Muscle Strain v Cramp? How to know the difference and what to do:

  • 9 July 2018
  • Simon Noad

Hi, welcome to my blog post. I’m one of Physio Forms newest addition to their physio team and thought it was time I introduced myself and posted something that you will hopefully find useful. Here goes….

I was watching England play Colombia in the world cup the other night and towards the end of the main game and in extra time noticed that a fair few players were going down with cramp. This is not uncommon, especially when a match reaches extra time, but it made me think of clients and athletes in the past who I have seen and I wanted to shared my experiences with you.

I have had the pleasure of working throughout different levels of premier league football and have been seeing private patients for a long time. In both settings it’s quite common for a person to book in complaining of muscle pain. When asked what happened the client often describes a sudden onset of tightness and discomfort which they thought was cramp. Thinking it was just cramp they tried to ‘run it off’ which resulted in the muscle feeling progressively sorer until they had to stop due to the pain. Often they wake up the next day and the injured muscle is painful, maybe slightly swollen and moving/contracting the muscle makes the pain worse. At this point they’ll often book an appointment to see a physiotherapist.

Following an assessment such a problem often turns out to be a muscle strain. The client is often surprised by this as they thought it was just cramp and that it would ease off quickly. This brings us to the point of this post. Quite often people aren’t aware of the difference between muscle cramping and a muscle strain. It’s really important to know the difference.

A cramp is an involuntary forceful muscle contraction that takes a while to relax.  Although it will be uncomfortable (sometimes very uncomfortable) at the time, feeling like an ‘intense gripping’ sensation, once it eases there should not be much pain accept for a dull ache. You might have to cease activity if the muscle keeps cramping and you may wake up the next day with the muscle feeling tender but you should be able to function well.


A muscle strain is where the actual muscle fibres are separated/pulled apart. There are different levels of separation, normally the more separation there is the more painful. This results in inflammation and pain on muscle contraction. The brain will then not contract the muscle to prevent this pain, causing it to feel weak. A muscle strain normally presents as an acute pain, some describe it as a stabbing like. If you run or ‘push through’ through this pain you’ll potentially pull more muscle fibres apart, which will result in a bigger injury with more pain and a longer recovery time.


This is why it’s so important to know the difference in sensation between your muscles cramping and a strain. If you cramp a little and are able ‘push through it’, chances are you’ll be a little sore but okay. This is common in football and other sports. However, if you actually strain a muscle and ‘push through it’ you’ll likely make the injury worse and worse. A small muscle strain (grade 1) normally keeps people out of action for 10-14days. A significant strain (grade 2) normally takes between 6-8weeks to recover! In my experience, the number of people who ‘push through’ a muscle strain, turning a 2weeks recovery into a 6-8week recovery, because they thought they had cramp is actually quite high.  Please don’t let this happen to you!


Take care and stay healthy. Simon

About Simon Noad

MSc PGDip BSc (hons) MAACP MMACP MCSP Chartered Physiotherapists Simon graduated from Coventry University in 2007 with a First Class Honours degree and has spent his career specialising in Sports and Manual Physiotherapy. He has a range of experiences in sporting, education and private practices. These include heading the Science & Medicine Department at West Bromwich Albion Academy and leading the physiotherapy programme for Great British Canoeing under the English Institute of Sport. Simon has worked hard to expand his expertise and knowledge base, which allows him to offer a comprehensive range of assessments and interventions to a high standard. As well as his Masters Degree in Sports & Exercise Medicine he has also completed a two year Post Graduate Diploma in Manual Therapy, allowing membership to the Musculoskeletal Association of Chartered Physiotherapists. He is also a fully accredited Acupuncturist, well trained in advanced movement/injury prevention screenings and has extensive experience with the creation of personalised exercise programmes that the aim to improve health, well-being and athletic performance. Simon’s philosophy is to find, treat and then rehabilitate the root cause of the problem. He believes every person is different meaning that no injury is the same. His range experiences with different people, from the general public to elite sports-men/women, combined with his broad spectrum of treatment techniques leaves him well placed to provide you with an individualised treatment plan that could make a real difference.

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  • Bob
  • 28 Nov 2018
  • 2:56 pm

Thanks for this post! So how do I treat a great one strange?

  • Allister Horncastle
  • 3 Jan 2019
  • 2:12 am

Great post Simon, and easy to follow the thought process. I find it quite simple to diferentiate between grade II/III stains and cramp. I do find a grey area in the low grade strain and cramp?? Any advice on this? Ie. A patient has a MOI suggestive of strain/cramp. They have sharp pain on contraction and stretch but are cleared with functional tests. What would your advice be here? Cheers Al

  • Sefah Richard
  • 16 Nov 2021
  • 6:44 am

It has been made simple and clear Thank you

  • zead
  • 20 Jun 2022
  • 8:36 pm

ما هو الكيتو دايت يعتبر الكيتو دايت من اهم واشهر الانظمه في العالم فهو يعمل علي انقاص الوزن بشكل فعال بمرور الوقت القليل يشعر جسمك بتحسن واداء افضل فهو يعمل علي تناول كميه عاليه من الدهون والبروتين ونسب قليله جدا من الكارب هيدرات ولا تتعدى الـ 5% من الاستهلاك اليومي للشخص والتي تُقدَّر بنحو 50 غراماً من استعملاك وتناولك الطعام علي مدار اليوم كان الاعتماد في الاساس في برنامج الكيتو علي علاج الصرع الا طفال

  • zead
  • 17 Jul 2022
  • 7:21 pm

يعتبر الكيتو دايت من اهم واشهر الانظمه في العالم فهو يعمل علي انقاص الوزن بشكل فعال بمرور الوقت القليل يشعر جسمك بتحسن واداء افضل فهو يعمل علي تناول كميه عاليه من الدهون والبروتين ونسب قليله جدا من الكارب هيدرات ولا تتعدى الـ 5% من الاستهلاك اليومي للشخص والتي تُقدَّر بنحو 50 غراماً من استعملاك وتناولك الطعام علي مدار اليوم

  • pes
  • 1 Sep 2022
  • 4:16 am

Hi, this is Irina. I am sending you my intimate photos as I promised.

  • 10 Jul 2023
  • 8:29 am

Hi Simon Noad, I appreciate your contribution to knowledge. I am a lecturer in Sports Physiology, Department of Human Physiology, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria. Am requesting for materials on Sports Physiology (text books, journals and others) in soft copies from you. Kindly send them to this email; Thank you

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