Steven Chang, MD

Quirky Questions:

What causes a charley horse?

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Q What causes a “charley horse” and how do I prevent one from occurring?

A While the origin of the term “charley horse” is unclear, its meaning is all too familiar: a sudden, involuntary spasm or cramp of a large muscle, typically occurring in the calf (gastrocnemius), thigh (quadriceps), or hamstring. A charley horse can be caused by a direct blow or sudden stretch of the muscle, but most of the time they’re caused by strain or fatigue during exercise. If you aren’t properly conditioned or if you haven’t adequately warmed up before physical activity, your muscles may not receive sufficient blood flow, which can result in cramping. Cramps are also more likely to occur if your body is low in minerals like sodium, calcium, and potassium, which play critical roles in muscle function. Poor diet, dehydration, and use of medications such as diuretics can all be associated with mineral depletion.

A charley horse will usually go away after a few hours or days. However, gentle massage or holding the muscle in a stretched position will help resolve the cramp more quickly. Ask your doctor or physical therapist if you are unsure about specific stretches for certain muscles. Tight muscles will often respond to heat as well. A warm water bottle or heating pad applied in 20 minute intervals will help increase blood flow to the cramping muscle.

To prevent muscle cramps, try these tips:

1.    Stretch regularly before and after exercising to increase your flexibility.
2.    Do workouts that match your level of physical fitness. Build up to harder, more intense workouts gradually rather than overusing and straining your muscles.
3.    Eat a well-balanced diet with plenty of potassium-rich fruits and vegetables. Oranges and bananas are especially good sources of potassium.
4.    Stay well-hydrated before, during, and after exercise.

If you develop recurrent cramps that disrupt your sleep, make an appointment with your health care provider. In some cases, medication may be helpful.

Got a quirky health question? Email it to Dr. Steven Chang and he may answer it on the blog!

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comments:

  1. Lawrence Kenney says:

    I am a 62 year old male who does alot of baseball umpiring during the spring and summer. Even though I am well hydrated, eat a banana before every game, and take extra water before and after games, as well as potassium pills, I still get Charlie horse cramps in the hamstings and medial quads. It is very frustrating and all the my prevention remedies are no longer working. Aside from stopping working behind the plate so often, what kind of medications or particular dietary regimin might you recommend? Thank you .

    • Patrina Gates says:

      Magnesium does the job well…cured my cramps…and I make sure I do stretches every morning and night before bed..Sometimes I feel a slight one coming on in my calf but it goes away with the help of magnesiu…drink at least 8 glasses of water a day

  2. Steven Chang, MD says:

    Lawrence – do you do regular stretching and conditioning exercises outside of your umpiring sessions? One of the keys to prevent muscle cramping is to make sure they are well conditioned for their job and umpiring is not necessarily an easy task. Doing stretches before, during and after each game may help as well.

  3. SD Axtell says:

    I’m a 20 year old female and I’ve had muscle cramps in my calves on and off for years. This past year they have become more severe and more frequent. I drink water, try to eat healthy, and take my multi-vitamins. What could be causing it? Thank you.

  4. Maya says:

    Im currently having charley horses In my thigh. Its really getting overwhelming and fustrating. What do I have to do to get rid of them?

  5. Corey says:

    I get Charley horses in my stomach while doing sit ups. What stretch could I do to prevent this?

    • First, make sure you’re doing your sit-ups properly — slowly, clasping your hands behind your head to support your neck, and rising only until your shoulder blades don’t touch the floor. Second, prior to your sit-ups, do some yoga poses that stretch out your abdominals while extending your back. One good pose is a half push-up: Lying on your stomach, slowly raise yourself until your arms are fully extended (or as close as you can comfortably get), keeping your pelvis and legs flat on the floor. Hold this pose for 7 deep breaths and release. Then put your hands together at the small of your back and again arc upward (this won’t be as far), hold for 7 breaths, and release. Let us know if these help.

    • Lucas Diaz says:

      That’s not a Charlie Horse.. You just have to fart

  6. Kim says:

    I am 19 years old and have always been super active and athletic. I drink tons of water and eat plenty of fruit. The only deficiency I know of that I have is iron….. Why am I getting such severe cramps in my calfs that wake me up almost every night? I’ve always gotten them at least once a month but in the past two months it has been close to every night. I know that I have weak calf muscles but I do not know why that is either because I work them out all the time, they just stay the same no matter what I do.. So why am I suddenly getting these so bad?!?!?!?

    • Hi Kim

      Nighttime leg cramps are incredibly common, so don’t feel you have been singled out for special punishment! There are many possible causes, ranging from structural causes (e.g. flat feet), prolonged sitting, dehydration from excess sweating, and various neurologic and metabolic diseases (e.g. diabetes or a low thyroid), but in the vast majority of people no specific cause is found. Here is what you could try:
      - See your primary care physician for some blood work and a quick exam just to make sure you don’t have any underlying cause that needs treatment
      - If your visit to your PCP does not reveal any particular diagnosis, try taking a B complex vitamin and 500 mg of calcium every night – there is some evidence that these supplements can be beneficial
      - Stretch your legs carefully for a few minutes just before bed time – your PCP can give you the proper exercises to do
      - Hydrate like crazy – you may think you are drinking enough, but you may not be; and I wouldn’t use just water if you are exercising for long periods of time – try diluting a sports drink like Gatorade 1:1 with water
      Give this all a try and let your PCP know how you are doing – for severe cases there are medications that can be tried, but I would use those only as a very last resort.

      Malcolm Thaler, MD
      Clinical Editor
      One Medical Group

  7. mary says:

    i have pain in my thigh when i am about to get up from chair,lift my leg or make sudden move. pain is sharp and makes me buckle. i never know when pain will occur. i did exercise before this happened and eat balanced diet. advil and aleve did not help.

  8. Jennifer says:

    My husband will get cramps in his thigh that wake him up at night. The cramps will occur sporadically, but always when he has been stressed at work or doing extra work like moving his Mom from one house to another. He is a fairly active individual, never just sitting around, however his job is a desk job and he puts in long hours.
    His cramp will start and then seem to “spread” and radiate down the leg.
    He has seen a neurologist and they said it was nothing to worry about, but it has started again and he is concerned.

  9. Darwin says:

    Hi I’m a 17 yr old male I ALWAYS get a Charlie horse when I’m in the tread mill even when I’m just walking on it . And I ALWAYS get a Charlie horse when I do squats. I drink about 3-5 bottles of water everyday and eat a banana every day. And as I was running outside I suddenly got a Charlie horse 1 hr into the running I did stretches and warmed up how do I stop getting Charlie horse PLEASE HELP!!

    • Hi Darwin

      This could be a variety of different issues depending on which part of the leg you are experiencing pain. It is definitely worth a visit to your primary care physician to check this out. He/she will want to examine you and may need to get some blood tests done.

      Malcolm Thaler, MD
      Clinical Editor
      One Medical Group

  10. chloe says:

    My mom once in a blue moon gets Charley horses in the back of her head by her neck.

  11. Austin says:

    I’ve read that I should do certain exercises in order to build up my arch/feet muscles, but when I do these stretches, I get charley horses. They go away when I stretch in the opposite direction, but while stretching, they hurt.

    The obvious answer is that I should not do these stretches, but I want to build the muscles for other medical reasons. The charley horses are basically self-inflicted, but should I suffer through the stretching in order to build the muscles? I’m a bit confused.. :(

    • Hi Austin,

      Thanks for reaching out to us. This depends on which specific stretches you’re doing, but they should be done gently–think “yoga” and not “pumping iron.” You should warm up before you stretch (i.e. 10 minutes on a stationary bike) so your muscles are warm and pliable, then gradually ease your way into stretching. Take your time and hold at the point where you feel the stretch but don’t feel pain–hold at least 30 seconds, gently release, and repeat as often as you’d like. See if that helps, but we recommend you also check in with your primary care provider to look into further.

      Malcolm Thaler, M.D.
      Clinical Editor
      One Medical Group

  12. valeria says:

    Hi i get Charley horse in my right arm from color guard. and i dont know how to get rid of it.

  13. Keri says:

    I get terrible charley horses in both feet and shins every night. I’m not dehydrated. I take calcium, potassium, magnesium, and taurine supplements. I haven’t been excercising regularly for about two weeks, and every time I try to stretch, it causes a charley horse. I’m at a loss what to do. I’m trying to do everything to go to my MD, but it’s looking like that is the next route.

    • Hi Keri,

      Sorry to hear that. It is definitely time to see your MD. You may need some lab work to see what’s going on. Please make sure to get in touch with your primary care provider.

      Malcolm Thaler, M.D.
      Clinical Editor
      One Medical Group

  14. barbara says:

    i just got a cortisone shot 3 days ago and since then have had a severe charlie horse in my right calf (shot was in my right knee) it is causing me to have very limited sleep at night. i just had all my blood work done and all is well that way. i am dieting but do drink 10-16 glasses of water a day and eat pretty healthy for the last 3 months. i can’t understand that why after i got the shot this has started i have never had them before other than maybe once or twice in my life. could this shot have anything to do with it? please help i need to sleep at night.

    • Hey Barbara,

      Unfortunately we cannot provide specific medical advice online. We suggest contacting your primary care provider to look into further to see if there’s any correlation between the cortisone shot and the charlie horse.

  15. MARGUERITE MCCORMACK says:

    I GET CHARLY HOURSES LATE AT NIGHT. WHEN I DRINK TWO GLASSES OF WATER THE CHARLY HOURSES SUB SIDE.I HAVE BEEN DRINKING LOTS OF WATER GOT RID OF SODA AND SUBSTITUTING WATER ESPECIALLY WHEN I EAT

  16. David says:

    I get a charlie horse at night while sleeping a few times per year. Sometimes the calf, sometimes where my foot arches. I found that if I wait for more than a minute, the pain lasts for hours, and I cannot get back to sleep. One thing that helps me with both types of these is to immediately stand up on the leg or foot affected, put the foot flat on the ground, and straighten the leg. Sometimes getting that stretch in hurts worse than the charlie horse. However, the pain vanishes within a second or two, I climb back into bed, and fall back to sleep. I have trained myself that within 15 seconds after I wake up, I am standing up. No pain whatsoever after when I climb back in bed, or the next morning. So when you get them, and you do your stretching (and whatever works for you), remember that time is of the essence.

  17. Chris S. says:

    I was suffering from the worst charley horses ever last year. I was getting them every night, and I would limp for a day or two afterwards. I was becoming afraid to go to bed at night, knowing what was going to happen. A friend of mine told me how to make them stop (google it!), and it worked!

    Solution: buy a bar of Ivory soap and put it under your fitted sheet in bed. It does not need to be touching your leg (in fact, the wrapper can still be on the soap). Your charley horses will STOP! The soap needs to be changed every three months or so because its effectiveness wears off. Nobody knows why this works, but it does! What have you got to lose?

    • Cindi Cagle says:

      I read that as well a few years ago. My husband was having leg cramps almost every night. I put the bar of soap, (it wasn’t Ivory, but whatever brand I had) with out the wrapper under the fitted sheet, at the foot of the bed. My husband laughed and thought I was crazy. IT WORKED!!! I did that for a few months and all leg cramps stopped.

  18. Brittney says:

    I started getting Charley horses almost every morning at like 7:00 or 8:00 when I wake up! I just started playing volleyball before I got charley horses so that might be why but it hurts so bad and I’m only 14 so I didn’t know if playing sports can cause it but I stretch before I play and I eat like 3 bananas a day so I don’t know what’s going on… What do you think?

  19. tasha says:

    I get Charlie horses in both legs almost every night. Ill be end my toes up and itll go away. But im tired of it!

  20. Leah says:

    Hi, I really need some advice. I am getting severe Charlie horses in my toes, its primarily my left toes but my right 1s do get them occasionally. I can’t get into my PCP for another 4 weeks. The pain is horrible and really starting to disrupt my life BC they’re causing my to not have adequate rest. They occurs in the evening, once I’m done w my day and laying down attempting to relax and throughout the night. I use to just get them in my left foot occasionally but the frequency and intensity has continued to increase and increase. Its to the point where its a daily occurrence every since evening and once I get the 1st 1 of the day they reoccure like every 15-40 min. About a week and a half ago I started to eat a banana a day and take 20 mg of potassium supplement a day, but like I said they’re not getting any better they’re getting worse with increased pain, intensity, and frequency. Since I can’t get in to see my Dr for another 4 weeks to get checked out by him and with blood work, can you please help me with some advice and suggestions to help me relieve these in the mean time while I’m waiting to see my Dr to find the medical reason for this problem? Please, please, please HELP!!!!!!!
    Thank you so much in advance for any advice and suggestions you may be able to offer! :-)
    -Leah

    • Thanks for your question Leah. We can’t give specific medical advice online so we’d suggest getting in touch with your PCP. If you’re a One Medical member, you can always give us a call or send us an email. Our virtual care team can provide you with some medical advice until you can see your PCP.

      If you’re not a member, you can sign up in a snap at onemedical.com.

  21. Peg h says:

    Tonic water will work almost immediately to alleviate muscle spasms. My orthodox surgeon gave me this trick. Works WONDERS, Good luck, the spasms are the no fun!

  22. Sister says:

    I get them in my weak legs. They’re most painful when I get them on the sides of my stomach area and right underneath my ribcage. Mine are always really bad and sometimes they hurt more when I take in a deep breath. The pain is so bad, it makes me sweat.

  23. Lauri says:

    I have been following a low carbohydrate diet since February. I went back to a normal diet last week, and have been getting muscle cramps in my legs. I’ve been training for a long bicycle ride and have been putting 100-150 miles a week on my bike with no trouble until now. Today I was putting along in my street clothes for transportation, and I had the most awful cramps in both glutes, medial quads, and hip flexors. Any light you can shed on this would be tremendously helpful, as my big ride is coming up soon.

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