DEAR DR. ROACH: I am a 77-year-old woman who has enjoyed good health. Several weeks ago, I fell off a stepstool while trimming a tree in the backyard, bruising the shin on my left leg. The bruising has all disappeared by now, but a large (quarter-size), hard lump remains on my leg. I massage it gently each day, hoping it will dissolve. Should I be concerned about this, or will it take care of itself in time? — P.L.

ANSWER: Bruising is caused by broken blood vessels internally. Although the body’s systems will clot the broken vessels, the blood can be visible in the area of the injury (or pulled by gravity to an area that’s lower than the injury) as a reddish/brown color, gradually changing to green and yellow as the blood is metabolized and reabsorbed.

In the case of the shin, the tibia bone is very superficial, and pretty easily can be damaged. If the blood vessels in the periosteum, the lining of the bone, are damaged, one can develop a periosteal hematoma, or a ”bone bruise.” These last for weeks and can be quite tender when they first appear. I suspect that it will disappear. If it doesn’t, go see your doctor.

Rarely, there is a bone tumor, which usually is benign but unfortunately isn’t always, that is brought to one’s attention by trauma at or near the area.

DEAR DR. ROACH: Would you please comment on high-school football coaches encouraging their players to use bodybuilding supplements such as creatine and others? Coaches want kids to bulk up to play high-school football. What happens to that body mass in five or 10 years, when physical activity slows? You would be doing a great service to millions of high-school students. I think these coaches should be reprimanded for the future harm they are doing to these high-school kids. — Anon.

ANSWER: Your question is about building muscle mass in young athletes, with the concern that they may become obese in later years. This isn’t necessarily true. Building muscle, through tremendous activity and weightlifting, can be somewhat increased by creatine, a supplement that is a key component of muscle. All this muscle activity burns calories, and football players eat a great deal just to keep up with calorie needs. (A large number of high-school athletes use anabolic steroids to build muscle, which I recommend against in the strongest possible terms.)

If the physical activity decreases, then food intake needs to decrease also, or the athlete will begin to gain fat. It is not the case that muscle turns to fat, but muscle bulk will decrease without regular exercise.

Excess calories have to go somewhere, and in men, that often means around the middle. It isn’t the creatine or the muscle gain that’s responsible, it’s the balance between eating and exercise.

I still don’t recommend high-school football. Despite recent improvements in coaching and technique, injury rates for high-school football players are unacceptably high, in my opinion as a parent and a physician. However, I recognize that that decision is made by the athlete and parent.

READERS: The booklet on COPD explains both emphysema and chronic bronchitis, the two elements of COPD, in detail. Readers can obtain a copy by writing: Dr. Roach Book No. 601, 628 Virginia Dr., Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.


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