Confronting your worst nightmare: Nocturnal leg cramps

By Hershel Sarbin and Jim Brown
Golf After 50 Editors

Younger golfers get heat cramps during the day. Older golfers get leg cramps in the middle of the night. Medical experts haven't figured out the exact cause, the best way to treat them, or how to prevent either type. We'll let the young guys worry about heat cramps while we take a stab at nocturnal leg cramps.

Causes

There are a couple of things we do know about aging and nighttime muscle cramps. Two-thirds of everyone over the age of 65 will get them, so ready or not, here they come. As we get older, circulation to the legs diminishes, making it likely that something bad will happen to muscles not getting enough blood.

After that, things get pretty fuzzy. Some say it's not enough exercise during the day, while others say muscles that have been fatigued by activity are more likely to involuntarily contract during the night. Other possible causes include lack of sodium, dehydration, alcohol, caffeine, or tobacco use, too much sugar in the diet, pinched nerves, prolonged sitting, flat feet, certain medications, and less commonly, diseases like diabetes, anemia, and hypoglycemia. It can't be all of those things, so you might try making a list and checking off the least likely suspects. Then take action on the others one at a time. That may be the only way to isolate or identify the problem.

Treatment

If you are one of those golfers who already gets cramps, you are more interested in what to do when they jolt you out of sleep tomorrow morning at two o'clock. One "expert," who obviously hasn't had a nocturnal leg cramp, recommends that you completely relax the leg. Forget it. If you could relax the leg, you wouldn't be having a cramp.

After you finish screaming, go straight to plan B, C, D, or E until something works. B) Jiggle the leg or try to walk on it. C) Straighten your leg and bend your ankle back so that your toes point toward your knee. D) Straighten your leg, loop a towel around the top of your foot and pull -- anything to stretch the cramped leg. E) Take a hot shower or warm bath. F) Massage the muscle with ice or a chemical cold pack.

Prevention

Again, there are no guarantees, but there are ways to at least reduce the probability of getting leg cramps at night. The one stretch recommended by almost every doctor and physical therapist is the "Calf Stretch" or "Wall Stretch." Stand 2-3 feet from a wall, feet parallel to each other, and hands on the wall at head height or above. Keep your feet flat on the floor and lean forward until you feel a stretch - not to the point of pain - in your calves. Hold for 30 seconds and repeat at least once, maybe twice. Make this stretch part of your daily routine -- once in the morning, once late in the afternoon, and one more time before you go to bed. Vary the exercise by doing a "wall pushup" from the same position.

Other measures that may or may not prevent cramps include doing a better job of staying well-hydrated (six to eight glasses of water or sports drinks per day), wearing shoes that provide better support and cushioning, taking magnesium, potassium, calcium, or sodium supplements, or using prescription muscle relaxants at night. Before you experiment with supplements, talk to a physician who knows something about nutrition and sports medicine - and don't assume that they all do -- or a registered dietician who has experience working with athletes and exercisers.

Sorry we can't give you an exact answer to the nighttime leg cramp dilemma, but it just doesn't exist. What causes the problem in one person may not cause it in another. The same goes for effective ways to treat and prevent cramps. But at least you now have a working list of causes, treatment options, and prevention measures to consider. Good luck in finding the combination that works for you.

Keep in touch with Jim at hmspublishing@mindspring.com Hershel at HershelS@aol.com.

©2004 Hershel Sarbin Associates