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


Allister Horncastle

Allister Horncastle

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



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

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