Step 3. Repeat. Then celebrate with a cold beverage. You stretched your piriformis.
Ask Kate: Bum Sore, Beyond the Reach of Cream
This week's question comes from Celia in Beaverton, who asks why running leaves one buttock sore deep inside. PT Josh Zavertnik of Portland's Elite Orthopaedic PT says it sounds like typical piriformis issues. Piri-what?
Piriformis issues are a common problem for runners. The piriformis muscle runs from the sacrum (tailbone) to a part of the femur (thighbone) called the greater trochanter. It rotates our leg externally (think duck-foot). When runners' feet pronate excessively and their knees drop in, the piriformis works hard, maybe too hard, to correct this motion. An overworked or overtrained (and under-recovered) piriformis muscle will compress and irritate the nearby sciatic nerve. That elicits the tell-tale pain deep in the rear and/or down the back of the thigh, but not across the knee joint. Pain typically comes on with activity and subsides with rest, but it may linger for a bit right after a run or walk. Mobility isn't limited, usually. Compressing the affected area by sitting down can be painful.
There are a number of things you can do to address the problem. Make sure you have adequate ankle-joint mobility and calf flexibility. A strong core and hips improve movement patterns and reduce the work of the piriformis. Address dynamic stability with single-leg balance exercises and single- or double-legged squats. Planks and bridges strengthen the core and hips. Stretching the piriformis can help as long as it doesn't make your symptoms worse. Lie on your back with both knees bent and your feet on the floor. Cross your legs by placing the ankle of the painful leg onto the knee of the other leg. This will create a Figure 4 leg position. Gently pull the unaffected leg up towards your shoulder, which should produce a stretch in the buttock of the achy leg. Hold for 30 seconds and repeat.
Remember, running is a skill, and a difficult one at that. Take the time to do all the cross-training, drills, and bodywork that will make you a well-rounded and less-often-injured runner.
PRC's Kate Novakovich doesn't know all the answers, but she'll ask someone who does! Send your "Ask Kate" questions to
, or ask her on our weekly Sunday run.
French Tricolour: Raynaud's makes hands white, then blue, then red.
Ask Kate: What's Wrong with My Hands?
A couple of us runners were sitting around after a long run recently comparing our cold, pale, and painful hands. They looked drained. Does this happen to you after a run? Well, there's a name for it: Raynaud's disease (after nineteenth-century French physician Maurice Raynaud). Sounds serious, but it's very common for men and women. Local sports medicine doc and UP team physician Dr. Jonathan Crist, MD, has an explanation that won't scare you:
Raynaud's disease is a condition where the blood vessels abnormally constrict in response to certain stimuli. The usual trigger is cold temperatures, but emotional responses can also trigger this. The fingers and hands are most commonly affected. It is usually characterized by the fingers appearing pale and cool to the touch. This is frequently followed by a rebound vasodilation (opening of the blood vessels) which may cause the hands and fingers to be red and warm. Raynaud's can be associated with a variety of disorders or simply occur by itself. Acute treatment usually involves simply warming the hand or extremity. While there are medications that may help with this, sometimes it can be avoided by just wearing gloves. If it persists, the athlete should usually be seen by their doctor for evaluation.
Got it? Wear gloves, and don't be alarmed if your fingers turn white after one of those early-morning runs. Raynaud's is all over the web, including several running discussion boards. According to some, caffeine consumption may make the phenomenon worse. And warming your hands with your cigarette? Don't even start.
Ask Kate: Help, My Bunions Are Blistering!
Thanks for the comments on this annoying issue. We hope you can try the suggestions and find relief. Shoes, inserts, skincare, socks, roads. Any other issue bothering you? Send us an email and we will consult the experts for solutions.
Ask Kate: Hips Don't Lie Down
I've been experiencing pain in my hip when I try to sleep on my side. A Portland Fit runner mentioned to me that she has been having the exact same pain. My PT said a tight iliotibial band was to blame, but I thought ITB syndrome only crops up on the outside of the knee, not the hip. Turns out I was wrong.
Josh Zavertnik of Elite Orthopaedic PT explains that a tight ITB and other lateral thigh structures can create compression over a part of the hip known as the greater trochanter, causing pain that worsens when you lie on the affected side. Women are more susceptible to this condition than men, due to differences in pelvic alignment between the sexes. Sorry ladies.
Zavertnik points out that the location of the pain is often not the source of the problem. The real culprit could be in the back, excessively tight calves, or poor movement patterns. He recommends stretching the calf complex for starters and using moves like a lateral plank to build core stability and lateral hip strength.
Can you stand on one leg for more than 15 seconds? If not, Zavertnik says, you probably need to work on your balance.
"This is essentially what running is: hopping from one foot to the other while maintaining some level of stability."
Other useful tools are ice, foam rollers, and of course, cross-training if the pain persists in spite of your attempts to address it.
Any other issue bothering you? Send us an email and we will consult the experts for solutions.
Cherry Blossoms on the Portland waterfront mark the arrival of spring. Get out and play!
We Are PRC: Spring Training Tips from Our Staff
With Portland Fit underway and Shamrock just around the corner, it's clear that spring running season is here! What's your spring thing: New kicks? New clothes? Maybe a new running route?
PRC's Holly Paige asked some of our staff members to weigh in on how they celebrate the changing of the season.
Anna Connor: Ramp it up slowly. Get a solid group of people to train with that are at your pace or a little faster. Do ALL the little stuff like core strength and drills. Find new routes to run on recovery days. I like running new neighborhoods on recovery days because this means I get to explore!
Mike Orr: One day a week, leave the iPod, GPS, and running buddies at home and go out and just RUN! Look at it as your time away from everything else. Be completely present in the moment. Listen to your breathing and the sounds around you. Don't try and distract yourself from how your body is feeling. There were a lot of things that had to align for you to be able to go out and run. It is a gift to have the time, resources and an able body to go out and get a few miles in. Be thankful for that 30 minutes or hour. The human body is an amazing machine!
Kristen Ott: Join a running group or find a running buddy, and most of all, have fun out there!
Shauna Dool: I have found that the thing that works best for me is running partners. If I'm accountable to someone or multiple someones I tend to get up early and get my run in before my day even starts. It's a great way to wake up! I never regret meeting my friends for a run, but I always regret cancelling!
Alex DeCino: Spring means track season, and even if you're training for a marathon, don't be afraid to run some shorter, faster races or workouts. Mix it up! Variety is the spice of life!
Phil Orlowski: I usually try to throw in some kind of weekly speed work—nothing formal like a track workout, just some "fun" running at a faster pace, over various distances, to blow out some of the cobwebs that may have accumulated over the winter months.
Jim Ney: Running Terwilliger is good. Big sidewalk, low noise, good view, hilly.
Ryan Heal: Get online and pick some races to do in summer and fall. Your enthusiasm for working out will skyrocket. Pick a race that some friends or family are doing. If you know that they're out there somewhere training, you're going to do it, too. Look back at the last year or two of your training logs. Figure out what works for you and what hasn't. Commit to not committing the same mistakes. Read a book on running that you haven't read; bring some new ideas to your training.
Staci Bielenberg: I like to take a day trip to a new running route (usually a new trail I haven't explored yet). This always gets me excited and helps to clear my mind. One major tip is don't start to much too soon. If you didn't run all winter, you are not going to pick up where you left off in the summer. Prevent injury by easing into a routine.
Kate Novakovich: K.I.S.S.—you know what that means! From shoes to training plans to nutrition and recovery just keep it as simple as you can. Not everyone's advice is right for you!
- Be Flexible: If you can't make a run when scheduled, do it another time.
- When I hear "I don't have time to train" or "It takes away time from the family," I remind runners that if you get up at 5 and run by 5:30 the only person you inconvenience is you. And we can live with that, can't we?
- Water belt: Get one for long runs. Gatorade diluted to taste. Can't stand GU? Think outside the box and pack peanut butter-stuffed pretzels in a snack-sized bag. Stuff it down your bra. Pack a peanut butter sandwich.
- Get good shoes. Always. The rest will follow. BTW, who invented cushioned socks?
- Don't eat oysters on the half shell the night before a marathon.
- Never give up, never cheat. Be in it for the long haul, not just the next race. Don't ever feel less of a successful runner because you are slow.
Great advice, everyone! See you on the roads, the track, and the trails!
I Am PRC is a regular feature on our site. For more click here. All interviews by PRC's Holly Paige.