Q: I jog regularly and play golf as often as I can. Recently, I've been feeling pain on the bottom of my heel. Any suggestions?
A: You may have plantar fascitis, one of the most common injuries among recreational tennis players, golfers and joggers. Other, less frequent causes of pain on the bottom of the heel include a small crack in the heel bone, a pinched nerve or a swelling in the cushioning pad underneath the heel.
The plantar fascia is a band of tissue that runs from your toes, along the bottom of your foot, and attaches to the bottom of your heel. Exercisers often tear the tissue at its weakest point, the spot where it attaches to the heel. It causes pain on the bottom of the heel and is most severe when you first get up , when you start to exercise and when you raise yourself on your toes.
When you stand on your toes, all your weight is supported by the plantar fascia. You increase your risk of tearing it with additional stress that may be caused by wearing shoes with stiff soles that do not bend in the right place (just behind the ball of your big toe); shoes that are too wide; running too fast for the strength of your plantar fascia; and not allowing enough time to recover from vigorous workouts.
No medications help a torn plantar fascia heal more quickly. Cortisone injections and aspirin-like pills may reduce pain, but they also may delay the healing process.
Stop running until free from pain. Ride a bicycle to keep in shape while you heal. When you return to your regular sports activities, wear shoes with flexible soles. Wear arch supports that limit the "rolling in" motion of your feet. And stretch your calf muscles before you exercise.
ZTC Q: Is the food you eat at night more fattening than the food you eat in the morning?
A: Logically, the time you eat a meal should have no effect on its caloric content. However, studies from the University of Minnesota show the food you eat in the evening may be more fattening than food you eat earlier in the day.
For four to six hours after you finish eating, your body produces extra heat, which burns calories that otherwise would have ended up in your body as fat. Exercise also raises your metabolism, so exercising after eating burns far more calories than resting after eating.
Most people are far more active in the morning than in the evening. After breakfast, they go to work. After dinner, they often watch television. You do not burn a lot of calories sitting in front of the TV set.
Dr. Mirkin is a practicing physician in Silver Spring specializing in sports medicine and nutrition.