DEAR DR. DONOHUE: I am 34 and play in an adult men’s hockey league. Our season is over, but I have a groin pull. At least, that’s what I’ve been told I have. What is that? It’s getting better, but I wonder how long it takes to heal. Should I see a doctor? – R.K.

ANSWER: Let’s define what the groin is. It’s the crease where the thigh joins the lower abdomen, and usually it’s reserved for the inner part of that crease. It does not include the genitals, as many mistakenly believe. Sports announcers love to make the diagnosis of a groin pull from distances that don’t permit experts to make such pronouncements.

Groin pulls are like shin splints, a nebulous diagnosis that covers many different injuries. They are common in all sports, but especially in hockey, soccer and football, where cutting movements are important and where there are many accelerations and decelerations.

One such injury is a strain of the adductor muscles. The adductor muscles are on the inner part of the thigh, and they are attached to the pubic bone, the front pelvic bone. They draw the legs together. You should be over an adductor strain in three weeks.

The strong abdominal muscle also attaches to the pubic bone, and it can pull away from its attachment. It, too, should heal in three weeks. If it lasts longer, a doctor must be consulted, for it could require reparative surgery.

The two pubic bones, which are involved in many groin conditions, meet in the middle of the body and are joined to each other by tough tissues. The union of those two bones can pull apart due to the forces generated on the bone from the muscles attached to them. It, too, is something that should heal in less than a month.

This is only a sample of injuries referred to as “groin pulls.” I know you’re not going to be able to distinguish among the many possibilities. The only thing you have to remember is to consult a doctor if your groin pain hasn’t responded to the simple measures of heat, rest and anti-inflammatory medicines (Aleve, Advil, Motrin) in three weeks.

DEAR DR. DONOHUE: I am currently incarcerated. Before I was locked up, I weighed 325 pounds. Now I weight 230. I work out in my cell doing pushups, jumping jacks, lunges and crunches. I have lots of loose skin, and I mean a lot of it. Will I ever get rid of the loose skin? Inmates tell me to go back to being fat because that loose skin isn’t going anywhere. Will giving up white bread, mashed potatoes and white rice help? – B.E.

ANSWER: I am sorry to tell you that there is nothing short of surgical removal that will get rid of skin that has been stretched past its elastic limits. No change of diet will shrink that skin. It’s not a terribly involved procedure to remove it.

Don’t go back to your former weight. Loose skin is not a health issue. Fat is.

DEAR DR. DONOHUE: Does exercise increase your metabolic rate? I mean, can a person who exercises regularly eat a whole lot more without gaining weight? It hasn’t worked for me. Why not? – L.L.

ANSWER: The metabolic rate is a measure of how much energy you burn in 24 hours, sort of like your gas mileage. You burn calories just by breathing and pumping blood. That’s called basal metabolic rate, and it accounts for at least half of people’s daily calorie-burning. You can’t do anything about your basal metabolic rate. Digesting food also burns calories. Exercise accounts for 30 percent to 40 percent of calories burned. You can do something about your exercise. You have to increase the intensity or duration of your exercise, and you will lose weight if you don’t increase your calorie consumption.

Muscles are active even at rest. So I take back what I said about not being able to increase your basal metabolic rate. If your muscle mass increases, you will burn more calories.

DEAR DR. DONOHUE: I have been diagnosed with congestive heart failure. Three months after the diagnosis, I began to become fatigued after slight exertion, and was short of breath. I’ve had to have a pacemaker implanted. I was told I probably have amyloidosis, the senile form. Is there any hope of my living a near-normal life? – L.M.

ANSWER: Amyloid is a protein produced by bone marrow cells. It can infiltrate a number of body organs. Many forms (20) of amyloidosis exist, and they all have distinctive longevity projections. Senile amyloidosis does not affect as many organs as do the other forms of this illness, so that is one thing in your favor. In this illness, when the amount of amyloid in the heart is great, the heart’s pumping action falters, and congestive heart failure is a consequence. Amyloid deposits often interfere with the generation and transmission of the electric signals that regulate heartbeats, so a pacemaker can be needed.

I can’t give you a prediction about the length of life. Of course, your life span is bound to be affected, but how greatly, no one can tell with certainty.

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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