Hamstring strains are very common in spring sports in Northeastern Pennsylvania in great part due to our climate. Each spring, as the season begins, many athletes suffer from pain in the back of their thigh when they pull or strain the hamstring muscle from aggressive activity in cold temperatures, following a long winter layoff. Even for those involved in winter sports, the muscle may not be accustom to working in the same manner as required for the specific spring sport. This week’s column presents the cause and symptoms of a hamstring strain. Next week will be dedicated to the diagnosis, treatment and prevention of this injury based on new research supporting specific training techniques.
A hamstring strain is a tear of the muscle fibers of the muscle group in the back of the thigh called the hamstring. The hamstring muscle is a group of three muscles that run from the back of the hip (lower pelvis), crossing the back of the knee and attaches to the knee bone (tibia). The hamstring muscles work to extend the hip and bend the knee during running and walking activities. They are very active when an athlete changes direction, especially forwards and backwards or decelerating. This injury, like others, varies in intensity. Severe hamstring strain occurs when many muscle fibers are torn. In very severe cases, the boney attachment can be pulled so strongly that a small fracture can occur. Healing time can be as short as a few days or as long as weeks or even months.
SOURCES: Journal of Physical Medicine & Rehabilitation and American Academy of Orthopaedic Surgeons
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Hamstring Strains – 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.
Guest Columnist: Gary E. Mattingly, PT, PhD
The first robin, the last mound of snow melting, crocuses emerging from the ground, the budding of trees: these all signal the beginning of Spring. But for some, Spring doesn’t officially begin until the first pitch is thrown with the start of baseball practice. Ron Chiavacci, former professional baseball player, coaches aspiring pitchers, and offers advice on pitching with accuracy.
What got you started teaching young pitchers?
While in the off season, I was asked by parents and teams to help their young pitchers with some one-on-one instruction, which I enjoyed. Later, I became an instructor at Pro Staff Baseball Camp, which I now run.
What are the major things you work on with young pitchers?
I work on all aspects of pitching: the basic fundamentals, strengthening and conditioning, the mechanics of the pitch delivery, and the physical and mental aspects of pitching. With one-on-one instruction, I enjoy developing programs that are specific for the individual.
What are the three most common mistakes you see in young pitchers today?
What suggestions would you give to a young pitcher who wants to take it to the next level?
Other than dedicating and committing yourself to that goal, it is important to understand the game. Baseball is a game of failure. A batter with a 400 batting average fails 6 out of 10 times at bat and yet has a very good chance of ending up in the hall of fame. The same thing applies to pitching. No pitcher is perfect and will always have times of failure. It’s important to learn how to deal with failure in the game. The people that fail the least are the ones that move on to the next level. As we like to say to all developing pitchers, “Strive for perfection, but be content with excellence, because you will never be perfect in this game.”
Chiavacci began playing locally with the Southside Little League and later played with the Moosic Mets, 948 Legion, Lackawanna Junior College, and Kutztown University. Professionally, Chiavacci has pitched for the Montreal Expos, Pittsburg Pirates, Detroit Tigers, Philadelphia Phillies, and Huston Astros. He also played one year of major league baseball in Korea.
Gary E. Mattingly, PT, PhD is a professor at the University of Scranton, Dept of Physical Therapy and an associate specializing in the prevention and rehabilitation of shoulder injuries at Mackarey & Mackarey PT Consultants in Scranton, PA.
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.
Guest Columnist: Gary E. Mattingly, PT, PhD
Last week’s article emphasized the importance of exercising core body muscles to prevent back and shoulder pain which can occur with the onset of spring sports. Today’s article emphasizes core exercises that are more sport specific. These exercises are for sports that emphasize the use of the arms. This would include all throwing sports (baseball, softball), all racket sports and golf.
Try 12 repetitions of the following exercises every other day. Increase weight or resistance as needed but maintain excellent form throughout the exercise.
Back Throws: This takes two people. Lay on your back. The second person should stand about ten feet away from the feet of the person. The person lying on his back throws the weighted ball to the second person. This throw should emphasize the follow through with the person sitting up following the throw. While the first person is still sitting up the second person tosses the ball back to the first person who catches the ball and returns back to their supine position.
Theraband Punches: Attach the theraband at shoulder height to a door or heavy furniture. With the theraband behind you, pull the theraband through the movement of a throw. The follow through should be emphasized or exaggerated.
Theraband Up-Sweeps: Attach the theraband at knee height to a door or heavy furniture. With the theraband behind you, pull the theraband forward and up in the movement of a tennis forehand. The follow through should be emphasized or exaggerated.
Theraband Down-Sweeps: Attach the theraband at head height to a door or heavy furniture. With the theraband behind you, pull the theraband forward and down in the movement of a tennis serve. The follow through should be emphasized or exaggerated.
NOTE: Once mastered, the above exercises can be performed on dynamic discs or pillows for greater challenge to the core muscles and improve balance in preparation for the throwing a baseball, hitting a golf, tennis or baseball.
Training Program for the Throwing Shoulder - is every other day with a day’s rest in between. A ten minute warm-up such as light jogging is suggested before throwing.
Day 1: 45ft – 25 throws - rest - repeat
Day 3: 45ft – 25 throws - rest – repeat – rest – repeat
Day 5: 65ft – 25 throws - rest - repeat
Day 7: 65ft – 25 throws - rest – repeat – rest – repeat
Day 9: 90ft – 25 throws - rest - repeat
Day 11: 90ft – 25 throws - rest – repeat – rest – repeat
Day 13: 120ft – 25 throws - rest - repeat
Day 15: 120ft – 25 throws - rest – repeat – rest – repeat
Day 17: 150ft – 25 throws - rest - repeat
Day 19: 150ft – 25 throws - rest – repeat – rest – repeat
Day 21: 65ft – 25 throws - rest - repeat
Day 23: 65ft – 25 throws - rest – repeat – rest – repeat
Gary E. Mattingly, PT, PhD is a professor at the University of Scranton, Dept of Physical Therapy and an associate specializing in the prevention and rehabilitation of shoulder injuries at Mackarey & Mackarey PT Consultants in Scranton, PA.
Model Credit: We would like to thank Ron Chiavacci for agreeing to be our model. Ron is a profession baseball pitcher having experience with the Tigers, Expos, Pirates, Phillys, and Astros. Ron is also the director of Pro Staff Boot Camp, an instructional clinic for aspiring pitch
Photo Credit: Jen Hnatko
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.
Although most people are coping with the first flakes of snow and the holidays are just behind us, it is not too early to think about the onset of spring sports. Golfers might remember last spring's pain between the shoulder blades following that first bucket of balls. The young ball player or maybe his/ her dad may remember the soreness in the shoulder following that first game of catch. The tennis player may fondly miss the well honed serve from last season and wonder why the first tennis games of the season are followed by so much pain. Fear not, the problem is not serious, and in most cases preventable. The number one underlying cause of all these future sports problems is loss of core body strength. Someone might comment "but wait, I go to the gym every other day - I certainly am not prone to this loss of core body strength." Well, maybe yes maybe no. Many gym routines work on aerobics, and the "showy" muscles of the arms, chest and legs. These include such well known muscles such as biceps, triceps, pecs, hamstrings and quads. The core muscles many times are the forgotten muscles such as the erector spinae, the multifidus, and the rotators. For upper extremity sports, the forgotten muscles also include the trapezius, the rhomboids, the levator scapulae, and the serratus anterior.
Obviously, for a smooth transition to spring sports (aka pain-free) it is important to work on the core muscles. One should first work the core muscles by themselves and afterward work the core muscles in exercises more specific to the individuals sport. The focus of this week's article is exercising the core muscles in isolation. Next week article will emphasize exercises that are more sport specific.
The following is a list of exercises that concentrate on the core muscles. Try to perform 12 repetitions every other day to prevent some unwanted sports pain in the spring.
T's - Lying on a Flat Surface on Belly - Extend your arms out from your side to form the letter "T'. While keeping your arms straight, raise your arms off the floor and hold for a count of ten. Do not raise your arms high - just get them off the surface. Start with no weight in our hands. After 2 weeks, try the exercise with light weights such as 1, 2, or 3 pounds.
Y's - Lying as Above - Extend your arms up and out to form the letter Y. (Think of the song "Y-M-C-A"). While keeping your arms straight, raise your arms off the floor and hold for a count of ten. Do not raise your arms high - just get them off the surface. Start with no weight in our hands. After 2 weeks, try the exercise with light weights such as 1, 2, or 3 pounds.
Lats - Standing - Secure a piece of theraband to a door knob or heavy furniture. Maintain good posture and stand with your back to the wall. Your head, butt, and heals should be touching the wall. With straight arms, reach out and grab the theraband. With straight arms, pull the theraband back to the wall and hold for a count of ten.
Rows - As Above - Secure a piece of theraband to a door knob or heavy furniture. Maintain good posture and stand with your back to the wall. Your head, butt, and heals should be touching the wall. With arms bent at the elbow, reach out and grab the theraband. While keeping the arms bent at the elbow, pull the theraband back to the wall and hold for a count of ten.
Ceiling Punches - Lying on Back - on a flat surface (mat or floor). With two pound dumbbells in your hands raise your arms toward the ceiling. Cross your straight arms in front of you. Reach as far as you can toward the ceiling. Your shoulders should come off of the floor as you reach toward the ceiling.
As these exercises get easier with time, increase the resistance by increasing the resistance with thicker theraband or increased weight. To avoid injury, be mindful of form. Perfect form with minimal weight is always more important than too much weight with poor form.
Adherence to these exercises should result in much less pain in the coming spring sports season.
Gary E. Mattingly, PT, PhD is a professor at the University of Scranton, Dept of Physical Therapy and an associate specializing in the prevention and rehabilitation of shoulder injuries at Mackarey & Mackarey PT Consultants in Scranton, PA.
Model Credit: We would like to thank Ron Chiavacci for agreeing to be our model. Ron is a profession baseball pitcher having experience with the Tigers, Expos, Pirates, Phillys, and Astros. Ron is also the director of Pro Staff Boot Camp, an instructional clinic for aspiring pitchers.
Photo Credit: Jen Hnatko
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.
Contributing Author: David FitzPatrick, MD
February is American Heart Month! This month is dedicated to raising the level of awareness about heart disease across the country.
This is the third of three parts on managing cholesterol. Part I defined the problem and Part II defined the solution. Today’s column will discuss how stress can affect cholesterol and the importance of making a commitment to a healthy lifestyle that includes daily exercise.
According to a recent long-term study, both men and women without a history of coronary artery disease or high blood pressure suffered from both diseases when they did not manage stress well. Those who allowed stress to upset them, (short fused and easily frustrated) had significant increases in cholesterol and blood pressure when compared with those who were more even-tempered and easygoing under stress.
Everyone encounters potentially stressful situations each day. For example, many face coping with a chronic illness or the loss of a loved one. For others, stress may be associated with financial shortfalls, making a presentation at work, or adequately balancing your time between family and career. For students, stress may be social or academic, with final exams and papers due.
In general, stress usually fluctuates over time. Interestingly, a stressful situation for one individual is perfectly comfortable for another. People handle stress differently. One thing is certain, life is full of potential stress and it cannot be avoided. But, you can learn to handle stress better. Exercise, meditation, and counseling are some resources you may want to explore.
Exercise fights high cholesterol by reducing stress and by reducing body fat. The key to success when it comes to improving your life with exercise is to develop a regular, consistent program.
Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:
Some simple suggestions for beginning an exercise program are:
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
Sources:
Guest Contributor: David FitzPatrick, MD, cardiologist, Great Valley Cardiology, Scranton, PA.
Guest Contributor: David FitzPatrick, MD
February is American Heart Month! This month is dedicated to raising the level of awareness about heart disease across the country.
This is the second of three parts on managing cholesterol. I am happy to say that my “research assistant” for this column was David FitzPatrick, MD, and we gathered our data at State Street Grill in Clarks Summit, PA while dining in good health: drinking red wine (pinot noir), and eating ahi tuna. During this meeting, Dr. FitzPatrick said that I may also enjoy the sweet potato fries on occasion and not feel guilty.
As discussed in last week’s column, Dr. FitzPatrick feels strongly that those with genetically high cholesterol should use exercise and diet to maintain health, but will still most likely need to take a statin in order to manage cholesterol effectively.
Education – Know your numbers. Learn the difference between unsaturated and saturated fats. Make yourself a student of healthy living through diet and exercise. Avoid fads, and focus your effort on scientifically proven methods.
Statin Drugs - There are many methods to lower your LDL (bad cholesterol). However, no method has been proven more successful than statin drugs. Multiple landmark studies confirm that for those individuals needing statin drugs to control their cholesterol, the benefits far outweigh the risks.
By inhibiting an enzyme in the liver, statin drugs limit the liver’s ability to produce cholesterol thereby significantly lowering LDL (bad cholesterol) and triglycerides and modestly increasing HDL (good cholesterol). As a result, their unique benefits include preventing and reducing plaque in arteries, stabilizing existing plaque, reducing inflammation of the arterial wall, and improving overall vascular function. Statin Drugs Include: Lipitor (atorvastatin); Lescol (fluvastatin); Mevacor (lovastatin); Pravachol (pravastatin); Zocor (simvastatin); Crestor (rosuvastatin).
Clinical studies that have shown that statin drugs significantly reduce the risk of heart attack and death in patients with proven coronary artery disease (CAD), and can also reduce cardiac events in patients with high cholesterol levels who are at increased risk for heart disease. And although statins are best known for lowering cholesterol, they may also have several other benefits: they may prevent Alzheimer’s disease, and they may also have a positive impact on diabetes and blood pressure.
Exercise – Second only to statin drugs, no other method of the prevention of CAD has proven more effective than exercise, specifically aerobic exercise. It is well documented that physically active people have a lower incidence of CAD than sedentary people. For the prevention of CAD, the following exercises are defined as aerobic: High Amount/High Intensity – a caloric equivalent of jogging 20 miles per week at 65 -80 percent intensity, Low Amount/High Intensity – a caloric equivalent of jogging 12 miles per week at 65 to 80 percent intensity, Low Amount/Moderate Intensity – a caloric equivalent of walking 12 miles per week at 40 to 55 percent intensity.
Exercise is a valuable prevention tool on many levels: it reduces weight, LDL, and blood pressure, and it increases HDL. Research has found that the amount of exercise matters more than the intensity. For example, those exercising 5 or more days per week benefited more than those exercising less often. However, it is important to remember that ALL exercise groups showed improvement.
Diet – Following a Mediterranean diet is one way you can reduce CAD and cut your risks for other diseases. While no Mediterranean diet has more value than another, the following equation highlights the factors that make a Mediterranean diet so valuable. First, eat a variety of fruits, vegetables, whole grains, beans, nuts, and seeds, with olive oil as an important source of fat. Then, add moderate amounts of fish, poultry and fresh dairy. Finally, subtract red meat from your diet, or at least limit your consumption.
The Dietary Approaches to Stop Hypertension (DASH) diet is the American version of the Mediterranean diet and has been found to reduce blood pressure and LDL levels. It is rich in fruits and vegetables, moderate in low-fat dairy, and low in animal protein. It promotes the use of legumes and nuts as plant sources of protein.
Along with increasing your plant-based foods and decreasing your consumption of red meat, you may also want to replace some of the carbohydrates in your diet with proteins or monounsaturated fats. This switch can improve lipid levels.
Fiber, Nuts, Tea, and Alcohol – Dietary soluble fibers such as pectin, wheat dextrin, and oat products will reduce LDL. Some suggest that a combination of soluble fiber with plant sterols many have be beneficial. Walnuts, high in polyunsaturated fatty acids, have been shown to positively impact serum lipid levels. Almonds, pistachios and other nuts have shown similar results. Those consuming nuts more than four times per week showed the most significant improvement. Also, those with moderately high LDL who drank green tea once to twice per day while following a low-fat diet found more improvement in LDL reduction than they did with a placebo. Moderate alcohol consumption (1-2 drinks per day) has been shown to improve HDL levels. Red wine, in particular, has the added antioxidant benefit even in its non-alcohol form.
Weight Loss – David FitzPatrick, MD, states unequivocally, “Adipose tissue (excess body fat) is the enemy for the average person with high cholesterol!” Fat cells secrete chemicals that negatively affect lipid metabolism. “Maintaining a body that is slim and trim with consistent exercise and a low calorie diet limited in saturated fats is the key”
Supplements – While the internet is littered with information on thousands of supplements claiming to lower cholesterol and provide other life enhancing outcomes, few are proven effective. Of these, only fish oil, taken in concentrated high doses (> 6g/day) has been proven to lower triglycerides and LDL.
Multivitamins, soy proteins, and other grain products, while not cholesterol reducing, are valuable to many. But when it comes to reducing cholesterol, garlic, policosanol, Vitamin E, and isoflavone supplements have failed the scrutiny of scientific research. Plant sterols such as BenecolR sisosterol and campesterol, found in Promise activTM, have been shown to slightly reduce serum cholesterol levels; however, no studies have actually demonstrated their ability to lower the incidence of CAD. In fact, the Nutrition Committee of the American Heart Association has suggested that the general population not use these products until further studies determine their safety and efficacy, due in part to potential side effects.
NOTE: While Current HDL Raising Medicines Are Relatively Weak, More Potent HDL-Raising Medicines Are On The Horizon.
Sources: WebMD
Guest Contributor: David FitzPatrick, MD, cardiologist, Great Valley Cardiology, Scranton, PA.
Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Monday Read Part III of Cholesterol – The Truth
Guest Contributor: David FitzPatrick, MD
February is American Heart Month! This month is dedicated to raising awareness of heart disease across the country. Heart disease strikes more men than women; but among women, it is the leading cause of death. The purpose of the next three columns is to dispel the myths that surround the topic of cholesterol and heart disease and provide accurate information that may help you protect your heart.
I share my personal story about my genetically high cholesterol, not to brag that I took control of my life and became a fanatic, but rather to illustrate two truths about high cholesterol. One: if you are the “Average Joe” with high cholesterol associated with too little activity and too much weight, you can take steps to resolve the problem. Two: if you, like me, have “genetically high” cholesterol, you can exercise and diet endlessly, but you will likely need a statin to truly control your problem. In either case, the ultimate goal is to prevent atherosclerosis (the build-up of plaque in arteries, caused by excess cholesterol), which leads to heart attack and stroke.
It has been almost 20 years since the traumatic day that I discovered I had high cholesterol. I was in my mid-thirties, and was working at a health fair when I decided to visit the booth labeled “cholesterol screening.” Little did I know that the information I would receive at this booth would change my life. The blood test revealed that my blood cholesterol level was almost 300 mg/dL—I was in shock. Concerned, I then visited my family physician, Peter Cognetti, MD, for follow-up. A 12-hour fasting blood test found similar results: 280 mg/dL.
It turns out I have a strong family history for this problem, and I needed to take corrective action immediately. I was hesitant to take medication because I was young, healthy, and determined to “beat it.” I became a vegetarian and ate limited portions of fish containing omega-3, such as salmon, mackerel and sardines. I did not eat meat or dairy. I increased my running workouts from 30 minutes, 2-3 times per week to 45-60 minutes 5-6 days per week. I trained for, and ran, marathons, and I took vitamins and supplements including fish oil and vitamin E. In three months I lost 10 pounds (150 to 140), and my total cholesterol went from 280 to 170. For 8 years I was able to control my cholesterol in this manner. However, once I reached my mid forties, the numbers crept up (210 – 220) in spite of maintaining my rigid program. My physician informed me that cholesterol levels increase with age, and I needed to strongly consider taking a statin medication. I agreed to take the minimum dose and maintain my program. After three months, the statin, in combination with my strict diet and exercise regimen, lowered my total cholesterol from 220 to 167 and increased my HDL from 32 to 52.
Cholesterol is a fat substance that is present in all parts of the body. While it is needed for normal cellular functions, when too much is present in your blood, it can deposit in the walls of your arteries. This contributes to plaque (atherosclerosis) and can accumulate to narrow or eventually block the artery wall. Therefore, high levels of cholesterol in the blood can increase your risk of heart disease.
Cholesterol comes from two sources: your body and your food. 75-percent of the cholesterol in your blood comes from your liver and other cells in the body. The remaining 25-percent comes from the foods you eat. Cholesterol is found only in animal products. High cholesterol shows no signs or symptoms, but can be detected by a blood test.
High cholesterol is also called hypercholesterolemia, hyperlipidemia or dyslipidemia.
The two most commonly measured forms of cholesterol particles are high density lipoprotein (HDL) and low density lipoprotein (LDL). LDL is the “bad cholesterol,” because it accumulates in the walls of your arteries. HDL is considered to be “good cholesterol,” because it reverses cholesterol deposition in your arteries. Men with HDL levels lower than 40mg/dL (50mg/dL for women) have been shown to have a greater risk of heart disease. Age, family history, smoking and high blood pressure are additional risk factors that, when combined with high LDL and low HDL cholesterol, dramatically increase the risk of heart disease.
Total Cholesterol Ranges:
HDL Ranges:
LDL Ranges:
NOTE: Updated National Cholesterol Treatment Goals Are Expected Some Time in 2011.
Sources: MedlinePlus, Prevention Magazine, UpToDate
Guest Contributor: David FitzPatrick, MD, Cardiologist, Great Valley Cardiology, Scranton, PA.
Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II: Top Ten Ways to Lower Your Cholesterol
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
This Valentine’s Day do not allow back pain to limit your sexuality! Back pain sufferers can have fulfilling sex lives! While this topic may be slightly awkward for some, those suffering from back pain realize its importance. Communication with your partner, diagnosis from a licensed medical professional, and limiting pain with proper positioning or use of alternatives to intercourse are three critical areas to consider when back pain interferes with intimacy.
Clear and honest communication with your partner is at the top of the agenda. Back pain is invisible, subjective, and unique to the individual. Therefore, it is your responsibility to help your partner understand your limitations. This is accomplished with a thorough discussion of positions and movements that elicit pain in order to discover the most comfortable alternative. Also, it is your partner’s responsibility to listen and try to understand. Moreover, both partners need patience, tolerance, imagination, and gentle experimentation to maximize sexual pleasure.
Schedule a visit with your physician to accurately diagnose the origin of your back pain. Your doctor may recommend referral to a physical therapist for examination and testing in order to determine your physical limitations. Guidelines for specific positions and movements which support your back and minimize pain will be provided. Remember you may have to initiate this discussion with your physician or a physical therapist. Ideally, your partner should be present to express his or her questions and concerns.
Remember, sex does not necessarily mean intercourse! Alternative sexual techniques (massage, digital stimulation, or oral sex) may be initially required when extreme back pain prohibits penetration. Take time to pleasure each other. Giving stimulation can be just as erotic as receiving it!
To discover the sexual positions that provide the most comfort requires some imagination, creativity, and experimentation even after your medical professional has educated you about supporting your back to minimize pain. Some individuals with back pain achieve pain relief with bending forward (flexion) and others with bending backwards (extension). Sexual positions need to be adapted for each and every individual. Your symptoms may change over time so you may need to work with your health care provider from time to time as you go through the many stages of recovery. Here are some suggestions:
Valentine’s Day should be a romantic time for lovers. Sex is an important part of an intimate relationship. Do not allow back pain to condemn you to life without sex. Appropriate education, an open attitude, and effective communication can help you recover what you lost and may even result in something better than what you had before!
CONTRIBUTING AUTHOR: Janet Caputo, PT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic and sports physical therapy. She is currently a Doctor of Physical Therapy student at the University of Scranton.
Professional Contributor: Ward FitzPatrick, DDS
February is National Dental Health Month and seems like an appropriate time to present information about a new technology available in dentistry which provides a minimally invasive, painless and more effective alternative to traditional dental surgery to the gums, Laser Assisted New Attachment Procedure or LANAP.
It is estimated that greater than 50% of the adult American population has moderate to severe gum disease. Yet less than 3% of those individuals receive periodontal treatment annually.* In addition to the risk of losing their teeth, there are new and growing bodies of evidence that show a link between periodontal disease and serious systemic problems like atherosclerotic heart disease, osteoporosis, stroke, diabetes, preterm low birth weight babies and Alzheimer’s disease. And the list is growing.
“What scientific research is finding is that there may be a lot more at stake in treating patients with periodontal disease than just their teeth”, says Dr. Ward FitzPatrick, a practicing periodontist with offices in Kingston, PA and Port Jervis, N.Y. “It turns out that the chemicals involved in chronic inflammation as well as the bacteria associated with gum disease can travel throughout the body and contribute to other problems. It is very likely that by adequately treating gum disease and reducing inflammation as well as the bacterial challenge, we are helping patients to be less at risk for developing these other problems or at least helping to better control them.”
So why are so few periodontal patients receiving adequate treatment, and frequently foregoing referral by their general dentist to see a periodontist (gum disease specialist)?
Dr. FitzPatrick explains that many people don’t know they have gum disease, because they don’t get evaluated. It requires a careful periodontal exam and diagnosis by a dentist or specialist. Many people are afraid of conventional periodontal therapy even though it is effective. “Unfortunately, because gum disease itself is often without pain symptoms, they choose to ignore the dire consequences of their disease, often until it is too late, rather than submit to what they perceive as unpleasant or painful treatment.”
Now there is another effective treatment option however for most periodontal patients that uses modern technology to manage moderate to severe gum disease. Laser Assisted New Attachment Procedure or LANAP is a minimally invasive, alternative to conventional periodontal surgery.
“Most people don’t necessarily look forward to a procedure where their gums are cut with a scalpel, the gum is opened, the roots are scraped and stitches are placed. LANAP eliminates most of the negatives associated with surgical periodontal treatment from a patient’s point of view” says FitzPatrick, a Diplomate of the American Board of Periodontology and certified in LANAP. “It is still surgery, but done in a kinder and gentler way with a laser. The laser is not a ‘magic wand’, but it is safe and effective in properly trained hands. Unlike conventional surgery, it only removes the diseased and inflamed tissue within the periodontal pocket. The healthy tissue remains intact- a big plus. In addition, there are no scalpel incisions, no stitches, very little bleeding, little or no post op swelling or pain, and the amount of further gum recession or sensitivity caused by treatment is negligible.”
The treatment protocol is very specific and focuses on the premise that the body has an amazing capacity to heal and even regenerate as long as a favorable environment is established. Regeneration happens via stem cells located in the bone and periodontal ligament tissues adjacent to the teeth roots.
The laser and special cleaning tools are used under local anesthesia to selectively remove only the diseased periodontal pocket tissue, along with the root surface tartar. The laser kills most of the pocket bacteria, and denatures the tartar to make it easier to remove. Then, on a different setting, the laser creates a biologic seal under and around the gumline of the teeth to create as sterile an environment as possible. This allows the natural healing processes to occur resulting in pocket reduction and even regeneration of bone and supporting tissues.
Important to the success of LANAP is the elimination of any excessive biting or chewing forces by selective reshaping and or splinting of any loose teeth so that the body has a chance to heal and regenerate; much like when a broken bone is immobilized to give it a chance to recover.
In addition, LANAP has been shown in prospective human histological studies to be effective, and result in true regeneration of lost support, in moderate to advanced periodontitis. Meaning that with treatment, in addition to providing a healthier periodontal environment in a patient’s mouth, some increase in the fundamental supportive structures of the teeth is expected.”**
Dr. FitzPatrick further explains that LANAP is a patented treatment protocol developed from a long established, but little used therapy called Excisional New Attachment Procedure (ENAP). It is an old treatment concept that never had the right instruments to be effective.” Now, that has changed with the laser. Specifically the use of an nd:yag laser, (the Periolase MVP 7”***) FitzPatrick adds “LANAP is to periodontal therapy what LASIK is to vision correction…. along with the Periolase, it is the only laser treatment protocol cleared by the FDA for treatment of periodontitis.”
Sources: nepalanap.com; fitzpatrickperio.com
PROFESSIONAL CONTRIBUTOR: Dr. Ward FitzPatrick, is a practicing periodontist with offices in Kingston, PA and Port Jervis, N.Y.
Many people living in Northeastern Pennsylvania exercise outdoors year round. The psychological benefits are many. We live in such a beautiful environment. Each season brings its own unique beauty and winter is no different. Most will not have to abandon outdoor activities but you must make some adjustments in equipment, clothing and food for each season and temperature changes that go with it.
These tips are appropriate for those who did well in the Steamtown Marathon in October, qualified for the Boston Marathon in the spring, and will be training all winter. Furthermore, those who enjoy winter exercise through walking, running, snow shoeing or cross country skiing will also benefit from this information. Consider the importance of making changes and adjustments in training according to the weather and temperature.
Over the past several years, great strides have been made on understanding the effects of extreme temperatures on performance. Current wisdom from the University of Otago in New Zealand has found:
Researchers have developed various strategies for athletes to stabilize their core temperatures in extreme hot or extreme cold conditions:
Visit your doctor regularly and listen to your body.
