HEALTH & FITNESS
 

 

 


Piriformis Syndrome

No one really knows exactly what causes piriformis syndrome. The piriformis is a muscle that travels behind the hip joint. It is small compared to other muscles around the hip and thigh, and it aids in external rotation (turning out) of the hip joint. The piriformis muscle and has a close relationship to the sciatic nerve--the largest nerve in the body--which supplies the lower extremities with motor and sensory function.

 

It can be characterised by an entrapment, (pinching), of the sciatic nerve as it exits the gluteal region. There are two normal variations for the exit of the sciatic nerve in this region. The first places the sciatic nerve below the piriformis muscle and above the gemellus muscle. Entrapment in this area is likely due to a tightening or shortening of either of these two muscles.

 

The second common site of entrapment is when the sciatic nerve actually pierces the piriformis muscle itself. This can occur in about 1% to 10% of all humans. In this case spasm of the piriformis muscle itself can lead to pain along the back of the thigh to the knee, loss of sensation or numbness and tingling in the sole of the foot. This particular syndrome can often mimic its more notorious counterpart known as sciatica, and that being the case; it is often misdiagnosed as sciatica. The main difference between sciatica and piriformis syndrome is in the cause. Sciatica is directly due to a lumbar disc pressing on the sciatic nerve as it exits the lumbar spine.

 

Signs and Symptoms:

·         Deep aching in the buttock and thigh on the involved side. Usually not beyond the knee.

·         Pain is often aggravated by sitting, squatting or walking.

·         Affected leg is often externally rotated (toes point out) when relaxed, such as when lying face down on the bed with your feet over the end of the mattress.

·         Right leg often affected after driving a long distance if the foot has been in external rotation while depressing the accelerator.

·         Often causes low back pain

 

Treatment:

Any treatment plan must include stretching of the gluteal muscles as well as stretching of the piriformis muscles.  A Chiropractor can help by performing spinal adjustment and/or hip adjustment.

 

Deep tissue massage to the piriformis muscle in the gluteal region will help to relax these muscles, making them easier to stretch.

 

There are some stretches shown below and these are best performed 2 or 3 times a day, starting with 5-10 seconds and progressing up to 60 seconds. It is important that any abnormal biomechanical problems, such as overpronation of the foot or other coexisting conditions, are treated.

 

Lie face down and bend one leg under your stomach, then lean towards the ground.

Note: In this example he is stretching his left piriformis.

Sit with one leg straight out in front. Hold onto the ankle of your other leg and pull it directly towards your chest.

 

 

Sources:

http://orthopedics.about.com/cs/sprainsstrains/a/piriformis.htm

http://www.chiro.cc/health_page.php?page=piriformis_syndrome

http://www.rice.edu/~jenky/sports/piri.html

http://www.thestretchinghandbook.com/index2.php

 

Prepared by: Brian Porter

Submitted: October 2007

Eight Essential Jogging Tips

Trouble is, when a lot of you otherwise sensible readers see how much verve is to be had while jogging, you are going to try jogging yourself. So we also feel it is essential that you bear in mind the "Eight essential tips for the beginner":

  1. Loosen up first. The ideal method is to throw back four fingers of scotch. If the urge to jog persists, double the loosening exercise.
  2. Check your resting pulse. If you can't find your pulse, check the pulse of a loved one. This is sometimes called "playing doctor" and, with any luck, will take your mind completely off running.
  3. Never run if you are a short person. Short persons are built too close to automobile exhaust pipes. The noxious fumes get into their brains and make them crazy and they try to bite buses, which can be pretty dicey, especially if the bus has not stopped.
  4. Always wear - a) a brassier, and b) a jockstrap. (Strike out where inapplicable). The worst jogging injuries result from flopping. Never wear both at once. At least not in public.
  5. Children often taunt passing joggers. After a while, you will become accustomed to this and even grow to enjoy it, especially if you carry a golf putter and rap taunting children smartly across the back of the head with it.
  6. Dogs can be a threat. If a huge, vicious dog charges you and lunges at your throat, say "There, boy down!” If that doesn't work, show him your membership card from the Humane Society.
  7. Set your own pace. If you black out after five minutes, you are probably running too fast. If workman from the city come by and paint you green, you may be running too slow.
  8. After jogging, check your pulse rate again. This time if you can't find it, you are quite possibly dead. Look at it this way: your corpse is sure in great shape.

Sports Nutrition
Cold and Hungry

Ever feel like you're more famished after a long ride on a cold morning than if you did the same workout during the heat of the day? Do short swimming workouts leave you hungrier than a long run in the heat? Well, it turns out there's a scientific explanation to your cold hunger.

Essentially, your body wants you to eat to help it warm up. By chewing down on food, the body literally burns through energy to digest the intake and metabolize it into a form your body can use or store. And as a result, your body's core temperature naturally increases. Until you reach a nice and comfy body temp, your body will shoot "I'm hungry" messages to your brain which, in turn, will have you reaching for a cinnamon roll. Intellectually, you know you don't need that baked good, but that's not the message your stomach's telling you.

 Did you know? The opposite response happens during exercise in hot weather. Instead of feeling like you can scarf down a Thanksgiving turkey, you'll probably have little or no appetite at all. That's because the body is doing everything it can to cool down and eating food, thus generating heat, is not on the immediate agenda. However, it's times like this that you must eat to quickly restore your glycogen, a.k.a. fuel stores, in order to keep your energy levels up and recover.

 What does this mean for you? If you're looking to lose or maintain your weight for competition, knowing how to manage the "thermic effect" of food and the hunger signals attached to it will go a long way toward keeping you trim. For example, swimmers have a tendency to over eat right after practice. That's because the cool water keeps the body's core temperature in check. Upon exiting the pool on a cold morning, they'll actually feel cold -- and hungry -- almost immediately. The same effect can hit a cyclist who is underdressed for a long ride on a crisp fall morning. Instead of arriving home feeling warm, they feel chilled to the bone and start eating their way to warmth. In both cases, it'd be better to eat a small high-carbohydrate snack and then sit under a hot shower until they warm up before raiding the pantry.

Health

The Annual Back-to-School Cold

By Chris Carmichael

It happens every year: my son Connor starts elementary school in August, and within the first week of messing around with 25 other kids in the classroom, he catches a cold—doesn’t matter that it’s still 85 degrees out and hot, he wakes up sniffling and complaining about a sore throat. And that’s when I start to get paranoid about catching it myself. You see, for the last two years, I’ve trained for the Leadville100 mountain bike race in August. It’s a tough ride that takes a lot out of me, enough to make me highly-susceptible to catching a cold.

I call this the curse of the super-fit. Athletes of all ability levels who train hard are constantly walking a fine line between stressing their bodies just enough to make them grow stronger and pushing a little too hard, to the point where their battered immune systems can’t fend off a bug that will lay them out for days or a week. For Triathletes and runners in the middle of carefully planned, high-intensity training programs for fall races, this is a very real concern. The last thing these people can afford is to miss out on a critical stretch of workouts due to an illness and the corresponding recovery time.

For me, I faced a different concern. After a race like Leadville, it takes a while for my body to bounce back to what I’d describe as full strength. Unfortunately, this window coincides with my son’s return to school, which is a stressful experience for him (It takes work for a 6-year-old boy to go from the freedom of summer to staying focused in the classroom for 6 hours a day.) Last year, Connor’s back-to-school cold hit me hard and due to my weakened condition, long hours at the office, and travel, I struggled with a cold for weeks. It just would not go away.

Since I knew it wouldn’t be his last cold of the year, (across the US, school-age kids average 6 colds a year), I decided I needed to be more vigilant about protecting myself. Here’s what worked for me last year, and what has continued working for me this year:

  1. Keep your hands clean: Perhaps the most effective way to prevent the majority of colds. You don’t have to become obsessive compulsive about it, either; just wash your hands with regular old soap and water for 20-30 seconds about four times a day. And since meal times offer the greatest opportunity to transfer the cold virus from your hands to your mouth, follow your mother’s advice and always wash up before you eat.

    If you have small children at home who need help with their meals, make sure you wash your hands before you feed them (for their sake), and after you feed them (for your sake).
  2. Stay hydrated: This tip came about after I caught my son sneezing in the sunlight. As I saw the spray I remembered that one of snot’s primary functions is to trap allergens and germs before they can establish a foothold in your body. A sneeze, cough, or runny nose is your body’s attempt to rid the body of something bad. Snot is mostly water, and when you’re dehydrated (as most Americans are on a regular basis), you’re making it harder for your body to protect you from a cold.
  3. Back off your training: Though there are times when I have athletes train through fatigue, I generally believe that it’s better for an athlete who’s feeling run down to take a rest day than to go out and train. Workout quality is better when you’re fresh, and a little more recovery isn’t going to hurt your training, so it pays to be a little conservative at this time of year. And while we’re on the subject, yes, you can train with cold symptoms (runny nose, sore throat), but you shouldn’t train with systemic symptoms (fever, flu, achy joints, diarrhea). In either case, workout quality suffers, so what are you really accomplishing anyway?
  4. And at the first sign of a cold, I turn to zinc. I’ve tried zinc lozenges and Zicam nasal swabs, and the swabs work better for me. I was so impressed with the product last winter that I partnered with them as a spokesperson. Their research suggests that the zinc gluconate nasal swab can reduce the duration of a cold. My colds have always lasted exactly seven days (don’t ask me why, but it’s been that way since I was a teenager); and Zicam gets me over the cold faster. The key is to act quickly; research indicates that zinc is most effective when used within the first 48 hours of noticing cold symptoms.

Colds happen, but they won’t happen as frequently if you take these precautions. Connor’s cold is almost gone, and so far I haven’t felt the slightest sign that I’m going to get it. In fact, since my fall cold last year, I’ve only had the sniffles once—in spite of training harder than I did in 2006. It’s working for me; let it work for you, too.

Food Marina

Mornings on the Run: Fast-Food Breakfast Sandwiches

By Jamie Lau, Dietetic Intern

You’ve hit the snooze button one too many times and now you’re late for work. Sound familiar? For many of us, breakfast is a quick stop at the drive-thru window for a nutritionally suspect breakfast sandwich and cup of coffee. Congrats, you do deserve a pat on the back for not skipping the most important meal of the day. But for the love of your arteries, let’s get real. There are breakfast sandwiches that will start your day on a solid nutritional foundation and others that will leave you feeling like you should’ve stayed in bed.

Motor Yacht (Quality Carrier)
These foods provide good fuel sources to power your activities.

  • Our Pick: Subway’s 6” Cheese Omelet Sandwich
  • What’s on Board: Nutritionally, the ingredients and nutritional breakdown of this sandwich comes pretty close to our not-so-great Row Boat selection below. But by customizing your order, you can jack up the quality of this Subway breakfast. Do ask for the whole wheat roll, add some vegetables, and go light on or skip the cheese. We went light on the cheese and added fresh veggies for a bolder taste and to up the nutritional value.

Row Boat (Empty Carrier)
Like a rowboat, these foods provide energy to help you get where you need to go, but they deliver little in the way of nutritional amenities.

  • Our Pick: McDonald’s Egg McMuffin
  • What’s on Board: Introduced in 1973, this breakfast sandwich has stood the test of time, but not the test of our Food Marina. Per 100 gram serving, this Row Boat carries almost twice the amount of cholesterol as our Motor Yacht—not a good trade off for 34 less calories you get with the Egg McMuffin.

Garbage Barge (Pollutant Carrier)
These foods do you more harm than good because they carry chemicals and preservatives and are loaded with high levels of saturated fat, trans fats, and excessive amounts of sodium.

  • Our Pick: Burger King’s Double Croissan’wich with Sausage, Egg, & Cheese
  • What’s on Board: The name of this sandwich spells out BAD. In the world of breakfast sandwiches, unless you’re throwing on lettuce and a slice of tomato, any additional ingredients to the plain egg sandwich just adds on more calories and more total fat. Put the whole combo on a croissant and you’re in for trouble, in this case double trouble. What gives croissants their flaky texture is vegetable shortening, a major source of trans fats, which are known to increase your LDL (bad) cholesterol and decrease your HDL (good) cholesterol. Steer clear of this one.

What’s in the Marina this time?
Breakfast Sandwiches
(Standardized for 100 gram servings)

 

Motor
Yacht

Row
Boat

Garbage
Barge

 

 

Motor
Yacht

Row
Boat

Garbage
Barge

Calories

228

216

316

 

Dietary Fiber (g)

4

1

0

Calories from Fat

82

79

213

 

Cholesterol (mg)

96

187

102

Total Fat (g)

9

9

24

 

Sodium (mg)

563

590

744

Saturated Fat (g)

3

3.5

8

 

Vitamin A (%DV)

16*

7*

N/A

Protein (g)

10

13

13

 

Vitamin C (%DV)

39*

0*

N/A

Total Carbohydrate (g)

28

22

12

 

Calcium (%DV)

12*

22*

N/A

Sugar (g)

4

2

3

 

Iron (%DV)

18*

14*

N/A

*Daily value based on a 2,000 calorie/day diet

Sports Nutrition
Three Most Important Nutrients for Women

At CTS, after working with hundreds of female athletes, we've found that they're often in need of three key nutrients: calcium, iron, and folate, which, in addition to ensuring a woman performs at her best on the field, helps her maintain her overall health. Let's take a closer look at why.

CALCIUM
Calcium is essential for the development and maintenance of healthy bones and teeth. It also helps regulate heartbeat, muscle contraction, nerve impulse transmission, and blood clotting.

Everyone needs calcium, but female athletes should pay special attention to their calcium intake since they lose calcium through sweat, and face a higher risk of osteoporosis, a disease resulting in calcium loss from bone that occurs with aging.

Find it Here: Milk, cheese, yogurt, broccoli, kale, and calcium-fortified foods are good sources of calcium, although dairy sources have the highest concentration of calcium in an easily digestible form. Try 1 cup of milk at breakfast, 1 cup of low-fat yogurt with fruit at lunch, and stir fry 8 ounces of tofu with 1 cup of broccoli for dinner to meet the recommended daily amount of 1000 mg.

IRON
Iron is a key component in helping to get oxygen to your working muscles. Without it, your red blood cells won't grab onto oxygen and distribute it all over your body. And with less oxygen for your muscles and brain to tap, performance -- both mental and physical -- can suffer.

There is a high incidence of iron-deficiency among female athletes due mostly to the smaller calorie needs of women, avoidance of red meat in their diets, menstruation, and loss of iron through sweat.

Find it Here: There are two types of iron: heme iron (well absorbed by the body) found in red meat, poultry, and fish, and non-heme iron (not as well absorbed into the bloodstream) found in fruits, vegetables, dried beans, nuts and grain foods. However, most grain foods such as cereals, pasta, rice and bread now come fortified with heme iron and make for good alternatives to meats and fish. Everybody can increase the amount of iron absorbed from all food sources by pairing it with Vitamin C-rich foods. Next time, have a glass of orange juice with steak or pair it with vegetables like red and green bell peppers or broccoli. Women should aim for 18 mg/day of this mineral.

 FOLATE
Folate or folic acid is a B vitamin that plays an important role in the prevention of birth defects and is required for normal DNA and red blood cell synthesis. Without enough of it, a woman's chances of heart disease increase, which makes it a concern for any female's overall health.

Getting enough folate into the system requires a helper in the form of Vitamin B12. It's this reason that you'll find folate/folic acid supplements packaged with Vitamin B12. With it, the body won't synthesize all the folate it needs.

Find it Here: Dark green leafy vegetables, dried beans, fortified cereals/grains, and strawberries are all good sources of folate. Vitamin B12 can be found in fish, meat, poultry, milk, eggs, and fortified cereals. Vegan athletes may need Vitamin B12 supplements. Women should strive to consume 400 mcg/day of folate and 2.4 mcg/day of vitamin B12.

Question: Is it true that chocolate milk works as a recovery drink?

Answer: Seth, I’m glad you asked this question. For over a year, my colleagues and I have been fielding queries from our athletes and friends who all want to know if chocolate milk really is an adequate source of easily digestible carbs and protein that can quickly restore a body’s energy levels after a workout. This hubbub came out of a paper published in the International Journal of Sports Nutrition and Exercise Metabolism last year that seemed to be picked up in every magazine and newspaper on earth. In the study, researchers from the Department of Kinesiology and Applied Health Sciences, Indiana University in Bloomington, IN, compared chocolate moo juice to Gatorade (as a fluid replacement drink) and Endurox R4 (as a carbohydrate replacement drink) and concluded that the sweet dairy drink may be considered an effective alternative to fluid replacement and carbohydrate replacement drinks for bouncing back from exhausting exercise, the kind that empties out your glucose stores, called glycogen. Its glucose, after all, that your muscles use as an energy source, and restoring your reservoirs of the stuff quickly is the goal of a recovery drink. Now, I emphasized “effective alternative” for a reason, which I will describe later.

First, let’s look at what defines recovery: During training, our bodies tap our glycogen stores (made up of carbohydrates) since they are readily available and easy to use for energy during intense exercise. If we exercise long enough and hard enough, we eventually deplete these reserves. And our glycogen stores running empty, we will not be able to maintain high-intensity exertions the next time we train. If we try to, we risk chronic fatigue as our body never gets a chance to restore its energy supplies. Recovery drinks are designed to quickly replenish these stores by flooding the body with easily digestible carbohydrates and a small amount of protein immediately after the training session or race. Looking back at the study, the researchers had the subjects do a “glycogen-depleting” exercise session before a 4-hour recovery period in which chocolate milk, Gatorade, or Endurox R4 were consumed. After the 4 hours was up, the subjects then road stationary bikes to exhaustion at 70% of their respective VO2 max values.

Looking more deeply into the results reveals some important points of consideration. When the subjects, who, it must be noted, also served as their own controls, consumed either chocolate milk or Gatorade, time to exhaustion and total work accumulated (kJ) were not significantly different. Drinking both chocolate milk and Gatorade after the first workout, however, significantly improved time to exhaustion and total work (kJ) during the second workout when compared to Endurox R4.

As with any scientific study, methodological considerations need to be examined carefully. In this study, there were only 9 subjects, only 3 types of recovery drinks were used, and all three drinks contained different amounts of carbohydrate, fat, and protein. Plus, the Dairy and Nutrition Council, Inc. partially supported the study, which raises questions of bias. While the research seems to pass muster as a solid piece of science, the results from the minuscule number of subjects shouldn’t be generalized across the entire population.

Getting back to my note about “effective alternative": Yes, assuming you’re not lactose intolerant, chocolate milk can be an effective alternative to other sports drinks when those beverages aren’t available. However, after looking at the difference in carbs, protein, and fat between chocolate milk and a product such as PowerBar Recovery—which CTS helped develop and endorses—I won’t say the chocolate milk is the best solution to recovery. The PowerBar product is. It's specifically formulated to replenish all the essential calories and nutrients, including electrolytes, without added fat.

Question: How can I drink beer so it doesn't affect my performance?


Answer: We’ve got good news for you, Marc. A beer with dinner, or while watching the game, won’t destroy your strength and endurance. However, alcohol right after a big workout isn’t going to help you recover for tomorrow’s training. Immediately after you wrap up any exercise, you need to focus on downing a carb-rich recovery drink that contains electrolytes. Then eat a full meal within an hour of finishing your workout to take advantage of the “glycogen window” that enables you to replenish your carbohydrate stores rapidly.

Beer’s perception as a carb-rich liquid is plain wrong. In reality, the alcohol is primarily metabolized into fatty acids rather than to usable carbohydrate energy. Yes, beer originated as carbohydrate—in the form of grains—but now it’s alcohol, and your body treats it differently by shooting it straight to your waistline as fat.

That said, be our guest to cracking open a bottle or two later in the evening. Just remember to do your body’s hydration status a favor and chase each bottle with a full pint of water.

TRAIN RIGHT NEWS

Woman-power Isn't Manpower

By Ivana Bisara, CTS Coach

If women and men compete separately, why do so many women train with men? Most women will tell you that it’s to help them ride, run, or swim stronger—if they always chase after someone who’s faster, then it makes sense that they’ll eventually get faster too, right? But is this the best way to do so? Not really.

In the winter of 2001, my collegiate cycling team was preparing for a strong performance at the road racing championships later that spring. Our team consisted of ten men and three women. At that time I believed that the harder I trained, the better and harder riding I’d do. So I trained with the men.

But after only one month of training with the guys I was tired, cranky, and skipping rides due to physical and mental burnout. Sure, I earned some praise for being able to keep up with the boys, but I was struggling mightily to do it.

Physiologically, riding with men every day was taking too much out of me and psychologically it was self-defeating. Instead of comparing apples to apples—my fitness to other women—I was comparing myself to men, a game that all women are set up to lose.

X Never Equals Y
A woman’s heart is smaller than a man’s, which means that the volume of blood pumped with each heart beat is going to be less than that of men. Also, on average, women deliver less oxygen to their muscles than a man can pump to his.

Combined, these factors lead to a lower aerobic capacity, and it’s this lower aerobic power, coupled with lower muscular strength and maximum power output in females, that separates women from men.

It’s all right to train every once and a while with a male friend, spouse or boyfriend, but you should match your moderate to moderately hard workouts with his easier training days for the best chance of actually working out together.

I learned from my mistake in college in time to salvage my season. I started training by myself instead of with the team, and as a result of my focused effort I earned a podium finish at Nationals. Even now, 6 years later, I rarely deviate from my training program to join the men. And I’ll tell you why: winning races feels so much better than being able to say, “I can keep up with the guys” on a Tuesday training run.

Train Right

You Missed It

By Abby Ruby, CTS Coach

Recently a highly motivated Ironman Triathletes I coach had to skip a five-hour bike ride. Since the training day was only a few weeks away from his race, he’d thought that missing those five hours on the bike had shattered his chances for achieving a personal best come race day.

This was far from the case: he’d been training for nearly six months—the groundwork for his endurance was laid down months ago. But as with a lot of athletes I and my fellow coaches work with, my Triathletes had overvalued high mileage workouts at this point of his season. He didn’t realize that his long rides and runs weren’t a priority like they were back towards the beginning of his training. Now I wanted him to focus on building up his speed. I told him to forget worrying about the lost time on the bike and move on.

Look, life happens. The kids get sick, you have to work late, the dog needs a walk, or the in-laws pop into town suddenly. And like my Triathletes above, you’re going to miss some workouts. What’s important is to know which workouts to reschedule and which ones to drop. To help you make an informed decision, I’ve put together a quick guide to prioritizing your schedule.

At CTS, we use distinct phases of training to build specific elements to a fast and strong athlete. The Foundation phase is where you build an efficient aerobic energy system; the Preparation period starts to work on your exertion at lactate threshold; the Specialization weeks push your limits with max efforts; and last is the Taper or rest phase right before an event. The phase you are in determines which workout needs to happen and which workout you can spare. So how do you know? Ideally, you could ask your coach. But in the event that you don’t have a coach, figure out what your goal for the week is (endurance, power, speed) and which workouts focus on that goal.

Foundation: During this phase, the key workouts are the long runs, rides, or swims—usually on the weekends—that build an aerobic base. Don’t skip these training sessions. They’re the core workout during this period. Reschedule them if necessary, and make sure you give yourself a day or two of rest after them. If that means losing a shorter, somewhat faster, mid-week workout, so be it.

Preparation: At CTS the key workouts during this period are Tempo and Steady State Intervals. The bread and butter of the Prep weeks, these longish blocks of higher intensity workouts build your stamina at threshold. Long endurance work (Endurance Miles in CTS-speak) is second in priority. It’s actually okay to reschedule Tempo and Steady State days back-to-back. This is called a “block,” and I use it often with my athletes. However, I make sure they take at least a day or two off afterwards to rest and recover.

Did You Know: The habit of doubling up workouts—that is, adding a missed workout to the next day’s scheduled session—is not an effective use of your time or body? Each workout (intervals, Tempo work, aerobic endurance, and even recovery) asks your body to perform specific and unique types of work. Doubling up an Interval session with a Tempo day, for example, will just leave you tired and unable to perform to your best ability, or even worse, cause you to injure yourself.

Specialization: Here’s when you’ll find your schedule comprised of Power Intervals, swim sprints, and other workouts designed to develop the upper limits of your anaerobic energy systems. These workouts, while often shorter than the rest of your week’s work, demand a lot from your body. Don’t skip ’em; they’re what make you faster. The rest of your workouts are essentially built to maintain your endurance or recover from the sprint work, and can be missed.

Taper: In the taper block if you miss a workout, forget about it. The worst thing you can do for your race is to double up a missed workout in the days before the event. All you’re doing is tiring yourself out before the big event. When in doubt, REST. 

(Information supplied by: Mick Edge)