Tuesday, July 8, 2014

TTT Mysteries: Nervous Breakdown! The Case of the Tight End

As my kids took in their 3rd movie in the back seat, my wife and I attempted to keep some conversation going to pass the time. We were en route to our 4th of July weekend in St. George with her family, and had an hour or so left to kill. After a brief pause, here’s an abbreviated version of where the conversation turned:

“I’m still so confused by what happened with my leg at Ragnar.”

“Where exactly does it hurt?”

“Nowhere now, it doesn’t hurt at all… before it seemed to be centered here (pointing to my upper calf), but it literally hurt from my hip all the way down.”

“Did it feel like you pulled something?”

“No, it was kind of a dull, weak feeling, but really painful, and like the muscles just wouldn’t activate at all.”

“Maybe it was a nerve issue... the sciatic nerve runs right through there.”

(Grabbing her by the shirt collar and speaking with a frantic British accent) “By George, woman, you’ve cracked the case! Tell me, how did you do it?”

“Elementary, my dear Watson.”

Ok, I made up the last two lines, but when Lindsay mentioned “nerve issue” it clicked that she was spot on. She started Googling stuff, and the more she read to me, the more convinced I became.

nice bum where ya from?
In a nutshell, there’s a muscle in your butt called the piriformis… it’s nestled in there somewhere next to the gluteus maximus, and is also near the top of the sciatic nerve, which runs down your legs into the calf muscles.

According to Wikipedia:

Piriformis syndrome is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the piriformis muscle, causing pain, tingling and numbness along the path of the sciatic nerve descending down the lower thigh and into the leg.

When the piriformis muscle shortens due to trauma or overuse, it can compress the sciatic nerve beneath the muscle. This can result from activities performed in the sitting position that involve strenuous use of the legs as in rowing and bicycling. (Ding ding ding ding ding!)

Runners, bicyclists and other athletes engaging in forward-moving activities are particularly susceptible to developing piriformis syndrome if they do not engage in lateral stretching and strengthening exercises. When not balanced by lateral movement of the legs, repeated forward movements can lead to disproportionately weak hip abductors and tight adductors. This can cause the piriformis muscle to shorten and severely contract. Upon a 40% increase in piriformis size, sciatic nerve impingement is inevitable.

A highly effective and easy treatment includes stretching and strengthening these muscle groups, and warming up before physical activity. An exercise regimen targeting the gluteus medius and hip abductor muscle groups can alleviate symptoms of piriformis syndrome within days.

If you’ve ever dealt with the symptoms that I described and didn't know why, now your mystery is solved!

You know how the end of crime shows (including such staples as Scooby Doo) often flash back to show clues, or how the crime was committed? Here are my own:

Flashback 1: two Ironman 70.3's in a 5-week span

Flashback 2: ramped up interval/intensity training in the weeks following

Flashback 3: thinking during this time that I hadn’t been very consistent with stretching lately

Flashback 4: two particularly hard interval and hill repeat sessions on the bike, Jun 19 & 21

Flashback 5: feeling tight at my track workout on Jun 24, even getting down like a baseball catcher on several occasions in an effort to “limber up” – which, as I’ve now learned, gets at the ol’ piriformus!

Flashback 6: feeling twinges of what I now know is “sciatic pain” towards the end of said track workout

Flashback 7: flare up of same symptoms following pounding downhill Ragnar run (Jun 27)

The point is, despite the complexity of the human body, there are often simple answers to what ails us as athletes. We can also often look back and identify what led up to an injury. I’m still a little hesitant to run much right now, but with the case cracked, I know what I’ve gotta do: stretch, stretch, stretch, warm up, ice as needed, and get my punk piriformus in gear.

Me to piriformus “hey, just back off, man”

Piriformus: “look, I'm tired… stop workin me so hard”

Me: “how bout you shut up and lay off my sciatic nerve?”

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