DEAR DR. DONOHUE: My son plays high-school basketball. He developed a pain in the back of his left ankle. The doctor says it is an inflammation of his Achilles tendon. He told my boy to ice it. For how long? Can he do anything else? — O.T.

ANSWER: Usually, two days of icing is standard for an acute injury. After that, switch to heat. The source of heat can be hot water, a heating pad or hot compresses.

Professional athletes often use contrast baths for tendon inflammation, muscle strains and ligament sprains. You have to have two basins or buckets that his foot fits into comfortably. Fill one with hot water at a temperature of 100 F (37.7 C) and the other at 50 F (10 C). Your son plunges his foot up to and including the sore area of his heel into the hot water for four or five minutes and then into the cold water for one minute. He continues to do this four times, and he repeats the ceremony two or three times a day.

Rest is equally important. It doesn’t have to be total rest, but he shouldn’t do anything that hurts. If walking hurts, he ought to use crutches.

He needs to continue this until he is pain-free before he attempts playing basketball again.

TO READERS: The booklet on Aerobics and Fitness provides instructions for newcomers to exercise to learn how best to go about devising for themselves an exercise program. To obtain a copy, send a check or money order (no cash) for $4.75 U.S./6$ Can. to Dr. Donohue — No. 1301, Box 536475, Orlando, FL 32853-6475. Enclose the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I swim for my school and have hopes of getting a college scholarship. My left shoulder bothers me some. (I’m right-handed, if that makes any difference.) What should I do? — K.M.

ANSWER: Shoulder problems afflict many swimmers. Some swimming strokes put a great deal of stress on the shoulder joint. A host of problems result — torn rotator cuffs, inflammation of the biceps tendon at the shoulder and compression of tendons and ligaments between the shoulder bones, a condition known as impingement syndrome.

The most sensible thing for you to do is to take a two-week rest. That ought to be enough time to calm your shoulder. An anti-inflammatory drug like Aleve, Advil or Motrin is a good idea. You’re past the stage when icing your shoulder would be useful. That only helps in the first two days after an injury. Now apply heat to it for 15 minutes at a stretch and do so three or four times a day.

Some swimming strokes lead to uneven development of muscles that control shoulder movement. Many strokes strengthen the chest muscles and muscles that turn the hand to the thumb side when it enters the water. Once your shoulder stops hurting, an overall upper-body strengthening program will prevent a recurrence of shoulder pain.

You also should have your coach analyze your strokes to see if simple changes will stress your shoulder less.

If after two weeks of rest the shoulder still isn’t 100 percent, you need a doctor’s evaluation for a diagnosis of the exact problem.

DEAR DR. DONOHUE: Which swimming stroke provides the best exercise? I’m trying to lose some weight, and I want to know the stroke that burns the most calories. — P.S.

ANSWER: I have to rely on others for this. I’m not exactly material for the next Olympic swim team.

I am told the crawl and the butterfly strokes burn the most calories. They’re reputed to burn 750 calories for one hour of swimming for a person weighing 150 pounds.

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

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