DEAR READER: Osgood-Schlatter (OS) causes a painful lump below the kneecap (where the tendon attaches to the shinbone) in some children. It results from growth spurts during puberty and typically occurs in children who participate in sports that involve jumping, running and swift changes in direction.

OS was more common in boys in the past, but as more girls become active in sports, this gap is narrowing. It affects about one in five adolescent athletes. Because puberty occurs at different ages between genders, OS commonly affects girls around age 11 or 12 and boys around age 13 or 14.

Symptoms of OS include tightness of the muscles around the knee, especially the thigh muscles; pain, swelling and/or tenderness of the uppermost portion of the shinbone, just below the kneecap; and knee pain that worsens with activity and improves with rest.

The cause of OS is repeated stress. Children have growth plates at the ends of bones, which are made of cartilage. These growth plates are not as strong as bone, and recurrent stress can cause injury. When the tendon that holds the kneecap in place is pulled constantly, it can begin to separate from the bone. In some cases, the body may try to bridge the gap by building more bone, causing a tender lump.

Osgood-Schlatter typically improves without treatment and disappears once the bones stop growing. In the meantime, if the swelling and pain become truly bothersome, over-the-counter anti-inflammatory medications or pain relievers may be used. Rest is also important to prevent further injury. In some cases, this may include wrapping the knee or discontinuing or reducing the offending activity. In some instances, physical therapy or strengthening exercises may be beneficial.

Home treatments include stretching, ice, rest and even switching to different activities that don’t involve running or jumping until symptoms resolve.

During the day, I occasionally feel the same discomfort but not to the same degree, and it’s not as bothersome. Do you have any ideas on what it could be or how I can work toward making it go away?

I’m 51 years old, slender and in good health. I do not smoke or drink, am not diabetic, and I don’t have high blood pressure. My cholesterol levels are a little higher than they should be, so I have been taking red yeast rice. Also, I’ve developed a bit of a rash on the inside of both my knees. I hope you have some ideas because my doctor doesn’t. I’ve been researching circulatory problems, but nothing there rings a bell.

DEAR READER: Your initial pain certainly could have resulted from using the glute machine. The use of any new and different piece of equipment may result in unexpected stress and strain on bones and their connective tissues.

The outer edge of the tibia, the large prominent bone in the front of the lower leg, causes the pain of shin splints. And frequent starts and stops from sports such as tennis or basketball, from training too quickly and/or to excess, are what cause shin splints. The pain may be continuous. Relief is often found through rest, ice or hot packs, over-the-counter salves with cayenne pepper or eucalyptus formulas, physical therapy and massage.

If the pain is in the calf area, it’s possible your red yeast rice could play a role. This product contains lovastatin (with statin being the key part of the word). About 10 years ago, the Food and Drug Administration came down hard on several manufacturers and has since monitored the market closely. Any red-yeast-rice product found to contain more than “trace” amounts of lovastatin is considered an “unapproved drug” and may be banned. Studies have shown the product does work for some people (despite low statin levels, suggesting something else might be at work), but it may still cause the problems statins cause. Given its unregulated manufacture, there is no way for consumers to know exactly what dosage they are using.

Side effects include muscle pain or damage and kidney problems, and it isn’t recommended for people with liver disease. I don’t think your problem is vascular in nature. I suggest you buy a hypoallergenic pillow for your knees.

Discontinue the red yeast rice to determine whether the pain subsides, use ice or hot packs, exercise in moderation, and attempt to control your cholesterol levels through proper diet. If these recommendations fail to provide relief, request a second opinion.

To provide related information, I am sending you a copy of my Health Report “Understanding Cholesterol.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

First, my daughter has flat feet and regularly suffers from leg pains that her doctor says is due to her flat feet and over-activity. She is only five and I worry that this is something she will have to suffer with for the rest of her life. Is there anything I can do to help her? I also worry that this will only worsen as she is estimated to be nearly six feet tall when she is done growing.

Second, I have high-arched feet. I have recently developed a heel spur on one foot that over the course of about eight months caused worsening pain. It no longer aches the way it did but it is still painful to stand on it after sleeping at night. The stiffness and feeling of swelling usually disappears within about 30 to 60 minutes. What do you recommend?

DEAR READER:
You are correct that I am not a podiatrist who specializes in feet and related disorders. I can, however, offer you some general advice.

In the simplest terms, the feet are made of four regions, the toes, ball, arch, and heel. The toes aid balance, the ball and heel are the primary walking surfaces and the arch is like a spring that connects the two surfaces. As humans walk, the heel makes contact first followed by the ball and toes. The arch cushions the impact by slightly flatting to absorb the weight. It turns to normal when the weight has been removed.

Flat feet refers to feet that flatten too much during normal walking or standing. They tend to roll inward which strains the tissue on the bottom of the foot. Essentially, the arch compresses too much. This can lead to heel pain, bunions and hammer toes. It can also cause shin splints in runners and ankle swelling and pain in more sedentary individuals.

Treatment for adults with flat feet generally involves shoe inserts that create an arch. I am unsure if these are available in children’s sizes. I recommend you speak with her pediatrician about possible orthotics or a referral to a podiatrist or orthopedic specialist.

As for your feet, high arches are not as common, in my experience, as are flat feet. In your case, the arch isn’t as flexible as it should be and doesn’t absorb the shock of walking correctly. Essentially, your feet are the opposite of your daughter’s. High arches tend to cause the foot to roll outward putting pressure on the outer ball, heel and big toe of your feet. The condition can also cause heel pain, sprains and inflammation of the tendons of the ankle, stress fractures on the outer part of the foot and pain and calluses.

Treatment generally consists of gel inserts for shoes which act as artificial shock absorbers, avoiding running and walking on hard surfaces (use grass or dirt surfaces instead) and wearing high-topped shoes with extra cushioning.

Both flat feet and high arches will benefit from regular stretching and strengthening exercises of the calf and foot. For severe or persistent pain, a podiatrist or orthopedist is the best option.

I’m an 83-year-old man with type 2 diabetes and am medicated pretty well. I walk sometimes but usually get little exercise. I am starting to have bad cramps at night and my legs are getting very weak. I fear losing my feet and lower legs.

Frankly, I love having a 3 oz. glass of red wine before lunch and twice that before dinner. I also love my 4 oz. dish of iced cream at about 9 PM. Are these habits which give me pleasure doing me in? Please advise me.

DEAR READER:
As you are aware, type 2 diabetes is non-insulin dependent and is the more common form. The pancreas continues to produce insulin but the body develops resistance to its effects, resulting in a deficiency. While the condition can affect people of every age, it most commonly occurs after the age of 30. Age, weight and heredity are major risk factors for type 2 diabetes.

Long-term complications can result in poor circulation that might lead to heart disease, stroke, infection, poor vision, kidney failure and nerve damage. An individual might experience gradual weakness of the arms or legs, tingling and accompanying pain of the hands and feet, difficult healing of the skin, infection, and more.

It appears that the leg weakness and cramps are among your list of unpleasant side effects. You admittedly do not exercise on a regular basis and this activity is extremely important for all diabetics. Make a plan that works for your lifestyle. Perhaps that translates simply to walking around the block every day. If you have access to a swimming pool at a community center, take advantage of the resource. Perhaps a stationery bicycle indoors will work. Your circulation is likely impaired. While you may not be able to reverse the situation completely, you can definitely take steps to improve it. Start now.

There are several remedies for the leg cramps. The first is simply to remove the wrapper from a bar of soap. Place the soap under your bed sheet at night, where your legs ordinarily rest. This should eliminate the cramps. Some people have even had success with rubbing a bar of soap on the calves of their legs. Do what works best for you.

Pickle juice or a dill pickle incorporated into your diet may help prevent muscle cramping. Both products are available in grocery stores. Numerous drinks (to include pickle juice) contain electrolytes. Read labels at your local market before making a selection.

If your medication keeps your sugar levels under good control, I urge you to continue with the medications prescribed. If you are dissatisfied with the physician you are seeing, request a referral to another primary care physician or to an endocrinologist, a specialist in the field.

To give you related information, I am sending you a copy of my Health Report “Living with Diabetes”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
I have received several letters from people who drink dill pickle juice (the liquid left in the jar after the pickles are gone). Many claim it is instantly effective. Others have had success with sports drinks that contain electrolytes and still others apply liquid soap directly to the sore muscle. Soap-under-the-sheets still seems to be the preferred method for preventing nocturnal leg cramps.

Recently, I was sent a sample of a product called Pickle Juice Sport which claims to prevent muscle cramps if drunk prior to or during rigorous exercise and activity. Based on the ingredients, it appears to be a hybrid of sorts between sports drinks with electrolytes and dill pickle juice.

Since I have no experience with this product, I am curious to know what my readers think. If you have tried this product or plan to try it, please let me know your results. Anyone interested in more information about it can visit the website at www.PicklePower.com.

Before I am slammed for promoting a product for financial reasons, I will say that I have no affiliation with this product in any way. I simply want to find out if this novel product is beneficial to my readers.

I have suffered from nighttime leg cramps all my life just like my mother before me. Before the pickles I had tried just about everything I could find but the only thing that worked was to jump out of bed once one started, stand on the affected leg and drink lots of water. Needless, to say it wasn’t exactly conducive to sleep and I often awoke feeling tired and irritable. Now all I do when I get a cramp is take one or two bites of a dill pickle and go back to bed. It works very quickly.

I hope this helps your other readers as much as it has helped me.

DEAR READER:
Dill pickles for nocturnal leg cramps is new to me. I have no idea how this would help relieve the pain of the cramps but if it works for you, stick with it. Other options include drinking eight ounces of tonic water before bed and the soap-under-the-sheets trick.

I am curious to find out if others have tried this remedy so please write to me with your experiences, either good or bad. When I get enough responses I will follow up with a results column.

To give you related information, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

The activities of the day cause fatigue and perspiration, resulting in depletion of saline and other electrolytes from the bloodstream. Tired and sensitive leg muscles respond by cramping. The cure is simple. Replace the electrolytes!

As soon as the cramps begin, drink an entire glass of Gatorade and wait five minutes. If the cramps have not stopped, drink another glass of Gatorade, go back to bed, and enjoy a peaceful and painless sleep! Forget the soap and prescription drugs. I have a hunch that restless legs syndrome (RLS) will respond to this therapy as well. And, for Heaven’s sake, stop the quinine. I’ve been told it can be harmful.

Professional athletes know all this. That’s why Gatorade was invented.

DEAR READER:
Gatorade was formulated in 1965 to replenish nutrients lost during rigorous exercise and sweating. It replaces electrolytes and carbohydrates, as well as glucose.

Today, there are numerous electrolyte replacement products. Pedialyte is one such product that was specially formulated for children suffering from vomiting and/or diarrhea. Most chain retailers now make store brand equivalents for both children and adults.

Restless legs syndrome (RLS) has no identifiable origin and may result from multiple causes and mechanisms. It is an extremely complex disorder that can reflect, among other possibilities, a dopamine deficiency. RLS can be triggered by certain drugs, alcohol, caffeine, and physical trauma. If it were relieved by as simple a thing as Gatorade or other electrolyte replacement drink, I would be rather surprised and am sure the manufacturer would be elated. Nonetheless, if a reader is pacing the floors at an ungodly hour, it will do no harm to try your suggestion. I’d be grateful for comments.

I would like to reiterate the fact that Gatorade can only be useful once a cramp has started, whereas the soap-under-the-sheet trick can prevent the cramp. It would seem to me that soap is still a superior option for those suffering nocturnal leg cramps because sleep won’t be interrupted at all for most individuals.

If you would like to know more about RLS I recommend the book “Restless Legs Syndrome” by Robert Yoakum. In it the author discusses relief and hope for sleepless victims. It is available through most book stores, online or can be special ordered if your bookstore doesn’t have it in stock.

DEAR READER:
I cannot offer any conclusion about why the wine works. It seems to me that is may simply be a placebo effect because ¼ cup every month should have no effect. The wine will not stay in the body for more than a day.

As for the TUMS, they are great source of calcium, which can, in theory, block cramps.

For many readers with leg cramps I have recommended putting a bar of soap under the sheets to prevent cramps. Again, I have no knowledge about why this works.

If the wine works for you, stick with it. There is no harm in drinking ¼ cup once a month.

DEAR READER:
I have had no experience with this product but am passing it on to my readers. I ask that anyone with “Leg Cramps” experience (either good or bad) write to me with their results. I will put the answers in a future column. Thanks for writing.

To give you related information, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
I cannot speculate on why your sweating occurred, since one of Premarin’s purposes is to reduce the incidence of hot flashes. On the down side, leg cramps have been reported with its use. Perhaps your hormonal changes and long-term use of the product have played a role in your recent unpleasant symptoms. Listening to your own body is always important, as Nature tells you things if you just pay attention. The elimination of your night sweats and leg pain, signifies to me that you did the right thing in stopping the hormone replacement.