5 Simple Exercises To Help Keep Seaside Cramps At Bay

Dr. Soraya Burrows

​Summer can be such a diverting time of the year; the days are longer and finer, if we choose, we can stretch our leisure time well past our usual mid-year hours.  We may feel inspired to rise with the sun and exercise or spend the later afternoon drinking up the last rays of sun relaxing in the backyard or as we sit by a large window.  Usual aches or niggles could have been kept to a minimum as we’ve probably been a bit more active.  No wonder; movement is the best medicine!
Earlier this February it has felt more like the wheel of the year is turning quicker, with the crisp mornings and plenty of rain.  I’m a lover of the beach, nothing’s better than heading down to the Mornington Peninsula, taking my underwater camera out on an early morning dive, swimming with the local sea creatures. 

One thing that used to trouble me swimming in the Melbourne surrounds was toe and foot cramps.  It may be a beautiful day, arid on the sand but in my experience Port Phillip Bay requires many sustained hot summer days for the water temperature to rise.  I’d be out there, passively observing a gracious stingray or cuttlefish, waiting for the right moment to take the photo when a cramp would come on and I’d have to struggle in the water,  removing my fin to mobilise and take time to massage my foot and toes out of their twisted position – definitely not the safest thing to be having to do whilst in water! ​

I have learnt the hard way to approach water activities with patience, swim in the company of friends and that a few simple stretches and warm ups on the shore will save me from an unpleasant or potentially dangerous experience.

There are many factors that can contribute or lead to leg, foot and toe cramps, ranging from but not limited to:

• Dehydration and electrolyte abnormality, concerning calcium, magnesium, potassium or sodium (1, 2, 3).
• Underlying health conditions and certain medications such as diuretics and statins (2, 3, 4).
• Lack of circulation to the muscles (3, 4).
• Modern footwear causing muscle imbalances; high heels or shoes that contribute to toe spring (holding the toes in an upwards angle) change the biomechanics of the feet.  This causes tightening of the calf and shin muscles which can lead to muscle imbalances where the muscles at the arch of the foot (plantar intrinsic muscles) are held in a lengthened state.  When muscles are held in positions outside their optimum length, their function is compromised, and they can become prone to problems such as cramping when stressed (5, 6).
• The cold temperature of the water

If you are experiencing frequent lower limb cramps, whether at all hours or sometimes waking up with cramps, it may be a good idea to chat to your GP just to be sure, clear up whether this could be a side effect of any medications, caused from a vitamin deficiency or perhaps another underlying health issue that could be identified and addressed (1, 2, 3, 4). 
​
If it’s more an experience like mine; where modern footwear is most likely a contributing factor and the pain is brought on by swimming around Victoria’s chilly shores, simple management strategies can include making sure you’re hydrated by carrying a drink bottle with you (and reminding yourself to actually drink from it!) and warming up with stretching and mobilisation before you enter the water (1, 5, 6).  

I begin with a walk along the water’s edge; not only does that wake up my legs but also gives me a chance to assess the area. I’m a freediver, so safety is always first in my mind, so I observe for any beach traffic and check that the seaside conditions approximately match those the Bureau of Meteorology forecast. 
Then I find a firmer patch of sand or go back to the path to perform some standing calf muscle stretches.  There are two muscles that make up the calf; gastrocnemius closer to the surface and soleus lies deep.  It would be great to stretch both by finding a post/wall for support but at the beach you may need to attempt to balance without, placing your hands on your hips or on your front leg as it may aid with balance and centring yourself.  

You can stretch your gastrocnemius muscles by standing with one leg stretched out behind you and the other out in front.  Keeping your heel on the ground, you lean slightly forward and down until you feel a stretch in the calf of the back leg.  It’s a good idea to hold this for at least 30 seconds, rest and repeat and then repeat for the other leg.  ​

​You can stretch the soleus muscle by assuming the same position as the gastrocnemius stretch but bend your back leg at the knee, keeping your heel on the ground and your bodyweight will cause a stretch through your calf.  Again, hold this for at least 30 seconds, rest and repeat and then repeat with the other leg.  

​Then going back to your towel, you can start to really address some of the joints and muscles of the feet.   Sit on the sand and assume the position seen in the picture. 
​From here you can perform ankle dorsiflexion (by pulling your toes towards your body), producing a stretch in the arch of your foot
or   

ankle plantarflexion (by pulling your toes downwards towards your body), where a stretch may be felt in the top of your foot or shin.

​Repeat these several times on each foot, until the tissues feel warm and loose.  It is common for cramps to occur when the foot is in plantar flexion.  If this occurs, perform dorsiflexion and it would be beneficial to wiggle the toes and massage the muscles of the foot and arch (plantar intrinsic muscles). ​

​Finish up with some ankle and foot mobilisations by rotating each ankle clockwise and anticlockwise for several passes, alternating by pointing the toes up and down. 

To warm up the toes even more, especially if they’re about to be scrunched into fins for snorkelling, you can sit with your soles on top of your towel and bend and straighten your toes until the towel is crumpled up.

​For those who are super motivated, strong calf muscle stretches can be achieved by placing a towel around your foot, as shown in the picture and pulling your toes towards your body.  Again, it would be ideal to hold this for at least 30 seconds, rest and repeat and then repeat with the other leg.

Once you’re feeling limber and want to try the water, my suggestion is don’t take a running leap just yet! 

I know it’s fun, but I find that shock of plunging in before your body can adjust can bring on foot cramps. 
Let your body acclimatize to the cooler temperature first and once in you can do a dolphin dive hopefully without too much discomfort. 
If cramping does occur, it would be advisable to alert your swim buddy and get to the shore or a shallower area where it’s safe. 
Repeating ankle plantarflexion until the pain subsides, followed by ankle rotations and calf stretches can be a good way to settle things again.  Grabbing your drink bottle to re-hydrate and a small snack could be helpful before getting back to your water activities.  

​Here were just a few suggestions that have enabled me to enjoy the water safely and for as long as possible into autumn.  Over the years I’ve been able to swim comfortably well into March, even into May with the aid of a thick wetsuit.  I hope that, despite the recent temperamental weather, mingled heat and chilliness, the consistent fine days will return so that we may squeeze as much enjoyment on the water as we can out of this season.

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​Photographs and artwork by Soraya Burrows
Diagrams modified from The Saunders Groups Inc. and Physio Tools Ltd

​Sources:

1. Jung, A. P., Bishop, P. A., Al-Nawwas, A., & Dale, R. B. (2005). Influence of Hydration and Electrolyte Supplementation on Incidence and Time to Onset of Exercise-Associated Muscle Cramps. Journal of athletic training, 40(2), 71-75.
2. Rabbitt, L., Mulkerrin, E. C., & O'keeffe, S. T. (2016). A review of nocturnal leg cramps in older people. Age and ageing, 45(6), 776-782.
3. Hallegraeff, J., de Greef, M., Krijnen, W., & van der Schans, C. (2017). Criteria in diagnosing nocturnal leg cramps: a systematic review. BMC family practice, 18(1), 29.
4. Allen, R. E., & Kirby, K. A. (2012). Nocturnal leg cramps. Am Fam Physician, 86(4), 350-355.
5. Hallegraeff, J. M., van der Schans, C. P., de Ruiter, R., & de Greef, M. H. (2012). Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. Journal of physiotherapy, 58(1), 17-22.
6. McKeon, P. O., Hertel, J., Bramble, D., & Davis, I. (2015). The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med, 49(5), 290-290.