DEAR DR. DONOHUE: I have two problems with the game I love – golf. Last year, my lower back started hurting right at the beginning of the season and wouldn’t let up until I took a full month off. This year it’s my right shoulder. What’s causing the pain? – J.F.

ANSWER: A probable explanation for the shoulder pain is irritation of the rotator cuff tendons, tendons that come from upper-back muscles and wrap around the shoulder to keep the shoulder’s head in its socket.

An explanation for the back pain is similar. It’s probably a strain of the lower-back muscles.

The golf swing is a huge arc through which the shoulders, lower back and hips must rotate. Repetitively making that motion irritates tendons and muscles. Some tendon and muscle fibers are damaged.

If your shoulder is without pain, try this exercise to keep it limber: Hold on to a towel with your left hand. The hand is behind the head. Grab the bottom of the towel with your right hand behind the back at about waist level. Inch the right hand upward. When you feel things stretching, hold that position for 10 seconds. Then relax and repeat the exercise 10 times. Reverse hand positions and start the exercise over.

For your back, sit on the floor with your right leg straight out in front of you. Cross the left foot over the right knee and let it come to rest on the floor next to the knee. Support yourself with your left hand on the floor. Now turn your head, right shoulder and waist as far to the left as you can and, when you reach that position, hold it for 20 seconds. Repeat two more times, and switch leg positions and turn to the right.

This sounds terribly complicated. I tried it, and I can follow the instructions OK. I’m sure you’ll be able to do so too.

DEAR DR. DONOHUE: What is my ideal weight? I am 5 feet 7 inches tall. My body is on the borderline between a normal and stocky frame. I walk one hour a day. I am 78. – J.B.

ANSWER: For a healthy body mass index – an indication of a good proportion of muscle and fat weight – you should weigh around 165 pounds. That gives you a BMI of 24.9 – normal. Older people can actually weigh more. Body mass index is more liberal at older ages.

DEAR DR. DONOHUE: My knee has been on the bum for about three weeks. I don’t know what I did to it. I can’t recall any injury. I’m afraid that my leg muscles are going to shrink if I don’t exercise them. What kind of exercise can I do that exercises muscles but doesn’t hurt the knee? – W.W.

ANSWER: Forget exercise and stop worrying about muscle shrinkage. Your first concern should be finding out what’s wrong with your knee. Three weeks of pain is too long to go without an explanation. The knee is a complicated joint, and many things can go wrong with it, so I’m not going to try to guess. You need a doctor’s examination.

However, while you’re waiting for the verdict, you can exercise your leg muscles by sitting on the floor with your legs out in front of you. Tighten the thigh muscles and hold the tightened position for 20 seconds. Relax the muscles and repeat the tightening procedure 10 times. Do the same for the calf muscles. If you do both exercises three times a day, you should preserve some muscle strength.

DEAR DR. DONOHUE: When I lose weight, it comes off my face. I want to lose it from my stomach. A few pounds of weight loss make me look gaunt. What can I do to keep my facial fat? – R.R.

ANSWER: When people lose weight, they lose fat from all fat deposits. A small amount of fat lost from the face can make some people look like a skeleton. The same amount of fat lost from the waist is hardly detectable. I admit that I don’t know any way to prevent this. Nature can be most unfair.

DEAR DR. DONOHUE: I’m a man who has a woman’s problem – hot flashes. They feel like someone has thrown a blanket over me. They don’t last long, but I’m told my face turns red too. They’re embarrassing and annoying. What’s going on? – J.R.

ANSWER: Hot flashes aren’t for women only, even though menopause is their No. 1 cause. Let me mention three rare conditions that should bring you to your doctor in spite of their rarity. One is carcinoid syndrome. A tumor found in the intestines or airways is responsible for it. The tumor secretes a mix of chemicals that causes hot flashes, blushing, often diarrhea and sometimes wheezing.

Pheochromocytoma (FEE-oh-CROW-moe-sigh-TOE-muh) is a tumor of the adrenal gland that synthesizes hormone-like substances that bring on hot flashes, sudden increases in blood pressure, throbbing headaches and palpitations.

The third infrequent cause is mastocytosis, a condition in which there are too many specialized cells called mast cells. The product of these cells leads to hot flashes, sometimes itching, sometimes abdominal pain, often headaches and occasionally wheezing.

The chances that you have one of these are slim, but mention your flashes to your doctor. More commonly, flashes result from eating foods such as tomatoes, spinach, some cheeses, chicken liver, beefsteak, alcohol and the universal flavoring agent monosodium glutamate. And even more commonly, there is idiopathic flushing. “Idiopathic” means the cause has not yet been discovered. Beta blocker medicines like Inderal can, at times, control idiopathic flushes. If the attacks are numerous and are interfering with your life, then thoughts turn to surgical procedures that cut nerves responsible for flushing and sweating. Such surgery can often be done with a scope and a few small incisions. It’s not as formidable as it sounds.

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. Readers may also order health newsletters from www.rbmamall.com.

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