Author Affiliations: School of Health Sciences, The University of Newcastle, Ourimbah, Australia (Dr Hawke); and Institute for Neuroscience and Muscle Research, Faculty of Health Sciences, The University of Sydney, Sydney, Australia (Dr Burns).
We read with interest the communication between Dr Daniell1 and Dr Garrison2 regarding calf stretching prophylaxis for nocturnal cramps. Dr Garrison cites our Cochrane systematic review of nondrug therapies for lower limb muscle cramps,3 in which 1 randomized controlled trial of calf stretching for nocturnal cramps in adults taking quinine was included. Since the publication of our systematic review, an additional randomized controlled trial has been published.4 This well-designed and reported trial evaluated calf and hamstring stretching before sleep vs no intervention for nocturnal leg cramps in 80 people older than 55 years. After 6 weeks, the mean difference in change of cramp frequency between groups was −1.2 (95% CI, −0.6 to −1.8) cramps per night in favor of the stretching group. This difference represents a 35% reduction in cramp frequency from baseline with stretching. As calf and hamstring stretching were combined, it is not possible to extricate the effect of calf stretching alone for nocturnal cramps. Nevertheless, this study makes an important contribution to the evidence base for stretching prophylaxis for nocturnal cramps and will be included in an update of our Cochrane review.
Hawke F, Burns J. New Evidence for Stretching for Preventing Nocturnal Cramps. Arch Intern Med. 2012;172(22):1770-1771. doi:10.1001/2013.jamainternmed.123