Dear Dr. Roach: I am 60, with high blood pressure and history of TIA. I stopped smoking five years ago and gained 50 pounds. I eat healthy and am on the treadmill 30 minutes five times a week. I'm fairly active otherwise, but am not losing weight. My doctor says vigorous cardio exercise is a no-no for me because of the TIA. My friends and family say yoga is good for high blood pressure and anxiety. Would it be a good weight-loss program?


Dear C.B.: Yoga has many benefits, but there are two points I need to make. The first is that there are many different ways to do yoga, and some of them are intensive cardiovascular exercise. It would be good to get your doctor to give you an idea of how intense an exercise he or she wants you to avoid. Even less-intensive yoga practice can have significant benefits for overall health, and possibly for blood pressure and anxiety.

The second point is that exercise alone is unlikely to get you to lose significant amounts of weight (such as 50 pounds) without reducing caloric intake. Fortunately, increasing exercise somewhat while decreasing calorie intake somewhat can lead to significant weight loss. More importantly, even moderate exercise and healthy eating can reduce risk of a stroke, which must be a big concern in someone with a history of TIA (transient ischemic attack, a frequent precursor of stroke).

Weight gain after quitting smoking is common, but it usually amounts to 10 or so pounds, not 50. Your doctor should evaluate whether there are any other reasons for your weight gain (especially medications, but also other medical conditions) and discuss with you dietary programs to help.

Dear Dr. Roach: How long do shin splints last? Is there anything besides ice that'll make them go away faster? My left shin started hurting more than three weeks ago, and I ran once or twice on it, then stopped, but it still hurts. Is this normal? When do you think I can run on it? I don't think it was increasing my distance that did it, but I ran longer run on a flat path, and normally I do it with hills.


Dear H.O.: Pain in the shin bone (tibia) is common in runners, but the hard part is distinguishing between "shin splints," properly called "medial tibial stress syndrome," and a stress fracture of the tibia. A stress fracture usually has a discrete area of tenderness, but MTSS has more diffuse tenderness. An X-ray may be needed to be sure it isn't a stress fracture, since the treatment is very different.

A runner with a stress fracture needs to avoid impact activities like running, whereas MTSS usually gets better with just lower running mileage.

In your case, the degree of pain is higher than I would expect after three weeks. I'd recommend an X-ray.

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