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Quick reference medical handouts used by Pediatric offices

Muscle Cramps and what to do about them

  Have you ever experienced a "charley horse"? If yes, you probably still remember the sudden, tight and intense pain caused by a muscle locked in spasm. A cramp is an involuntary and forcibly contracted muscle that does not relax. Cramps can affect any muscle in the body that is under your control.  Muscles that span two joints are most prone to cramping.  Kids experience muscle cramps as well, and the most commonly affected muscle groups are:

Front of thigh (quadriceps)

Back of thigh (hamstrings).

Back of lower leg/calf (gastrocnemius).


Cramps in the feet, hands, arms, abdomen and along the rib cage are also very common. Muscle cramps range in intensity from a slight tic to agonizing pain. A cramping muscle may feel hard to the touch and/or appear visibly distorted or twitch beneath the skin. A cramp can last a few seconds to 15 minutes or longer. It might recur multiple times before it goes away.

Why cramps happen

Although the exact cause of muscle cramps is unknown, the best explanation is that inadequate stretching and muscle fatigue leads to abnormalities in mechanisms that control muscle contraction. Other factors may also be involved, including exercising or working in intense heat, dehydration and depletion of salt and electrolytes. 

Stretching and muscle fatigue:  

Muscles are bundles of fibers that contract and expand to produce movement. A regular program of stretching lengthens muscle fibers so they can contract and tighten more vigorously when your child exercises. If your youngster does not stretch properly,  they are more likely to experience muscle fatigue, which can alter spinal neural reflex activity. Overexertion depletes a muscle’s oxygen supply, leading to build up of waste product and spasm. When a cramp begins, the spinal cord stimulates the muscle to keep contracting.

Heat, dehydration and electrolyte depletion

 Muscle cramps are more likely when your child exercises in hot weather because sweat drains their body’s fluids, salt and minerals (i.e., potassium, magnesium and calcium). Loss of these nutrients may also cause a muscle to spasm.

Who gets cramps

Some kids are pre-disposed to muscle cramps and get them regularly with any physical exertion. Those at greatest risk for cramps and other ailments related to excess heat include infants and young children,  and those who are ill, overweight, overexert during work or exercise, or take drugs or certain medications. Muscle cramps are very common among endurance athletes (i.e., marathon runners and triathletes).  

  • Student athletes are more likely to get cramps in the preseason when the body is not conditioned and therefore more subject to fatigue. Cramps often develop near the end of intense or prolonged exercise, or the night after.


Treatment and prevention  

Cramps usually go away on their own without seeing a doctor. Self-care includes:

  • Have your child stop doing whatever activity triggered the cramp.
  • Have your youngster gently stretch and massage the cramping muscle, holding it in stretched position until the cramp stops.
  • Apply heat to tense/tight muscles, or cold to sore/tender muscles.

To avoid future cramps, have your child work toward better overall fitness. They should doo regular flexibility exercises before and after they work out to stretch muscle groups most prone to cramping. Always make sure they warm up before stretching.

Calf muscle stretch: In a standing lunge with both feet pointed forward, straighten the rear leg. (Repeat with opposite leg.)

Hamstring muscle stretch: Sit with one leg folded in and the other straight out, foot upright and toes and ankle relaxed. Lean forward slightly, touch foot of straightened leg. (Repeat with opposite leg.)

Quadriceps muscle stretch: While standing, hold top of foot with opposite hand and gently pull heel toward buttocks. (Repeat with opposite leg.)

Hold each stretch briefly, then release. Never stretch to the point of pain.

Abdominal spasms and the "Stitch in the Side" can be caused by a variety of exercises and stretches, even excessive deep inspirations and expirations. They are generally caused by any of at least 13 muscle groups and are very difficult to isolate. Therefore, it becomes almost impossible to  release the spasm. 

The best move to try to alleviate the spasm is to have your child lay on their back and place both arms under the head, grasping both elbows. Support the head by raising it as high as you can. Have them take a deep forced inspiration and hold it for a count of 8, then a deep forced expiration for a count of 8. Repeat as needed, until there is relief of the spasm. For the "Stitch in The Side", if the spasm is on the right side, repeat the above maneuver while pulling the right elbow and head as far to the left as you can. For spasm on the left side, reverse the above procedures.

To prevent cramps, make sure your child keeps their body adequately hydrated as youngsters especially do not drink enough liquids to replenish fluid lost during exercise. Some tips:

  • Drink water at regular intervals, before you get thirsty.
  • Drink more than your thirst requires.
  • Drink fruit juice or a sports beverage if you are working in heat or sweating for more than an hour.
 source: American Academy of Orthopaedic Surgery; posted 05-26-04 on


As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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