Medical

Piriformis Syndrome

If it hurts to touch a point that's in the middle of one side of your buttocks, you probably have piriformis syndrome. This chronic condition is very difficult to diagnose, because other injuries may produce exactly the same symptoms. Similar pain may be the result of an injury to bones, muscles, tendons, bursae (pads between the tendons and bones), the hip joint, or the sciatic nerve, but there are ways to determine from which condition you might be suffering.

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Blocking Inflammation Key to Preventing Heart Attacks

In the biggest advance in knowledge about the prevention of heart attacks since the discovery of statins, researchers at Harvard Medical School have shown that blocking inflammation helps to prevent heart attacks (New Engl J of Med, August 27, 2017) and cancers (Lancet, August 27, 2017). You can help to protect yourself from having a heart attack by making lifestyle changes and taking statins to lower cholesterol. However, five years after people who suffer a heart attack have made some lifestyle changes and taken statins, 25 percent will suffer another heart attack. Hundreds of previous research papers point to continuing inflammation as the cause.

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Calculate Your Fitness Age

VO2max can be used to predict a person’s risk of premature death from a heart attack. Researchers at the Norwegian University of Science and Technology have developed a simple way to estimate a person’s VO2max, his maximal ability to take in and use oxygen (Med Sci Sports Exerc, November 2011;43(11):2024-30). The researchers had 4,637 healthy adults, average age near 50, run to exhaustion on a treadmill and measured their VO2max (a complicated test that measures oxygen and carbon dioxide concentrations). They then developed a formula that correlated very well with the subjects’ actual VO2max.

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How Exercise Helps Prevent Heart Attacks

Two recent breakthrough studies give the best explanation yet of how exercise helps to prevent heart attacks. Competitive older endurance athletes may have more plaques in their arteries than non-exercisers, but they have the type of plaques that are far less likely to break off and cause heart attacks (Circulation, April 27, 2017;136:138-148; May 2, 2017;136:126-137). The studies showed that competitive master athletes have:

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Cancer-Causing HPV Found in 20 Percent of U.S. Teens and Adults

Human Papilloma Viruses (HPV) that cause cancers of the mouth and sexual organs are the most common sexually-transmitted diseases in the United States today, infecting 20 percent of people under age 60 (CDC's National Center for Health Statistics, April 6, 2017). The Communicable Disease Center estimates that these cancer-causing viruses infect 80 million Americans, with more than 14 million of the new infections occuring among teenagers. They found that almost 31,000 new cases of cancer each year from 2008 to 2012 were attributable to HPV and that most could be prevented with immunization.

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Power Napping Delivers Myriad Benefits

Power napping for an hour can help you to learn, remember and interpret more efficiently. Try to nap before having an important interview, writing a report or learning new concepts. Many employers such as Google, Uber, Zappos and PricewaterhouseCoopers provide facilities for their employees to nap during their workdays. Napping also helps athletes to recover faster after intense workouts. Meb Keflezighi, the 2004 Olympic marathon silver medalist and winner of the 2014 Boston Marathon, naps regularly.

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No Amount of Overweight is Healthful

Earlier this month, researchers at Boston University and Harvard reviewed three studies following more than 225,000 adults over age 50, for eight to 20 years, and showed that being even slightly overweight can increase your risk of dying by 6 percent, and in those who are obese, by a whopping 73 percent (Annals of Internal Medicine, April 3, 2017). The main causes of death are heart and lung disease and cancers, and the more overweight you are, the greater your chance of dying prematurely.

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Competitive Athletes and Doping

An important article in the May 19, 2017 New York Times discusses the latest accusations that some of America's top athletes are using supplements, both legal and illegal, in the hope that they will improve athletic performance. I will present a brief review of some of the supplements that the accused U.S. athletes are taking and comment on their effectiveness or worthlessness, side effects and potential dangers to their health. 

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Blood Pressure During and After Exercise

Editor's Note:  Dr. Mirkin's article today began as a response to one of our Premium MembersGreg C. wrote us: "I ride about 4,500-5,500 miles a year. This is the first year I've been monitoring my blood pressure after riding and noticed the systolic drops significantly after my rides. I typically run 110-120 over 70-80, but after rides it's sometimes barely above 95 over 60-70. Is this normal, or something to be concerned about?" After the reassuring response to Greg, Dr. Mirkin continued to write his typically thorough, educational piece that we have come to expect and enjoy. 

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Latest on Testosterone for Older Men

Earlier this month, medical journals reported the largest trials ever to examine the benefits and harms of taking testosterone for men over 65 with low blood levels of testosterone (less than 275 ng/dL). At 12 study sites across the country, a total of 790 participants were given testosterone gel or a placebo applied daily to the skin. Most of these men had low testosterone due to aging, not due to damage to the testicles or brain where testosterone levels are controlled. Over a year, investigators measured the effects of testosterone on: 

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Don’t Get Baked In The Summer

I raced the Furnace Creek 508 through the Mojave Desert and Death Valley in 1989 and 1993. I set a course record and won both times. I raced for over 30 continuous hours in each of those two races. The 508-mile race, with 35,000 feet of climbing, is a qualifier for the Race Across AMerica. I wasn’t the fastest rider—many would have beaten me in a 40-km time trial. I wasn’t the lightest rider, nor was I the best climber. But I was the smartest about riding in the heat! Here’s what I learned about racing in the heat, which I’ve "road tested" as a coach working with ordinary roadies over the years since.

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What Causes Belly Cramps in Cyclists vs. Runners

When it comes to belly cramps, cyclists are different from runners. The most common cause of belly camps in a cyclist is stool in the colon. In runners, it is a stretching of the ligaments from the diaphragm that holds up the liver. Fit athletes rarely suffer discomfort from small amounts of food in the stomach. 

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