Exercise-induced muscle cramps

Below Mark Holroyd, an exercise physiologist from BUPA's Bristol Wellness centre, explains how you can treat or avoid muscle cramps.

Definition of muscle cramps

Exercise-induced muscle cramps are painful spasms that occur during or immediately after activity. During a muscle cramp, the muscle goes into a hard and contracted state that you cannot voluntarily relax. Exercise-induced muscle cramps may well cause an athlete to temporarily stop what they are doing, but cramps generally have no serious long-term consequences.

What causes muscle cramps?

The exact cause of cramping is still unknown, but there are several factors that are associated with muscle cramps:

  • overexertion
  • failing to stretch adequately before exercise
  • extreme hot or cold
  • dehydration
  • salt imbalances after sweating
  • low blood sugar

The most prevalent cause of muscle cramps appears to be overexertion, either exercising for a longer duration than normal or at a higher intensity. This is why cramps are common at the end of a long or strenuous activity, such as a marathon, or after a particularly high-intensity exercise, such as a sprint. Despite the fact that the risk factors are known, the exact cause of cramping is not well understood. One theory is that muscle cramps occur when muscles are shortened and repeatedly stimulated without being stretched.

Treatment of muscle cramps

Although any muscle can go into spasm, muscle cramps generally occur in three different muscle groups:

  • the quadriceps (front of the thigh)
  • the hamstrings (back of the thigh)
  • the gastrocnemius (calves)

If a muscle cramp does occur, doing the following may help to relieve the spasm:

  • gently stretch the cramped muscle - this is the quickest and easiest method of relieving a muscle cramp. By stretching the contracted muscle, the pressure on the muscle will be reduced, causing temporary relief
  • apply ice that is wrapped in a soft material - this can be used along with stretching, as this will numb the area and cause an increase in circulation once the ice is removed
  • gently massage the muscle
  • start replacing lost fluids

Treating cramp at the front of the thigh (quadriceps)

If cramp occurs at the front of the thigh, then stretch the quadricep muscle while either standing up or lying down.

Standing quadriceps stretch

To stretch the quadricep muscle while standing, lift your ankle toward your gluteal muscles in your buttocks. Reach back with the right or left hand and gently hold the ankle. Press the front hip bone forward and slightly extend the hip. Keep the torso lifted with your head up. Get to the point of a mild stretch and hold until the cramp subsides.

Side-lying quadriceps stretch

You may find the standing stretch difficult to perform when you have cramp in your thigh because it requires you to stand on one leg. An alternative is to try the side-lying stretch. To stretch the right leg, lie on your left side with the left arm extended and head resting on it. Bring the right ankle back towards the gluteal muscles in your buttocks. Reach back with the right hand and gently hold the ankle (the right knee should be parallel to the floor). Press the front hip bone forward and slightly extend the hip. Hold the stretch until the cramp subsides.

Treating cramp at the back of the thigh (hamstrings)

If cramp occurs at the back of the thigh, then stretch the hamstring muscles.

Standing hamstring stretch

To stretch the hamstring muscles while standing, extend the leg so it is stretched straight out with the heel of the foot on the floor and toes pulled up toward you. The opposite knee should be bent and takes about 75 per cent of the body weight. Again, stretch by bending forward at the waist. Hold the stretch until the cramp subsides.

Seated hamstring stretch

To stretch the hamstring muscles while sitting down, place the leg to be stretched straight out. Keep the knee straight. Bend the opposite knee in. Pull the foot of the outstretched leg toward you. Lean forward toward your leg by bending at your waist. Hold the stretch until the cramp subsides.

Treating cramp of the calf (gastrocnemious)

If cramp occurs in the calf muscle, the following stretch may help.

Standing gastrocnemius stretch

Face forwards towards a wall or other solid object and lean against it with both palms flat. Place the leg to be stretched behind you and keep it straight while bending the front leg. Make sure that the heel of your back leg is not turned inward or the forefoot turned outward. The forefoot and the heel should be in straight alignment. Lean forward towards the wall to stretch the calf muscles. Hold the stretch until the cramp subsides.

Prevention of exercise-induced muscle cramps

As with any type of athletic injury, preventing exercise-induced muscle cramps is more desirable than treating them. In order to prevent muscle cramp, consider the following issues:


Training to the level of anticipated activity in your event may reduce the chance of sustaining cramp. Be careful to increase your training intensity and duration slowly, to give your body time to adjust to the progressive training load.


Dehydration is believed to be a common cause of muscle cramps. As a general guideline, try to consume 16 ounces of fluid per hour, or four ounces every 15 minutes in order to prevent dehydration. Urine colour is a useful way to determine how well hydrated you are. Colourless urine indicates adequate hydration, dark yellow urine indicates dehydration and pale yellow urine indicates that you are somewhere between hydration and dehydration.

Electrolyte replacement

After exercise, balanced electrolyte replacement may help to prevent muscle cramping. Except in extreme heat or humidity, dietary intake will normally replace these losses. If you are going to be exercising in excessively hot or humid conditions, pay close attention to your salt intake and even add half a teaspoon of salt (1150mg of sodium) per day to your food. So long as you use this as a short-term supplement, you should not need to worry about long-term health risks, because it takes months and even years for problems to develop. However, do not do this if you have high blood pressure, heart or kidney problems. Sports drinks that contain small amounts of electrolytes are also available.

Muscle glycogen reserves

Replenishment of glycogen (the body's store of sugar) is important for proper muscle cell functioning. Eat before exercise to stock up, and then replenish carbohydrate losses by eating during and after training. Foods that contain complex carbohydrates such as pasta and bananas are ideal.


Wear proper clothing and avoid exposing muscles to rapid changes in temperature.


Stretching before and after exercise can reduce the muscle's susceptibility to cramps.

If you regularly suffer from muscle cramps, then it is advisable to consult with a medical professional for more advice.

Why not find out what more BUPA can do for you?

For more information about discounted BUPA private medical insurance for members of approved fitness centres, please call BUPA today on 0800 600 500 and quote A711.

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