DEAR DR. DONOHUE: I don’t have a sports-related injury. At least it didn’t happen while I was doing anything athletic. But it’s something that keeps me sidelined from jogging and distance walking. My left calf hurts when I walk — not a little, a whole lot. It’s a bit swollen, too. I’ve been icing it, and that has helped. What could this be? — R.B.

ANSWER: The calf is the gastrocnemius muscle. Tears of that muscle can explain your symptoms. Those tears often occur in sporting activities — when twisting the leg, shoving off on it or just running. The many moves a quarterback makes are examples of actions that tear the muscle. It also can occur during ordinary daily activities. I guess that’s when it happened to you.

Small muscle tears heal in a couple of weeks if you don’t aggravate them through overuse. Icing in the first two days is useful. It controls bleeding and takes down swelling. Large tears are injuries that require the attention of a doctor.

Swelling and pain just a bit up from the gastrocnemius could be a Baker’s cyst. It’s a bursa filled with fluid. The fluid comes from the knee and usually indicates a knee problem, like a torn cartilage or ligament, or arthritis. The usual answer to muscle, joint and inflammatory problems is NSAIDs, nonsteroidal anti-inflammatory drugs such as Aleve, Advil, Motrin and many others. Rest is important, not immobility, but curtailing any activity that hurts. If the pain and swelling aren’t responding, the bursa can be drained, and a cortisone medicine injected into it to prevent it from reforming. Bursas are disk-shaped structures wedged between tendons and bones. They prevent friction when tendons move over the bone.

Perhaps the most serious condition is a clot in a leg vein. Pain, swelling and skin redness are signs of one. This is something that can’t be ignored. Pieces of the clot can break loose from the main clot and be swept to the lungs through the circulation. Those pieces are pulmonary emboli, and they can be life-threatening.

You’ve self-treated this long enough. It’s time you consulted the family doctor.

DEAR DR. DONOHUE: Is there some kind of test I can give myself to see if I’m fit enough to do a rigorous exercise program? I’ve let myself go, but now I want to get into shape again. — H.L.

ANSWER: I need to know your age, your weight, and your medical and family history before I can give you an opinion on whether you are fit for demanding exercise. Your family doctor can give you that advice.

However, if, at the present, you do some exercise, one way to judge how healthy your heart is and how safe more-strenuous exercise would be for you to take your pulse immediately after exercising and again after one minute of rest. A fit heart should slow its rate by 12 beats a minute after a full minute of rest.

DEAR DR. DONOHUE: Please alert your readers to the dangers of lightning. My 19-year-old nephew was struck by lightning and was close to dying. He was hospitalized for three months and now is undergoing a therapy program. He was playing basketball with a friend when it started to rain. They continued to play. He was holding onto the pole supporting the basket when lightning struck it. — N.H.

ANSWER: Lightning kills more than 100 people yearly in Canada and the United States. A lightning strike can stop the heart and cause severe heat damage to many internal organs, including the brain. Close to 50 percent of lightning injuries occur during recreational activities.

If it begins to rain, people should get to a building or their car. If neither is around, avoid trees, poles or other tall objects. They act like lightning rods.

Leave high ground. Avoid any body of water. Assume a crouched position. It makes you a smaller target for a direct lightning strike.

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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