DEAR DR. DONOHUE: What’s your take on massage? — B.J.

My take? I can’t find a whole lot of scientific studies to support or to condemn massage.

Proponents say it increases circulation to sore muscles and speeds healing. It drains swelling fluid out of tissues. It’s said to increase muscle flexibility. It can lessen pain.

Skeptics say none of this has been definitely proved.

There is a sophisticated, specialized kind of massage that’s very useful in ridding swollen limbs of accumulated fluid – lymphedema. That fluid often forms after cancer surgery when lymph nodes and lymph vessels have to be removed. People who are skillful in this kind of massage receive specific training, and they are frequently successful in reducing such swelling. For regular massage – the kind you’re talking about – 33 states require a license. In those states, licensed masseurs and masseuses have been schooled in massage techniques and have taken qualifying examinations.

My opinion? I have had a sore spot that, on two separate occasions, massage has relieved. I’m for it. If, of course, a massage hurts, stop it. Furthermore, an inflamed, swollen and painful joint is something massage doesn’t help and could hurt.

DEAR DR. DONOHUE: Sometimes when running, I get a sharp pain on my right side under my ribs. What causes it? How should I handle it? – N.N.

That pain is a side stitch. No one is positively sure why it happens. It might be a cramp in the diaphragm, the horizontal muscle that separates the chest from the abdomen and that serves as the principal breathing muscle.

There are a couple of ways runners can handle a side stitch. One is to purse the lips to form a fish mouth and breathe in and out through those pursed lips. Some insist that raising the arm over the head on the side of the side stitch gets rid of it. Many dig their fingers into the painful spot and keep firm pressure on it until the pain subsides.

DEAR DR. DONOHUE: I had been running two miles a day for more than three years. I decided to up my mileage, and began running five miles a day.

That undid me. I have pain on my inner left shin that stops me from running. I’m OK at rest. I don’t want to get out of shape waiting for it to go away. What do you think this is, and what can I do for it? Is it shin splints? – W.D.

“Shin splints” is such an all-inclusive word and such an indefinite one that I have stopped using it. It’s applied to any pain between the knees and the ankles. There are too many things that cause pain in that area to label them all “shin splints.”

The one specific leg problem that I picked for you is something called medial tibial stress syndrome, MTSS. It appears in the inner shin area, the side of the leg that faces the opposite leg. It comes from overuse and, in your case, from the sudden increase in your mileage. You can test yourself for this syndrome by rising on your toes. If doing so increases the pain, that’s a pretty good test to confirm MTSS.

In addition to overuse, most runners who fall victim to this condition roll their foot inward when it strikes the ground. Doing so causes leg muscles to tug on the bone covering – the periosteum. That irritates the covering and produces pain.

You have to rest until the pain goes. To stay in condition, it’s OK to pedal a stationary bike. Anti-inflammatory medicines are helpful. If your feet roll inward on ground strike, a shoe insert can prevent them from doing so.

DEAR DR. DONOHUE: Since taking up bodybuilding, my arm veins have become quite prominent and have bumps in them. Is this bad? – N.R.

It’s normal. Exercise makes arm veins prominent. Those bumps you see are vein valves, and they’re supposed to be there.

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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