Marion County Medical Center

Health Shorts

February 2006

Why Is Heel Pain Worse in Morning?
If you feel a sharp stabbing pain every morning when you step out of bed, you probably have plantar fasciitis, inflammation of the ligament that passes along the bottom of your foot. The pain may subside after a few steps but returns later in the day or when you’re feeling tired.

The reason it hurts worse in the morning is that the tissues tighten up during the night and the first step in the morning rapidly stretches the inflamed tissue. The solution is to stretch your foot and ankle and maybe even massage the heel before getting out of bed. And don’t walk in bare feet. Have a pair of supportive slippers or shoes handy and use them immediately.
[SOURCE: “Why Does My Plantar Fasciitis Hurt Most When I Get Out of Bed in the Morning?” Prevention, January, 2004]

If It Feels Good, Wear It
If you’re a runner, walker, dancer or spend a lot of time on your feet, you may benefit from wearing custom or prefabricated orthotics in your shoes either to prevent or treat foot and leg problems. These shoe inserts are designed to support the arch and correct biomechanical imbalances that may be putting undue stress on joints and muscles.

One study conducted for the Canadian military found that when subjects were allowed to choose their inserts on the basis of comfort, they tended to make wise choices. Subjects using any of six prefabricated inserts for four months had 40 percent fewer foot or leg injuries than subjects who did not use inserts. A previous study by the same author concluded that comfort was a reliable reflection of how well the orthotic device was functioning in changing the mechanics of the foot.
[SOURCE: Cary Groner, “Orthosis Symbiosis–Clinicians Are Finding a Middle Ground in the Debate over Custom versus Prefab Foot Orthoses,” Biomechanics, May 1, 2005]

Be Patient When Heel Doesn’t Heal
Persons suffering from plantar fasciitis, sharp pain in the heel that is usually worse on the first step out of bed in the morning, often feel frustrated when symptoms persist for 6 to 12 months or longer. Most doctors advise a conservative approach, however, noting that symptoms eventually get better regardless of treatment.

One study of 237 patients with plantar fasciitis found that 80 percent were satisfied with treatment that involved anti-inflammatory medications, stretching, night splints and custom or prefabricated arch supports. Only 10 percent had surgery.
[SOURCE: Stephen F. Conti and Deepak K. Jain, “Managing Plantar Fasciitis and Other Heel Pain,” The Journal of Musculoskeletal Medicine, October, 2004]

Heel Cups Least Effective Treatment
Heel cups have often been recommended to treat heel pain caused by plantar fasciitis. Theoretically, they ease tension on the inflamed ligament by lifting the heel, and they provide a soft cushion to absorb impact. In a survey of 411 patients with plantar fasciitis, however, heel cups were ranked as the least effective of 12 treatment options. As one doctor put it, heel cups may be more effective for “treating patients with fat pad syndrome and heel bruises than patients with plantar fasciitis.”
[SOURCE: Craig S. Young, M.D., Darin S. Rutherford, M.D., Mark W. Niedfeldt, M.D., “Treatment of Plantar Fasciitis,” American Family Physician, February 1, 2001]

Snorers–Wake Up to the Danger
Does your bed partner wake you up frequently to tell you you’re snoring so loud she can’t sleep? Have you found yourself nodding off while your boss is making an important presentation? Do you feel tired, even when you wake up from a full night’s sleep?

If you answer yes to any of these questions, you could be suffering from obstructive sleep apnea, a disorder that causes a person to stop breathing for 10 seconds or longer numerous times every night. It’s estimated that 90 percent of Americans with sleep apnea don’t know they have it nor that it increases their risk of heart attack, stroke, heart failure and other serious illnesses.
[SOURCE: Tips for Vibrant Health and Beauty at Every Age,” Saturday Evening Post, January-February, 2005]

Exactly How Loud Do You Snore?
The louder you snore, the greater your risk of obstructive sleep apnea, a breathing disorder that increases the risk of heart attack, stroke and heart failure as well as accidents related to sleep deprivation.

Severity of snoring, from the bed partner’s point of view, is graded at four levels:

Grade 1: heard only if you lean over the person’s face,
Grade 2: heard in the bedroom,
Grade 3: heard just outside the bedroom with door open,
Grade 4: heard outside the bedroom with the door closed.

[SOURCE: “Snoring,” Mayoclinic.com, July 15, 2005]

African-Americans at Greater Risk
A recent survey of 523 individuals attending the Chicago Health Fair found that African Americans had an increased risk of obstructive sleep apnea but that they were less likely than white subjects to be encouraged to seek treatment. More than 30 percent of blacks but only 18 percent of white subjects considered snoring to be normal.
[SOURCE: “African Americans Need More Education on Sleep Apnea,” Family Practice News, December 15, 2005]

Sleep Apnea: Not for Obese Only
Despite the classic profile, not all persons suffering from obstructive sleep apnea are overweight, middle-aged males. One recent study found that 20 percent of patients were normal weight or thin and that these patients were more likely to be over age 50 and to use sedatives compared to the patients who were obese.

Another study of military personnel found no correlation of disease severity with either age or body mass index. The authors concluded that obstructive sleep apnea “should be considered in symptomatic patients regardless of age or BMI.”
[SOURCE: Christopher J. Lettieri, et al, “Obstructive Sleep Apnea: Are We Missing an At-Risk Population, Chest, October, 2005; Ammar Ghanem and syed Mahmood, “Is Obstructive Sleep apnea in Non-Obese Patients a Less Serious Disease than in Obese Patients?” Chest, October, 2005]

Some Drugs Increase Sun Sensitivity
Some medications such as diuretics, antibiotics and antihistamines can increase a person’s sensitivity to sunlight, causing burning with less exposure than normal. St. John’s wort is one of several dietary supplements which can increase photosensitivity.

If you take any of these substances, make a special effort to limit your time in the sun and to use protective sun screens.
[SOURCE: Sara Burr and Rebecca Penzer, “Promoting Skin Health,” Nursing Standards, May 18, 2005]

Ease Your Pain with Exercise
A 14-year study of men and women in their 50s and 60s found that those who exercised vigorously for at least six hours a week had 25 percent less joint and muscle pain than those who were sedentary. “Vigorous exercise” was defined as any activity that produced sweat and raised the heart rate above 120.
[SOURCE: Joy Keller, “Vigorous Exercise Lessens Pain in Older Exercisers,” IDEA Fitness Journal, January, 2006]

Fake Tan Healthier than a Real One
A tan is the body’s protective mechanism to protect the DNA of skin cells from excessive exposure to ultraviolet radiation, and tanning is never healthy. If you really desire the bronzed look, self tanning products that you spray or rub on the skin are much safer. These tanning products offer no protection from the sun, however. If you’re going to the beach, don’t forget the sun screen.
[SOURCE: Barbara Eaglesham, “Is It Possible To Get a Healthy Tan?” Odyssey, May, 2005]

Lycopene Promotes Healthy Skin
To promote healthy skin, many nutritionists recommend foods rich in the antioxidant lycopene. These include cooked tomatoes, watermelon, guava and red papaya.

Males get a double plus from eating these foods; lycopene has also been found to reduce the risk of prostate cancer.
[SOURCE: Collette Bouchez, “When It Comes To Good Skin What You Put in Your Body Is as Important as What You Put on It,” WebMD, June 8, 2005]

A Little Intensity Goes a Long Way
Only three six-minute bursts of high-intensity exercise a week allowed subjects to nearly double their exercise endurance in a short time, according to a study published in the Journal of Applied Physiology.

At the beginning of the study, moderately active males and females who were asked to ride exercise bikes at 80 percent of their maximum aerobic capacity had to quit because of exhaustion after 26 minutes. By adding three six-minute sprint sessions a week for two weeks, the subjects were able to bike at 80 percent of maximum heart rate for 51 minutes. That kind of improvement would require many hours of training at regular intensity.
[SOURCE: Alexa Joy Sherman, “Fitter, Faster,” Natural Health, November, 2005]

Give Strength, Aerobic Exercise
Their Proper Place in Your Routine
A good exercise program should include both aerobic exercises such as biking, walking or running and strength training. Combining the two is an excellent way to maintain a desirable body composition and build strength, endurance and fitness. Yet trainers point out that each type of exercise has its own requirements for balancing work and rest.

Studies suggest that persons who do more than 45 minutes of aerobic exercise on the same day that they do weight training may be giving a mixed signal to their muscles and have a lessened training response to both kinds of exercise.
[SOURCE: Robert A. Robergs and Len Kravitz, “The Role of Cortisol in Concurrent Training: During Exercise, Regardless of Whether It Is Strength or Cardiorespiratory Training, Cortisol Is Released in Proportion to the Intensity of the Effort,” IDEA Fitness Journal, October, 2005]

Health Shorts

February 2006

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