DEAR DR. DONOHUE: We have our own backyard swimming pool, and my daughter has taken to swimming like a fish. She has dreams of the Olympics, but her shoulder has bothered her this summer. How can we help her? – J.W.

ANSWER: Shoulder injury is the bane of swimmers. During a lifetime of swimming, more than 70 percent of swimmers have to contend with one or more shoulder problems. It’s no wonder. A competitive swimmer in training often performs more than 1 million shoulder rotations every week. That’s an enormous amount of stress to put on the shoulder.

Your daughter’s swim stroke might be compounding the problem. Holding the head too high out of the water puts the shoulder at a mechanical disadvantage and adds to shoulder stress. If the fingers, not the thumbs, do not enter the water first, the shoulder is stressed. The stroking arm should never cross over the middle of the body. With each stroke, the body should twist 45 degrees to minimize shoulder stress. I am not a swimming coach. I am only parroting information. Have a coach examine your daughter’s swimming form and suggest needed modifications.

Strong shoulder muscles protect the shoulder joint. When she has no pain, she can begin a program of muscle strengthening that includes the following exercises.

With the arms hanging down straight alongside the body, she holds on to a 2-pound dumbbell, with the palms of her hands facing forward. Keeping her elbows straight, she raises the dumbbell to shoulder height and then slowly returns it to the starting position. She performs as many lifts as she can until fatigue sets in, then takes a rest and repeats another set of lifts.

Another good exercise is one done sitting on the edge of a sturdy chair that has arms. Have your daughter put her hands at the ends of the chair arms and lift herself upward by straightening her elbows. When she has lifted herself to maximum height, have her hold that position for two seconds, lower herself back down and repeat as many times as possible.

DEAR DR. DONOHUE: You had an article on swimmer’s ear that caught my attention some time ago. I cut it out. I have lost the article. Would you be so kind as to repeat it? The season for swimmer’s ear is upon me. – K.K.

ANSWER: Swimmer’s ear comes from softening of the ear canal by water, which, in turn, promotes bacterial and fungal invasion.

Drying the canal after each swimming session is essential for prevention and cure. If water won’t come out of the canal when the head is tipped, the edge of a towel carefully inserted into the canal can often draw it out.

Eardrops made by mixing equal parts of white vinegar and rubbing alcohol keep the canal dry and germ-free. Alcohol is a drying agent. Vinegar gets rid of bacteria and fungi.

Two drops of the mixture two or three times a day can usually prevent or treat simple swimmer’s ear. Let the drops stay in only for a minute or two and then turn the head so they drain out.

If the ear is severely inflamed or painful, then self-help is not wise. Let the family doctor take care of that sort of involvement.

DEAR DR. DONOHUE: I believe in fasting, both to lose weight and to purge poisons from the body. Is there any scientific support for my belief? I am quite active physically. – G.K.

ANSWER: None that I know of. Fasting is not a good way to lose weight. Fasting throws the body into a calorie-conservation mode and makes weight loss difficult. Furthermore, fasting leads to loss of muscle weight.

The poison theory leaves me cold. Our bodies have been designed to eliminate any wastes that arise from body metabolism. Fasting does not improve their admirable janitorial skills.

DEAR DR. DONOHUE: My grandson has come down with Kawasaki disease. I looked for information about it on the Net, and the more I read, the more concerned I became. Quite often the information stated that permanent heart damage would result. Will you straighten this out for me? I am quite worried. – S.J.

ANSWER: Kawasaki disease – named after Tomisaku Kawasaki, a Japanese physician who was the first to describe it in 1967 – is a childhood illness that is being diagnosed with greater frequency now that more doctors have learned to recognize its symptoms. More than 80 percent of cases occur before age 5, and the majority, before age 2.

An as-yet-unidentified germ is the suspected cause. Researchers have tried to find the germ for the past 40 years, and eventually they will succeed.

Infected children break out in a rash that has a wide variety of shapes and sizes but always has a red color and almost always involves the palms of the hands and the soles of the feet. Temperature rises. The lips are dried and cracked. The tongue turns strawberry red. The whites of the eyes redden, and children can be sensitive to bright light. In the second or third week of the illness, the skin peels just as sunburned skin does.

The feared consequence of Kawasaki disease is aneurysm formation on heart arteries. Aneurysms are bulges on the arteries, and they represent weak spots that can spontaneously break, with disastrous consequences. Untreated children have a 25 percent chance of developing aneurysms. Treated children have less than a 5 percent chance of forming aneurysms. The aneurysms are detected by sound wave pictures of the heart, and I am sure your grandson already has had one done or will shortly have one.

Treatment consists of aspirin and intravenous gamma globulin – protein antibodies taken from a pool of donors. The illness lasts four to eight weeks.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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