Dear Dr. Donohue: I need your help, fast. I have pain in my heel cord, and sometimes it makes a creaking sound. My brother had a similar thing about five years ago, and his heel cord ruptured. He was laid up for quite a long time. I don't want that to happen to me.
The pain isn't so bad that I can't walk, but I cannot run. What caused this? What should I do? Should I get a cortisone shot into my heel cord?
L.H.
The heel cord is the Achilles tendon, the body's longest and strongest tendon. It connects the calf muscles to the heel bone. Contraction of the calf muscles draws the heel off the ground so we can walk, jump and get up and down stairs. The Achilles tendon makes these movements possible. At times, the force on the Achilles tendon is 12 times the body weight. It takes a beating. It was the one vulnerable spot of the Greek warrior Achilles, and it's one of our weak spots, too. It has a poor blood supply.
Achilles tendinopathy consists of pain, swelling and warmth, most often centred in the middle of the tendon. It frequently makes creaking noises, like yours does. These are warning signs to be very careful. They're a prelude to tendon rupture.
The first thing to do is stop running. You can walk if walking isn't painful, but don't push it. Warm compresses applied to the tendon often make the pain less intense. If they don't, try icing it.
Taking one of the non-steroidal anti-inflammatory drugs, like Advil, controls pain and takes care of any inflammation. Above all, rest is the most important ingredient for healing.
Don't attempt to run until the tendon has been free of pain for two weeks. You can stay in good condition by exercising in other ways. Swimming won't put the tendon in jeopardy.
You want to know the cause; usually, it's overuse. You have started running farther than usual or have increased your running time. New running shoes also can be responsible. Runners whose feet turn inward, on the big-toe side of the feet, are more likely to get this kind of tendon trouble. Don't ask for a cortisone injection. It can weaken the tendon.
If your pain lasts longer than another week, get to the family doctor for an evaluation.
Dear Dr. Donohue: My wife and I are retired. We love to dance, and have done so our entire married life. Now we teach ballroom dancing and have a large clientele of retirees and quite a few younger people, too. I don't remember you ever mentioning dancing as a good exercise for health.
J.R.
Dancing is an excellent exercise. It fits the definition of aerobic exercise, the kind of exercise in which large muscles - in this case, the leg muscles - are moving continuously for a protracted period of time. Dancing also increases the heart rate, another criterion for aerobic exercise. It provides the same benefits that jogging and brisk walking provide.
In an hour, dancers burn from 250 to 300 calories. If the dance is one of the faster dances, the calories burned in an hour can reach 400 or more.
