Guest Columnist: Anthony J. Yanni, MD, FACP, CPE
Part 1 of 2
At this time every year, patients come to our office with questions and concerns about the flu shot. In an attempt to educate the public and dispel any fears or misconceptions, I have taken this issue directly to the experts… the people who manufacture the vaccine at Sanofi Pasteur in Swiftwater, PA. Anthony Yanni, MD, Director of Clinical Development at Sanofi was kind enough to assist me with this column for your health and wellness.
Influenza has a long recorded history in medicine. It was first mentioned by Hippocrates in 412 BC. The first epidemic was reported in 1510 and the first pandemic in 1580. There have been 32 pandemics since 1580 with the most recent being in 2009 with the well known H1N1 virus. Influenza remains a serious illness with 40,000 deaths and 200,000 hospitalizations annually in the US. It’s estimated that between 5-20% of the US population will get Influenza each season with an estimated direct cost for care of 10 billion dollars.
Haemophilus Influenzae virus infects the respiratory epithelium or lining in the lungs. Onset of symptoms can be sudden with high fever, fatigue and muscle aches. Cough is usually present, is non-productive and can be severe. Symptoms can last for several days with fatigue lasting for 2-3 weeks. During the acute phase of illness, patients are at higher risk for secondary bacterial infections such as pneumonia.
Definitive diagnosis of influenza is made with a nasal swab and culture. The swab is obtained by placing a small probe into the nose and obtaining material from deep inside. This material is then sent to a lab and cultured in the hopes of identifying the causative agent.
There are effective antiviral medicines for the treatment of influenza. They are best used at first sign of disease and may shorten the period of illness or decrease disease severity. Other medical interventions are supportive. Treating any underlying symptoms such as muscle pain and promptly treating any complications such as bacterial pneumonia. Antivirals can also be used to prevent influenza and are used when exposure to someone with influenza is known and unavoidable such as in nursing home patients.
Influenza can strike any age group and both males and females are at risk. However, the elderly, the very young and those with underlying medical conditions are most at risk. Those over the age of 65, those with underlying lung disease, heart disease, diabetes, cancer, kidney disease or those with impaired immune function are at particularly high risk. Additionally, those in nursing homes and chronic care facilities are also at increased risk.
Vaccination is recommended for those 6 months and older. There are 2 main types of vaccines available: live attenuated (weakened) and inactivated. Because the live attenuated vaccine carries very small risks of disease in certain high risk groups (ie: impaired immune function), the live attenuated vaccine is only recommended for use in healthy adults under the age of 50. The inactivated vaccine can be administered to anyone without previous reaction or known allergy.
The effectiveness of the influenza vaccine depends on a few factors. One is the match of the vaccine to circulating strains in the community. When the strain predicted to be circulating and thus present in the vaccine is a good match, the vaccine can provide protection in greater than 75% of those who receive it. Another important factor in vaccine effectiveness is the individuals’ immune response. Those over the age of 65 have been shown to have a slightly lower immune response to the vaccine. It is a function of general immune responsiveness and not due to the vaccine itself. Clearly, however, those individuals who receive the vaccine are much more likely to be protected than those who remain unvaccinated.
Vaccine manufacturers continue to work on improving the influenza vaccine with the aim of providing broader coverage to a greater number of people. For example, there is a great deal of work being done on developing a Universal Flu Vaccine; one that identifies commonality among the many strains and will provide broader protection without the concern of strain match. A recently available high dose vaccine for those over the age of 65 was developed in the hope that a higher dose would provide those individuals in this age range a better and more consistent immune response than standard dose vaccine. Manufacturers are also looking to increase the virus types included in the annual vaccine from 3 to 4.
Visit your doctor regularly and listen to your body.
Guest Columnist: Anthony J. Yanni, MD, FACP, CPE, Director, Clinical Development Sanofi Pasteur, Swiftwater, PA.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: The Flu – Part II
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept
Crying is a normal and valuable part of human communication and emotional expression. No doubt, some use this form of expression more than others and being of Mediterranean descent, my family will tell you not to sit next to me in the movie theater if a “tear jerker” is playing. “The Notebook” really got me! House Speaker John Boehner and I have this in common. While the public may not like to see leaders cry and may view it as a sign of weakness, current research shows that at appropriate times it may be healthy.
We cry for many reasons. Babies cry to communicate, adults cry when they are overwhelmed with positive emotions like a wedding, or negative emotions like a funeral. Crying too easily or too often can be a sign of an underlying emotional or physical problem. However, recent research has suggested that letting out a good cry at times of intense emotional build up, may be healthy.
Crying has intrigued scientists and medical professionals for centuries. Darwin, for example, purported that crying may have a role in evolution and natural selection. If tears can be a sign of emotional vulnerability and bonding, then it may keep communities together for the purpose of procreation.
According to research conducted by Dr. William Frey, humans may be the only species engineered to have such strong emotions that provokes the production of tears. Studies show that the fluid in a tear produced by emotion has a very different chemical makeup than the normal fluid that protects and lubricates the eye or the tears produced when peeling an onion. Recent research has found that a woman’s tears produced in response to sadness may counteract aggressive behavior in men. In the study, men were able to distinguish tears produced from a woman after watching a sad movie compared to saline tears by smell. Simultaneously, scans of the men’s brains while smelling the actual tears found decreased activity in areas of the brain associated with aggression.
Research on the health benefits of crying support the notion that a “good cry” is good for you. Nine out of 10 people report that after a “good cry” they feel better and are less stressful. The best thing about crying for good health is that it is free, almost everyone can do it, and except for a runny nose, red eyes and runny mascara, it has no side effects. While not a miracle, some of the recent research suggests crying is highly effective at healing, and that it improves the mood of almost 90% of weepers, with less than 10% feeling worse. Some of the researchers go as far as suggesting that there may be a case for inducing crying in those who find it difficult to let go and cry, especially in people with clinical depression or mood disorders.
For some, the emotional build up prior to the cry was so stressful when trying to hold back the tears, crying served as a good emotional release. For others, while the emotional build up was stressful, the embarrassment of crying in public was more stressful. Overall, 60% of those who cried experienced a physiological response. The emotional buildup prior to the cry and the physical act of crying releases adrenaline to create a “flight or fight” response. This is immediately followed by a post-adrenaline period in which the person experiences a physical and emotional release as the heart rate and blood pressure decreases when compared to the suppression of the cry.
Crying is a normal response to stress, emotional or physical trauma in both men and women. Not surprisingly, research has confirmed a long held belief that those suffering from depression cry more than others. However, more concerning is the fact that those suffering from severe and debilitating depression with mood disorders have lost the ability to cry. Consequently, these individuals have lost the ability to derive the health benefits of crying such as the emotional release and physiological response. While both men and women cry equally when suffering from depressive mood disorders, men who are unable to cry tend to become more aggressive and irritable.
Crying is much more common among those suffering from a feeling of being overworked, overstressed and a loss of control. For these reasons, 71% of 3rd year medical students admitted to crying at least once in the past year. Among this group, most reported that crying was a valuable way of communicating and stress release.
So, the next time someone calls you a “cry baby” when you express your emotions by crying, tell them your “working out” by having a “good cry” to release stress, lower your heart rate and blood pressure and you don’t have time to go to the gym!
Source: Harvard Health Letter
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
October is National Physical Therapy Month! The American Physical Therapy Association (APTA) would like the public to recognize the dedication of physical therapists as health care providers. Moreover, physical therapists would like to thank the public for allowing us to participate in your health and wellness.
This column will address a question that is frequently asked by people of all ages and activity levels…stretching. First, it is important to keep in mind that stretching should NEVER be performed without warming up your body and muscles first. This can be done by running slowly in place or around the block for 5-10 minutes. Second, stretching should NEVER be painful. Third, a good stretch should be performed slowly and feel like slight tension in the muscle. NEVER bounce or jerk. First, perform the stretches by actively moving your muscles slowly and deliberately 5-10 times. Then, hold the stretch for 5-10 seconds, repeat 5-10 times, 2-4 times per week.
Remember, flexibility is only one aspect of complete health and wellness. Strength training, cardiovascular fitness, meditation and stress management and proper nutrition are also necessary for a healthy lifestyle. Also, be careful not to overstretch before competition as it may weaken the muscle.
Stand with your feet facing a wall shoulder width apart.
Step your right foot back keeping it facing forward.
Bend your left knee and keep the right knee straight
Lean forward and push against a wall for the best stretch, keeping heels on the floor.
Feel the stretch at the back of your right leg below the knee
Repeat on the left
Stand with your left arm holding on to a stable object for balance.
Bend your right knee and bring the heel up toward your butt by pulling up/back with your right hand.
Feel the stretch at the front of your right thigh.
Repeat on the left
Lying on your back, clasp the back of your right knee
Straighten out your right knee slowly up toward the sky
Feel the stretch at the back of your right thigh.
Repeat with your left leg straight.
Sit with your legs bent with heels together. (Indian Sit)
Hold your ankles or feet with both hands.
Keep your back straight and stomach in.
Push your knees toward the floor.
Feel the stretch on the inside of your thighs.
Lie on your back and raise your knees to your chest.
Hold the knees with both your hands.
Feel the stretch at the bottom of your back.
Lie on your belly and prop up on your forearms
Hold this position and inhale and exhale
Feel the stretch in the small of your back
Stand with your left hand on your hip and your right arm above your head.
Bend to the left without leaning forward or back.
Feel the stretch on your right side.
Repeat with your left arm.
Stand upright with feet shoulder width apart
Cross arms over chest and turn to the right with your upper trunk
Keep lower body facing straight
Feel the stretch on the left lower back and trunk
Repeat turning to the left
Take your right arm across your chest.
Use your left hand to pull your right elbow across your chest.
Keep your body facing forward.
Feel the stretch on the back of your right shoulder.
Repeat with your left arm.
Stand facing a corner with feet 12 inches away and put both arms up in a “T” position
Lean into wall with chest and keep feet away from wall
Feel the stretch in your biceps and chest.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliate faculty member at the University of Scranton, PT Dept.
Congratulations to all the runners who participated in the 16th Annual Steamtown Marathon yesterday! In addition to the euphoria and pride that comes with successfully completing such an arduous task, one other feeling is present: pain! You may have blisters, black and blue feet, black toe nails, chaffed skin, stiff and painful lower back, knees, ankles and feet, and muscle tightness and soreness. This column on recovery tips is for you!
Do not take this recovery lightly. Respect the distance and its toll on your body. Remember what happened to the first man to run a marathon. In 490 BC, the Greek soldier Pheidippides ran approximately 25 miles from the city of Marathon to the city of Athens to bring the news of success in the battle with the Persians, who had been invading their country. Upon informing the people of good news, he fell over and died.
Next Monday: Read Dr. Paul J. Mackarey in “Health and Exercise Forum”.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliate faculty member at the University of Scranton, PT Dept.
Guest Contributor: Tito Ogunsola, SPT, ATC
October is National Physical Therapy Month! Stop by my office at Mackarey & Mackarey PT on Penn Avenue in downtown Scranton for First Friday festivities on Friday October 7 from 5:30 to 8:30 to celebrate PT Month. We will have live music by East Coast Trio and photography by Eileen Barrett Notarianni. Remember to hug your PT today! In honor of PT month, today’s column has been written by a guest contributor from my alma mater, Temple University. Tito Ogunsola, SPT, ATC, Temple University, (Doctor of Physical Therapy 2011), submitted this column as the 2011 recipient of the Dr. Paul Mackarey, Physical Therapy Health Care Journalism Award.
Do long days at work feel like a pain in the neck, literally? Over time, long hours spent in front of the computer or on our feet all day can lead to poor posture and affect the alignment of our bodies. We have all been told to sit up straight more times than we would like to remember, all the while not realizing how severe an impact our posture has on our well being. Poor posture can contribute to neck pain, headaches, low back pain, poor flexibility, jaw pain, shoulder pain, muscular fatigue, as well as declines in overall fitness. Improper body positioning when sitting, standing or when performing daily activities can cause your body to work harder than necessary by over stressing the muscles. The overstressed muscles fatigue and become less efficient, which thereby leads to injury. Fortunately, it is possible to prevent further damage by correcting your everyday bad habits.
The following tips can be implemented in your daily life to help reduce and/or prevent injury:
In conjunction with modifying your posture, it may be necessary to see a medical professional such as your family physician or physical therapist who can further help relieve to your symptoms. This is very important for those with a history of neck or back pain, osteoporosis, scoliosis, or flat feet.
Physical Therapists are experts in conservative management of movement disorders. Physical therapy can teach individuals how to decrease stressful living and working habits. A goal of physical therapy is address patient specific complaints and to correct the existing tissue problems in order to help patient’s function safely when performing life activities. Physical therapy will help patients to avoid further injury by addressing specific impairment such as: decreased range of motion and flexibility, lack of muscular strength, endurance, etc. Physical therapy can also help providing muscle relaxation and pain relieving interventions. On your first visit, you can expect the physical therapist to examine your posture in various positions and conduct a number of examination tests to find where possible muscle imbalances and tissue dysfunctions lie. Moreover, the physical therapist will teach you postural re education techniques that will further help decrease the stressors being placed on your body. To find a licensed physical therapist in your area with orthopedic certification visit: APTA.org or ask your physician for referral.
Visit your doctor regularly and listen to your body.
Guest Contributor: Tito Ogunsola, SPT, ATC, Temple University, Doctor of Physical Therapy 2011, submitted this column as the 2011 recipient of the Dr. Paul Mackarey, Physical Therapy Health Care Journalism Award.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Part 3 of 3
This is the third of three columns dedicated to healthcare for college students Please find the “10 Tips to Keep Yourself Healthy in College” helpful. However, no discussion regarding the health and wellness of college students would be complete and thorough without addressing what health care and university experts consider the two most dangerous behaviors on college campuses across the nation: binge drinking and unprotected sexual activity. While it is not my intent to offend the religious and moral values of any reader, it is my purpose to provoke direct and meaningful conversation between parents, religious leaders and students. To prevent serious health problems in college, parents must share their experience and discuss their values regarding sexual activity and alcohol consumption with children before they leave home to live independently in college. If you are unable to have a direct conversation about these issues, consider doing what several readers have done; mail a copy to your child!
(American Academy of Pediatrics)
SOURCE: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
This is the second of three columns dedicated to healthcare for college students.
As part of the preparation, think about a first aid kit, health care history, and insurance file. Once you finish with these preparations, plan to take dance, art history and conversational Italian classes to occupy your time without children, especially for those who will be empty-nesters. Life goes on!
Remember, in living a large community and sharing close quarters makes the development and spread of disease a natural progression. College life can be very unhealthy for many reasons: lack of sleep, poor eating habits, poor hygiene and stress.
(American Academy of Pediatrics)
Last week we discussed common illnesses among college students, how to manage and when to seek professional help. Below you will find a list of symptoms that should never be ignored. The college health services department should be contacted if you have any of the following symptoms:
(American Academy of Pediatrics)
Get a small/medium plastic storage box and use it to keep all of the following health care items together in one place.
SOURCES: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Health Tips for College Students – Part III”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Labor Day Weekend is here! For many it means the end of summer and the beginning of the school year. Over the past month I have received several requests for a copy of my three part series of columns on health tips for college students. In view of this, I thought other parents preparing to send a child off to college this fall might also find this information valuable.
To fully appreciate the importance of this topic, one must keep in mind that living in a large community and sharing close quarters is the first ingredient in the development and spread of disease. College life can be very unhealthy for many reasons. Lack of sleep, poor eating habits and stress add spice to the recipe for disease. Lastly, poor hygiene added to the equation, will really get the Petri dish cooking up some nasty germs.
Common Health Problems for College Students (American Academy of Pediatrics)
SOURCES: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Health Tips for College Students – Part II”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
This upcoming weekend I encourage you to put your sneakers on and “Race for the Cure!” In honor of National Breast Cancer Awareness Month and the Susan B. Komen “Race for the Cure,” I would like to share some very encouraging current research regarding improve breast cancer survival with exercise. I have discussed this research with local physicians, Dr. Joseph Bannon, Delta Medix Breast Care Center and Dr. Christopher Peters, Northeast Radiation Oncology Center, for their impressions with these findings. Both physicians state that they regularly council their patients about the value of exercise in the recovery of breast cancer. They usually recommend aerobic exercise such as walking and/or biking and mild resistance exercise. They also emphasize that a formal rehabilitation program is often necessary if surgery was performed to prevent frozen shoulder of the involved extremity. A recent study in the Journal of the American Medical Association from Harvard now shows that regular exercise can actually improve the survival of patients with breast
cancer.
Previous studies have shown many benefits of exercise for breast cancer patients including improving immune functioning and controlling depression. However, new research recently presented at the American Association for Cancer Research annual meeting was the first report to conclude that physical exercise may improve survival in breast cancer patients. Additional studies have shown other benefits of exercise. For example, a study conducted at Vanderbilt University found that women who had high activity levels throughout life were less likely to develop endometrial cancer. At the Hutchinson Cancer Research Center in Seattle, researchers found that exercise with moderate intensity can reduce serum markers of inflammation (C-reactive protein), which, when elevated, are associated with chronic disease and poor cancer survival.
In the current study, conducted at Harvard University, researchers compared survival rates in women with breast cancer with exercise levels in terms of metabolic equivalent (MET) hours per week. While women with high activity levels of exercise had the best outcomes, even women with moderate exercise benefited.
In conclusion, current research supports the fact that exercise may improve breast cancer survival. The following guidelines are proposed:
This year when you’re warming up at the starting line to walk or run in the “Race for the Cure,” remember you are literally “RACING FOR THE CURE!”
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Last year’s Steamtown Marathon saw the influence of the new “barefoot running” fad, with R. J. Stiltenpole of Scranton Running Co. as one runner who sported the barefoot look and plans to do so again in October 2011. He, like many other “barefoot runners,” sported minimalist shoes to prevent cuts and blisters from the pavement. Stiltenpole wore Vibram FiveFingers Shoes, which he sells in his store. (The truth is that few barefoot runners actually run barefoot, thus the oxymoron, “barefoot running shoes!” Most runners use “minimalist footwear” such as Vibram FiveFingers Shoes or Nike Free Shoes to protect their feet from glass and other dangerous debris. You can find information on shoes at www.barefootrunningshoes.org.)
In essence, running is a minimalist sport—just lace up your shoes and go! Now some runners are making it even simpler by running barefoot. While it is not new, barefoot running has become extremely popular in the last few years, due in large part to the popularity of the book, Born to Run, by Christopher McDougall, which recently made the New York Times’s best-seller list.
Who runs barefoot? The Tarahumara people of Mexico, the Kenyen tribesmen, and the Kalahari hunters all run barefoot. But what sets these people apart is the fact that they have been running barefoot all their lives! For Zola Budd from South Africa, who set world-records running barefoot, this style of running was one he had practiced from childhood.
So, why does the Average Joe Runner think that he should abandon his running shoes and race in the buff? The first reason is that some scientific evidence suggests that contemporary running shoes contribute to running injuries. As shoe manufacturers pour money into the development of new shoes, their technology may actually allow runners to exceed their anatomical and physiological limitations, thereby contributing to repetitive stress (i.e. overuse) injuries.
A second explanation for the popularity of barefoot running is that novice runners want to imitate elite runners. They do this by adding variation to their routines to achieve balance and prevent injury.
Third, barefoot running may reduce impact forces, offering a softer landing than running in shoes. According to runners like Stiltenpole, running barefoot changes the way the foot strikes the ground, causing a runner to land more gently and lightly. Proponents of barefoot running say that this emphasis on a “soft landing” of the forefoot—or ball of the foot—causes barefoot runners to suffer less impact than hard heel-striking shoe-runners.
Research performed in 2007 revealed that most runners (75-percent of those studied) strike the ground with their heel. 24-percent struck the ground with their mid-foot, and only 1.4-percent of runners struck the ground with their forefoot. All runners were wearing footwear.
Dr. Daniel Lieberman from Harvard University contends that barefoot runners are more likely to strike the ground with their forefoot or mid-foot rather than their heel, which generates lower impact forces. Dr. Lieberman says that this running style is observed primarily in those who had been running barefoot from childhood, and he maintains that the “world’s best natural runners are forefoot strikers.”
The Pose Method of running may offer the best of both worlds, as it promotes soft running in a running shoe, on the ball of the foot. Dr. Romanov (INSERT FIRST NAME) proposed this theory after observing the running style of animals such as the cheetah. He recommends keeping your center gravity over your base of support and using gravity and momentum to propel you forward. When a runner uses the heel-strike method, his center of gravity falls behind his base of support, and he must use excessive muscular effort to advance his body forward. Dr. Romanov believes that the heel-strike method is an inefficient way to run, but he also admits that his Pose Method is hard to master. I have seen encouraging results after using the Pose Method in both my own running and in the rehabilitation of patients with running injuries. For more information on this method, visit http://www.the-master-runner.
Not all experts agree on the merits of barefoot running. First, it may not prevent the majority of running injuries. As Dr. Lieberman discussed, even though people who run barefoot experience lower impact because they are less likely to strike with their heel, research does not correlate the amount of impact with the severity of injury. Dr. Lieberman concedes that the most common running injuries are not the result of impact, and evidence does not reveal that “shod running” (running with shoes) weakens the muscles of the foot.
Second, barefoot running may actually increase the incidence of Achilles problems, plantar fasciitis, patello-femoral (i.e. anterior knee) pain, and iliotibial band syndrome according to Dr. Ferber from the University of Calgary. Running barefoot can also lead to overuse syndromes and osteoarthritis.
Third, barefoot beginners may underestimate the training that is required to lose the shoes. Stiltenpole finds that barefoot runners think more is better, and they attempt to run barefoot too much too soon. This causes many barefoot beginners to suffer from painful calf muscles and Achilles tendons. Stiltenpole recommends running 3-5 minutes upon the first use of minimalist shoes, and gradually adding a few minutes at a time as the foot muscles get stronger. Consider starting with 5 minutes at a slow pace, and run on soft surfaces such as grass or sand. Advance slowly (5 minutes per week), and use it as a training method on off-days. Before changing your running style or footwear, consult with a professional who specializes in this sport. Stiltenpole stresses that technique is important, and he recommends taking a mechanical running class, such as the free class that is offered at the Scranton Running Co. on Tuesday and Thursday nights at 6 pm.
A fourth drawback of barefoot running is that your feet are more vulnerable to injury from sharp foreign objects and infectious matter. Those with diabetes, peripheral vascular disease, or a compromised immune system—like those with HIV or rheumatoid arthritis—should avoid barefoot running.
While barefoot running has caught a great deal of attention in the current professional and consumer literature, current scientific studies do not favor barefoot running over running in footwear. Consider using barefoot running as a training method on off-days for 5 to 10 minutes. This can help you learn the concept of “soft running” to lessen impact, develop other muscles of forefoot and calf more effectively, and possibly prevent injury. Then, add a few minutes each week until you reach 20 to 30 minutes. Until a sufficient amount of quality evidence is available, common sense must prevail when it comes to barefoot running.
CONTRIBUTING AUTHOR: Janet Caputo, DPT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic, neurological and sports physical therapy.
Read “Health and Exercise Forum” by Dr. Paul J. Mackarey every Monday in The Scranton Times-Tribune. Dr. Mackarey is a doctor of orthopedic and sports physical therapy with offices in downtown Scranton. He is an affiliated faculty member at the University of Scranton, Department of Physical Therapy.
