DEAR DR. DONOHUE: My right heel has hurt for the past two months. It’s worst in the morning. I was a runner, but I have had to stop running because of the pain. What do you think this is, and will it go away? What can I do for it? – L.R.

ANSWER: If I have to put my money on a contender, I’ll put it on plantar fasciitis.

The plantar fascia is a sling of dense tissue that attaches to the front of the heel and runs to the toes. It supports foot bones and maintains the arch of the foot when a person pushes off while taking a step. Inflammation of the fascia – plantar fasciitis – happens for a number of reasons. Feet that have to support heavy bodies are prone to getting it. People whose occupations keep them on their feet for most of the day are other potential victims. Flat feet make a person vulnerable to this inflammation. Runners who suddenly increase their running distances or who run on hard surfaces are another group who frequently develop the problem.

People with plantar fasciitis almost always complain that their pain is worse after rising from a night’s sleep. The pain can be so intense that they walk on their tiptoes in the morning. It tends to lessen during the day but intensifies as evening approaches.

Stretching the fascia can hasten healing. While sitting, cross the leg with the affected heel – your right leg – over the other leg. Grab the toes with your hand and pull them toward your shin. When you feel a stretch in the bottom of the foot, hold that position for 10 seconds. Do this first thing in the morning and repeat twice during the day. In addition, anti-inflammatory medicines such as Aleve can help, as can a heel pad obtainable in almost all drugstores. If nothing is bringing relief, your doctor might inject the heel with cortisone and arrange for you to get a splint that holds the foot, during the night, in a position that takes tension off the fascia. Eighty percent are better by one year – at most.

DEAR DR. DONOHUE: How many grams of protein do you need per day? I am trying to rebuild my muscles and keep my weight down. – M.C.

ANSWER: Since muscles are mostly protein, the logical assumption is that the more protein eaten, the bigger muscles will grow. It’s true to a point, but not to the point where people should become protein worshippers.

The recommended daily protein allowance for the average person is 0.36 grams for each pound of body weight (0.8 gm/kg). For a 160-pound person, that would be 58 grams of protein.

For people engaged in intense muscle building, the daily protein allowance is 0.77 grams for each pound of body weight (1.7 gm/kg). A 200-pound bodybuilder, for example, would need 155 grams of protein a day.

Meat and dairy products are the biggest sources of protein, and I’ll give you a few examples of serving sizes and their protein content. One egg has 6 grams. There are 24 grams in 3.5 ounces of lean beef. One ounce of cheese has 8 grams, as does 8 ounces of milk. One cup of cottage cheese has a whopping 31 grams.

DEAR DR. DONOHUE: I have pain in my backside that my doctor says is piriformis syndrome. He told me to exercise but failed to tell me what kind of exercises to do. Will you? – J.K.

ANSWER: The piriformis muscle lies beneath the largest buttock muscle, the gluteus. Hours of sitting or certain twisting athletic motions, such as serving a tennis ball, can inflame the piriformis, which then compresses the sciatic nerve to cause pain.

Sit on the floor with your right leg straight out in front of you. Cross your left leg over your right leg and let the left foot rest next to the right knee. Push your left knee away from you with a little pressure. When you feel a strain in your buttock, hold that position for five seconds, relax and repeat 10 times, and then change leg positions.

If this hurts, stop and get back to your doctor for a referral to a physical therapist.

DEAR DR. DONOHUE: I have a problem with my left heel. It hurts worse in the morning when I get out of bed. I put an ice pack on it twice a day. Do you have any suggestions? – R.R.

ANSWER: Take this answer for what it is – a guess. I would lay odds on plantar fasciitis, a very common foot problem.

The plantar fascia is a sling of sturdy tissue that runs from the bottom of the heel to the front of the foot. Among other things, it maintains the foot arch. Inflammation of the fascia comes from overuse and from aging. A young foot has a fat pad that covers the fascia’s heel attachment and cushions it. With age, the fat pad thins and leaves the fascia unprotected.

The pain of plantar fasciitis is most severe upon rising from sleep and after prolonged sitting. Continuous walking also aggravates it.

Rest is important for healing. Rest does not mean staying in bed. It means limiting your walking and stopping when the heel hurts.

A heel pad or a specially constructed shoe insert (an orthosis) can ease the stress on the fascia and heel.

Switch to warm soaks for 15 minutes three times a day.

In bed, while lying on your back, keep your feet propped up so the toes are pointing to the ceiling. You can do this by wedging a pillow between the soles of your feet and the end of the bed. Anti-inflammatory medicines – Aleve, Motrin, Advil, etc. – quiet the pain and inflammation.

Sound wave treatment of this condition is popular with some doctors. The sound waves are purported to break up any scar tissue that has formed and to stimulate healing. A podiatrist or your family doctor can tell you if this treatment might be worthwhile for you.

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.