DEAR DR. DONOHUE: No matter the season, no matter the sport, I sprain an ankle at least once a year. People tell me I have weak ligaments. They fail to tell me how to strengthen them. Is there some way I can do that? I haven’t sprained my ankle yet this year, but I know it’s coming as soon as I start playing softball. ­- A.Q.

ANSWER: Do you have a clear idea of what an ankle sprain is? It’s a tearing of some or all of the fibers in a ligament or ligaments that hold a joint solidly in place. There are many ligaments that keep the ankle firm, and they are subject to great stresses when the foot hits the ground.

The slightest ankle wobble at the time of impact is enough for it to turn completely to one side, inside or outside, and tear ligaments. The ankle vies with the knee as being the most injured joint, and in most surveys it comes in first.

Some people do have weaker ankle ligaments than others. Having had one sprain makes a person more vulnerable to future sprains. You are among the vulnerable.

Exercises can make ankle ligaments more resistant to sprains. A simple one is done seated, one foot resting on the floor, the other foot straight out in front.

With the airborne foot, trace all the capital letters with the big toe acting as a pencil. Do it over and over. When that foot tires, switch to the other.

One-legged standing, with the other leg bent, is another way to strengthen the standing leg’s ankle. Try to stand for 20 seconds. You won’t be able to do so at first, but with practice you can. Switch legs and repeat the exercise as often as you can.

Walking toe-to-heel is another way to firm ankles. It helps if you vary the surface you walk on. At first, a flat, solid surface is best. Graduate to an uneven surface. If you live near a beach, toe-to-heel sand walking is excellent.

You might ask about ankle braces. I don’t know the answer. If they aren’t expensive, you can give them a try. I don’t believe, as others do, that they weaken ankles.

DEAR DR. DONOHUE: I am a 23-year-old female who has her first job after completing college. I am gaining weight since one of my duties is to take clients to lunch. Furthermore, I don’t have the time to exercise like I used to.

What time of day is best for exercise? I can do so early in the morning, but I’ve been told this isn’t a good time and that it is instead a dangerous time. What do you say? – A.J.

ANSWER: Any time that’s available for exercise is the best time to do it.

More heart attacks occur in the morning hours, but I haven’t read that those morning heart attacks occurred while people were exercising. A 23-year-old female generally is not a candidate for a heart attack. It could happen, but it’s not likely to happen.

Later in the day, body temperature rises and makes people a bit more flexible. That’s supposed to make them less apt to injure a joint. A higher body temperature also improves reaction times. All this is well and good, but it has no application to the kind of exercise you want to do.

Exercise when you can.

DEAR DR. DONOHUE: How soon after exercising can you build back your energy stores? I’m very interested in sports medicine, and I plan to make it my career. I’m also interested in nutrition. I’m a 14-year-old girl just finishing my freshman year in high school.

ANSWER:
Did you ever consider the field of sports nutrition? There is so much misinformation in that field provided by untrained people who know little about what they say that you would find yourself sought-after.

If you eat high-carbohydrate foods within at least six hours after depleting your muscles’ glycogen – their stored carbohydrate energy source – you replenish those stores quickly. Don’t wait until the next day to do this. High-carbohydrate foods are such things as pasta, breads, fruits and most grains.

DEAR DR. DONOHUE: Two years ago my husband was at death’s door due to a hemorrhagic stroke. Now he doesn’t do a thing his doctor told him to do. He takes blood pressure medicine, but he heavily salts his food, eats anything he wants and does none of the exercises he was told to do. What can I do? – K.C.

ANSWER:
You can do very little if your husband insists on ignoring the facts of life. Most strokes are due to a blockage in one of the arteries that bring blood to the brain. Those strokes are ischemic strokes. Your husband had a stroke due to a bleeding brain artery – a hemorrhagic stroke.

Such strokes comprise 15 percent of all strokes. They are frequently medical calamities. Only about 20 percent of people who have had a hemorrhagic stroke regain good function after it. He’s among a select few.

High blood pressure plays a major role in many hemorrhagic strokes. He should be monitoring his own blood pressure daily. He should be on a low-salt diet.

He needs to be on an exercise program to keep from gaining weight, another factor in stroke occurrence.

Your husband doesn’t know how lucky he is, or how unlucky he could be if he doesn’t shape up.

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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