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Foot cramps are something that plague many peoples’ daily lives, especially for those who suffer from conditions like plantar fasciitis. The cramps will usually pop up in the foot arch, sometimes closer to the ball of the foot and sometimes closer to the heel. I personally get them just below the ball of my foot when I try to spread my toes out, particularly pushing my big toe out.

These are a hard one to crack. The typical advice everyone will give you is that you’re probably dehydrated, you’re exercising too much, and you just need to stretch. These are all the classic, lazy assumptions people throw out when they hear the word “cramp” and while they may even be right on one of them, it’s not going to solve your foot cramping.

So I checked out my most trusted podiatrist, Dr. Ray McClanahan of Northwest Foot and Ankle. He happened to not only have a video about why foot cramping happens, but a comprehensive one giving us everything we need to know about the situation. It is so helpful that I figured I couldn’t do it any more justice. I just decided to write what is basically a summary of his video. Enjoy!

The Causes

The causes of foot cramps can be divided into two major groups: medical issues and muscular imbalance.

Some of the medical issues can include an electrolyte abnormality (deficiency in potassium, calcium, or magnesium), a lack of circulation, side effects to medication (common with statins for cholesterol), or other nerve problems. These medical cases must be treated directly to relieve the cramps.

Foot cramps, however, are more often the result of a muscular imbalance. 

Most people’s cramps happen in the arch flexor muscles, which reach from the heel to the tips of the toes. Unfortunately, most Americans (among many others) have spent nearly their entire lives in shoes with elevated heels and toe springs without even noticing it.

A toe spring is the end of the toe box which props up your toes above the ball of your foot.

A study done on the effects of heeled shoes showed just how detrimental they can be to our health. The study looked at two groups of women, one wearing completely flat shoes and the other wearing 2 inch high heel shoes. The women wearing the high heels had experienced a 13% shortening of their calf muscles.

It is now understood that heeled shoes will shorten the musculature in the back of our legs to varying degrees. This opens the door to many more problems throughout the body created by a muscular imbalance.

Regarding toe spring, a paper was written in 1905 by Dr. Phil Hoffman who noticed that only in industrialized cultures where people wear heels and toe springs do people develop tightness and contracture of the muscles on the front of the leg.

So if you can imagine having tightness and shortening in the back of your calf muscles from the elevated heel as well as tightness and shortening in the front of the calf muscles due to toe spring, the only other layer of muscles in the foot are the small intrinsic muscles.

When the foot is in the shoe position, the arch muscles become overstretched, creating a length to tension imbalance, which may result in foot cramps.

In order for your arch muscles to function properly, they need to be in their proper length to tension relationship.

This means that if the heel bone is pulling upward and the toe bones are pulling upward (typical shoe position), these little arch muscles are being held in too long of a position and they will no longer function appropriately. 

According to Rebecca Shapiro, LMT Medical Assistant from Dr. McClanahan’s clinic,

“In general, muscles are more prone to cramping if they are weak, or if they’ve been held in a chronically lengthened position before being asked to flex or contract. In the case of the plantar foot muscles, cramping is common for both reasons. When the brain sends a message for these muscles to contract, the muscle fibers fire in an erratic and disorganized way which is the cause of cramping.”

The Solutions

As you can probably tell, the main culprits here are our shoes for the specific reasons of the elevated heel and the toe spring. So what easier way to fix this problem than to just remove them from your life?

A flat sole is exactly what we’re calling out for and that’s exactly what minimalist footwear provides: a flat, zero-drop sole, no arch support, and no toe spring (kind of like a natural foot 😉 ).

You can reset your foot and lower leg muscles back to their original length to tension relationships: lengthen the calf muscles, lengthen the shin muscles, and shorten the arch muscles again to restore the balance. 

For an active recovery technique that you can do at any time, try Dr. McClanahan’s toe extensor stretch. It’s simply pushing your toes down and under your foot; the exact opposite position that our shoes have been holding us in. Here is another one of Dr. McClanahan’s videos demonstrating it:

If you try this stretch and instantly feel cramping again, that is the ultimate indicator that you have a serious muscular imbalance going on. On the bright side, this clearly identifies what your problem is and how to solve it.

Do this stretch for as long as you can, anywhere from a few seconds to a few minutes at a time, and do it several times throughout the day. You can cross one leg over the other and push the toes down with your hand or you can press your foot into the floor so your toes get pushed backwards, all while barefoot.

To increase the effectiveness, press your thumb upward into the metatarsal while doing this stretch. This is where the upper arch meets the ball of your foot, on the soft spot. 

If you need instant relief while you’re wearing shoes, maybe for work or at the gym, try metatarsal pads.

They can be inserted into your shoes so they sit underneath the lower ball of your foot. These will create a more level platform for your feet to stand on so the slant of the heel and toe spring isn’t as severe.

Metatarsal pads can help restore the natural shape of a foot after it has been malformed from years of wearing shoes that hold your toes upward.