DEAR DR. DONOHUE: I did a very foolish thing. I joined a walking club. I am a 63-year-old woman whose only physical activity is taking care of our home. I thought I should be doing more exercise, so I joined the club. On my fifth walking day, I started to have pain on the top of my foot. I had to stop walking. The pain continued, and I saw our family doctor. He said I had a stress fracture and told me to stay off the foot and take Advil. I’d like to know more about this. How long does it last? — D.D.

ANSWER: Joining the walking club wasn’t foolish. The veteran walkers should have warned you not to keep up with them. Doing so led to your stress fracture. Stress fractures are small cracks in the bone. Most often, they’re due to a sudden increase in physical activity. Exercise breaks down bones. New and sturdier bones replace the old ones. If the level of exercise is too intense, the body cannot match its bone building with the bone breakdown. The result is a stress fracture.

Foot bones are targets for stress fractures. Army recruits frequently suffered from them until the Army changed its training methods. Foot bones are faced with the challenge of supporting body weight. Landing on the foot when taking a step puts about two or more times the force of body weight on it. When starting any exercise, you have to go at it slowly.

Most of these fractures heal in a month or two if you stay off the foot as much as possible.A cane or crutches, or even a cast, might be needed to provide enough rest for the fracture to heal. Icing the painful area for 10 minutes three times a day eases the pain and limits swelling. Once the pain has completely gone, you can resume your normal activities. And you can rejoin the club, but do so at a lower level of intensity. It would be a good idea for you to be checked for osteoporosis. You are at an age when osteoporosis can cause things like stress fractures.

DEAR DR. DONOHUE: What do you have to say about injections of platelet-rich plasma? One of my friends had this treatment for his Achilles tendon and said it worked like a charm. I have tennis elbow and have had it for three months. I have done all the things you’re supposed to do — icing, then heat, anti-inflammatory medicines and no tennis. I have played since I was a teen, and I play year-round. I never had this before. If I don’t get back on the court soon, I’ll forget how to play. — R.T.

ANSWER: Tennis elbow is damage to the tendons and ligaments that attach forearm muscles to the side of the elbow. Your program of rest, ice, heat and anti-inflammatory meds should have healed your elbow by now. You really ought to check with an orthopedic doctor.

Plasma is the liquid part of blood. It contains proteins useful for healing. For treatment, a small amount of blood is taken from a patient and spun in a centrifuge. That separates the blood cells from the plasma. The plasma also contains platelets, the tiny blood cells that form clots. These contain growth-promoting materials. The liquid is injected into the tendon to promote healing.

I can’t give you an honest appraisal, because the technique is somewhat new. Reputable doctors claim it is a wonder cure. Equally reputable doctors doubt that claim. I’m sure it won’t hurt you.

DEAR DR. DONOHUE: I swim and swim hard. I have gotten into the habit of weighing myself before and after I swim. I lose about a pound. Is that fat? — L.F.

ANSWER: It’s loss of body fluid through sweat. Swimmers do sweat. They don’t sweat as much as would a person who is exercising on land during a hot day. Fluid loss is the only way to explain such a loss of weight in so short a time.

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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