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Part II of II: Gardening with Disabilities

Summer (and Memorial Day, the kickoff of the gardening season) will be here soon and gardeners in northeast PA are anxious work in their gardens and enjoy the fruits of their labor. Last week, Health & Exercise Forum presented tips for gardeners for preventing hand and arm injuries such as carpal tunnel syndrome. This week’s column is dedicated to prevention of lower back and lower body injuries when working in the yard and for gardeners with disabilities.

A relaxing and enjoyable activity for many, gardening can turn dangerous without proper precaution as repetitive stress injuries, back pain, muscle pulls, can stem from raking, weeding, digging and pruning, can turn into serious problems if not treated appropriately.  Since prevention is the best approach, the US Dept of Agriculture promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.

People with various disabilities enjoy gardening at different levels. For example, those suffering from neurological diseases with muscle weakness, paralysis and poor balance as well as those with musculoskeletal problems such as neck and LBP or hip and knee arthritis can safely enjoy gardening at some level. This outdoor labor of love is very therapeutic.

Warm up and stretching is important. Don’t garden first thing in the morning before you have a chance to warm up. Get up, go for a short walk, have breakfast and maybe warm up with a hot shower before working in the garden. Some stretches include:

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Corner Stretch: Stand facing a corner wall with arms and shoulders at 90 degrees. Lean into corner and stretch shoulders and back. (PHOTO 1)

Knees to Chest Back Stretch: While lying on your back, bring both knees up towards your chest. (PHOTO 2)

Note:  These exercises should never be painful when completing them.  You should only feel a gentle stretch. Hold the stretch10 seconds and repeat 5 times before you garden and every 2-3 hours while working. Should you experience pain, please consult your family physician or physical therapist.

The following guidelines to prevent injury and foster healthy gardening for those with and without disability:

  1. “Easy-Grip” tools are available for those unable to grip strongly. For example, hand shovels and weed cultivators that attach to the wrist/forearm with Velcro straps and tools with telescoping extensions are available. (www.wrightstuff.biz)
  2. Mobile Adjustable Stools – with arm rests and 2-3 steps that allow you to go from sitting upright to a position closer to the ground.
  3. Elevated and Raised Beds – allows gardening from a standing, sitting or wheelchair height for improved safety and enjoyment.
  4. Pipe Planter or Seeder – a PVC pipe 5-6 feet long allows planting and seeding without bending or kneeling. For example, a 6 or 8 inch pipe allows plants to slide down and be tampered into a hole and a 1-2 inch pip allows seeds to slide down to the ground for cover or planting.
  5. Kneeling Pads, Mats, Carts – are healthier for your knees and back.

Source: Karen Funkenbusch, MA; Willard Downs, PhD.: U. S. Department of Agriculture - Agricultural Engineering Extension

Model: Ashley Ottaviani, PTA

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 associate professor of clinical medicine at GCSOM. Access all of Dr. Mackarey's articles at our Health and Exercise Forum!

Part I of II: Prevention of Hand Injuries Associated with Gardening

Farmers and gardeners in NEPA always say that Memorial Day, the “kick off” day for planting without the fear of frost, however, it is not too early to start to prepare…not only the beds but your body! While gardeners are anxious to work in their gardens and enjoy the fruits of their labor, a relaxing and enjoyable activity can turn dangerous quickly. Precautions are necessary as repetitive stress injuries such as shoulder and elbow tendonitis and carpal tunnel syndrome can stem from raking, weeding, digging and pruning. Additionally, simple scrapes, blisters, and bites can turn into serious problems if not treated appropriately.  Since prevention is the best approach, the American Society of Hand Therapists (ASHT) promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.

ASHT recommends following these upper extremity warm-up exercises prior to gardening:

Note:  These exercises should never be painful when completing them.  You should only feel a gentle stretch. Hold 10 seconds and repeat 5 times. Should you experience pain, please consult a physician or hand therapist.

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1. Forward Arm Stretch: Fold your hands together and turn your palms away from your body as you extend your arms forward.  You should feel a stretch all the way from your shoulders to your fingers. (PHOTO 1)

2. Overhead Arm Stretch: Fold your hands together and turn your palms away from your body, but this time extend your arms overhead.  You should feel the stretch in your upper torso and shoulders to hand. (PHOTO 2)

3. Crossover Arm Stretch: Place your hand just above the back of the elbow and gently push your elbow across your chest toward the opposite shoulder.  This stretch for the upper back and shoulder and should be performed on both sides. (PHOTO 3)

ASHT recommends the following guidelines to prevent injury and foster healthy gardening practices:

Professional Contributor: Nancy Naughton, OTD, CHT, is an occupational therapist and certified hand therapist practicing in NEPA. Model: Heather Holzman

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  Next Week: “Prevention of Gardening Injuries” Part II of 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 associate professor of clinical medicine at GCSOM. Access of all of Dr. Mackarey's articles at our Health and Exercise Forum.

Part II of II

After a long winter, spring is finally in the air as indicated by the warm (summer-like) temperatures last week. While your mind may be ready to play golf (and other outdoor activities), however, it is important to remember that without proper warmup and preparation, the risk of injury can increase substantially. PGA professionals benefit tremendously from sport science, physical therapy and fitness programs on tour year round. Amateur golfers in northern climates require diligence and planning to prepare for the game after 4-6 months off to avoid injury.  

 Muscle strains, ligament sprains, neck and LBP is prevalent in the early season for golfers, especially for the amateur. The reasons are many: general deconditioning after winter inactivity, poor golf swing mechanics, excessive practice, inadequate warm-up and poor flexibility and conditioning. The very nature of the golf swing can create great stress on the body, especially after time off.

PRESEASON TIPS FOR GOLF

Keep Fit and Trim

Core Tips- A Strong Core is Critical for a Healthy Golf Swing

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MODELS: Ross Zanghi, Physical Therapy Student; Ashley Ottaviani, Physical Therapist Assistant
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 associate professor of clinical medicine at GCSOM

Access all of Dr. Mackarey's articles at our Health and Exercise Forum

Part I of II

After a long winter, spring is finally in the air as indicated by the warm (summer-like) temperatures last week. While your mind may be ready to play golf (and other outdoor activities), however, it is important to remember that without proper warmup and preparation, the risk of injury can increase substantially. PGA professionals benefit tremendously from sport science, physical therapy and fitness programs on tour year round. Amateurs in northern climates require diligence and planning to prepare for the game after 4-6 months off to avoid injury.   

Muscle strains, ligament sprains, neck and LBP is prevalent in the early season for golfers, especially for the amateur. The reasons are many: general deconditioning after winter inactivity, poor golf swing mechanics, excessive practice, inadequate warm-up and poor flexibility and conditioning. The very nature of the golf swing can create great stress on the body, especially after time off.

PRESEASON/GENERAL WARM-UP TIPS FOR GOLF

Best to begin 4 -6 weeks before the season

Get to the course early enough to make time to stretch before you play and hit a few balls at the range. Always start with low irons and work up to driver. Take a hot shower before an early morning round and use compression shorts and shirts on cool days. Do Not Bounce or Overstretch! Stretch slowly, holding for 10-20 seconds:

Visit your doctor regularly and listen to your body.     

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II - Preseason Golf Tips.

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 associate professor of clinical medicine at GCSOM.

For all of Dr. Mackarey's articles visit our Health and Exercise Forum

Part II of II

According to the American Diabetes Association (ADA), 32.2 million adults and children, 10.5% of the population in the United States, have diabetes. Unfortunately, one-third of these people are not aware that they have the disease. It will be the purpose of this column to raise the level of consciousness through education and offer recommendations for lowering blood sugar levels naturally.  

Perhaps no goal is more important to a person with diabetes than maintaining a healthy blood sugar level. When managed over time, healthy blood sugar levels can slow the onset of complications associated with the disease. According to the ADA, pre-diabetes, or impaired glucose tolerance, occurs when blood glucose levels are higher than normal (110 to 125mg/dl) but below type 2 diabetes levels (126mg/dl). 54 million Americans have pre-diabetes in addition to the 20.8 million with diabetes.

While medications are effective in maintaining blood sugar levels, for those who are borderline, there are effective ways to lower your blood sugar naturally. Your physician will determine which treatment is most appropriate for your problem. Also, maintaining your ideal body weight is always important.

10 Tips to Lower Your Blood Sugar Naturally

**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD, the American Diabetes Association L (ADA), and Lifescript

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 associate professor of clinical medicine at GCSOM.

For all of Dr. Mackarey's articles, visit our Health and Exercise Forum

Part I of II

What is Diabetes?

Diabetes is a disease in which the hormone insulin is not adequately produced or used by the body. Insulin is needed for cells to take up glucose after it is broken down from sugars, starches and other food that we eat. When working properly, this provides the fuel necessary for activities of daily living. While the exact cause is not completely understood, genetics is known to play a big role. However, environmental factors such as obesity and inactivity have also been found to play a large role.

According to the American Diabetes Association (ADA), 10.5% of the population in the United States or almost 34.2 million adults and children has diabetes. Unfortunately, one-third of these people are not aware that they have the disease.

Diagnosis

A Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT) can be used to screen a person for diabetes or pre-diabetes. Due to the fact that it is easier, quicker and cheaper, the FPG is the recommended test by the ADA. A FPG test results between 110 and 125 mg/dl indicates pre-diabetes. A FPG of 126 mg/dl or higher indicates diabetes.

Type 1 Diabetes

Type 1diabetes occurs when the islet cells of the pancreas are destroyed and unable to produce insulin. Without insulin the cells of the body are unable to allow glucose (sugar) to enter the cells of the body and fuel them. Without the hormone insulin, the body is unable to convert glucose into energy needed for activities of daily living. According to the ADA, 5-10% of Americans diagnosed with diabetes has type 1. It is usually diagnosed in children and young adults.

While type 1 diabetes is serious, each year more and more people are living long, healthy and happy lives. Some conditions that may be associated with type 1 diabetes are: hyperglycemia, ketoacidosis and celiac disease. Some things you will have to know: information about different types of insulin, different types of blood glucose meters, different types of diagnostic tests, managing your blood glucose, regular eye examinations, and tests to monitor your kidney function, regular vascular and foot exams.

Symptoms 

While symptoms may vary for each patient, people with type 1diabetes often have increased thirst and urination, constant hunger, weight loss and extreme tiredness.

Complications

Type 1 diabetes increases your risk for other serious problems. Some examples are: heart disease, blindness, nerve damage, amputations and kidney damage. The best way to minimize your risk of complications from type 1diabetes is to take good care of your body. Get regular checkups from your eye doctor for early vision problems, dentist, for early dental problems, podiatrist to prevent foot wounds and ulcers. Exercise regularly, keep your weight down. Do not smoke or drink excessively.

Type 2 Diabetes

Type 2 is the most common type of diabetes as most Americans are diagnosed with type 2 diabetes. It occurs when the body fails to use insulin properly and eventually it fails to produce an adequate amount of insulin. When sugar, the primary source of energy in the body is not able to be broken down and transported in the cells for energy, it builds up in the blood. There it can immediately starve cells of energy and cause weakness. Also, over time it can damage eyes, kidneys, nerves or heart from abnormalities in cholesterol, blood pressure and an increase in clotting of blood vessels.

Like type 1, even though the problems with type 2 are scary, most people with type 2 diabetes live long, healthy, and happy lives. While people of all ages and races can get diabetes, some groups are at higher risk for type 2. For example, African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders and the aged are at greater risk. Conditions and complications are the same as those for type 1 diabetes.

Symptoms

People with type 2 diabetes experience symptoms that are more vague and gradual in onset than with type 1 diabetes. Type 2 symptoms include feeling tired or ill, increased thirst and urination, weight loss, poor vision, frequent infections and slow wound healing.

**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD and the American Diabetes Association and Harvard Health Publications

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 associate professor of clinical medicine at GCSOM.

One of the most common questions I receive from patients is related to the management and care of their cast or splint. Given the fact that one may have to live with a cast or splint for four to six weeks (sometimes less, sometimes more), many people have concerns about hygiene, swelling, pain and function while wearing a cast…

WHY DO YOU NEED TO WEAR A CAST OR SPLINT?

Casts or splints are used to support and protect bones and soft tissues after injury or surgery. A broken bone or severe ankle sprains are two good examples. Consequently, the immobilization provided by a cast or splint protects the injury, allows healing with proper alignment, and reduces pain, swelling and muscle spasm.

WHAT ARE THE DIFFERENT TYPES OF CASTS OR SPLINTS?

Casts, half- casts or splints are made of plaster or fiberglass. A doctor or assistant individually makes them for each person and injury. In addition, custom-made splints are often made by occupational therapists for the hand or physical therapists and certified prosthetists for other body parts such as the trunk or limps. Fiberglass splints are made with Velcro straps and are removable, which could be used for the wrist for carpal tunnel or the foot for ankle sprains.     

Both plaster and fiberglass come in rolls, while fiberglass comes in different colors, which are dipped in water and wrapped around the injured part. It is often necessary to apply the cast to the joint above and below the injury. Then, the material will dry and harden in minutes. The cast must fit the shape of the injured part snuggly, but comfortably. If a cast is applied to a new injury or immediately after surgery, the cast will be too big once the swelling subsides. At this point, a new cast is applied. Padding is used under the cast to protect the skin. Sometimes special padding can be used under fiberglass to allow the cast to get wet in the shower or pool. 

GETTING ALONG WITH YOUR CAST

Most fractures or severe sprains require 4-6 weeks of casting, sometimes less, sometimes more. Often, once the cast is removed, a removable half-cast or splint is applied. This allows the injured part to be washed and exercised several times a day without the splint and then reapplied.

The American Academy of Orthopedic Surgeons offers the following recommendations for cast care and warning signs of cast problems:

Recommendations:

  1. Follow your doctors cast instructions carefully
  2. Swelling – may occur 48-72 hours after the cast is applied.
    • If the cast feels snug, you can then control swelling by:
      • Elevate the injured arm or leg
      • Move the fingers or toes of the injured arm or leg
      • Ice the cast with a cold pack or ice in a plastic bag
  3. Keep Cast Dry - moisture will cause your skin to breakdown; therefore, use two plastic bags with duct tape to keep it dry in the shower
  4. Keep Weight Off Cast- unless allowed by your doctor; if allowed, you must wait until the cast is completely dry ( 1 hour for fiberglass and 2-3 days for plaster)
  5. Keep Cast Clean – keep dirt, sand and powders from inside of the cast
  6. Keep Hangers, Sticks, etc. – out of the inside of the cast. You can irritate or cut your skin and get an infection
  7. Inspect the Cast – examine the cast for damage, soft spots and weakness, but do NOT break the edges on your own. Call your doctor
  8. Inspect the Skin – if the skin is raw, red or severely irritated/itchy, call your doctor
  9. Never remove the cast yourself - Call your doctor 

Warning signs: if the above recommendations fail to provide a reduction in swelling or pain or if you have the following warning signs, contact you doctor:

  1. Significant Increase in Pain – with an increase in swelling and tightness in the cast
  2. Numbness and Tingling – in the hand or foot of the casted limb which may be caused by pressure on the nerves
  3. Burning and Stinging -  which may be cause by too much pressure on the skin
  4. Excessive Swelling – below the cast may be due to pressure of the cast slowing blood flow
  5. Loss of Active Movement – in the fingers or toes of the casted limb requires urgent action to see your doctor or visit the emergency room

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!”  

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 associate professor of clinical medicine at GCSOM.

Access all of Dr. Mackarey's articles in our Health Care Forum!

1. No Pain, No Gain

Pain is different than discomfort! Muscle soreness and “feeling the burn” can occur during a normal healthy exercise routine. However, you should never experience a sharp, deep, intense, or lingering pain during or after exercise. In fact, if the soreness lasts more than 24-48 hours, than you did more damage than benefit to your muscles and other tissues and it is time to scale back and take time off. If necessary, use RICE (rest, ice compression and elevation). It is important to get in tune with your body and learn the difference between muscle strain and fatigue discomfort and pain from soft tissue damage from overuse and overload. Find the proper amount of weight and repetitions and gradually increase over time.

2. Always Stretch Before You Exercise

There is no solid evidence that stretching alone before a sport or activity prevents injury. In fact, over stretching may be counterproductive before a sport as it may weaken the muscle. The current wisdom on the matter is; never stretch a cold muscle. Instead, warm up for 5-10 minutes by actively moving the extremities and light jogging or biking and THEN lightly stretch the arms, legs, back etc. More vigorous stretching should be performed to improve the flexibility of tight muscles (ie calf and hamstring muscles) and best done after your workout but not before a sporting activity (tennis, basketball, etc.).

3. Lifting Weights Will Make You Bulky

It depends on your body type and hormones! It is very unlikely that women and prepubescent males will bulk up from lifting weights…especially light weights (blame or thank hormones). It will, however, increase metabolism and fat burning efficiency which can lead to weight loss and good muscle tone. Stick with low resistance and high repetitions for best results.

4. With the Correct Program, Spot Reduction Can be Achieved

It is not possible to target an area of the body to burn more fat! It is very common for women to ask for a specific exercise to reduce the fat in their buttocks, thighs, and abdomen. Regretfully, it is not possible to target weight loss in these areas or other body parts. In fact, when you lose weight through diet and exercise, the caloric expenditure will be evenly distributed throughout the body. However, once the adipose tissue in a specific part of the body such as the abdomen is reduced from general weight loss, targeting the area with exercises specific to that muscle group will improve the tone and definition for a leaner look in that region.

5. If you don’t have 45-60 Minutes to Exercise, Don’t Bother

Sure, it would be great to dedicate 60 minutes 5 -6 days a week for exercise. But for most of us who work and raise a family it is not practical. The good news is that the research supports 30 minutes of exercise 3-5 days a week. Moreover, evidence shows that 10 minutes, three times a day, 5 days per week will help you attain the 150 minutes a week supported in most exercise studies.

6. If you have Arthritis, Exercise Will Make it Worse

Most people with the most common form of arthritis, osteoarthritis, feel better when they are moving. That is not to say that they don’t have increased symptoms when they OVERDO it. An exercise program specifically designed for a person’s problem and limitations will improve their symptoms and function. For example, if an individual has arthritis in their knees, they should use an exercise bike (partial weight bearing) or swim (buoyancy effect of water) instead of walk or run (full weight bearing) for aerobic exercise.

Furthermore, they would do far better with light cuff weights in a sitting or lying position to strengthen their legs than performing squats or lunges. It is important to remember, the weight gain and joint weakness and stiffness associated with a sedentary lifestyle will do more harm to an arthritic joint than a proper exercise program.

7. You Need a Sports Drink When you Exercise

Not unless you are planning a killer workout! The number one reason most of us exercise is to lose or control body weight. High calorie sports drinks are counterproductive and unnecessary. If you do not plan on exercising for more than 60 minutes, good old fashion H2O is more than adequate. However, if you plan to do a “killer” workout for more than 60 minutes and may incorporate a high intensity interval training (HIIT) program, than a sports drink with electrolytes and other nutrients, may be of value.  

8. Exercise Machines are Better than Free Weights

For most of us, effective resistance training is not about the equipment. It is safe to say, caveman was pretty fit and strong despite the fact that he never went to a gym and lifted weights. He did however, lift, push, pull, and carry heavy stones, timber, and animals for day-to-day survival. So too, it is for modern man, the body does not distinguish between the resistance provided by a elastic band, dumbbell, or cable with pulleys and weight stacks. As long as the basic principles of strength training are applied, (isolating a muscle or muscle group, loading the muscle with enough force to bring it to fatigue without causing tissue damage, and allowing for adequate rest and recover) than the muscle will gain strength regardless of the type of resistance.

9. Running is Better Than any Other Form of Aerobic Exercise

First, let me confess that I love to run and up until recently, ran almost daily. However, now that I am over 60, I had to find new forms of aerobic exercise which would be kinder and gentler to my joints. So, I mix it up between biking (indoors and outdoors, recumbent and upright), brisk walking or hiking, elliptical and stepper and swimming laps. Again, like the caveman weightlifting example, the body (heart and lungs) does not know what is causing an increase in heart rate for 30, 45 or 60 minutes, it only knows that it must respond to allow the body to function under this stress. And, in the process it becomes conditioned to the point that it will work much more efficiently when not under stress with a lower heart and respiratory rate and blood pressure at rest.

Those over 50 would be well-advised to engage in low-impact aerobics on a regular basis. For example, if you want to run two to three days per week, do not run two days in a row and consider performing low impact exercise in between. Some examples of low impact aerobics are walking, treadmill walking, swimming, elliptical trainer, and an exercise or road bike.

10. Continual Exercise Never Needs to be Adjusted

Change is necessary with age! For many years, I have repeatedly preached about the value of engaging in an active lifestyle throughout life. It is especially important to be active as one gets older to maintain mobility and independence. However, many take this advice to an extreme and refuse to accept the inevitable changes that occur in the body with age. They run, jump, lift and throw like a teenager and often fail to modify their activity or exercise regimen appropriately for their age. Consequently, they suffer from multiple injuries, including muscle tears, tendonitis, bursitis, impingement, and advanced osteoarthritis.

Keep in mind, everyone ages differently. One person at 60 years of age may be the equivalent of another at 50. However, change with age is inevitable, so be kind to your body…it’s the only one you have! It is always prudent to consult your physician and physical therapist for a program designed specifically for your needs.

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 associate professor of clinical medicine at GCSOM.

Access all of Dr. Mackarey's articles in our Health Care Forum!

Exercise is important for prevention!

In 2000, President Bill Clinton dedicated March as National Colorectal Cancer Awareness Month. The purpose of this designation is to increase public awareness of the facts about colon cancer – a cancer that is preventable, treatable and has a high survival rate. Regular screening tests, expert medical care and a healthy lifestyle, which includes a proper diet and exercise, are essential for prevention. Several studies have demonstrated that exercise can also help prevent colon cancer. 

The American Cancer Society estimates that there will be approximately 107,000 new cases of colorectal cancer in 2023. Of these, 52,550 men and women will succumb to the disease. It is the second-leading cause of U.S. cancer deaths for both men and women combined. The good news is incidence and mortality rates are dropping both nationally as well as in northeast Pennsylvania. The bad news is northeast Pennsylvania still has increased incidence and mortality rates when compared to the national average.

Colon Cancer Facts:

Studies show that prevention of this disease is multifaceted and includes: engaging in daily exercise, eating a low-fat diet with little red meat, avoiding smoking, drinking in moderation and having regular colonoscopy screenings.

Early detection is the key to survival. Death from colorectal cancer can be eliminated if caught at the earliest signs of disease. Colorectal cancer progresses very slowly, usually over years. It often begins as non-cancerous polyps in the lining of the colon. In some cases, these polyps can grow and become cancerous, often without any symptoms. Some symptoms that may develop are: blood in stool, changes in bowel movement, feeling bloated, unexplained weight loss, feeling tired easily, abdominal pain or cramps, and vomiting. Contact your physician if you have any of these symptoms.

The risk of colon cancer increases with age, as 90 percent of those diagnosed are older than age 50. A family history of colon cancer increases risk. Also, those with benign polyps, inflammatory bowel disease, ulcerative colitis or Crohn’s disease are at greater risk and should be screened more frequently.

Prevention of Colon Cancer:

  1. Colonoscopy – The colonoscopy is the most accurate screening test for detecting polyps and colorectal cancer. A long, thin, flexible tube with a camera is used to visually examine the lining of the colon. Polyps can be removed at the time of the exam if necessary. Most people should have this test starting at age 50, although high-risk populations (i.e. those with genetic predisposition or inflammatory bowel disease) may begin at age 40 to 45 or even younger.
  2. Diet & Nutrition – Diets rich in fiber are generally considered beneficial for overall health, including colorectal health. Limit high-fat foods especially from animal sources. Limit red meat and dairy. A diet consisting of fish, fruit and vegetables is valuable. Some researchers theorize that Brussels sprouts, broccoli and cabbage may trigger a chemical process to turn on a gene to suppress tumors. Sunlight and vitamin D are thought to be important too. 
  3. Lifestyle & Personal Habits – Smoking and excessive alcohol use increases risk for colorectal cancer and other forms of cancer. Stress and anxiety can be cancer triggers.
  4. Exercise – While there have been many studies about the benefits of exercise for colon cancer, none have been more encouraging than a recent study from the Hutchinson Cancer Institute in Seattle. Patients with abnormal cells on the lining of their colons, as found by colonoscopy, demonstrated positive changes and reversal of these cells after engaging in four hours of exercise per week for one year. Some studies have shown that exercise can reduce the risk of colon cancer by 50 percent.

How Exercise Prevents Colon Cancer:

The intestine works like a sewage plant, recycling the food and liquid needed by your body. However, it also stores waste prior to disposal. The longer the wastes remain idle in your colon or rectum, the more time toxins have to be absorbed from you waste into the surrounding tissues. One method in which exercise may help prevent colon cancer is to get your body moving, including your intestines. Exercise stimulates muscular contraction called peristalsis to promote movement of waste through your colon.

Exercise to prevent colon cancer does not have to be extreme. A simple increase in daily activity for 15 minutes, two times per day or 30 minutes, once per day is adequate to improve the movement of waste through your colon. This can be simply accomplished by walking, swimming, biking or playing golf, tennis or basketball. For those interested in a more traditional exercise regimen, perform aerobic exercise for 30-45 minutes four to five days per week, with additional sports and activities for the remainder of the time. For those in poor physical condition, begin slowly. Start walking for five to 10 minutes, two to three times per day. Then, add one to two minutes each week until you attain a 30-45 minute goal. 

Medical Contributor: Christopher A. Peters, M.D

Dr. Christopher Peters is a partner of Radiation Medicine Associates of Scranton (RAMAS) and serves as medical director of Northeast Radiation Oncology Centers (NROC). He is an associate professor of clinical medicine at GCSOM. Sources: American Cancer Society/Northeast Regional Cancer Institute, and CA Cancer J Clin.

EVERY 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 associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's Articles, visit our Healthcare Forum!

Part II of II

PEOPLE WILL OFTEN ASK ME, “IS THERE SUCH A THING AS AN EXERCISE RUT?” THEY WANT TO KNOW WHY THEY DO NOT SEEM TO BE IMPROVING WITH THEIR EXERCISE PROGRAM…they exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut.

The purpose of this column will be to offer suggestions on how to improve or get more out of a “stale” exercise program. Last week’s column offered tips to improve a stale cardiovascular and strength program. This week we will discuss flexibility and functional training tips and include the components necessary for a healthy mind, body and spirit connection.

1. Flexibility Training

Flexibility training involves the careful stretching of the muscles, tendons and joints to improve the range of motion in order to safely perform daily activities and sports without injuring or tearing soft tissues. It is probably the most neglected part of the fitness program. However, while the amount of inherent flexibility varies for each person, a minimal range is necessary as it relates to daily activities and sports. For example, as you age it is important to have enough flexibility in your back, hips and knees to wash your feet, put shoes and socks on. Flexibility exercises should always be performed after a warm –up activity and done slowly and gently.

The Two Types

There are two types of flexibility exercises; dynamic and static. Dynamic stretching is performed with movement such as pushing the ankle up and down like a gas pedal. Passive stretching is performed using an outside force such as using a towel to pull the ankle up in order to stretch the calf. Dynamic should be performed before an activity (before running or playing tennis) and static performed after the activity is over in order to increase range of motion for future activities.

Improving a Flexibility Training Program:

2. Mind, Body, Spirit

Conclusion

In conclusion, it is easy for fitness enthusiasts to get so focused on maintaining a routine that they allow their program to become stale and ineffective. It is essential to reassess and update your program to prevent stagnation.

Make sure the routine has all three fundamental components of a well-balanced exercise program; cardiovascular, strength and flexibility training. Moreover, to be truly healthy, one must work toward a “Healthy Mind, Body, and Spirit. Therefore, in addition to traditional exercise one must incorporate the following: nutrition; meditation, relaxation techniques, yoga, core fitness; functional/sports specific training; leisure sports and activities

In order to prevent an exercise program from getting stale, one must incorporate all aspects of wellness…a healthy mind, body and spirit!

While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED.

Sources: National Institutes of Health; American Council on Exercise

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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 associate professor of clinical medicine at Geisinger Commonwealth School of Medicine

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