DEAR DR. DONOHUE: I look forward to a summer of golf, but I don’t look forward to a summer of shoulder pain. I come down with it every year, especially my right shoulder. I am right-handed. Do you have any hints on what I can do not to get it this year? – D.M.

ANSWER: The golf swing requires both shoulders, both hips and the back to rotate through a very large arc. The head of the upper arm bone, the humerus, is a ball that fits into a depression on a bony projection of shoulder blade. That depression is a socket that accommodates the ball-shaped head of the humerus and the two bones make up the shoulder joint. Holding the head of the humerus into its socket are four tendons that sweep around the shoulder joint from back muscles. Those tendons constitute the rotator cuff, and that’s where I think your pain comes from. The pain is always worse in the dominant arm.

Constantly swinging a golf club inflames and swells the rotator cuff tendons. They crowd each other and impinge on adjacent bones. That produces shoulder pain. The pain worsens when you swing the club behind you and whenever you stretch your arms upward. The pain keeps you from making a large arc. The smaller the golf swing arc, the less force you apply to the ball and the less distance you hit it.

Start limbering those tendons right now. Hold a towel behind you. Specifically, your right hand is behind your neck holding the top end of the towel. Your left hand is behind your back at waist level and holds the bottom end of the towel. Hold both ends tightly and have your left hand pull the towel downward so your right hand and right arm are also pulled downward. When you feel a strain in your right shoulder, you know you are stretching the rotator cuff tendons. Hold that position for 15 seconds, relax and repeat the procedure 10 times. Then switch arms, so you stretch the left rotator cuff tendons.

The shoulders are not the only structures that a golf swing stresses. The hips and the back suffer too. They should also be stretched and strengthened.

DEAR DR. DONOHUE: My husband and I began an exercise routine at a local gym six months ago. While we are both getting good results, I would like to know the benefits of taking extra protein supplements. We have a good diet and are not overweight. – M.N.

ANSWER: People who eat a well-balanced diet get more than enough protein. For example, a person who weighs 160 pounds (73 kg) needs only about 1.9 ounces of protein a day, a tiny amount. Three ounces of beef has 1.7 grams of protein. Three ounces of beef is the size of a deck of cards, a couple of mouthfuls for most men. You don’t have to go out of your way to meet the daily protein requirement.

If a person is engaged in really hard physical exercise or labor, that person can stand twice the recommended amount of protein.

There is an allure to protein. Muscle is mostly protein, so eating protein would logically equate with muscle building. It doesn’t – at least in large quantities it doesn’t.

DEAR DR. DONOHUE: I am a person who hates to exercise. I am 62 and have osteoarthritis every place a person can have it.

If we need to exercise to get our heart rate up in order to benefit the heart, why can’t we take a pill that speeds the heart? Wouldn’t we get the same benefits? – C.G.

ANSWER: That’s a nice thought and it makes some sense, but it doesn’t work. If it did, watching a scary movie would be considered exercise.

In addition to raising the heartbeat, exercise makes the heart pump harder with each beat. A pill doesn’t. Neither does a scare. It is the combined elements of a faster beat and a harder beat that gives the heart the exercise it needs.

DEAR DR. DONOHUE: I am a 70-year-old woman. My doctor has instructed me to take 1,500 mg of calcium along with vitamin D every day. I eat healthy, but I don’t think I eat the recommended amounts of vegetables each day, so I take a multivitamin daily. It has calcium and vitamin D in it. I also take a tablet that contains 500 mg of calcium and 200 IU of vitamin D three times a day. The daily totals come to 1,662 mg of calcium and 1,000 IU of vitamin D. On the Internet, I saw that 600 IU of vitamin D is the recommended daily intake for me, and a booklet says people should not take more than 2,000 IU of the vitamin. Someone told me that for calcium to be absorbed, I need to take calcium and vitamin D at the same time. I am really confused. I would appreciate some help. – N.W.

ANSWER: The recommended daily amount of vitamin D for people 70 and older is 600 IU. Vitamin D enhances the absorption of calcium from the digestive tract. The upper limit for the vitamin is 2,000 IU a day. You take more than the currently recommended amount but less than the upper limit. You’re fine.

Many experts feel that the recommended amount of vitamin D is too low. They want someone like you to take 1,000 IU – the amount you take. You’re ahead of the crowd, and you’re not putting yourself in danger by taking that much vitamin D. The amout of calcium recommended for older people is 1,200 mg to 1,500 mg a day. The upper limit for daily calcium is 2,500 mg. Your calcium intake is a bit higher than the recommended but not enough to cause trouble. You can safely continue with it too.

Vitamin D and calcium do not have to be taken at the same time for calcium absorption. The vitamin has a long half-life, 10 days. Say you take 600 IU of the vitamin on Day 1. Ten days later, there is still 300 IU in your blood. You also take 600 IU on Day 2, 3 … and 10. There’s more than enough vitamin D around to assure that calcium gets into your blood. The reason why the manufacturer includes 200 IU of vitamin D with 500 mg of calcium in a single tablet, taken three times a day, is to ensure that people get their daily requirement of both the vitamin and calcium. It’s better to take only 500 mg of calcium at one time. The absorption is not 100 percent if 1,500 mg of calcium is taken as one dose.

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

Copy the Story Link