Yoga and Foot Cramps

by Baxter 

One of our readers sent in a question that I was surprised we had never received before:

“I'm having this ongoing cramping of the feet, mostly the arch during yoga classes. The cramping I experience happens is not flex, such as in seal or cobra or even in a kneeling pose where the top of my foot is on the mat. It's then I get the cramp in the upper arch of my foot. Each foot will cramp and sometimes both cramp at the same time. I've read about electrolyte balance and eating bananas and I have a pretty healthy diet and I practice yoga in a studio 5 days a week. I've been cramping almost from the beginning of doing yoga, about 2 years ago.”

This is such a common experience for most yoga students, certainly when they first begin doing yoga asana, but even over time. I know that both Nina and I have experienced this first hand, so we are empathetic to our reader’s plight! That said, it might be nice to have a better understanding of what I jokingly refer to as “the deadly yoga foot cramp” (news flash: no one has actually died from these inopportune and usually harmless cramps that anyone at YFHA is aware of, but, boy do they hurt!).

A foot cramp is a sudden and involuntary (you can say that again!) contraction of one or more of your muscles. In the case of the foot, it is most likely the smaller muscles that reside solely in the foot, called “intrinsic" muscles, but may also involve those that originate near the knee and end on one of the foot bones, called “extrinsic” muscles of the foot. Your average person may have experienced a sudden muscle cramp elsewhere in the body, quite commonly in the calf at night (Charlie horse), which can be very painful until the cramp subsides. If it weren’t for the pain and the muscle going offline temporarily, we wouldn’t likely even talk about muscle cramps. And, although when you are in the midst of a sudden foot cramp in class or at home, it seems like it may last forever, it usually resolves in seconds or minutes, especially if you come out of the pose you’re doing and do a little self-care to help things along.

Even though in many cases the exact cause of muscle cramps is not known, there are certain causes for having them more often. The National Institutes of Health (NIH) website has a pretty exhaustive list of possible causes:

• Brain disorders, such Parkinson’s, MS, Huntington’s Disease, to name a few
• Chronic kidney disease and dialysis
• Damage to a single nerve or multiple nerves that are connected to muscles
• Dehydration (not having enough fluids in your body)*
• Disorders or injuries that involve peripheral nerves
• Heavy exercise*
• Hyperventilation, which is rapid or deep breathing (can occur with anxiety or panic)*
• Increased levels of phosphate in the body
• Overuse of muscles during sports or work activity*
• Pregnancy, more often during the third trimester*
• Reduced levels of magnesium or calcium in the body*
• Thyroid disorders
• Too little vitamin D
• Certain medications*

* Indicates conditions that are easier for us yogis to evaluate or have checked out by our docs if foot cramps don’t gradually subside over time.

That list above does include some serious and somewhat scary possibilities, so if your foot cramps lead to any of the following conditions, you may want to have a more thorough evaluation with your physician:

• Cause severe discomfort
• Are associated with leg swelling, redness or skin changes
• Are associated with muscle weakness
• Happen frequently
• Don't improve with self-care
• Aren't associated with an obvious cause, such as strenuous exercise

(List from the Mayo Clinic.) 

Factors that may increase your risk of muscle cramps include:

• older age, when sarcopenia or muscle mass loss has set in and the remaining muscle may be more easily overstressed
• dehydration, which is both a cause and a risk factor, especially in athletes who become fatigued and dehydrated while participating in warm-weather sports
• pregnancy, when muscle cramps are more common
• medical conditions, such as diabetes, or nerve, liver or thyroid disorders

So, some common-sense actions may reduce the chances of continued problems with foot cramps during yoga practice, such as staying well hydrated, and stretching your muscles in sensitive areas before and after your yoga practice. But, hey! Wait a minute! Aren’t I already stretching my muscles simply by virtue of doing yoga poses? Well, a beginner might think such a thing, but experienced yogis know that many poses involve the contraction and strengthening of muscles to enter, maintain and exit a pose successfully. And, in some traditions, the poses are held for several minutes, probably enough time for a sensitive muscle to cramp and spasm. So, if you suffer from frequent foot cramps during your practice, you might want to develop a foot warm-up sequence to do before or/and after your regular class or home practice—more on that in a moment!

During an acute foot cramp, I have always found that coming out of the pose that is triggering it, and stretching and massaging the part of my foot that’s cramping seems to speed up the release of the cramp and my return to my practice. Medical sources suggest the use of ice or heat, but I always find that the foot cramps resolve long before I am able to get to anything like that, so that suggestion would be for the more unusual and persistent forms of cramping.

A few ideas for a foot warm-up sequence:

• Massage the foot by hand for a minute or so before activity.
• Sitting or standing, roll a tennis ball systematically between the sole of your foot and the floor to massage and release tension in the muscles of the foot.
• From a kneeling position, turn your toes under and sit back on your heels with your hands on the floor in front of your knees or on your thighs to stretch the soles of the feet, possibly even the plantar fascia as well.
• In Reclined Leg Stretch pose on your back, put the strap on the arch of the foot and rock it side to side to massage the muscles on the sole of the foot.
  
• Stand facing a wall and step one leg back into Warrior 1 position, bending the front knee toward wall and getting a good calf stretch for the back leg.
• When doing standing poses, imagine the toes relaxing and releasing away from the balls of the feet, instead of clawing the floor.
• And for our reader who is experiencing cramps in a more unusual location of his foot, poses that stretch the tops of the feet, such as, Hero pose (Virasana) and Thunderbolt pose (Vajrasana), or if it’s comfortable for you, Reclined Hero pose (Supta Virasana) might be helpful.

A final note from Nina, who finds that in Cobra if she activates her hamstrings, her feet don’t cramp! Thanks, Nina, and good to know! 

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New Tricks for Old Dogs: Working with Bunions (Rerun)

by Baxter

It was my first class with Donald Moyer in the new year, January having flown by and February upon us. I checked in with him before class began and mentioned an unusual aching in the lateral aspect of my left foot that I had been experiencing for about two months. It was not bad enough to prevent me from participating in my normal activities, but I noticed it when turning my left foot out to 90 degrees for many of my standing poses. He gave me some pointers for the day’s practice, and then class began.

About half way through the class, while we were in Standing Forward Bend (Uttanasana), Donald had us slip a strap between our big and second toes, and bring the loose end over the top of the big toe and down to the floor to the inside edge of the toe. He asked us to gently pull the strap to move the big toe medially, so that it lined up more evenly with the first metatarsal, the foot bone just before you get to the toe itself (the toe bones are called phalanges, and the big toe has two, the other toes all have three).

In addition to re-aligning these two parts of the foot and toe, the bones of the toe rolled a bit medially on their axis. Donald made an offhand remark about this being beneficial for treating bunions (hallux valgus for you Latin lovers) and then we moved on. But treating bunions! Sweeter words were never spoken. I come from a family of bunion formers, my mom’s mother, my wonderful Grandma Lopresto, had an impressive one on each foot for as long as I could remember. Interestingly, I don’t remember her complaining about them much.

What, you may be asking yourself, is a bunion? Well, a bunion is a condition in which your big toe deviates toward your second toe instead of lining up with your first metatarsal. And although bunions have a genetic component and do tend to run in families, another huge factor is shoes that smash the toes together. While these shoes are often for fashion purposes only, I do teach to one group of students whose shoe wear is all about function and their passion for climbing. And while the shoes these folks wear help keep them on razor thin ledges, they do lots of harm to their impressionable toes and feet.

According to the PubMed Health website, bunions occur more commonly in women and people born with abnormal bones in their feet. Certain kinds of shoe wear, specifically narrow-toed, high-heeled shoes, may also lead to bunion formation. And although it can seem a bit unsightly, it is only when pain develops that most people seek help.

How can you tell if you are developing a bunion? You may begin to see a thickening or actual bump forming where the toe and foot meet on the inner edge of the foot. On the inner side of the big toe, a red callous may form from the big toe and second toe rubbing on one another. Pain can occur in this joint, aggravated by certain shoes.

What is the mainstream treatment for bunions? First off, they often tell you to wear different shoes, ones with a low heel and a wide area for the toes. That alone could do the trick. Sometimes special pads can be placed on the bunion or between the big and second toes, and wearing a toe spacer at night can start to influence the alignment of the toes. If that does not work, there are only a mere 100 different surgical approaches to treat bunions. One of my long time students has had both toes operated on, and says it made a huge difference for her, eliminating the pain. However, it has had an effect on her balance.

So, here was Donald offering up a really simple way to affect the toes! A few years back, my colleague and friend JJ Gormley shared her favorite method to get the big toe back on track, which you can do at your desk. With your feet parallel, place a can of your favorite organic goodies between your inner arches and put a veggie rubber band, one of those strong ones, around the big part of your big toes, so they deviate a bit towards the midline between your feet. You can do this for 10-15 minutes a few times a day, and watch for results.

Obviously, if either Donald or JJ’s techniques result in worsening symptoms, stop them right away! But if not, give it a go. And remember, since a lot of the problem stems from being in shoes, yoga itself can go a long way to help the problem, as you are barefoot and you are strengthening and stretching many of the muscles and other structures that can affect the big toes.

For more information on yoga and bunions, there is a good article by Doug Keller in Yoga + Living Magazine from 2008 that you can find online. I hope the photos of Donald and JJ’s bunion recommendations are helpful in your home practice.

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