DEAR DR. DONOHUE: My 14-year-old granddaughter has been playing soccer for seven years. She has experienced leg cramps (her calves) off and on in the past few years. We attempt to prevent the cramps by having her drink at least two quarts of water a day, along with eating a banana. It hasn’t helped. Does cold weather provoke cramps? – C.G.

ANSWER: Attention, readers: The muscle cramps talked about here are not the muscle cramps that happen in bed at night. These muscle cramps are exercise-associated muscle cramps. Granted, a cramped muscle is a cramped muscle. However, nocturnal muscle cramps happen to older people. Exercise muscle cramps happen to younger people while they are playing or practicing a sport.

Why muscles cramp during exercise hasn’t been explained to everyone’s satisfaction. One explanation is that they come about from a depletion of sodium, potassium or magnesium and that prevention lies in replenishing these minerals. Your granddaughter might find that a sports drink, like Gatorade, with all those minerals might keep her muscles cramp-free. (Bananas are a good potassium source, and she can continue to eat them as she has done.)

Another theory is that dehydration encourages muscle cramping. Your granddaughter takes pains to stay hydrated. When is she drinking these two quarts of water? If she drinks them early in the day, she’s going to lose that fluid through natural elimination. The body doesn’t have a water tank. She should drink a little more water closer to game or practice time. This would be a good time for her to substitute the sports drink for water.

A third explanation is that muscle fatigue is responsible for muscle cramps. It’s impossible to fight fatigue during a sporting contest. But athletes can make sure their muscles have plenty of stored energy in the form of muscle glycogen – muscle sugar – by eating a high-carbohydrate diet the day before and the morning of a long practice or a game.

I haven’t heard of cold causing muscle cramps. I have heard of heat being responsible for them.

Stretching and massaging a muscle that has cramped usually can pull it out of a cramp quickly. If your granddaughter feels one coming on, she should immediately stretch and massage the muscle before the cramp hits.

DEAR DR. DONOHUE: I am an active 67-year-old. I walk two or three miles a day on my treadmill. Walking has reduced my stomach and waist; however, it has increased my thighs. This makes me very unhappy. Is there another beneficial exercise for my thighs? – M.S.

ANSWER: Are you positive your thighs have actually increased in size? Could it be that you notice them more because your waist is smaller? What makes me ask is the fact that you are not putting fat on your thighs through exercise. If you’re adding inches, it must be muscle. It is difficult for a woman of your age to add so much muscle to the thighs simply from walking.

I have another piece of bad news. It is impossible to reduce a particular body area through exercising that area only. Fat is lost from all the body’s fat-storage places. I don’t have an exercise for you. I want to encourage you to continue with your treadmill walking. It’s good for your heart and your weight.

DEAR DR. DONOHUE: I was recently hospitalized for pancreatitis. Everything I can find about it says it’s caused by drinking alcohol. The doctors kept asking me if I drank now or in the past. I might have had 12 to 15 alcoholic drinks in my 64 years. What else causes this problem? – R.M.

DEAR DR. DONOHUE: What happens in pancreatitis? My husband had it. He is not a drinker. – C.K.

ANSWER: Many things can cause pancreatitis – inflammation of the pancreas. Alcohol is only one of them. A gallstone that blocks the duct that drains both the gallbladder and the pancreas is the No. 1 cause. Any abdominal injury can cause it. So can high blood triglycerides or high blood calcium levels. Some medicines can bring it on. A number of viruses are able to inflame the gland – mumps and coxsackie are two of them. An immune attack on the pancreas is another possibility.

The pancreas makes enzymes that digest carbohydrates, fats and protein. Nature has given it a protective barrier that keeps these enzymes from digesting the gland, or cannibalizing itself, so to speak. If the barrier is disrupted, whatever the cause, the pancreas falls victim to its own digestive enzymes: pancreatitis.

There are about 185,000 cases of it yearly in the United States. An attack can be one of life’s most painful experiences. It starts with steady, boring pain around the navel, and the pain bores into the back or spreads to the chest, the side or the lower part of the stomach.

Most people – close to 90 percent – get over the attack without any permanent damage to the pancreas. A few, however, have continued pancreatic problems. Treatment of the first attack is to rest the pancreas by feeding the patient intravenously.

If people continue to grill you about alcohol use, rattle off all the possible causes and tell them their knowledge of pancreatitis leaves much to be desired.

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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