a wall or door for stability. Keep your legs straight as bend forward at the hips reaching towards your toes. The first few times you try this, you may need to bend your knees slightly if you have tight hamstrings, over time you will be able to get a deeper stretch. A more advance version is sitting on the floor (see image to the right), one leg out stretched, the other knee bent in with your foot resting against the inside of the opposite thigh. Again, stretch forward at the hips, reaching your hands towards your feet. A little bend in the knee is fine. With regular practice, you should work towards touching your toes or even the floor.

Calf stretch
Stand approximately one metre from a wall. Set one foot forward placing it flat on the ground, bent knee. At the same time, places your hands flat against the wall. Press the heel of your outstretched foot firmly into the ground pushing against the wall firmer for a deeper stretch.

Obviously if your pain persists or worsens, getting assessed by your local physiotherapist (there may be more significant inflammatory causes for your pain that can be treated) would certainly be worth your while.

Adrian Quinn – Physiotherapist and Director, Back In Motion Camberwell