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DEAR DR. DONOHUE: If I'm not mistaken, you wrote about how the foot should land when running, and you favored the heel as the place to plant the foot. I also remember you not favoring barefoot running. Would you reconsider these issues? Barefoot running decreases runners' injuries, and landing on the heel increases them. -- W.W.
ANSWER: The proper way to first strike the ground when running and the question of barefoot running are contentious matters. I don't believe that anyone has the definitive answers to these questions. Both issues are addressed in the April issue of Exercise and Sport Science Review. One is a short article by Walter Herzog, and the other is by Daniel Liberman, who has done a great deal of work in evaluating the benefits of barefoot running.
Walking and running are things that are rarely taught. We learn them instinctively. When they are taught by coaches and others, they generate a great deal of controversy. Running in shoes is said to contribute to the great increase in overuse injuries in runners, both in the feet and legs. Barefoot running appears to lower the injury rate. According to some, shoes dampen proprioception, the subconscious ability to maintain balance and alter stride from signals sent to the brain from the feet. Shoes also encourage a running form where heel strike is favored. And they seem to contribute to weak and inflexible feet. Barefoot running corrects these problems. The bare foot is vulnerable to obstacles on the running path, but calluses form on the balls of the feet to protect them, given enough time to do so.
When the feet are not in shoes, a person almost instinctively strikes the ground with the balls of the feet. Impact on the foot from such a landing greatly lessens forces that are transferred to both the feet and legs. That is thought to be one of the reasons why barefoot runners have fewer injuries to their feet and legs.
Many highly successful Olympic runners do not wear shoes.
All this information is fascinating. I know I wouldn't think of running barefoot. I don't know whether everyone should abandon heel-strike running. I'm waiting to see more evidence from the experts.
DEAR DR. DONOHUE: I swim at a Boys and Girls Club in our town. Some of the women are causing trouble over the water temperature. I have been swimming at the club for 14 years. I had open-heart surgery to correct two leaky heart valves.
When I read your article that said cold water makes your heart beat faster and harder and could lead to chest pains, I tried to tell the women that this is true. They will not listen. I asked my cardiologist, and he said that the temperature should be 82 F.
I would like to post your reply to cold water for all members to see it. -- G.I.
ANSWER: Water temperature between 82 and 86 F (28-30 C) is the temperature used for competitive swimming. I like water at the higher end of those temperatures.
At temperatures less than 77 F (25 C), the body is stressed. By "body," I mean the heart. Heat-conserving measures are thrown into high gear. The heart beats faster. It is stressed.
DEAR DR. DONOHUE: I am a professional swim instructor and have been teaching swimming for many years.
I would like to know about water intoxication in small children. I don't think parents should put their child under water in swimming lessons until that are at least 2 years old, as they can swallow lots of water. -- D.C.
ANSWER: Water intoxication occurs when anyone, regardless of age, takes in too much water. The excess water leads to brain swelling. The situation is urgent. Corrective measures have to be taken quickly.
The American Academy of Pediatrics used to say that 4 should be the age that children learn how to swim. It has now lowered the age to 1 year.
People instructing such young swimmers must have had professional training and know how to keep such young infants safe.
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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.