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- Charley horses are intense and painful but you can quickly relieve them by stretching.
- You can also try rubbing the muscles and applying heat or ice to further relieve the pain.
- It's possible to prevent charley horses in the future by stretching and flexing those calf muscles.
A charley horse is an intense cramp or spasm that happens when one or more muscles, usually in your calf, suddenly and involuntarily contract, sometimes causing a hard lump of muscle tissue beneath your skin.
While they can be extremely painful, charley horses typically only last for several seconds to minutes. But your muscles in that area might hurt for hours after the cramp goes away.
You can get a charley horse at any time, but up to 60% of adults experience them at night. They can also strike during athletic activities that involve kicking motions, such as running and swimming.
Here are some ways to release a charley horse, alleviate the pain, and prevent it from happening again.
1. Stretch it
Usually, the reason behind a charley horse is an overused muscle, so that when you go to use the affected muscle, "it kind of gets angry, if you will, and the muscle fibers sort of attach to one another and won't release without a little bit of force," says Lisa Nichole Folden, a licensed physical therapist and owner of Healthy Phit Physical Therapy & Wellness Consultants.
Stretching the muscle that has contracted is the best way to release it, Folden says. Stay calm, breathe, and then gently move your leg (or the affected body part) out of the position that it is in, she says.
If the charley horse is in your calf, flex your foot slowly. "It's going to feel like you can't do it, but you absolutely can. The muscle is not stronger than you," Folden says. Then the cramp should go away in seconds.
To stretch the calf, you can try straightening your leg, pulling your toes toward your shin, and walking around on your heels.
You may want to keep stretching for a couple of minutes after you start to feel the pressure diminish, to keep it from coming back, Hodges says.
2. Massage it
Although stretching is the best way to release the cramp immediately, massage can help reduce soreness after that, Folden says.
You can use your hands, a roller, or a percussive massager, like a Theragun, to massage the muscle.
While any type of massage is likely to help, the most effective method is called cross friction, Folden says. In the calf, the muscle fibers run from the back of the knee down toward the heel, so cross friction would be massaging perpendicular to that, back and forth across those muscle fibers, she says.
"As long as you're kind of rubbing and kneading and digging into the muscle fibers in any direction, you're going to find a little bit of pain reduction from that," Folden says.
3. Get hydrated and replenish electrolytes
Because dehydration or low levels of certain minerals might be to blame for a charley horse, you should immediately get hydrated and replenish the electrolytes you may have lost during exercise or exertion, Hodges says.
Sports drinks are a popular choice, but can be high in sugar. Hodges suggests trying coconut water, because it contains less sugar than some sports drinks.
4. Apply heat, ice, or both
Heat and ice probably won't loosen up a charley horse immediately, but they can make the muscles feel better afterward. Heat has more of a relaxing effect, so use a heating pad if it feels good.
Ice has more of a numbing effect, which may be more appropriate if you're feeling a lot of pain and tension, Folden says.
Ultimately, whether you use heat, ice, or both — and for how long — is a matter of personal preference.
"When we use heat and ice, they don't actually get through our skin and connective tissue and get near the muscle, so it's really just about what feels good to us," Folden says.
5. Take a bath
Like applying heat and cold, a bath is unlikely to help in the moment when a charley horse strikes, but a warm bath can help alleviate the soreness and tenderness you feel later, Folden says.
Adding Epsom salts may help, because they are commonly used to relax muscles. Some medical experts believe this is because the magnesium and sulfate in Epsom salt absorbs through your skin in the bath.
Causes and prevention
There are a few different things that can cause a charley horse. Here are the leading culprits and what you can do to prevent these painful cramps in the future.
Tight muscles
The most common cause of charley horses is lack of stretching and lack of muscle flexibility, Folden says. If your muscles are not being used through their full range of motion and stretched regularly, they tend to shorten over time, she says.
The older you are, the more likely you are to get these cramps, because your tendons naturally shorten as you age. Women are also more prone to getting them, according to the Cleveland Clinic.
What you can do: Stretching regularly can help prevent charley horses in the future. Always make sure to stretch before and after exercising, as well as around bedtime if you typically get charley horses at night.
You can also adjust your sleeping position. If you sleep on your back, use pillows to keep your toes pointed upward. If you sleep on your stomach, try hanging your feet over the end of the bed.
To stretch the two main calf muscles, the gastrocnemius and soleus, Folden recommends this wall stretch:
- Stand in front of a wall.
- Step one leg behind you into a lunge position, with your back leg straight, your front leg bent, and your hands on the wall.
- Make sure your back heel stays on the floor, and all your toes are facing forward, not pointing to either side.
- Hold the stretch for 30 seconds. This stretches the gastrocnemius.
- Now introduce a small bend into the back knee. You will feel it in the soleus, a flatter muscle that leads down to the Achilles tendon.
- Hold that stretch for 30 seconds.
"If you do that twice a day, most days out of the week, you'll probably find that your calf muscles are nice and long and you very rarely suffer from cramps," Folden says.
Dehydration
Most people don't get enough water in the course of a day, which leads to dehydration — another common cause of charley horses, Folden says.
So it's important to stay hydrated, especially if you're exercising or performing manual labor in hot weather, because it can cause you to sweat more and lose electrolytes like sodium.
"If you're exercising and you see the kind of salty stains on your skin, you definitely want to replace the sodium that you sweated out during exercise," Hodges says.
Mineral deficiency
Low levels of certain minerals such as potassium and calcium can cause charley horses. To make sure you are getting enough of them, you need to go to the doctor to be tested.
If your levels are low, you can include more of them in your diet, such as eating more bananas for potassium, Folden says.
If, however, you have an underlying medical condition — like Crohn's disease or ulcerative colitis — that makes it difficult to absorb nutrients from food, your doctor may prescribe you a more potent supplement.
Medical conditions
People who are pregnant or have certain medical conditions, such as diabetes and disorders of the nerve, liver, or thyroid, may have a higher risk of leg cramps.
Certain medications
Certain medications also may cause leg cramps as a side effect. They include:
- Diuretics, used to treat high blood pressure.
- Albuterol, used to treat asthma.
- Conjugated estrogens, used to treat symptoms of menopause.
Is it restless legs syndrome or some other condition?
Both charley horses and restless legs syndrome often cause discomfort at night, but they feel different.
A charley horse causes a sharp pain, and restless legs syndrome causes a feeling, sometimes like pulling or throbbing, that makes you want to move your legs.
Although most charley horses are harmless, some may be related to an underlying medical condition such as compressed nerves. According to Mayo Clinic, you should see a doctor if charley horses:
- Cause severe discomfort
- Are associated with leg swelling, redness, or skin changes
- Are associated with muscle weakness
- Happen frequently
Insider's takeaway
Charley horses can be intensely painful, but usually, they don't last long and are not a cause for concern. "It seems like the end of the world in that moment, but it's not," Folden says.
By staying hydrated and stretching daily, you can help prevent charley horses from recurring. "I don't think most adults recognize that we need to stretch on a daily basis, but we really do," Folden says.
"Our bodies, our muscles, our joints — they were all created to move. So the more we can engage in safe and efficient moving, the less likely we are to hurt ourselves and have cramps, spasms, and pain," she says.