DEAR DR. DONOHUE: I play basketball – a lot. My right knee has started to hurt. It hurts the most when I start to play, and then it eases off. My coach and dad say it is jumper’s knee. My coach says to play through it. My dad says I should rest it. What do you say? – B.J.

ANSWER: Give me a break. What do you think I’m going to say? I side with your dad.

At the start of every basketball season, I get many letters asking about jumper’s knee. It’s a common malady of that sport, but it affects players in many other sports, like volleyball. The forces on the knees and the knee tendons when a jumper lands on the ground can be greater than nine times body weight. That’s a great deal of force.

Jumper’s knee is an inflammation of the tendon that runs from the bottom of the kneecap to the top of the lower leg bone. The inflammation comes from too much use with too little rest. It gradually builds up over two to three weeks before a player starts to complain. Early on, the knee hurts the most when a player starts to move around and gradually lessens as he or she continues to play. If you don’t let the inflammation quiet down, the pain will worsen and last longer. At its worst, it is present even when you’re sitting.

If you press on the area beneath the kneecap, you’ll find it is tender if you have jumper’s knee.

A week or two of rest is all that’s needed in the early phases. Combining rest with Aleve, Advil or Motrin can speed the healing.

When you get back to playing, apply heat to the knee for 10 or 15 minutes before you start. After you play, ice it for the same amount of time.

I respect both your dad’s and your coach’s diagnostic abilities, but, if things don’t turn around shortly, I’d have a doctor examine your knee. Too many other things cause similar pain.

DEAR DR. DONOHUE: I have a personal trainer because I must lose some weight. I can’t do it on my own. I have tried many times. I need someone to push me. My trainer has mentioned core exercises many times. I don’t want to look dumb by asking her what they are, but I can ask you. What are they? – M.J.

ANSWER: The core muscles are the muscles between the ribs and the pelvis, front, back and sides. Core muscles maintain stability when you move your legs or arms. They transfer energy from your legs to your upper body. They’re important in all sports.

Stability balls are often used for core exercises. They’re big balls, 14 to 34 inches (35 to 85 cm) in diameter. The core muscles keep you on the ball. One excellent exercise on a stability ball is done by lying facedown on the ball with the fingers and toes supporting the body. Raise the left arm and right leg off the floor simultaneously. The core muscles work really hard to keep you on the ball. Lower them and then raise the right arm and left leg off the floor. A series of eight to 12 raises is good core training.

DEAR DR. DONOHUE: I walk half an hour each morning. Lately, I have experienced chest pain, followed by gas and sometimes heartburn. The same thing happens when I shovel snow. I am 81 and do not take any medicines. I have had all the lung and heart tests without any problems showing up. What do you think this is? – F.O.

ANSWER: When you say “all the tests,” does that include a stress test, the test taken while you walk ever faster on a treadmill and an EKG is constantly taken? If not, you need one. In fact, even if you have had a stress test, go back to the doctor. Undiagnosed chest pain that comes with exertion makes me leery of heart disease. Don’t give up the pursuit of trying to find an answer.

DEAR DR. DONOHUE: I am a 69-year-old man with hypertension. I keep track of my pressure with a home automatic readout pressure monitor. It has been checked at the doctor’s office. Why is the blood pressure in my right arm consistently 20 to 25 points higher than that in my left arm? – J.D.

ANSWER: A 10-point discrepancy between the readings in the two arms is normal. Some even consider a 20-point discrepancy acceptable. (A few say 40 points is OK.)

Your difference is at the limits of normal. The lower reading can indicate a blocked artery in that arm. You should inform your doctor of this.

The higher reading is the official blood pressure reading.

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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