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The Dreaded Piriformis Syndrome

by Coach Adolfo Salgueiro | Nov 17, 2020 | Article

By Coach Adolfo Salgueiro

A few weeks ago I read a social media posting by Mike Wardian, one of the ironmen of our sport, stating he was withdrawing his participation in an important race because of piriformis syndrome. My thought was that if this can happen to the king of recovery, a runner who competes every weekend, guy who is out there achieving superhuman feats, what is there left for the rest of us? Mere mortals that are just trying to do our best with what we have.

In his Instagram post from October 18, Wardian wrote: “Pro tip: don’t get Piriformis Syndrome the day before the race you have been looking forward to for years. It is a pain in the arse & literally brought me to my knees. Unfortunately, I need to withdraw from the #bigsbackyardultra so gutted to be unable to participate”.

Because it crosses the sciatic nerve, it can become tight from too much sitting or it come become strained from overuse. The tightness or strain will cause it to compress and rub against the sciatic nerve

The piriformis muscle is a small muscle located deep in the buttock (behind the gluteus maximus). It runs behind the hip joint and aids in the external hip rotation or turning your leg outward. Because it crosses the sciatic nerve, it can become tight from too much sitting or it come become strained from overuse. The tightness or strain will cause it to compress and rub against the sciatic nerve.

According to the Spine-Health website, piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).

In his book “The Athlete’s Book of Home Remedies”, Dr. Jordan Metzl, states the pain is often felt deep inside the buttock muscles and it makes it difficult to sit on the affected buttock.

Diagnosing piriformis syndrome is not an easy task even for the most experienced doctors. According to what I have read, and I am no doctor so please don’t take medical advice from me, there is no specific test for this condition so it is usually diagnosed by eliminating alternative options to the patient’s symptoms or pain.

A home-based stretch and strengthening routine could help prevent a visit to the doctor.

According to Dr. Metzl, many of the interconnected muscles in this region—piriformis, glutes, hip flexors, hamstrings, quads—support one another, and weakness in one area can mess up the works. If you face an unexplained soreness in the deep buttock area, and if the home-based care doesn’t improve your symptoms in a week, or sooner if the pain is severe, he recommends you see a doctor.

My point with this post is that this is an extremely painful condition that can easily sideline you. I have experienced it on a very mild level, and I do not want to know how much worse it can get. If it can bring a badass like Mike Wardian to his knees, it must be a horrible condition. I overcame it very quickly with home stretching and strength exercises. If you are diligent in doing these as soon as you feel a, putting it plainly, deep pain in the ass, you may be able to avoid pain and lost time.

While researching for this blogpost, I found the following video. It is about 6 minutes long and it talks about the differences between piriformis syndrome and sciatica, which need to be treated differently. I found it worth my time.

I also found the following video of five sciatica stretches for piriformis syndrome, which I found interesting, especially because they can be done anywhere and with no specific equipment.

I sincerely hope you never have to use the information in this blog post, but if you ever do need it, I hope you will be able to recognize the issue in its early stages so you are not brought to your knees and you don’t miss any miles.

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9 Tips to Run Safely in the Dark

by Coach Adolfo Salgueiro | Nov 10, 2020 | Article, List, Opinion

By Coach Adolfo Salgueiro

For us runners, first Sunday in November is usually reserved for the New York City Marathon and in the United States at least, it also means the end of Daylight-Saving Time. It is our one day with 25 hours. But with this time adjustment and the autumn months in full swing and the winter ones in the on-deck circle, there are longer nights which present a slew of challenges for runners.

If you can’t run without headphones, do not get into this setting. Jump on the treadmill, instead.

It is paramount to understand that our safety is our individual responsibility. In this litigious world where nobody take responsibility because they think they can sue whoever hurts them, you must be aware that as a runner, it doesn’t matter who had the right of way, who had the obligation to see you, or who will win the argument in court. If you get hit by a vehicle, you are the one getting hurt. Is up to you to make sure you are seen by those who could harm you.

The following are nine recommendations to keep you safe while enjoying your runs in less than ideal lighting conditions:

1. Do not improvise your routes: When you are running in the dark is not the appropriate time to be adventurous. Select routes you know are safe, well-lit and familiar to you. This is not the time to cross a street and find out there is no sidewalk, or that you are lost.

2. Wear at least one light/reflecting device: You must prepare to be visible at the time you end your run, not just at the start. You can run lit like a Christmas tree, or you can use a reflecting vest, or you can wear blinking lights on your shoes, shorts, or hats. The options are plenty and they fit every budget.

3. Run against traffic: It can’t be easier than this. By running against traffic you can be alert to any danger ahead of you. Drivers maybe playing with their phones and heading towards you. You won’t see these idiots unless you are facing them. This doesn’t mean to run in the middle of the road, make sure you obey all traffic guidelines.

4. Rethink your usage of headphones: Running in the dark has its own challenges. Don’t handicap yourself by not having your auditive sense available and/or half of your brain distracted with music or a podcast. If you can’t run without your headphones, jump on the treadmill or choose a well-lit, familiar route where you don’t have to cross any streets.

5. Run with your phone: Well into the XXI Century, phones are ubiquitous. Not even sure why we still call them telephones. Make sure you run with yours when you are in the dark. It is better to have it and not need it than to need it and not have it. Sharing your location on WhatsApp or any other app is a good practice. There are so many options to carry a phone these days, that there are no excuses to leave it at home if you are running into the dark.

6. Always tell someone where you are going and how long you plan to run: Even if you are taking your phone, but especially if you are not, make sure someone knows what your route is and how long do you expect to be gone. If you are going for 5K around the block and it has been two hours, someone should be checking on you.

Reflecting vests are good and affordable options. They also made you seen from both sides.

7. Run in groups whenever possible: There is always additional safety in numbers. It is easier for a driver to see a group of runners than to see just one. Plus, more eyeballs, more brains and more safety devices together can only increase the safety of your run in the dark.

8. Carry ID: I am not paid by them, but I do believe RaceID is the best alternative for carrying identification with you. I have been using it for years and they have plenty of unobstructive, affordable options so someone can take care of you if you are ever found in a ditch. Worse comes to worse, carry your driver’s license in a pocket.

9. Carry pepper spray: Having it is not enough. It must always be accessible. The moment you need it is not the time to figure out where it is or how it works. Mind the wind, or you will pepper spray yourself.

These are by no means all the safety precautions you must take to run safely in the dark. For one, make sure you trust your instincts always, so you don’t have to second-guess yourself when it is already too late. If something doesn’t feel right, get out of there immediately.

Anything else I forgot, or you would like to recommend to your fellow readers?

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My First Race in Times of Pandemic

by Coach Adolfo Salgueiro | Nov 3, 2020 | Article, Opinion

By Coach Adolfo Salgueiro

I was really looking forward to last Saturday (October 31st). For the first time since March, seven months ago, I was going to participate in a real race. None of the virtual stuff. A race where everybody was going to be in the same place, running the same distance, on the same course, at the same time. On one side, I was excited for this opportunity, on the other, I was not sure how comfortable I was going to feel given what is going on with the second surge of the Covid pandemic.

All masked up as we waited in line for our turn on the staggered starting line

But this 5K was on one of the runways of the Miami International Airport, a place where I may never, ever, have the opportunity to run, again, unless I am deplaning on an emergency landing. A tough race to pass, especially when I had been registered since January. The race was originally scheduled for April, but with everything going on, it was postponed.

A few weeks ago, participants got an email with the updated date, time and rules. Being in an active airport and in the middle of a pandemic, the instructions were strict and written in a straight, harsh tone. Somebody I know said he’d rather not participate because this felt like the “Gestapo 5K”.

The start was set in four waves, so participants could keep their distance. You were given a specific window of 30 minutes to come into the hangar, pick up your bib and get running. Organizers did not want too many people hanging out while waiting to start. The use of a mask covering your nose and mouth was mandatory except for when you were actually racing.

From there, you had to get in a loooong line to enter the runway. Once at the start, there were three lines of 10 cones separated by the appropriate socially distant space. Each runner had to stand by a cone. Once the front three were gone, you were asked to walk to the cone in front of you and about 5 seconds later, you could start the race. I totally understand the reason for this, but it was weird and uncomfortable.

Four planes took off abut 100 feet from where I was running, making the experience, worthwhile.

Running on the runway of an active airport (even though this was a taxi way not a landing one), was absolutely amazing. While I was running, I saw four passenger planes taking off maybe 100 feet from where I was, and two landing. We were on the other end of the passenger terminal. Surreal, worthwhile experience.

After crossing the finish line, you were given a medal, a bottle of water or Gatorade, picked up a race shirt and kicked out of there. There was no hanging out, checking for results or award ceremony. Once again, totally understandable but not what a post-race is supposed to feel like.

Because of the stacked start, all runners were timed individually, and the results compiled based on chip time. Fast, middle-of-the-pack, slow runners and walkers all mixed throughout the course. Good it was in an airport runway so there was plenty of space to pass without having to wave around people.

With the Miami International Airport 5K done, my conclusion is that I am happy I participated. I am not a big fan of the 5K distance, but this was a hard to pass course. But this did not feel like a race. For the third time, I understand the reasons why it had to be this way and there was no other way to pull this off safely, but still, it did not feel like a race. If I had been the Race Director, I would have done exactly the same. But the get-in-run-get-out approach was not conducive to a welcoming event. It did not have the right atmosphere; it was not encouraging to sharing the experience with your running buddies and it left my returning to racing expectations, unfulfilled. None of this is the fault of the organizers, it is just the way it is in 2020.

While most races round the world are cancelled for the 2020-21 season, there are still a handful in South Florida that got the necessary city permits and are moving forward. I sincerely hope they can pull it off and that no one gets sick, so these events can continue and runners, hopefully including me, will learn to adjust. But I am not sure when I will participate again, though. This new race style is not worth the risk, at least for me, at least at this time. My goal race is on February 14th, 2021. I will have to reassess by then if virtual or in-person is the way to go.

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My Virtual NYC Marathon of 2020

by Coach Adolfo Salgueiro | Oct 27, 2020 | Article, Personal, Reflection

By Coach Adolfo Salgueiro

When the New York City Marathon decided to go virtual, I received an invitation to participate in it, not sure why since I did not register even for the lottery. I had no interest. Why would I do a virtual New York when I’ve done it in person twice and it is one of the most amazing running experiences, ever? But the more I thought about it, having a 26.2 on my schedule would give me a tangible goal that, otherwise, there is no chance I would even get close to.

A beautiful addition to the collection that I should be getting soon. This will commemorate my 10th Marathon

Sixty dollars was an affordable price, and a spectacular medal a welcomed incentive. Not sure what else is included, but it is irrelevant. You had between October 17 and November 1 to complete the 26.2. This was just between 8 and 10 weeks away depending on the date I ran it. I settled for October 24th so I could have an extra week of training and a spare one should anything go wrong.

Because of an injury some and health issues I went through last year, I hadn’t run more than 10 kilometers straight during the year. I had gone longer when including walking breaks. Run/walk intervals allowed me to get my fitness and aerobic capacity back. I also had to shed a few extra pounds. So I prepared a NYC plan focusing on steady increment of mileage, management of effort and heart rate control based on full recovery. Finishing time for this one was a secondary consideration. Finishing strong and without injury was more than enough reward.

My plan called for a few running miles at the start and from there on, run half mile and walk another half. Yes, a lot of walking, but I didn’t want to get my heart rate so high that that it would become unsustainable and force me to walk the last 10 miles. As I trained and was able to run more miles, I felt the recovery periods were way too long, so I adjusted. My longest training session was 17 miles, my longest non-stop run was 9 miles. My run/walk intervals got set to .6/.4. I was ready to go.

Thanking God as I cross the finish line, surrounded by my running family.

Then, October 24th, 2020 arrived and at 2:26AM I hit the road. I ran the first 6 miles and met with Bill and Rita about 3:30 am for my first water and resupply stop. From there on, I started my run/walk protocol. At first it bothered me to walk when I still felt strong, but I knew it was an investment towards the last miles, and it paid off. At mile 10, I met up with Ted, who accompanied me the next 8 miles. Up to this point my wife followed me in the car, so slow that a cop found it suspicious enough to stop her.

Close to Mile 17, the most amazing thing happened. A caravan of my running buddies passed by with horns, cowbells, yelling and screaming. A shot of adrenaline invaded my body. They were going to our regular Saturday starting spot, where I met them to pick up my last supply cache from Patrick. Once there, I kept going for my last 8.2 miles with a few friends here and there. Ruben stuck with me and ran/walked with me the whole way, sacrificing his training for the day.

I may have missed then entrance to First Avenue from the Queensboro Bridge, but what my buddies from the No-Club Runners had at the finish line was equally impressive. I choked as I ran towards the line through a tunnel of screaming, yelling, cowbells, paparazzi and the support of those who were genuinely elated to share this moment with me. It was not Central Park, but I wouldn’t trade this finish line for it.

Final time accepted by NYRRC was 5:28:14. Almost two minutes below my wildest expectations.

Post-marathon celebration with my buddies from the No-Club Runners. What an amazing bunch of people.

I have been asked if I count this experience as a completed marathon. If I count it as my 3rd time completing NYC? The answer to both questions is yes. The answers are affirmative because this was an established and scheduled race. It did not happen this year because of Covid. This is not a race that popped up to sell you a medal taking advantage of the pandemic. There was a strict time frame on when to do complete the specific distance. This was not a “run what you want, when you want” scheme. On a personal level, it is not like I’ve ran 26.2 so often that I lost count. This is just my 10th time at the distance.

This experience taught me is that I am mentally stronger than I thought. That if I am smart about how to approach certain challenges, adjusting as I work towards them, I can achieve and complete them successfully and safely. That the marathon is still a great adversary, but no unconquerable. And, above all, that I have a running family for which superlative adjectives to qualify them would make no justice to what they mean to me.

Running with a Mask in Times of Pandemic

by Coach Adolfo Salgueiro | Oct 6, 2020 | Article, Reflection, Science

By Coach Adolfo Salgueiro

Before we get started, I must remind everyone that I am not an infectious medicine specialist. If you want scientific advice, I recommend you listen and follow what Dr. Anthony Fauci has to say regarding Covid-19. With this disclaimer out of the way, the following are my thoughts on running with a mask during times of pandemic.

By trial-and-error we will find what works best of us individually (Photo by cottonbro from Pexels)

Eight months or so into the Covid-19 pandemic, and four after the economy was inevitably reopened, we’ve returned to our group activities such as work, extended family and exercising with as much caution as possible. Social distancing keeps being the new norm, hugs and kisses have been replaced to fist and elbow bumps, and masks have become a political issue. As runners, we’ve had to adjust to this new reality in order to keep moving forward and to keep the social aspect of our sport alive. The uncomfortableness of wearing a mask is a small price to pay.

According to Certified Personal Trainer Timothy Lyman in a recent article in Runner’s World Magazine, “Running with a mask, or any other type of face covering, is inherently more difficult because you have to work harder to get the same amount of air into your lungs”. Of course this will vary depending on the type of are wearing.

Getting used to running covering your nose and mouth requires time, commitment and training. Figuring out what mask works better for you, when is the best time to have it on or just available for immediate use, are part of such training. Knowing in what situations you should or should not wear it has also been a trial-and-error endeavor.

The same article in Runner’s World states that: As a general rule, a mask is necessary if you’re running in a populated area where you’re likely to encounter other people. If you’re running alone in an area where you won’t encounter others or come within 6 feet (at a minimum) of others, it’s likely not necessary. But keep in mind that wearing a face covering is not a substitute for physical distancing—make sure to still keep at least six feet of distance between yourself and others while running.

Through my personal experience running over 600 miles during the pandemic, what I’ve figure out is that even though I may not need a mask when I run alone, I rather have one because inevitably I will cross paths with strangers that either do not care to help you create the safe distance or, you meet them in places where it is just impossible to separate. Therefore, I always run with a cloth mask on my chin or neck, which I can immediately access to cover my face when required. It has worked so far for me and I recommend it.

It is important to keep your social distance even if you are running with your buddies (check how I have a mask on my neck ready to be used at a moment’s notice) – Photo by Ted Sassi.

In my two running groups, we all use face coverings until we start. As for running together, we try to stay close enough to keep the social aspect of running alive but separate enough to adhere to the protocols. The post-run café-con-leche or beers, are strictly held outdoors.

For group running, Dr. Jennifer Marin, from @Obesalud, recommends not running one behind the next but keeping a diagonal formation with 5-meter (15 feet) of separation. This is an interesting, overcautious suggestion, worth looking into.

An important consideration is that, regardless of the type of mask you wear, you need to go out of your way to keep it clean and disinfected. The constant breathing will dampen it and thus less effective. I you don’t wash it; it will attract microorganisms that you will be breathing in and may negate the benefits of wearing a mask in the first place. So make sure you keep several of them in your running bag so you can rotate them appropriately.

Yes, running with a mask is a pain in the ass. No questions about it. But a worse option is having Covid-19. So suck it up, get used to the discomfort, wear a mask like a good citizen and keep on running with your buddies.

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The Hydration Urine Test

by Coach Adolfo Salgueiro | Sep 29, 2020 | Article, Coaching

By Coach Adolfo Salgueiro

We’ve heard about the pee test to figure out how well hydrated we are or not. If the pee it is clear, or pale yellow, then you are hydrated and ready to run; if it is yellow or darker, then you are dehydrated. Sure, this is a quick, easy and free test, but it does have some limits.

The need for sodium for us, long-distance runners, goes beyond the recommended guidelines

According to Andy Blow, a British Sports Scientist, the pee test is a good tool to gauge the general state of your hydration, but it is not the end-all word on the issue. “The time to look at your pee is when you wake up in the morning—Says Blow, who served as hydration specialist for two Formula 1 teams—because the color of the urine you first produce is a good indication if you are hydrated or not that day. By then, your body had all night to recalibrate itself, move fluids around and get into equilibrium. If you wake up and you feel a little bit thirsty, it is a good indication you are dehydrated.”

The problem of looking at your pee during the day is that you eat, you drink, you do things and the results become skewed. If you had a bottle of water, or two; if you drank a coffee, or two; or a sports drink, your body may be discarding a lot of the fluid it took in, which doesn’t mean you are fully hydrated. Even if your urine is clear as water.

Remember that dehydration doesn’t get solved chugging a gallon of water. If you are in a dehydration state, it may take your body 24-48 hours to recover. You can gulp all the Gatorade you want, yet this will not restore you. The body can’t absorb it all and most of that excess water will be peed out.

Dehydration doesn’t get solved by chugging a gallon of water (or five)

In a recent interview I heard, Mr. Blow explained that we see with a lot of overhydrated athletes at the starting line of races. They take a lot of water before starting and that has nothing to do with their state of hydration. A recent study showed that a significant percentage of athletes are in an early state of hyponatremia when they start long races on hot days, most likely because they prepare by drinking a lot of water to confront the weather conditions. They end up peeing the excess water, and valuable sodium with it, which eventually leads to trouble.

The best way to address this, according to Blow, is to ingest a much smaller amount of a high-sodium drink. This sodium will make it into the bloodstream and will hold water there as a reservoir so that you have something extra when you start. “This is a lot better than drinking loads and loads of water”, he affirms.

Sprinkling salt in a glass of water will do the trick. The right amount is about 1.5 grams of salt per liter of water consumed. But since it is hard to drink “ocean water”, Andy Blow recommends sodium citrate, which is more palatable. Sodium citrate can be purchased at a nutrition store or via internet. This is about three times stronger that any commercial sports drink.

Understand that a higher consumption of sodium is important for athletes that train a lot AND sweat a lot, like us as long-distance runners. Consuming all this sodium for sedentary people is not recommended. Our salt requirements can be up to three or four times more than those of sedentary people. That is why we crave salty stuff, such a pretzels or potato chips, after a hard training session.

Also, understand that you don’t need to replace 100% of what you are losing. You are supposed to sweat and lose electrolytes. Nothing wrong with that. You need to find the sweet spot between what you are losing and going hyponatremic; and from there, test what works better for you. Then, go check your morning pee.

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