Blog: Feature Stories

I know we sometimes say that staying in shape can be a pain, but we also know running shouldn’t cause pain. The calves, knees, and back can quickly tell us when we’ve done too much. But if running becomes a literal pain in the butt, it might be piriformis syndrome. The main cause of piriformis syndrome is overuse during exercise — like overdoing a new workout routine — or sitting too long.

The piriformis muscle runs from the lower spine to the top of the femur, on top of the sciatic nerve. If the piriformis gets tight or stressed, it can press on the sciatic nerve and cause pain. While the origin of sciatica is different from piriformis syndrome, they often share the same symptoms like pain in the lower back, buttocks, and down the leg.

A doctor can help you sort out whether your pain is a serious problem, or if it’s just sore muscles and a few stretches can help. We asked Will Hayes, Performance Manager at Novant Health Sports Performance, and Taylor Pigg, Clinical Exercise Physiologist, for suggestions. They remind us to do these gently, especially at first!

Foam Roller

“If your piriformis is tight and you want to alleviate that, and low back discomfort, you could use soft tissue work,” says Hayes. “If you have a foam roller, you can use that for soft tissue manipulation.”

Roll for about a minute on each side with the roller or a ball. It will take the tightness out of the tissue and allow the muscle to relax.

Figure 4 Stretch

Lie on your back and bend one knee up, and cross it over the other. Pull the bottom knee up to your chest. A couple of other variations include twisting the opposite way to stretch the muscle, or pulling the knee up to the opposite shoulder.

“Piriformis is a hip flexor and also external rotator, and Figure 4 will open that up,” says Hayes. “Lower back pain is usually caused by tightness above and below the sore area.   When we open that up, we alleviate those symptoms,” he says.

Seated Twist

Sit with legs criss-crossed and place your right foot over the left knee, pointing your right knee upright. Place your left elbow on your right knee and gently twist to the right. Hold, then switch legs and repeat.

“The key to relieving piriformis irritation caused by over tightness of this muscle is to gently get in poses that lengthen and release the tightness and ease the inflammation of this muscle,” says Pigg.

Standing Forward Fold

Stand with feet flat and legs mostly straight, but knees slightly bent. “Fold” over and touch the mat in front of you, stretching the lower back. If you can’t reach the ground right away, take your time. You’ll get there eventually.

Pigg likes both the seated twist and standing forward fold to gently lengthen the piriformis muscle, while strengthening the surrounding muscles.

“It’s important to note that the piriformis muscle is the key muscle in keeping the SI joint stabilized,” says Pigg. “A lot of times, when there is tightness in the piriformis muscle, the sacrum may be out of proper alignment. Once you have found some ease in the piriformis joint by gently stretching this muscle, you can then refocus on building proper pelvic alignment.” From there, says Pigg, you can work your way into the Tree Pose, which strengthens the piriformis muscle.

Pigeon Pose

And while you’ve got your mat out, slide into the Pigeon Pose. Facing forward, bend one knee under you and slide the other leg back. Bring the foot of the bent leg towards the opposite hip and gently lean forward.

“This targets your piriformis area,” says Hayes, “and will bring relief.”

These are great stretches to do before and after running, too. Don’t forget that part, Hayes reminds us. Getting muscles into work mode prevents injuries, and taking time to cool down afterwards allows the body to “rest and reset” after the “fight or flight” activity of exercising. Hopefully, this will let you both run and sit more comfortably.

We get it — this has been a rough year, and we’re itching to get back to normal. But there’s one itch we could live without: Spring allergies! Oh yes, we love when the cold weather breaks and cool, clear, sunny days lift our spirits. But if you’re an allergy sufferer, a long run means an itchy nose and watery eyes and maybe even a full-on allergy attack. Yikes.

And here’s a fun fact: Charlotte is typically ranked in the top 50 cities in the U.S. for worst allergies reported, according to the Asthma and Allergy Foundation of America. Ok, so probably not such a fun fact.

Running in a mask is always an option, but we’re pretty tired of those things, aren’t we? (Doctors say you should still wear one when you’re around people, or indoors — but outdoors and alone is our chance to be free of the fabric, right?) And they won’t filter out the smallest allergens, either. Your best bet is to know your allergens.

“In spring, we have tree pollen,” says Dr. Puja Rajani, a Novant Health Pediatric Allergy & Immunology Specialist. That’s a change from the Fall. “In Fall, we have weed pollen and mold because it’s the rainy season, which means increased mold.”

Before you cut down your giant blooming magnolia, realize that the flowering trees in your neighborhood likely aren’t the problem.

“Heavier pollens, like magnolia and pine, aren’t usually a trigger,” says Dr. Rajani. “The size of antigen — it’s too big. It won’t trigger asthma.” The larger pollens (including those flowering bulbs we associate with spring) will simply fall to the ground, and aren’t likely to get kicked up in numbers to cause a reaction. The culprits in the spring are the trees we love so much in North Carolina: elm, cottonwood, cedar, oak, birch, hickory/pecan, and sweetgum trees. Other culprits are black walnut, sycamore, maple-box elder, mulberry, bald cypress, ash, and willow.

Oh, and welcome to Tree City, USA. We have an official designation, you know. But even if you remove your trees (or grass or other allergens) from your yard, pollen travels, and you can’t do much about your neighbor’s landscape. So what do you do if you love running outdoors in our perfect Spring weather?

“You should never let allergies stop you from doing things you want to do,” says Dr. Rajani. There are solutions. “Local” treatments like nose sprays treat nasal tissue at the source (hence, “local”). Flonase and Nasacort are two good ones. It may take a couple of weeks to see the results, says Dr. Rajani, so plan their use around your runs.

For allergy pills, consider the chemical make-up — which ones may make you sluggish or hyper. For instance, Allegra (Fexofenadine HCl) doesn’t cross the blood-brain barrier, but Claritin (Loratadine) and Zyrtec (Cetirizine) have been shown to cause drowsiness in 10-15% of patients, says Dr. Rajani.

 

For holistic relief, turmeric can lessen symptoms for the long term because of its anti-inflammatory properties. A neti pot or nasal rinse can also relieve symptoms temporarily without side effects, but aren’t a long-term solution. You may need to try a few things to learn what works best for you.

And here’s the biggest piece of advice: Don’t try something new the night before or morning of the race!

If your allergies go beyond the mild and quickly treatable, you may consider immunotherapy — in other words, allergy shots. Skin tests can determine what your triggers are so you can treat them.

“That’s the only way we have that doesn’t just put a Band-aid on symptoms, it actually treats the underlying cause,” says Dr. Rajani. “We teach the immune system that it doesn’t need to be reactive.” Allergy shots help your body to build up a resistance to allergens. If severe allergies keep you from doing what you want, or induce asthma, shots might be a good option.

You can track daily allergens on popular weather apps, like WeatherBug, My Pollen Forecast, or Plume Air Report. That will let you know to have meds handy in case you need them. You can also control your environmental factors, by washing pets if they go outside, keeping your air filters clean, and taking a shower after every run. Washing your linens, especially your pillowcases, can help, too.

And as always, if in doubt, ask your doctor. Spring in North Carolina is beautiful — go out and enjoy it!

 

We’ve said it here before — to be the best runner you can be, you need to do more than run. Sure, a long run feels great if you only have an hour or so to get something in. But if all you do is run, you’re setting yourself up for muscle imbalances that lead to injuries. Great fitness combines cardio-pulmonary efficiency, strength, agility, and flexibility with that endurance long-distance runners crave.

There are a lot of cross-training choices for runners, but if you only have time for one, yoga is a good one. The total-body integration that comes from yoga’s combination of strength, flexibility, breathing, and mental focus will make your runs feel better, and your downtime less sore.

“Yoga can help elongate the muscles overtightened from repetitive motions of running, to create proper alignment and prevent injuries,” says Novant Clinical Exercise Physiologist Taylor Pigg. “Yoga helps not just in prevention of injuries, but after the run it can bring oxygen-rich blood back to those muscles to aid recovery.”

If you’ve never tried yoga before, don’t be put off by its unfamiliarity. Think of it as an enhanced pre-run stretch and post-run recovery exercise. Pigg suggests the 5 yoga poses below to get your started. Don’t forget to breathe deeply and slowly while you do them to increase circulation and relieve stress!

Downward Facing Dog

This stretch and its many variations are a yoga student’s best friend — and always fun for a joke or two. When unleashed, it stretches your calves and lower back.

“Downward Dog is a good stretch for the posterior muscles that tend to stay tight and make your back hurt,” says Pigg. It can also strengthen arms and upper body, core, and legs — basically everything.

Start with the basic Downward Dog: Lie flat with your hands on your mat a little wider than shoulder-width apart. Life up and point your hips to the sky to make a “triangle” with your body. For variations, reach one arm over and grab the opposite ankle and hold, or lift one leg so it is in line with back and shoulders. You can even try bending that knee for a little extra work, but take your time and don’t push it if it hurts too much!

Pigeon Pose

The pigeon is a good, basic pose for something runners don’t do nearly enough — open their hips. Those muscles and tendons need a good stretch to stay loose and keep you limber as the miles roll on. This stretch will strengthen your hip flexors, piriformis, and glutes.

“Pigeon Pose is good if you have sciatica and flare-ups,” says Pigg. If running makes your back and hips sore and tight, this is for you.

From Downward Dog, bring one leg forward and across, so the outside of the foot is down on the mat. Keep the other leg extended. Bend the open hip down to the mat and hold. Take a deep, slow breath.

Low Lunge

This is another great pose for tight hip flexors, says Pigg, and one many runners are already familiar with. Thought of as a basic running stretch, low lunges can help with hip, knee, and back alignment for a balanced, more efficient run.

“Runners have tight hips, because when you’re running those muscles are tightening a lot, and runners don’t take a lot of time to elongate those muscles,” says Pigg. “That can cause the hips to get out of alignment, which can hurt knees and ankles.”

From your pigeon pose, slide the bent leg forward so your foot is flat on the mat in front of you. Stretch your back up straight and rest your hands on your knee. Breathe deep and exhale!

Cobra

Cobra will stretch and strengthen your lower back and core, says Pigg. Lie on your belly with your legs behind you and your palms flat on the mat next to your ribs. Push your chest off the mat, trying to lift with your back muscles while using your hands to steady yourself.

“These are the muscles that support your lumbar spine, and will help strengthen your back, keep your core and your hips strong, and keep attaching muscles around your hips stabilized,” says Pigg. “If you have a stronger lower back and core, you don’t have to compensate with other muscles.”

As runners, all of your movement starts with a strong core and back. Keeping them strong can help add power to your run, whether distance or sprinting.

Thread the Needle, and other shoulder/neck stretches

Don’t exclude your upper body from your stretching routine! If you’ve ever been running and felt tightness across your shoulders, consider loosening up your trapezius muscle. Thread the Needle, Eagle Arms, and Bear Hug will help your whole body to work together by loosening up your traps.

To thread the needle, start on your hands and knees in tabletop position. Thread one arm under the other and bend down to bring your ear to the mat. Hold, breathe, and repeat on the other side.

For Eagle Arms, sit up. Cross your arms at the elbow and intertwine them so your palms are together. Bring your elbows up in line with your shoulders and hold. Breathe!

One more? Give yourself a bear hug. It will stretch and loosen the muscles across your back that get tight easily when you run. It’s also a great way to end your new yoga routine. Congrats!