Self-Help

Self-Help for Cramps, Sore or Injured Muscles

Note: The information contained in this article is for educational purposes and is not medical advice.

This information on self-help for cramps, sore or injured muscles has been divided up into several sections:

Injuries (contusions, sprains, strains)
Temporary muscle soreness or pain (usually from exercise or activity)
Muscle spasms (also called cramps; in the calf they are sometimes called charlie horse)
Recurrent or ongoing muscle soreness or spasms

1. Injuries

If you have had an injury to a muscle, tendon, or ligament, stop doing whatever caused you the pain, immediately. The sooner you initiate treatment, the faster your injury will heal. Avoid any significant activity until it is clear whether it is a minor or major injury.

If you have a mild injury, it may be treated with home care as described in a section below.

If thre is significant swelling and you have a moderate or severe injury, see a doctor. Especially with injuries to the wrists and ankles, it is wise to have x-rays taken to make sure no bones have been broken. If you have muscle problems or injuries due to a motor vehicle accident, see a physician, if possible within 72 hours of the accident. Always see a doctor if pain or swelling is extreme or if you have any concerns.

Contusions (bruising): A contusion is a bruise caused by a blow to your muscle, tendon, or ligament. The bruise is caused when blood pools around the injury and discolors your skin.

Strains (damage to muscle or tendon): A strain may be a simple stretch in a muscle or tendon, or it may be a partial or complete tear in the muscle-and-tendon combination. You can cause a strain or sprain by putting too much stress on a muscle or muscle group, or by twisting and pulling a tendon or ligament. Muscles are made to stretch, but if stretched too far, or if stretched while contracting, a strain may result.

Typically, strains hurt immediately and continue to hurt for hours and even days after the injury. A strained muscle may go into spasms or knot up instead of relaxing normally. Localized pain (during movement), swelling, and loss of mobility may occur. Swelling tends to come on rather slowly over a period of hours, but may reach rather large proportions.

Sprains (stretched or torn ligament): A sprain is a simple stretch or tear of the ligaments. You can cause a strain or sprain by putting too much stress on a muscle or muscle group, or by twisting and pulling a tendon or ligament. If too much force is applied to a ligament, such as in a fall, the ligaments can be stretched or torn. In a severe sprain, ligaments may be completely torn.

The signs of a sprain are rapid swelling, heat, and disability; often discoloration and limitation of function. When a ligament is torn, there is usually significant bleeding into the tissues around the joint, and swelling tends to come on quickly and be of impressive dimensions.

It is important to understand that the intensity of the symptoms and signs may not be accurate indicators of the difference between a sprain and a fracture. If in doubt, splint the affected area to stabilize it and seek medical help.

Home Care for Mild Injuries

Most mild contusions, strains, or sprains heal with "R.I.C.E." (rest, ice, compression, and elevation), followed by simple stretches to relieve pain and restore mobility. The RICE treatment reduces inflammation that comes with acute injury. Inflammation often causes redness, heat, swelling, and pain. The earlier the RICE treatment is started after an injury, the better it works.

Rest
Rest the body part affected. Less severe injuries, as well as some over use injuries, may be rested by merely avoiding any activities which use the affected body part.
If you experience pain in the affected area, you may be aggravating the condition. In some cases, in order for a musculoskeletal injury to heal, it needs to be immobilized for 2-3 days following the injury. Using the injured "part" too early can cause further damage to the area and prolong recovery. Wraps, tape, splints, casts, canes and crutches can all help keep an injury immobilized. For difficult areas, such as around the bony areas of the ankle, pads can be cut and held in place with athletic tape and/or an elastic wrap.

Also, allow your body to rest for a few days after an injury.
Ice
Using ice within the first 5 minutes of an injury will significantly reduce healing time. Ice reduces swelling, relieves pain, and reduces muscle spasms. Use an ice pack, ice cubes in a plastic bag, a bag of frozen vegetables, or place a mixture of one part rubbing alcohol and four parts water in a ziplock bag to form a slush-like mixture that will wrap well around an injured body part. Keep a cloth or towel between skin and ice.

For the first 72 hours, apply the cold treatment about every 1-1/2 to 2 hours. Do not keep the ice on for longer than 15 to 20 minutes at a time. (Do not apply heat as it can cause increased swelling and result in more pain.)

After three days, both cold and heat may be of benefit. Cold may be of more benefit if swelling remains in the area or if muscle spasms are present. Continue applying ice 3 times a day if necessary.

When using a cold pack or ice, be aware of the CBAN: Cold, Burn, Ache, Numb. When you apply ice to an injured area, you will first feel the cold, then it feels more like a burn, then it aches, and then the injured area feels numb. Some people experience this progression in a short amount of time, for others it is longer. Once numb, stop the ice treatment, because bringing the temperature of the tissue too low can cause damage. Another way to know exactly how long to apply ice is by appearance. If you apply cold correctly, the area you applied to cold pack to will become red. This is the normal response. If there are blotchy white spots in the red area after you remove a cold pack, this means the area has been cooled excessively and is a warning sign. Decrease the amount of time the cold pack is left on the next time.

NOTE: If you have a circulatory condition, previous frostbite, hypertension, a cardiac condition, or areas of nerve damage which would make the use of cold inappropriate, then consult your physician prior to the use of cold.
Compression
Compression may help to prevent or reduce swelling. Use a pressure bandage such as an elastic, or ACE, bandage. Wrap the injured area with the bandage, but not so tightly that the blood is cut off. It should not be painful. Fingers or toes beyond the bandage should remain pink and not become "tingly."
Compression should be removed at night and the affected area elevated above the heart.
Elevation
Elevation means raising the injured area above the level of the heart. Elevation helps reduce internal bleeding and swelling. This will decrease any bleeding, facilitate venous return, and prevent the pooling of fluids in the injured area. Elevation may also reduce the throbbing pain that may be present.
The injured area should be elevated above the level of the heart. Prop up a leg or arm while resting it. You may need to lie down to get your leg above your heart level. This is especially important at night when the body processes slow down.

Also helpful may be:

Protection
A strain or sprain may not completely heal for 4 to 6 weeks and requires protection during this healing period. Elastic bandages will not prevent reinjury, but will ease symptoms a bit, remind you to be cautious, and provide support. Make sure that the bandage allows adequate circulation. Refrain from using or putting weight on the injured area until it no longer causes pain to do so and the swelling has gone down.
Pain-relieving medications
Pain medications can sometimes break the pain-spasm-pain cycle, and provide temporary symptomatic relief
Stretching
Stretch gently every day after swelling has gone down. Don't allow the injury to get tight.
Massage
After a week or longer, localized massage may be helpful.
Caution
Keep a close watch for increased swelling and pain. If there is more than slight swelling or pain, despite the fact that the body part was immediately rested and ice was applied, see a doctor. By 24 hours after the injury, the area should look and feel relatively normal; after 72 hours, this should clearly be the case. If not, see your physician.

Preventing Injuries: Strains and sprains occur when muscles are too weak or too tired to carry out the physical stress placed on them. You can help prevent sprains and strains by stretching and limbering up before starting an activity. If your injury is due to athletics, cross train and choose activities that put very little stress on the sore body part. Make sure your equipment is supporting you properly. Typically it is easy to reinjure an area that has already been injured so be careful with future activities.

2. Self-Help For Temporary Muscle Soreness, Pain, or Stiffness:

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Temporary muscle aches may occur unexpectedly in situations like these:

Your back hurts after moving furniture.
You wake up with a stiff or painful neck.
Your body feels sore and achy following the first day of a new exercise routine.
You exert yourself or use your muscles in a way that you are unaccustomed to using them.
You have a muscle spasm (also called a muscle cramp) — which is any kind of undesired sustained involuntary muscle contraction. These can be short and sudden, causing severe intense pain (especially leg or foot cramps). They can also be longer lasting, as in a mild ache or discomfort that doesn't go away. See the section on spasms.

To get out of pain:

Self-Massage: If you have a painful sudden cramp or spasm, rub for relief. A little kneading may be all you need to do. Rub with the muscle, not across it. Have a family member massage you.
Stretching: Gently and slowly stretch the affected muscle. If you stretch too fast, you might make the cramp worse.
Visit a professional massage therapist for a therapeutic session. You can get a referral to a professional therapist in your area by calling the American Massage Therapy Association at (888)-843-2682 or the American Bodywork and Massage Professionals at (800)-458-2267.
Use muscle creams or rubs. Products such as Tiger Balm and Biofreeze can often provide temporary relief from pain.
Stretching: In cases of light to moderate muscle tightness, very gentle, gradual stretching can sometimes help relax a muscle and relieve pain.
Apply heat or moist heat. Moist heat is most effective. Hot baths, soaking in a hot tub, or simple hot packs (made by putting a damp towel in the microwave) can increase circulation to affected areas and relieve pain and tension.

About using heat: 1) Do not use muscle creams and heat at the same time, as they are both sources of heat and may cause burns. If you have used a rub or cream, wait an hour or two before using heat. 2) If there is an injury, do not use heat until 3 days have passed. See guidelines for injuries. 3) Heat should not be used by people with decreased or impaired sensation (i.e., diabetes with neuropathies, stroke, head injury, nerve damage), compromised circulation (peripheral vascular disease, arterial insufficiency, cardiac conditions, and diabetes), or over malignant tumors, open wounds, areas of suspected infection, swelling (edema), inflammation, or skin conditions.

Many episodes of muscle pain and stiffness go away by themselves within 2 to 3 days. If they persist longer than that, see a massage therapist or other health care professional. Also read the instructions below for recurrent or ongoing muscle soreness.

3. Self-Help For Spasms or Cramps

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Muscle spasms or cramps are any kind of undesired sustained involuntary muscle contraction. These can be short and sudden, causing severe intense pain (especially leg or foot cramps). They can also be longer lasting, as in a mild ache or discomfort that doesn't go away. I will especially talk about leg and foot cramps (sometimes called Charlie horse) since so many people ask about them.

To get out of pain:

Self-Massage: If you have a painful sudden cramp or spasm, rub for relief. A little kneading may be all you need to do. Rub with the muscle, not across it.
Stretching: Stretching the muscle slowly and gently, not forcibly, can help. For calf or foot cramps: sit with the leg outstretched, relax the leg and use a towel as a sling to pull the toes of the foot toward oneself. Lean forward in this position to put a further stretch on the calf muscle.
Contract the Opposing Muscle: When a muscle is contracted (tensed), it stimulates relaxation in the opposite side muscle. This principle can be applied to spasms. When a muscle is spasming, it will often relax if you contact or tense up the muscle on the opposite side.
Use muscle creams or rubs: Products such as Tiger Balm and Biofreeze can often provide temporary relief from pain.
Ice: For continuing pain, an ice pack may help, along with massaging the affected muscle.

For further help with recurrent spasms, read the instructions below for recurrent or ongoing muscle soreness.

Special instructions for foot and leg cramps:

Leg or foot cramps may be due to poor circulation, lack of salt, dehydration, abnormal mineral or hormone levels, pinched nerves (from spinal misalignment or muscle tension in the hips or legs), alcohol or tobacco use, decreased flow of blood to the legs, nutritional deficiency, environmental toxicity, or chemical sensitivity. Prescription or over-the counter medications, sugar, or caffeine can also cause or increase cramping.

As people age, leg cramps become common. This is related to reduced activity or muscle fatigue when the muscles don't get enough blood supply. Getting moderate regular activity during the day or stretching the muscles before bedtime generally reduces the likelihood of cramps during the night. Stretching the calf muscles of the leg before sleeping can also help.

If you have a cramp in your calf, contract the muscles in the front of the lower leg (the shin). To do this, straighten your leg and flex your foot (bend toes back towards knees) to contract the muscle in the front of the lower leg. This should relax the muscles in the back of the calf. If a cramp is very tight and painful, you may need to do this very slowly. Pressing against something can help contract the opposing muscle. For example, if you are flexing your foot to alleviate a calf spasm, place your other foot on top of the foot and press.

Additional suggestions: Sleep with legs bent, avoid high heels, eliminate sugar and caffeine (caffeine interferes with the body�s absorption of magnesium), soak feet/legs in warm/hot water, use a heating pad for ten minutes before bedtime, or place a pillow at the end of the bed to prop up your feet. For dehydration, drink more water, not alcohol or caffeine, because they will dehydrate the body even more.

If you have this problem, try increasing your consumption of calcium. Magnesium may be especially helpful. Other supplements that may lessen the severity (frequency or duration) of leg/foot cramps: daily use of Vitamin E, B-complex, Vitamin A, potassium, or folic acid. Homeopathic remedies and herbs especially for leg/foot cramps can be obtained at health food stores.

See a professional massage therapist for massage of the hips, legs, calves, and feet. If your muscles are tight in any of these places, they may be causing restriction of the nerves and blood vessels, triggering the spasms. Sometimes the muscles and tissues of the leg are so bound up, it takes professional help to resolve this type of problem. You will know in one or two sessions if massage is helping.

4. Self-Help For Recurrent or Chronic Muscle Soreness, Pain, or Stiffness

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Longer-term, chronic conditions are those that repeat or last over time. Some examples of chronic conditions include:

You regularly wake up with a stiff or painful neck.
You have recurrent muscle spasms (also called cramps or Charlie horse) or any kind of undesired sustained voluntary muscle contraction.
Your shoulders or wrists ache continually from months or years of using a computer.

First get yourself out of pain by following the recommendations in the above sections. Then, take steps to decrease the ongoing tension which caused the pain to begin with. Typically, chronic pain or problems occur and recur because a person's muscles are already tight, and then an event causes an episode of pain to "suddenly" happen. The potential for the problem has actually been building up for a long time, and it just took one last straw for pain to occur. Thus, the best prevention is to reduce muscle tension in daily life on a regular basis.

Some suggestions for prevention:

Receive massages on a regular basis from a professional massage therapist. Relaxation massage helps decrease your overall tension, and focused massage targets specific areas of the body.
Allow yourself regular times of rest and relaxation for decreasing overall tension in your body. If you are busy, tense, and tight all the time, your muscles have no opportunity to relax. There are many ways to achieve ordinary relaxation. A very effective way to reach a deeply healing state of relaxation in a short period of time, is the practice of Skilled Relaxation.
Stretch. A regular stretching program can relax muscles, decrease tension and stiffness, and promote flexibility.
Improve the nutritional quality of your diet. Poor nutrition aggravates muscle tension and stress. (See the Whole Foods Diet article.)
Drink plenty of water. Dehydration can cause muscle tension. When you feel thirsty, you are already dehydrated, so drink before you feel the need. Dehydration is common and can cause many health issues.
Exercise regularly, especially cardiovascular exercise. Increased circulation and blood flow nourishes muscles and eases tension.
Supplement your diet with calcium, magnesium, potassium, or zinc, or eat foods rich in those nutrients. Tight muscles cannot release without these substances in your body. Consult appropriate reference books or a knowledgeable employee at a health food store for amounts and types of these substances to take.
Practice self-awareness. Throughout your day, keep your awareness on the tight areas. What makes them feel better? What makes them feel worse? Do you find that you are constantly "holding" in those places? Learn to discover your patterns around tension and relaxation. Awareness is the key to change.
Transform stress. Pro-actively change aggravating habits or circumstances. For example, if your boss makes you tense, get counseling for how to deal with that person, or find out how the situation can be changed or improved. (See the Stress Relief article and the Mental/Emotional Health Links.)
Examine your environment. If your office chair causes muscle tension or soreness, adjust it or get a new one. (See further instructions for reducing workplace stress in the Ergonomics article.)
Visit a chiropractor, physical therapist, or D.O. Professionals with knowledge of bony structure can deal with postural problems which may be contributing to or be a root cause of muscle tension.
Explore the mind-body connection. Personal growth work or psychotherapy may help you discover and release belief structures, traumas, or unresolved emotions that are keeping your body in a pattern of holding tension. (See the Self-Help Book/Video List, and Mental/Emotional Health Links.)

By taking good care of your body on a regular basis, you may decrease both injuries and episodes of muscle discomfort.

For further information, search Amazon.com for books and materials on self-massage or muscle pain

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