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Jumpy Legs

The protocol described below works for one patient: me, a side sleeper weighing well over 200 pounds who already gets up several times every night for other reasons, is only a few years past retirement age, and has only a relatively mild case of HSP. It may not even be relevant to you, and it is certainly not medical advice.

I expect some parts of this will be helpful to you, others will spark your own thoughts about your handling of your problem, some parts will require modification, and some will not be applicable at all. An example of modification: if you are a back sleeper you will likely want to raise your knees by putting an extra pillow under them to keep your legs bent a little even when you're asleep. Another example of modification: you will need to adjust your magnesium supplement dosage to both your body size and your chosen formulation.

It's fairly obvious what to do about most symptoms of HSP: just use the same compensations as older people use for aging: walk with a cane, park close to where you're going, find and use the elevator in each public building, eschew throw rugs, and so forth. But a couple of symptoms of HSP present novel challenges.

An example of a novel challenge is dealing with legs that sometimes spasm, especially during the night. The spasms may prevent you from falling asleep, or may awaken you or your partner in the middle of the night.

For me, jumpy legs are a problem mostly at night. Daytime activity generally keeps my jumpy legs at bay (although it's sometimes a problem when I'm sitting still watching a movie in the evening). It's worst just after I go to bed, often preventing me from falling asleep. It's fairly bad in the middle of the night too, awakening me and keeping me from going back to sleep. It's less significant (but not entirely absent) during the last few hours of sleep.

Here's the protocol I've found works for me. It allows me to control my jumpy legs well enough to sleep (even though it doesn't altogether prevent them all the time).


Magnesium Supplement Pills

The human body uses traces of magnesium for many different things, including better nerve conduction. As traces of magnesium are available in most foods and in natural water sources, the human body never evolved the ability to store magnesium, but rather relies on more coming in all the time. Because our diets may no longer include as many leafy greens as it used to (leafy greens are especially rich in magnesium), and because many water purification processes remove magnesium as an unintended side effect, many modern humans don't get enough magnesium. Magnesium deficiency often manifests as Restless Leg Syndrome, particularly in older people. HSP, where unsound nerves need every bit of help they can get, is especially sensitive to magnesium deficiency.

One has to be careful with magnesium supplementation though, as too much magnesium can cause the runs. If you begin to have BMs much more frequently than usual, experiment with a different form of magnesium, take it on a different schedule, or back off how much magnesium supplement you take and rely more heavily on other tools. Some forms of magnesium supplements and some schedules for taking them are more prone to cause the runs than others. What works for me is a per day maximum of 1000 mg of slow release magnesium malate supplement.

To stabilize elemental magnesium for distribution, it's always combined with some other chemical into a simple molecule (called either a magnesium chelate or a magnesium salt). After consumption, the body splits the molecule apart so it can access and use the magnesium. The body finds it easier to split some molecules than others; the relative ease of splitting and using is called bioavailability. If you read labels carefully, you will find a wide range of molecules based around magnesium used in supplements: magnesium oxide, magnesium gluconate, magnesium citrate, magnesium chloride, magnesium hydroxide, magnesium malate, magnesium aspartate, magnesium glycinate, magnesium orotate, and magnesium L-threonate. And each of these may be in a regular pill, a "slow release" formulation, or an enteric-coated tablet for maximum time release. And sometimes, these are further combined with some other drug to form a combination pill especially suited to a particular use.

Fortunately the whole gamut of choices is not available in any one place; in fact, you'll likely have only a handful of options. Still, how do you choose which one works best for you? Probably all you need is this simple rule of thumb: if it costs more, it works better. And a second rule of thumb is: avoid extra ingredients you don't need. Cheaper magnesium supplements either have much lower bioavailability, or take effect all at once rather than spreading out in time, or both. I personally have settled on the Jigsaw MagSRT formulation using magnesium malate, which I buy directly from the company that makes it, as buying it that way is often a bit cheaper, especially as on 3 or more bottles they often offer free shipping and/or an (undocumented) discount. Its dosage is 500 mg per serving, which nets to 125 mg per pill (or 62.5 mg per half pill). My own daily maximum of 1000 mg is 8 pills.

Pickle Juice

This is a sports drink that may be unfamiliar to you, one that has lots of electrolytes and an unusual taste but no sugar or sweetener. You could produce it yourself by buying pickles, eating them, and saving the juice. But it's much easier to obtain it packaged as a sports drink. Either find a local source, or angle for free shipping, as this item is very heavy and shipping costs can be quite high.

It helps stop muscle cramps and spasms. How it works is unclear; there are not enough electrolytes (or fluids) in the amount you will typically consume to make a whole lot of difference. One theory is that the sour vinegary taste shocks the brain so much it breaks the loop that is sending your muscles an undesired spasm command over and over. But whether or not anybody knows exactly how it works, it does.

Calf and Hamstring Stretch

You need a relevant stretch you can do in the middle of the night without turning the light on, in your night clothes and without any equipment, such as the following.

Stretch Calves Hamstrings As in this picture, stand flat a few feet away from a wall or counter-top, reach out to it and brace yourself, then bend your arms to lean forward, keeping your feet flat. Stretch your calves and your hamstrings; change your posture until you feel it on the whole back of each leg. After a 30 second stretch, straighten up and relax for the same amount of time. Then do the cycle a couple more times.

Magnesium Lotion

Magnesium can be absorbed directly through the skin as well as travel through the circulatory system. Thus, jumpy leg sufferers can apply it directly to the spasming area. Magnesium for topical application comes in several forms: lotion, spray, and oil. I prefer the lotion form, as for me it's easiest to handle without turning the lights on in the middle of the night. Choose whatever you prefer from a scale of costs that goes up as the lotion gets more penetrating and the source of the magnesium more exotic. My experience is that the difference is not significant.

Rub the lotion vigorously into your skin, so more is absorbed and less remains on the outside. Occasionally, because of a small difference in pH between the lotion and your skin, you will experience a slight burning sensation. It's harmless (if a bit startling).

Magnesium lotion would be the ultimate solution for jumpy legs, if it weren't for the fact that too much lotion makes you feel like a greased pig that needs clean sheets and a shower. So reserve it for the most serious cases; use other tools first. (Or sluice your legs with a washcloth frequently, or shower and scrub in the morning.)

Daytime Protocol

Don't exercise too vigorously

Of course follow the use it or lose it mantra, ...but don't go too far beyond that. Exercising so much that your muscles feel stressed or sore won't do jumpy legs much good, and in fact is likely to make them worse.

Do hydrate

Drink lots of liquid during the day. Many older folks are chronically dehydrated, as they don't get as thirsty as they once did; dehydration unfortunately exacerbates their jumpy legs. Drink almost to the point where you have to get up too often during the night. Of course be sensible about it: drink during the day rather than right before bedtime, avoid caffeine (energy drinks, regular coffee), stay away from sugar (carbonated beverages, juices, many sports drinks), and shun alcohol.

Don't ignore this; surprisingly, hydration has a lot of effect on nighttime jumpy legs. (You may also notice that taking a shower in the evening may reduce jumpy legs that night, which happens if some water was absorbed through the skin.)

No Ankle Over Knee
Don't sit in any way that strains your legs

Don't do things like the yoga lotus position. Avoid crossing your legs if you feel any strain at all. Don't pretend you're a ballerina. And certainly don't cross one ankle over the other knee (like the picture), even though it may be a good position for reading.

Take magnesium supplements as necessary

Just moving around a bit all the time during the day may be enough to keep jumpy leg at bay. But if not, take a little bit of magnesium supplement even during the day. I take half a pill with breakfast and another half a pill a couple hours after lunch. If I have jumpy legs while sitting and reading in the evening, I will take another half a pill.

Go to bed at a regular time every night

Occasionally staying up several extra hours (perhaps because you're afraid jumpy legs will be bad:-) will likely make the jumpy legs problem even worse that night.

Nighttime Protocol

I had already needed to get up frequently in the night before I began dealing with jumpy legs, so I was able to simply incorporate my jumpy leg treatments into what was already happening. For a markedly different situation, you may need to modify parts of this protocol quite a bit, or even completely abandon it and start over.

Take one magnesium supplement pill a half hour before bed. Take two more pills just before bed. In bed, don't lay on your back with your legs out straight; instead, turn immediately to a comfortable relaxed position, keeping your legs slightly bent. And note the approximate time. (Avoid sitting up to read with your legs flat, as that position may aggravate jumpy legs quite a bit.)

If you get up 2 hours or more later, lay out another magnesium supplement pill; if you get up just 30-90 minutes later, lay out only half a magnesium supplement pill. If you get up again in less than 30 minutes because your leg is jumping, take serious action: rub magnesium lotion into the area(s) of your leg(s) that are jumping, and also spread it on the entirety of both legs, take half a magnesium supplement pill with pickle juice, stretch your calves and hamstrings, and note the time you go back to bed. If you have to get up again in less than 30 minutes because your leg(s) are still jumping, repeat all of this. This has always worked for me; I don't know what I would do if I had to get up a third time.

In less serious cases, before you return to bed, take whatever pill(s) you have laid out. If you haven't had any jumpy leg issues at all, just take the pill(s) with water, then note the time and simply go back to bed. But if jumpy leg issues woke you up, or you awoke for another reason but then noticed jumpy legs, or you felt jumpy legs while out of bed, take the pill(s) with pickle juice, then stretch your calves and hamstrings as above, then finally note the time and go back to bed.

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