DEAR DR. DONOHUE: Help! I have sprained my ankles three times in three years – the right one twice and now the left. What can I do to strengthen them? – P.L.

ANSWER: A sprain is ligament damage. Ligaments hold joints together. The more common ankle sprain happens from the foot turning under so the outer side of the ankle is bent to the maximum and all the body weight comes down on the turned ankle.

With a grade 1 ankle sprain, no ligament fibers are torn, but they are stretched to the extreme. The ankle swells and is mildly painful, but no bruises appear on the skin. A grade 1 sprain heals in one to three weeks. A grade 3 sprain, the worst kind, causes severe pain and great swelling. Bruises are seen on the skin. The injury does not allow any weight to be put on the foot. It takes months for this injury to heal. A grade 2 sprain falls between these two.

Immediate sprain treatment is RICE – rest, ice, compression and elevation. An ice pack should be applied to the injury for 15 minutes three times a day for the first 48 hours. Compression is achieved with an elastic wrap.

An ankle brace proves helpful in prevention of sprains if they are sports-related.

To strengthen the ankle once it has healed, lie on your side with the previously injured leg on top of the uninjured one. Turn the foot upward and hold that position for five seconds. Then return to the starting position for three seconds. Perform eight to 12 repetitions three times a day. Once you’ve gained some skill, add a 1-pound weight to the foot.

Balance is something that keeps ankle injuries to a minimum. A good balance exercise is one performed in a doorway where you can right yourself quickly if you’re about to fall. Stand on one leg. Swing the other leg in front of you like a pendulum. Then switch legs. Do as many exercises as you can as often as you can during the day.

DEAR DR. DONOHUE: I read your column about tennis elbow and thought you might like to have some additional information from a retired orthopedic surgeon. When associated with tennis playing (not all tennis elbow is), there are several direct relationships that players can address: a too-tightly strung racket, a too-stiff racket, an oversized grip, an improper placement of fingers on the grip and an improper backhand technique. – J.J.

ANSWER: Readers and I thank you, doctor, for taking the time to furnish this information.

DEAR DR. DONOHUE: Shortly after having a bypass operation some 10 years ago, I was informed that I needed a pacemaker. I am now 80. Recently I had to have the battery replaced. Now I can get my heart beating only to a maximum of 108 beats a minute during exercise. Am I getting any benefits from exercising at such a slow heart rate? – L.N.

ANSWER: Definitely you are. You’re at more than 75 percent of your maximum heart rate. That puts you at the high end of your training zone.

Sometimes I think we go overboard on using heart rate as the criterion of beneficial exercise. We can use subjective judgment just as effectively. If the exercise feels moderately hard, it is, and that’s enough indication that the exercise is beneficial.

DEAR DR. DONOHUE: How long after eating should one wait to exercise? And how long should one wait after exercise before eating? – A.D.

ANSWER: If a person eats a huge meal, he or she should wait three hours to exercise. If it’s a light meal, the person can exercise almost immediately after eating.

You don’t have to wait any interval after exercising before you eat, as long as you feel like eating. Eating soon after exercise quickly replenishes the muscles’ stored sugar.

DEAR DR. DONOHUE: For 20 years, my doctor has told me that my white blood count is low. I am 82. What can I take to improve the count? – L.F.

ANSWER: You might not need to. In those 20 years, has anything bad happened to you? Have you had one infection after another? If not, you don’t have a worry. White blood cells fight infections. There isn’t a lot you can do about raising the count.

READERS: For the many readers requesting information on asthma, the booklet on that topic gives succinct coverage of what happens and how to stop attacks. To obtain a copy, write: Dr. Donohue – No. 602, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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