This Is Why Your Toes Keep Cramping

You drink more water, you still get toe cramps. You get enough electrolytes. You still get toe cramps. So why do coaches, well-meaning friends, and even some doctors, keep telling you to do those things?

“The majority of people just keep going back to the dehydration and salt answer because it’s easy to understand and easy to explain,” says Nicole Nelson, adjunct instructor in clinical and applied movement sciences at Brooks College of Health at the University of North Florida.

But these performance-busting, sleep-wrecking, annoyingly painful episodes are more complicated than that. And while complicated sounds a bit discouraging and muscle cramps can vary from person to person, experts have dedicated research toward better understanding them and finding new ways to put you more at ease.

New thinking is that cramping is more of a neuromuscular problem than a fueling issue, explains Nelson, who co-wrote a review paper on the causes and management of muscle cramps in 2016.

Your muscles have protective reflexes that balance their contraction and relaxation, she explains. “When we’re in a fatigued state or when the muscles are overloaded or challenged in a new way, there’s a mismatch in that messaging that’s sent to the central nervous system. The end result is that the muscles are over-signaled, or they over-fire,” she says. Which feels like a cramp to you.

The details are still being worked out on exactly what’s going on in the nerve fibers and why some people’s get excited and others’ don’t. “We tend to pigeonhole ourselves into thinking there’s one specific cause, and we have to appreciate that it’s complicated, and the risk factors may even vary from person to person,” she says. But docs suspect there are some common causes.

Wearing stiff shoes (or any type of heel, by the way) can shut down the activity of your deep foot muscles—the ones that should do the majority of the work in stabilizing your feet. When those muscles get the pink slip, your toes have to work too hard to make up for them. Hard work equals fatigue which can equal cramps in people who are prone to them.

Shoes that are too tight can also restrict blood circulation, causing the muscles in your toes to cramp. If your feet start to feel numb, you have uncomfortable rubbing against your heels, or your shoes leave indentations in your feet, it might be time to ditch them and get a comfy, non-restrictive pair.

Muscles in your feet are constantly contracting and expanding throughout a normal workout. Exercising too hard can overload your muscles and lead to fatigue, ultimately making you more likely to get cramps. This can be overload from going out too fast in a workout or race, overtraining, or just doing a workout you're not used to.

Higher rates of cramps are seen in people with chronic diseases where blood flow to the muscles is impeded, such as cardiovascular disease, diabetes, or peripheral artery disease. Taking medications for these issues can also raise cramp risk, although the reasons why aren’t clear. Some ways to limit these cramps can be to avoid sitting or keeping your legs crossed for long periods of time, which can restrict blood flow.

“One thing we keep coming back to for resolving cramps is good old-fashioned stretching,” says Nelson. Maybe even contract the opposing muscles, which will trigger a stretch reflex in the cramped-up ones.

There are a number of easy at-home stretching techniques for working those muscles. For instance, grab a blanket or towel, sit on the floor or sofa with one leg outstretched in front of you and wrap the blanket around your toes. Gently pull the blanket, stretching only your toes toward you while keeping your leg straight.

Another tip to work out your toes is to find small household items, rubber bands for example, and place them on the ground. One by one, use your toes to pick up the rubber bands and place them to the side, encouraging more movement from your toes.

Repeating these exercises can bring relief to cramps as well as prevent them from occurring. When in doubt, stretch it out!

The research keeps going back and forth on this, but it’s likely that drinking pickle juice works in some people and doesn’t in others. “People assume that it restores your electrolyte balance,” Nelson says. But when relief comes from drinking the juice, it happens quickly—too quickly for the blood’s electrolyte concentrations to have gone up. The acetic acid in pickle juice is believed to trigger a reflex in the back of your throat that inhibits the muscles from over-firing and calms things down. And if you’re not the biggest fan of pickle juice, you might find comfort in knowing that you don’t even have to swallow the pickle juice in order to trigger the reflex. Once triggered, cramps can be relieved in less than four minutes.

There’s emerging research that when capsaicin—the stuff that puts the hot in hot peppers—hits certain receptors in the mouth and throat, it sort of jams the neuromuscular signals that were causing the cramp and makes it let go.

But if loading up on peppers isn’t ideal, there might be a solution for you. HotShot, created by Nobel Prize winner Dr. Rod MacKinnon, is a spicy drink that triggers the same nerve receptors as hot peppers. A 2017 study published by Penn State researchers found that the drink makes your muscles more cramp-resistant and shortens the duration of your cramp.