Ask Dr. H: Crunching, nibbling an apple for alertness

Question: I've heard from several people that eating an apple can help keep you awake just as well as a cup of coffee. Is that true?

Answer: There's no doubt that the caffeine in coffee, tea, or an energy drink has a stimulating effect on the brain to increase alertness - that is, until the "crash" occurs. While apples don't contain caffeine, they do contain the natural sugar fructose. (Oranges contain more.)

Other than the anecdotal reports of apples' increasing alertness, I've not seen any head-to-head studies comparing apples and coffee. Besides the effect that an apple's natural sugar can have on raising one's blood sugar, there are several theoretical ways that an apple may keep one awake and alert as well as a cup of coffee. The act of crunching into an apple and chewing it, for example, helps to stimulate alertness. And eating around the core of an apple requires a certain amount of concentration, which also heightens alertness.

Based on those assumptions, the peeling of an orange, not to mention its fragrant aroma, should also help to heighten one's alertness.

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Q:

How does one recover from shin splints? How can they be prevented? Is it true that some people are more prone to them than others?

A: Shin splints are an overuse injury, very common in athletes or weekend warriors who pound their legs by running, jogging, skating, weight lifting, or participating in any other sport where the legs take a pounding. Wearing shoes with both adequate arch support and cushioning helps to decrease the risk of getting shin splints. Custom orthotics may help as well.

Shin splints are actually a form of tendinitis. The pain of shin splints is generally on the inner part of the shin bone (tibia) where muscles attach to the back part. There's also inflammation of the periosteum, the sensitive connective-tissue covering of the shin bone, caused by tendons of the calf muscle tugging on the periosteum. If you've ever banged your shin, you know how painful an injury to periosteum can be. It may mimic the pain of stress fracture, which is a fine fracture of the shin bone not usually seen on X-ray. A bone scan can tell you whether or not a shin splint has progressed to a stress fracture.

The best way to deal with a shin splint is to avoid doing the activity that caused it. Start up again gradually, after a few weeks off to allow healing. When pain returns, reduce the activity. Ice is an excellent home treatment for shin splints. Anti-inflammatory medications like Aleve and Advil can help reduce pain and swelling. Taping the shins will often alleviate pain dramatically. I'd suggest seeing an orthopedist or physical therapist to learn the correct way of taping a leg.

Gentle exercises to stretch the calf muscles can be helpful, but not with acute pain. Running on softer surfaces will help decrease the risk of shin splints. Indoor tracks and basketball courts are rough on shins because of the tight turns and sudden stops and starts.