Guest Columnist: Janet Caputo, PT, OCS
The ability of the blood to clot to close and heal a wound is something most of us take for granted. However, when this system is not working properly, serious health problems can occur. Fortunately, it is treatable and preventable in most cases. There is good news for those with an active lifestyle. Researchers from Leiden University in the Netherlands evaluated almost 8,000 people ages 18 to 70 and found that regular participation in sports and exercise significantly reduces the risk of blood clots. Some specific findings that are noteworthy are; women received more benefit than men, obese people (body mass index or 30 or more) were four-times more at risk, even those only participating in sport or exercise once a week reduced their risks. So, this is another reason to KEEP ON MOVING!
If a blood clot from a vein travels to your lungs, a life-threatening pulmonary embolism can develop. It can be fatal even with prompt medical intervention. Because blood clots can develop without any sign, if any of the following signs of a pulmonary embolism develops, seek medical attention.
Another possible complication after a blood clot in a vein is a condition known as post-phlebitic or post-thrombotic syndrome, caused by damage to your veins from the blood clot and reduces blood flow in the affected areas. The symptoms may not occur until a few years after the clot resolves and include:
A blood clot that blocks an artery can result in various conditions. If the clot occludes one of the coronary arteries that supply your heart, you can experience a heart attack. A stroke occurs when the clot forms in one of the arteries within your brain. Poor circulation in your legs (i.e. peripheral vascular disease) can be caused by clots in the arteries of your legs. Blood clots from atrial fibrillation can travel through your bloodstream and cause a stroke or may occlude the arteries to your bowel resulting in a loss of blood supply to your bowel or even possible tissue death of your intestines.
Since a blood clot can result in devastating consequences, even death, your primary goal should be PREVENTION. Prevent blood clots from occurring, from worsening, or from happening again by following these simple suggestions:
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.
MEDICAL EXPERT REVIEWER: Anthony J. Yanni, MD, Chief Medical Officer, Mercy Health Partners, Scranton, PA.
Read Part 1 about detecting blood clots. And, read Part 3, which covers the association between blood clots and flying.
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: Janet Caputo, PT, OCS
The ability of the blood to clot to close and heal a wound is something most of us take for granted. However, when this system is not working properly, serious health problems occur. Fortunately, it is treatable and preventable in most cases. This week will be dedicated to the definition and cause of blood clots. Next week, the column will discuss symptoms and prevention. There is good news for those with an active lifestyle. A recent study published in Journal of Thrombosis and Haemostasis found that regular participation in sports and exercise significantly reduces the risk of blood clots in ages 18 to 70.
Blood clotting is an important mechanism to help the body repair injured blood vessels. A clot that forms as part of the normal repair process offers little consequence but, one that forms when not needed, can result in potentially significant consequences.
A blood clot can form in one or more of the deep veins in your body, usually in your legs. This condition, known as deep venous thrombosis (DVT), is serious. While clots can also form in the superficial veins, they are typically less serious. Even though many clots resolve without treatment, a DVT can break loose and travel to your lungs. When this occurs, the condition, known as pulmonary embolism, is life-threatening for which prompt emergency medical attention is necessary.
Occasionally, DVT develops without any noticeable symptoms but the warning signs may include:
If you experience any one of these symptoms, notify your doctor immediately.
Blood clots form when there is damage to the lining of the vein. Blood clots can also be caused by blood that does not circulate normally or clot properly. Many factors can increase your risk of developing DVT and they include: (1) sitting for long periods, such as driving or flying, (2) prolonged bed rest during a hospital stay or paralysis, (3) inheriting a blood clotting disorder, (4) injury or surgery, (5) pregnancy, (6) cancer and its treatments, (7) heart failure, (8) birth control pills, (9) hormone replacement therapy, (10) a pacemaker, (11) a thin, flexible tube (catheter) in a vein, (12) personal or family history of DVT or pulmonary embolism, (13) being overweight or obese, and (14) smoking.
Blood clots can also form in your arteries. With atherosclerotic disease, hardening of the arteries, plaque deposits form along the lining of the artery and cause narrowing of the vessel. This disease may cause heart attack, stroke, and peripheral artery disease (i.e. poor circulation). If a plaque ruptures, a blood clot can form which can completely or partially occlude the blood flow at that point.
Your heart can form blood clots! Atrial fibrillation, an irregular heartbeat, prevents your heart from beating in an organized manner. The blood becomes stagnant and this may cause clots to form. Clots can also form after a heart attack when the ventricle is damaged and cannot work properly. Since the damaged ventricle does not contract in sequence with the rest of your heart, blood can pool and lead to clot formation.
Since clots that form in your arteries prevent oxygenated blood from reaching specific areas, several predictable symptoms can develop:
Blood clots in arteries are life- or limb-threatening events and require immediate attention. If you believe that you may be experiencing a symptom of a blood clot in an artery, seek medical attention immediately.
The risk factors for and the conditions that cause clots to from in arteries must be controlled! Since blood clots can cause permanent damage to blood vessels and organs, prevention is critical for maintaining health. Minimize your risk of cardiovascular disease and hardening of your arteries with blood pressure and cholesterol control, diabetes management, and refraining from smoking. Because family history is such an important risk factor, be more vigilant about risk factors if there is a family history. Even if you manage all controllable risk factors, you may still develop a blood clot.
Join us in the next two weeks for Part 2, to discuss the possible complications from blood clots and prevention of blood clots, and Part 3, about the connection between blood clots and flying.
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.
MEDICAL REVIEWER: Anthony J. Yanni, MD, Chief Medical Officer, Mercy Health Partners, Scranton, PA.
Guest Columnists: Casey Burke, DO; Nancy N. Wesolowski, OTD, CHT
As Presidents weekend approaches many people and ski resorts anticipate one of the most popular ski weekends of the year. Hopefully, Mother Nature will cooperate with Elk Mountain and Sno Mountain. While this popular recreational winter sport is fun and a nice diversion from what can otherwise be a long cold season, it is not without its risk for injury.
The most common injury of the upper extremity that skiers experience is known as ‘Skier’s Thumb’. This condition refers to an injury to a ligament (the Ulnar Collateral Ligament or UCL) that connects two bones of your thumb together. Typically, the injury occurs when the thumb is moved forcefully away from the palm, causing the ligament to tear. This occurs commonly when a skier falls while holding ski poles. This injury, while common in skiers, does occur in other sporting activities such as football, basketball, and soccer. Sports that require the use of sticks, such as hockey or lacrosse may also predispose athletes to a ligament injury with the forceful movement of the thumb in an outward direction. It can also be the result of a chronic injury from repetitive stress on the thumb. (See Illustration “Skier’s Thumb Mechanism of Injury” www.eorthopod.com )
The Ulnar Collateral Ligament (UCL) stabilizes the thumb joint where the thumb connects to the hand. It is necessary for this ligament to be stable because it makes an important contribution to grasping movements of the thumb. If you have injured this ligament it may be managed conservatively with immobilization. In more severe cases if the ligament has been completely torn, surgery mat be required to repair the ligament.
Physical exam would demonstrate swelling, tenderness at the area of ligament insertion, instability and pain with movement.
X-ray: An x-ray would demonstrate any bony avulsion (a piece of bone torn away by the ligament. It would also demonstrate any joint malalignment caused by the ligament tear.
Non-surgical (conservative): Immobilizing the thumb in a neutral position to allow the ligament to here. This can be done in either a cast or splint.
Surgical treatment: Surgery would be indicated for a complete tear and/or joint instability. This would consist of outpatient surgery, where you would go home the same day. The surgery can be done with either a general anesthetic (where you would sleep throughout the procedure with breathing assistance) or a regional block (where you could either be awake or asleep while breathing without assistance).
Post-operative care would include a cast for two weeks, at which point the sutures would be removed and a removable splint applied. The ligament would take approximately six weeks to heal.
If you have a strained ligament and do not require surgery you may be referred to a hand therapist for the fabrication of an orthosis or splint which will be worn for 4-6 weeks. The purpose of the splint is for protection from further injury and to position the thumb appropriately to allow for optimal healing. If there is a complete tear and surgical intervention is necessary you may be placed in a cast for 2 weeks followed by a splint for an additional 4 weeks. You should avoid activities that may cause re-injury for another 4-6 weeks.
Following the removal of the cast the thumb will be stiff and weak. A supervised exercise program is important to regain thumb range-of-motion. Once sufficient range of motion is restored, strengthening exercise will be initiated to regain maximal thumb strength and function. When necessary, a smaller splint can be made to allow earlier return to activity.
New improvements have been made in breakaway ski pole straps that help prevent this injury. These devices can be found at local ski shops located by Elk Mountain and Sno Mountain.
It is comforting to know that there are options available if you experience an injury or have compromised thumb stability from a long standing problem. Our thumbs are an integral part of our hand function and a stable thumb is essential for allowing us to participate in all aspects of our daily lives.
CONTRIBUTING AUTHORS:
Casey Burke, DO, is an orthopedic surgeon specializing in hand surgery. He practices in association with Professional Orthopedic Surgeons in Scranton, PA.
Nancy N. Wesolowski, OTD, CHT is a doctor of occupational therapy specializing in hand therapy. She is the owner/director of The Hand Center at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton.
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.
On a very frequent basis, parents of young athletes ask when it is safe for their children to participate in weight training. This month, for example, I received three such inquiries. While I have addressed this topic in a previous column, I have decided to present the information again. I hope it serves to prevent injury and dispel fear and fallacy.
Weight training, weight lifting or resistive training all describes the use of a resistive force on a muscle to improve strength. While much attention has been given to the benefits of weight training in adults, much less has been written about its application in children.
According to the Journal of Pediatric Orthopedics, children less than 12 years old are considered prepubescent or before puberty. Teenagers who are between 12 and 19 are considered adolescents. Studies consistently demonstrate that strength gains are much more significant in adolescents than in preadolescents. It is important to note that these strength gains are not only from the enlargement of muscle fibers (hypertrophy), but also from the improvement in the coordination and efficiency in muscle contraction and the recruitment of motor units and fibers within the muscle.
Pre-adolescents lack the hormones necessary to develop masculine characteristics. Adolescents begin to produce the hormones of testosterone and androsterone to develop secondary sexual characteristics such as pubic hair and enlarged genitalia. In view of this, age 13-14 is the optimal age to safely begin and benefit from a well-designed weight training program.
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: Janet Caputo, PT, OCS
Today is the last Monday of January 2010. My associate, Janet Caputo would like to share her perspective and personal experience with health and wellness goals. She, like most of us, has had her share of struggles and offers some sage advice.
How many of you have remained true to your New Year’s resolutions? How many of you resolved to lose weight? I am sure that if you watched television since New Year’s Day, you were barraged with advertisements and infomercials for weight loss solutions! These products and programs can be very expensive but “the perfect body” is priceless! However, what plan do you have to maintain your weight loss once you have completed the “program” or finished the last of your “product”? The commercials do not give you that information because, if you discover the secret, you will not purchase anymore of the manufacturers’ weight loss plans and paraphernalia!
Personally, I have struggled with my weight all my life and have a closet full of clothes to prove it. My wardrobe consists of every size from six to sixteen! I not dare discard any item because I do not know what “size” I will require next month! I have “dieted” for approximately twenty-nine years and, through trial and (many) error, I have ascertained that the only permanent solution to maintaining my weight is a combination of a healthy diet and exercise or physical activity. What, did you think being “thin” was going to be easy?
First, let us discuss a “healthy diet”. High-fiber foods (whole grains, fruits, vegetables) are not only healthy but also provide less calories, contain less fat, and take longer to digest which delays the sensation of hunger. Select proteins that contain less fat: fish, poultry, and lean cuts of meat. Your plate should contain ¾ vegetables and your portion of meat should be the size of a deck of cards. Limit your starches (rice, potatoes, pasta, and bread) to “a serving size” which is usually ½ cup or one slice.
I know what you are going to say, “I don’t have time to prepare all that “good” food.” No excuses! Modern supermarkets have made it very convenient for consumers to eat healthy. For example, located in the produce section of most grocery stores are prepared packages of cleaned and “cut-to-fit-the-mouth” fruits and vegetables. Some manufacturers place their vegetables in bags that are designed to go straight from the shelf into your microwave. Steaming your vegetables in the microwave and broiling your meats and fish reduces not only preparation and clean-up time but also caloric consumption. I understand that fresh food is expensive but compare your weekly grocery bill to what you spend for one meal at a restaurant or to what you were willing to spend on those “diet” pills!
If you tend to be OCD, you can calculate the exact number of calories that would provide weight loss. Refer to the American Heart Association No-Fad Diet: A Personal Plan for Healthy Weight Loss for the full details. Generally you must consume 500 less calories each day to lose one pound each week. If you eat 1000 less calories each day, you can lose up to 2 pounds each week. A weight loss of greater than 2 pounds each week is not healthy and should not be attempted without the direction of physician. Starvation diets actually reduce your metabolism because your body believes that it is being starved. Therefore, your body decides to conserve calories which results in absence of weight loss.
In addition to limiting caloric intake, you must incorporate exercise or at least increase your physical activity. Exercise and physical activity are requisite for weight loss because they burn fat and calories. The AHA recommends 30 minutes of exercise on most days of the week and defines “exercise” as performing an activity that elevates your heart rate to your target heart rate. The target heart rate is 60% to 85% of your age predicted maximum heart rate (APMHR) which can be calculated using this formula: 220 – your age = APMHR. Your ability to “exercise” may be limited because of a health issue or physical disability but you can still increase your physical activity! Get up off that couch or get out of that bed and MOVE! Cleaning the house, cutting the grass, washing the car, taking a walk, using the stairs, and dancing with friends are some ideas to expend calories through physical activity.
If you are one of those unfortunate few who have tried these suggestions and failed to lose weight, then you may have a metabolic problem that would need to be addressed by a specialist. If you discover your decision to eat is not based on a sensation of hunger but rather on a feeling of depression or anxiety, then you made require some counseling in order for your weight loss program to be successful. Before initiating any exercise program or new diet regimen, please discuss your plans with your physician. Your doctor can provide guidance for proper decision making or may refer you to a weight loss specialist for additional assistance.
Guest Columist: Janet Caputo, PT, OCS is an associate and clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic and sports physical therapy. She is also a doctor of physical therapy student at the University of Scranton.
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.
There are many reasons we exercise. Some people exercise to prevent illness such as cardiovascular disease or osteoporosis. Others exercise for mental health and as a stress release; others do it to improve strength, flexibility, and endurance to prepare for a sport. However, the number one reason people exercise is TO LOSE WEIGHT!
When it comes to losing weight, patients have asked me a wide variety of questions over the years. However, certain questions are consistent. “What exercise is the best to burn calories?” “Even though I exercise 2-3 times per week, why can’t I lose weight?” “What is BMR?” “If I eat a Snickers bar, how much exercise do I need to do to burn it off?” “Are there any tools that I can use to help me track my calories and exercise output?”
Have you ever heard people say that they never felt better or burned more calories as they did when they ran? Well, they may be right! The following numbers are base on the average male weighing 150 pounds: running 6 miles per hour will burn 700+ calories (11-12 calories per minute); vigorously skipping with jump rope or fast cycling will do the same; vigorous walking at 4 miles per hour and moderate biking will burn 600+ calories (10 calories per minute). The 400-500 calorie club includes the following activities: slow jogging, swimming, football, basketball, baseball, tennis, skiing, and moderate walking (3.5 miles per hour). Light gardening burns more calories than golfing using a cart (250 vs. 180).
What is BMR?
How many times have you heard people say, “It is hard for me to lose weight because I have a slow metabolism?” What does that mean? To explain this in detail you first must understand BMR. BMR is basic metabolic rate. It is the number of calories that your body requires to operate basic body functions that you don actively control, such as continuing to breathe, and keep your cells and organs working each day. The BMR is influenced by age, height, gender, body fat, and fitness level. BMR is inherently different (high or low) in each individual. While you can’t change your gender or height, you can influence some things to influence your BMR and burn more calories at rest. One, exercise for longer durations, with greater intensity and more frequently. Two, lower your body fat by eating less calories, especially fat and carbohydrates in your diet. Simply, eat less calories than you burn! Three, improve you muscle/fat ratio by weight training.
Basic Metabolic Index (BMI):
BMI:
For example, I am a 48 year old male, weighing 140 pounds at 5 feet 8 inches tall with a BMI of 21.3
*Calculate you BMI by entering you gender, height and weight and find how many calories per food item at www.calorie-counter.net
There are several tools available for free online to help with tracking calories and exercise. Visit Prevention Magazine at www.myfooddiary.com
So remember, the number one reason we exercise is TO LOSE WEIGHT! But depending on exercise alone to lose weight is an exercise in futility. Losing weight is an intelligent and consistent combination of a balanced diet with portion control, proper nutrition, adequate exercise and activity grounded in lifestyle changes.
source: Mayo Clinic –December 2009
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 65 min, for 175-pound person= 43 min, for a 225-pound person= 37 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 28 min, for 175-pound person= 20 min, for a 225-pound person= 16 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 17 min, for 175-pound person= 13 min, for a 225-pound person= 10 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 8 min, for 175-pound person= 5 min, for a 225-pound person= 4 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 37 min, for 175-pound person= 27 min, for a 225-pound person= 21 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 16 min, for 175-pound person= 11 min, for a 225-pound person= 9 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 51 min, for 175-pound person= 38 min, for a 225-pound person= 29 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 22 min, for 175-pound person= 16 min, for a 225-pound person= 12 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 26 min, for 175-pound person= 19 min, for a 225-pound person= 15 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 11 min, for 175-pound person= 8 min, for a 225-pound person= 6 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 66 min, for 175-pound person= 48 min, for a 225-pound person= 37 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 29 min, for 175-pound person= 21 min, for a 225-pound person= 16 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 13 min, for 175-pound person= 9 min, for a 225-pound person= 7 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 6 min, for 175-pound person= 4 min, for a 225-pound person= 3 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 57 min, for 175-pound person= 42 min, for a 225-pound person= 33 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 25 min, for 175-pound person= 18 min, for a 225-pound person= 14 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 30 min, for 175-pound person= 22 min, for a 225-pound person= 17 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 13 min, for 175-pound person= 9 min, for a 225-pound person= 7 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 65 min, for 175-pound person= 48 min, for a 225-pound person= 37 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 28 min, for 175-pound person= 20 min, for a 225-pound person= 16 min.
Walk/Dance/Bike at Moderate Pace:
for a 125-pound person = 10 min, for 175-pound person= 7 min, for a 225-pound person= 5 min.
Walk/Dance Bike at Fairly Intense Pace:
for a 125-pound person = 4 min, for 175-pound person= 3 min, for a 225-pound person= 2 min.
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
Take a moment to think of our fitness role models. Usually, we think of personal trainers and fitness instructors. They are certainly good examples. But, this year, when you make it your goal to take control of life and begin a healthy lifestyle, choose a role model with whom you can identify…the average Joe! The New Year role model in 2009 was Joe Hogan, admired for his great health and wellness accomplishments. This year we recognize John Walker as the 2010 health and wellness role model.
John Walker, co-owner of R. J. Walker Co., is a friend of mine. He is truly a health and exercise role model for the general public. Unfortunately, most of us do not have the time, energy or gene pool to look like a personal trainer. But, that is not an excuse for doing SOMETHING! John did something…he took control of his life!
Last year John was 75 pounds overweight and suffered from sleep apnea and type II diabetes. He also had lower back pain, leg pain and Achilles tendonitis. He notes that he loved to snack on junk food throughout the day.
John came to my office for physical therapy. With our help, he managed his lower back pain and achilles tendonitis. Once pain free, he decided to take control of his life and get healthy as a goal for 2009. After six months, he lost 50 pounds. Through diet and exercise, he controlled his diabetes, no longer requiring medication. Moreover, John no longer suffered from sleep apnea, back or heel pain. Maureen, his wife, is thrilled because he no longer snores.
John shared that it did not happen overnight or by accident. With family support, hard work, dedication, discipline and commitment for six months he took control. He feels he has hit a plateau, but plans to make it through the holidays without gaining any weight and to get serious again for the New Year. He feels strongly that this is a lifestyle change for LIFE, not 1-2 months. He stated that is why he failed with fad diets and half hearted attempts at exercise. Now, with the support of Maureen, he is able to maintain a lower fat diet with portion and calorie control and eats healthy snacks.
In addition to his dietary changes, his exercise program is not complicated. He uses and elliptical trainer for aerobic exercise 5-6 days per week for 30-35 minutes, weight training 3 days per week for 30-40 minutes and performs core exercises 2-3 days per week for 15 minutes. He says he never felt better and plans to lose another 20-25 pounds in 2010. He is committed and I am proud of him. The message: regardless of your physical condition, there is some level of exercise that you can tolerate. You must begin somewhere and slowly. Get advice from your medical doctor and physical therapist.
According to the National Institutes of Health (NIH), while genes play an important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.
Physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to longevity. 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:
AEROBIC EXERCISE:
WEIGHT TRAINING:
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, exercise regularly, and live long and well!
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 Contributor: Y. Barry Kurtzer, MD
Happy Holidays! It is at this time of year that we celebrate life with great hope and faith. People of many faiths take time to reflect, respect, and resolve. Christians celebrate Christmas, the miraculous birth of Christ, the Son of God, and the Messiah. Jews celebrate Chanukah, the miraculous festival of lights, when one night’s oil provided enough light and safety for 8 nights. Both major faiths promote healthy lifestyles for the mind, body and spirit. These faiths are grounded in hope, faith, love and peace. It is no surprise that studies have repeatedly found that people of faith outlive those without!
In previous years, I have invited guest authors such as University of Scranton President, Fr. Scott Pilarz, S.J., Ph.D., and Scranton Preparatory School President, Fr. Herbert Keller, S.J., to share their thoughts on this topic. This year, I have the pleasure of sharing the expertise of Y. Barry Kurtzer, MD with you. Dr. Kurtzer is undoubtedly an expert on the healthy mind, body and spirit as he has the distinction of being both a Rabbi and Medical Doctor. He was kind enough to share his thoughts on this topic for our enlightenment:
“The Talmud (a book of Jewish law) states that preserving one’s life is considered by Scripture as preserving an entire world. Along these lines, it is understood that it is an axiom of Jewish law that preservation of life is a value of the highest order. When life is endangered, most commandments are disregarded. There are many other examples in the Torah (Bible) proving clearly that one must be very careful to take care of his health. The Bible tells us that one must build a fence around one’s roof t prevent tragedy. This is obviously and imperative to take aggressive remedial action against health hazards. Secondly, in the Shulchan Aruch (a book of Jewish law) we are clearly told that when an epidemic strikes, one is obligated to leave town. The present day equivalent for previous century’s epidemics would certainly be improvement of one’s health to escape disease. We find that a father is obligated to teach his children to swim to avoid potential future tragedy by drowning.
Maimonides, one of the great early codifiers of Jewish law and himself a physician, makes a very strong statement. The body’s health and perfection is one of the ways of serving God because it is impossible to understand and know God at all when ill; therefore, man must avoid that which destroys the body and conduct himself in ways which strengthen and restore the health of the body. Maimonides elaborates further by giving us a list of recommendations for diet, sleep and exercise.
Lastly, we are told in Genesis that man is created in God’s image. There is a story told of a king who went for a walk in his garden and saw a worker cleaning a statue of the king himself. When he asked the man “why are you doing this? He said, “The statue represents the king and it has to look its best.” So too, we, by taking care of our bodies that are created in God’s image, certainly are following God’s will.”
In 2010, in an effort to improve the health of your mind, body and spirit, I offer the following;
Guest Contributor: Y. Barry Kurtzer, MD, Rabbi and Medical Doctor specialized in the practice of Internal Medicine in Scranton, PA.
Source: (Elson M. Haas, MD)
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 Contributor: Judi Mackarey, Esq.
Last week’s article shared some of my fondest Christmas memories. For me, they are evoked by the smells and tastes of the holiday meals prepared with love by my Italian grandmother (or, as we affectionately called her, Noni). For our family, Christmas Eve was not just the night before Christmas; it was a celebration unto itself. My mother’s mother, Rosina Scalese, did more than turn on an oven as she transformed groceries into dinner. Planning, preparing, and shopping in preparation for the feast began the day after Thanksgiving. When my grandmother was in charge, my mother Angie Scalese Mackarey, was her sous chef. She was also responsible for desserts. Like Noni, her pastry making started at Thanksgiving. Weekly, batches of cookies were baked, and then stored in Charlie Chip cans. Unfortunately for us kids, other than a taste as they were coming out of the oven, the cookies were off limits until Christmas.
Mom will be making her annual visit from Florida for the holidays. A portable chest will be filled with items she has pre-prepared and once home; she will continue the tradition of the Christmas Eve gastronomic feast. She has also inherited the back, neck pain and headaches associated with long hours of food preparation. And I have inherited the job as assistant chef. For those who think all Italian males are like those portrayed on the “Sopranos,” I enjoy helping my wife and mother in the kitchen. Happy Holidays!
Make your Holidays more enjoyable by following these simple guidelines, which will assist in preventing or diminishing pain that originates from your spine.
Proper body mechanics are based on good posture. Proper body mechanics involve maintaining a neutral spine with transitions from one position to another during daily activities.
Driving: Seatback should be vertical. Back/neck supported with chin level. Move seat close to allow knees to bend and feet to reach pedals. Knees are at same height or slightly higher than hips. With hands on wheel elbows are slightly bent and relaxed. Place hands on wheel at 9 and 3 o’clock to relax shoulders. A lumbar roll is recommended.
Standing: Face work directly. Adjust height of table to allow good posture. If not possible, get closer to work by sitting/kneeling. Elevate one foot on a stool or box (weight shift). Change feet every 5 to 15 minutes.
Bending:
Good posture for prolonged periods or repetitive activity even with good body mechanics induces abnormal stresses on the body and leads to pain. Therefore, take breaks and move every fifteen to thirty minutes. Stretch your neck backwards, pinch your shoulder blades together and extend your lower back. This will help prevent muscle fatigue/tightness, joint stiffness, and reduced circulation.
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 Contributor: Judi Mackarey, Esq.
My fondest memories of the Christmas season are triggered by the fragrances wafting from homemade Italian ragu (tomato sauce/gravy) and the mere mention of the word calamari. The smell and taste of the food prepared with love by my “Nona” (we pronounced it Noni, grandmother in Italian) evoke the essence of Christmas for me, as a child -- and even today. For Rosina Scalese, my mother’s mother, holiday dinner was never merely a meal. It was a preparation for an event, much like one might do for a wedding. Once Thanksgiving was over (an American feast, so lesser in importance in the Italian food chain), the holiday planning began in earnest. Nothing was allowed to interfere with the preparing and shopping for the most important and sumptuous meal of the year, the Feast of the Seven Fishes, which was served on Christmas Eve. Based upon the effort involved, it would not have surprised us if the Holy Family showed up to dine with us. They would surely understand why you cannot get a bad meal in all of Italy. It is not permitted. I suppose that explains why some sophisticated epicureans believe that Jesus was actually born in Modena.
Nona would take her daily walk to buy fresh provolone, olives, olive oil, prosciutto, and suprasatta from Morazzi’s in North Scranton. She could only carry so much at a time, especially as she got older, so the shopping excursions themselves were a full-time job. Finally, all of the ingredients were assembled to make an assortment of homemade pasta: gnocchi, (my favorite), ravioli with cheese (no meat for the holiday), lasagna, and linguini. As she made the pasta, the big pot of sauce simmered on the stove all day. Next up in the grocery procession was the fish and bread order, which had to be secured weeks before the big night. She made it her business (pronounced bees-a-knees) to find out who made the best homemade Italian wine that season (Dago Red, of course) and made sure to reserve a few gallons for the family meal. As the day drew near, she soaked the bacala (cod), cleaned the calamari (squid), eel, smelts and anchovies. Unfortunately, many tasks could not be performed before Christmas Eve day.
Of course, no meal is complete without the appropriate dinner arrangements. Naturally, it was a requirement that the meal be served from her home. In her later years, Nona lived in a ½-double that was attached to my parents’ home, across the street from her original home, where several other aunts and uncles still resided. The first floor of her home was converted into a banquet hall, with tables and chairs to serve an army. The grandchildren were enlisted to help with the setup, under the supervision of my grandmother . Our extended family, like many of that time, was large. Because of the numbers of attendees, plates and silverware did not match. Glasses came in all sizes. But the power to draw aunts, uncles, cousins, and friends was that of one-thousand oxen (or Italian goats). For us, Christmas Eve was the highlight of our holiday, almost eclipsing Christmas day itself. Even as we grew older, no matter where we lived, we had to come home for the holidays. Nona was wise and knew that this celebration would keep us all together. She cajoled us with the threat of her demise before the next holiday season. She lived until she was 97, so we shared many holiday meals together. But, she was right. As is the case with many families, we have scattered across the country and now only see the entire family for weddings and funerals. I miss her, but she will always live in my warm memories of Christmas.
As I look back, I now realize that all of this fuss took its toll on my Nona. She worked non-stop. Not just the shopping, cooking and baking, but the house-cleaning in preparation for the holidays. It was her day and it had to be perfect. She glowed with pride and satisfaction on Christmas Eve when her entire family (la familia) sat down to enjoy the feast made from love.
But, I can also recall the end of the festive evening, after the entire family ate, Nona finally collapsing in her favorite chair. She complained of back and neck pain, and rubbed her head from headaches. I now know that her forward posture, from cooking, cleaning and lifting of heavy trays and pots, contributed to her pain. This column is dedicated to all the people who will spend countless hours preparing for the holiday season, whether it is Christmas or Hanukah. I offer suggestions for prevention and treatment of neck and back pain associated with these tasks. Hopefully, it will help make your holiday more enjoyable. Merry Christmas! (Bona Natale!) Happy Hanukah!
Research suggests that many spine problems can be prevented by maintaining a good position and proper body mechanics. Poor posture and improper body mechanics subject the spine to abnormal stresses that, over time, can lead to degeneration and pain. Good posture and proper body mechanics can minimize current spine pain and prevent recurrent episodes. Posture is the position in which you hold your body upright against gravity. Good posture involves positions that place the least amount of stress on the spine. Good posture maintains the spine in a “neutral” position. In a neutral spine, the three normal curves are preserved (a small hollow at the base of the neck, a small roundness at the mid-back and a small hollow in the low back). When viewed from the side, the upper back appears straight with a small hollow in the lower back.
Read more about cooking and neck pain in Part 2.
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.
