November is National Chronic Obstructive Pulmonary Disease (COPD) month. COPD is the fourth leading cause of death in the United States, according to the Centers for Disease Control and Prevention. This problem refers to a group of lung diseases that causes damage to the airways and air sacs in the lungs. People with COPD suffer from diminished airflow and difficulty breathing. Emphysema and chronic bronchitis are two of the most common types of COPD. The damage can't be reversed, so treatment includes medications and lifestyle changes designed to control symptoms and minimize further damage, according to the Mayo Clinic.
Exercise is an important part of life for those with COPD because it improves the overall strength and endurance of respiratory muscles. When you exercise, muscles adapt and use oxygen more efficiently so your lungs don't have to work so hard. Also, in addition to improvement in breathing, exercise boosts mental health, helps maintain a healthy weight and blood pressure, and improves circulation. Most importantly, exercise will improve your quality of life with COPD. Before you begin an exercise program, see your family physician or pulmonologist for approval. Then, see a physical therapist to design a program specific to you needs. Always begin slowly and rest if you get short of breath, have chest pain, feel dizzy or sick to your stomach.
While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.
Walk Around the House – Start walking around the house for 1-2 minutes nonstop. Every 1-2 hours. Then, add 1-2 minutes every week.
Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds. Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.
Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day. Then, add 1-2 times per day.
Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.
Recumbent Bike – If balance is a problem, but you can tolerate more extensive. Endurance exercise, use a recumbent bike (a bike with a backrest)
Walking is free exercise and can be done in some form by almost everyone…even with an assistive device such as a cane or walker. For those with COPD who are active and fit – walk 4-5 days per week for 30 to 45 minutes. Less fit individuals can walk for 15 to 20 minutes. For those with COPD who are in poor condition and have significant SOB – walk for 2-3 minutes (to the bathroom or around the house) every 30 to 45 minutes. Try not to sit for 60 minutes without getting up and walking around.
Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck. More erect posture promotes better breathing. Perform 5 repetitions each 3 -5 times per day
Row-The-Boat - Pinch shoulder blades together as if you are rowing a boat.
I-Don’t-Know – Shrug shoulders up toward the ears as you do when you say “I don’t know.”
Chin Tucks – Bring your head back over your shoulders and tuck your chin in
Bicep Curls – sit in chair and bend your elbows up and down with a can of peas in your hands
Wrist Curls – as above but bend your wrists up and down
Chair Push-ups – Push up with your arms to get out of a chair
Saw Wood – pull a light resistance band (yellow) back from a door knob as if you were sawing wood.
Hip Hikes – Sit in chair and march by hiking your hip and lifting up your heel 4-6 inches off the floor
Leg Kicks – Sit in chair and kick your knee out straight – then bend it down to the floor
Hips Out and In – Sit in chair and bring your knees in and out against a resistance band
Toe Raise/Heel Raise – Sit in chair and raise your toes up – then raise your heels up
Diaphragmatic Breathing - The diaphragm muscle is essential for breathing. While sitting or lying down, put one hand on your abdomen and the other on your chest. Slowly inhale through your nose and try to separate the hand your stomach from the hand on your chest. Then, slowly exhale through pursed lips.
Pursed Lipped Breathing - breathe in through your nose slowly for 3- 5 seconds. Then, purse your lips as though you're going to whistle. Lastly, exhale slowing through the pursed lips over 5 to 10 seconds.
“Better Breathers Club,” in conjunction with the American Lung Association, offers a free local support group to help patients and their families suffering from COPD and chronic lung disease. For more information contact the American Lung Association at www.lung.org
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 in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
World COPD Day 2022 is Wednesday November 16th! The purpose of this two part series on lung disease is to raise the level of awareness for the prevention and treatment of this disease.
Chronic obstructive pulmonary disease (COPD) has become the fourth leading cause of death and is one of the only major chronic diseases which has seen an increase in mortality rates. COPD includes emphysema, chronic bronchitis and asthma.
Patients with COPD suffer from progressive shortness of breath, cough, wheeze, and sputum production. Most patients with emphysema have been cigarette smokers.
Patients with emphysema develop obstruction to airflow as a result of narrowing of bronchial tubes due to excess mucous, smooth muscle constriction, and destruction of lung tissue. Eventually, the lungs become over distended, which leads to overexpansion of the chest itself. This process leads to the so-called ''barrel chest'' appearance of patients with advanced COPD.
The most common symptom of COPD is shortness of breath. Initially the patient complains of shortness of breath only with exertion, but symptoms progress over time to include difficulty breathing, even at rest. Eventually the disease worsens to the point that oxygen is required and the patient may become severely disabled.
Treatment of COPD starts with smoking cessation, and, when symptomatic, patients are started on inhaled bronchodilator medications. Some of these medications include albuterol, ipratropium, titotropium, and inhaled steroids. Long-acting bronchodilators such as formoterol or salmeterol and theophylline medications may be added. Oxygen is added when the patient's own oxygen level falls to a certain point. In fact, oxygen is the only therapy that has been shown to prolong the life of patients with COPD.
Over time, patients with COPD decrease their level of activity due to the sensation of shortness of breath. This downhill slide eventually leads to a very sedentary existence. Recent studies have shown that COPD not only affects the lungs, but is a condition which affects the diaphragm and the peripheral muscles. Patients with COPD have been shown to have abnormal limb muscles as a result of deconditioning and systemic inflammation.
Pulmonary rehabilitation has been shown in numerous studies to decrease the shortness of breath associated with COPD. Exercises to strengthen the arms are helpful to assist patients in performing activities of daily living such as combing hair, cooking, and reaching objects above their heads. Walking and riding a stationary bike are helpful to exercise the leg muscles, especially the large thigh muscles. Despite the fact that exercise programs may not improve lung function, the patients overall level of function are almost always improved.
Patients who participate in rehab programs have less shortness of breath, are less likely to be hospitalized, and have improved functional capacity. These patients have lower rates of healthcare utilization, and improved overall health status and quality of life scores. The ideal pulmonary rehabilitation program includes smoking cessation training, breathing and relaxation exercises, nutritional information, and training in proper use of medications. The most important feature of a pulmonary rehab program, however, is aerobic exercise involving the arms and legs.
Pulmonary rehabilitation is an integral part of the treatment of a patient with
COPD, and should be considered in any patient who can tolerate exercise. A cardiac stress test should be done to ensure that there are no occult coronary artery blockages or cardiac rhythm abnormalities.
In summary, COPD is a growing cause of disability, morbidity, and mortality. Medications, oxygen, and pulmonary rehabilitation can help to improve symptoms and quality of life. The combination of bronchodilator medications with pulmonary rehabilitation is the most effective approach when treating patients with COPD. Next week, in Lung Disease - Part II, learn more about pulmonary rehab for patients with COPD to improve their functional status.
Guest Columnist: Dr. Gregory Cali, DO – is a pulmonologist (lung doctor) in Dunmore, PA.
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!” COPD Part II – Exercise with COPD.
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 in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
See all of Dr. Mackarey's articles at www.mackareyphysicaltherapy.com/forum
According to the World Health Organization about half of the world’s adult population has had a headache at least once in the past year. Prolonged use of electronic devices has greatly contributed to this problem. For many people, these headaches are infrequent and do not often affect daily life. But what about when your headache occurs frequently or is so severe it prevents you from going about your day to day activities? Some types of headaches are more easily treated and managed than others.
There are two types of headaches: primary and secondary. Primary headaches occur without an underlying disease and include migraines and tension-type headaches. Secondary headaches can be associated with serious disease, requiring emergency care, or can be referred from other structures of the body such as the cervical spine (neck).
Headaches symptoms that may constitute a medical emergency are: vomiting, seizures, fever, muscle pain, night sweat, weight loss, and neurologic symptoms such as blurred vision. If you are experiencing any of these symptoms, if your headache worsens, or your symptoms change it is recommended that you seek medical attention. Any headache that is unusual for you and does not resolve itself in a reasonable time should be brought to your primary care physician’s attention.
Migraines: Migraines are a primary form of headache that typically lasts from four to seventy two hours, can range from moderate to severe pain, and typically are located on only one side of the head. Often they can be accompanied by an aura, nausea or vomiting, sensitivity to sound, or light sensitivity. Migraines can be aggravated by routine physical activity such as going up stairs. This type of headache is thought to occur in the central nervous system and is related to blood vessels.
Tension-type: Tension-type headaches are the most common primary headache disorder and can last anywhere from thirty minutes to seven days. These can often have a pressing or tightening quality that occurs on both sides of the head. Here there is no nausea, vomiting, light sensitivity, or aggravation with physical activity. This type of headache is thought to occur in the central nervous system but can have a hereditary component and is usually associated with muscle tender points. Tension – type headaches can be treated with relaxation techniques such as Progressive Muscle Relaxation (PMR), medications, and physical therapy.
The most common secondary headache that is not related to a serious medical condition is a cervicogenic headache (originating from the neck).
Cervicogenic Headache: The length of time a cervicogenic headache can last varies. Here the pain is on one side and usually starts in the neck. This type of headache is aggravated or preceded by head postures or movements of the neck. Due to the nerves of the neck and face sharing common connections, pain signals sent from one region can lead to discomfort in the other. Physical therapy can be an effective treatment to help relieve symptoms. For example: posture, exercise, ergonomics, massage, manual techniques, traction, trigger point, and acupressure.
A cervicogenic headache can be caused by an accident or trauma or can stem from neck movement or sustained postures. Sustained postures could mean sitting in front of a computer at work or looking down at your phone. Changing these postures throughout the day could help reduce symptoms. Changing postures could mean bringing your phone closer to you using pillows or another supportive surface when reading or checking social media. If you are someone who works at a desk, it could involve taking breaks or getting a standing desk. However your life requires you to move, there are some simple and effective exercises you can perform throughout the day to help cervicogenic headache symptoms.
5 TIPS FOR TENSION HEADACHES
Progressive Muscle Relaxation: PMR is an effective method for reducing tension throughout the body. With this method you first tense a muscle group, such as at the neck or shoulder, and then relax the muscles noting the difference between the two. This helps reduce both stress and tension. For more information or to learn how to do PMR, refer to podcast at: https://www.psychologies.co.uk/try-progressive-muscle-relaxation
Manage your stress level: While stressors vary from person to person, one method for managing stress is with exercise. Any form of exercise can help reduce stress, but a cost free method is aerobic exercise such as walking or running. A less time consuming method could be to perform deep breathing exercises throughout the day.
Heat or cold: When feeling sore or stiff, applying a hot or cold pack or taking a hot shower can help ease a tension headache.
Posture: Some tips for posture are to make sure your head is over your shoulders rather than sitting forward and making sure you are sitting or standing up straight with your shoulders back.
Over the counter medications: Talk to your doctor or pharmacist for additional information.
5 TIPS FOR CERVICAL HEADACHES
Posture: See tips listed under tension headaches.
Ergonomics: If your job or hobbies require you to sit for extended periods it may be beneficial to change positions throughout the day or consider getting a standing desk. Also, limit time on electronic devices. When sitting make sure the monitor is at eye level, your legs are able to fit under your desk, and you are close to the keyboard and monitor. If you are working with a laptop or phone, avoid putting it on your lap. Instead, bring your laptop closer to you by putting pillows on your lap.
Exercise: Some exercises to help relieve symptoms are chin tucks, shoulder blade pinches, and back extension. These exercises can be performed multiple times throughout the day in sitting or standing.
Physical Therapy: Physical therapy may include massage, manual techniques, stretching, traction/ decompression and exercise. A physical therapist can assess your posture and provide strategies specific to you.
Over the counter medications: While medication may not cure cervicogenic headaches, they may help relieve pain. Talk to your doctor or pharmacist for additional information.
Contibutor: Alexa Rzucidlo, PT, DPT
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 Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
Congratulations to the enthusiastic and dedicated runners who finished the 25th Annual Steamtown Marathon yesterday. Most, if not all of you are waking up this morning with a little less jump in your step than you had yesterday.
As active people by nature, many of you will resist the logic of rest, despite the pain and stiffness in your muscles and joints. Therefore, I would like to offer some words of wisdom, based on science, to encourage you to adequately rest and allow your body to recover.
With adequate rest and recovery, an elite runner can quickly regain full form in 3-4 weeks, while an average runner may require 4-6 weeks. Meb Keflezighi, an elite American runner and winner of the 2014 Boston Marathon, is an excellent example of the merits of rest and recovery. However, he discovered it by accident…following the 2012 New York City Marathon, Meb developed a foot infection which required three weeks rest. With the Olympic Trials just 70 days away, Meb quickly regained his pre-injury fitness level to win the 2012 US Olympic Marathon Trials and join the US Olympic Team in London. It may be that his injury was fortuitous and allowed him adequate recovery time, (that he might not have otherwise allowed), preparing him for intensive training leading up to the trials.
One of the most obvious effects of running a marathon is significant muscle and joint pain and stiffness. It will set in after you sit for a while and attempt to get up and move around. For most, it will be more pronounced the day after the marathon, as you get out of bed and limp to the bathroom. Studies show that the leg muscles, (especially the calf muscles) display significant inflammation and necrosis (dead tissue) in the fibers of the muscle. In other words, the trauma to the muscles is so severe that tissue damage causes muscle cells to die. Consequently, studies found that muscle strength, power and endurance is compromised and required significant time to recover… sometimes as long as 4-6 weeks!
Additionally, many runners report severe bone and joint pain following the race. Some studies report findings of microfractures or bone bruising from the repeated and prolonged pounding of the marathon. It is purported that the stress on the joints may be related to: weight and body type, running shoes, running style and mechanics. While not dangerous, again, it is important to respect the stress placed on the body and allow adequate healing…LISTEN TO YOUR BODY!
Creatine kinase is an enzyme found in the brain, skeletal muscles and heart. It is found in elevated levels in the presence of cellular damage to these tissues, for example, following a heart attack. Similarly, significantly elevated creatine kinase levels are found in the blood of runners up to 4 days post marathon, demonstrating extensive tissue damage at the cellular level. It is important to note, that these enzyme markers are present, even if a runner does not experience muscle soreness. So, adequate rest for healing and recovery is required, regardless of soreness.
It is not a coincidence that the runners are more likely to contract colds and flu after intensive training or running 26.2 miles. The immune system is severely compromised after a marathon and without adequate recovery; a runner can become ill and ultimately lose more training time or will underperform.
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.
See all of Dr. Mackarey's articles in our Health and Exercise Forum!
As the days continue to get shorter and temperatures begin a slow steady decline, athletes and exercise enthusiasts will work harder to “fit in” a warm-up before running or other activities during the winter months. But, no matter how limited time is, skipping the warm-up is risky. This time of year, one can expect to feel a little cold and stiff, especially if you are over 40, and therefore a little caution and preparation are in order to avoid muscle/tendon strain, or worse yet, muscle/tendon tears. The Achilles tendon is one of the more common tendons torn. Prevention of muscle tears, including the Achilles tendon includes; gradual introduction to new activities, good overall conditioning, sport specific training, pre-stretch warm-up, stretch, strengthening, proper shoes, clothing, and equipment for the sport and conditions.
A muscle contracts to move bones and joints in the body. The tendon is the fibrous tissue that attaches muscle to bone. Great force is transmitted across a tendon which, in the lower body, can be more than 5 times your body weight. Often, a tendon can become inflamed, irritated, strained or partially torn from improper mechanics or overuse. Although infrequent, occasionally tendons can also snap or rupture. A tendon is more vulnerable to a rupture for several reasons such as a history of repeated injections of steroids into a tendon and use of medications such as corticosteroids and some antibiotics. Certain diseases such as gout, arthritis, diabetes or hyperparathyroidism can contribute to tendon tears. Also, age, obesity and gender are significant risk factors as middle-aged, overweight males are more susceptible to tendon tears. Poor conditioning, improper warm-up and cold temperatures may also contribute to the problem.
Tendon rupture is very painful and debilitating and must not be left untreated. While conservative management is preferred, surgical management is usually required for complete tears. The purpose of this column is to present the signs, symptoms and management of Achilles tendon ruptures.
The Achilles tendon (also called the calcaneal tendon), is a large, strong cordlike band of fibrous tissue in the back of the ankle. The tendon (also called the heel cord) connects the powerful calf muscle to the heel bone (also called the calcaneus). When the calf muscle contracts, (as when you walk on the ball of your foot), the Achilles tendon is tightened, tension is created at the heel and the foot points down like pushing a gas pedal or walking on tip of your toes. This motion is essential for activities such as walking, running, and jumping. A partial tear of the tendon would make these activities weak and painful, while a full tear through the tendon would render these activities impossible.
With age, the Achilles tendon (and other tendons) gets weak, thin, and dehydrated, thus making it prone to inflammation, degeneration, partial tear or rupture. The middle-aged weekend warrior is at greatest risk. A full or complete tear (Achilles tendon rupture) usually occurs about 2 inches above the heel bone and is associated with a sudden burst of activity followed by a quick stop or a quick start or change in direction, as in tennis, racquet ball, and basketball.
In some instances, the tendon can be injured by a violent contraction of calf when you push off forcefully at the same time the knee is locked straight as in a sudden sprint. Other times, the tendon is injured when a sudden and unexpected force occurs as in a trip off a curb or sudden step into a hole or a quick attempt to break a fall.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Achilles tendon 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.
For all of Dr. Mackarey's articles visit our Health and Exercise Forum!
October is National Breast Cancer Awareness Month. Due in great part to improved awareness and advances in treatment and early diagnosis, the survival rate continues to improve. The American Cancer Society relies on information from the Surveillance, Epidemiology and End Results (SEER) database to provide survival statistics for different forms of cancer.
While the overall 5-year survival rate for breast cancer is 90% and the 10-year survival rate is 84%, the survival rate for those fortunate to have early detection and treatment is even more encouraging. For example, when breast cancer is determined to be “localized” (no sign that the cancer has spread outside of the breast), the 5-year survival rate improves to 99%! AWARENESS AND EARLY DETECTION ARE CRITICAL!
Maintain Healthy Body Mass Index (BMI) – studies repeatedly show that obesity increases the risk of breast cancer. A healthy BMI for women falls between 18.5 and 24.9. To find out your BMI visit: www.calculator.net
Maintain a Healthy Diet – the Mediterranean Diet emphasizes plant-based foods such as vegetables, beans, whole grain, fruits, nuts and seeds, and plant-based oils, especially olive oil. Avoid sugared drinks, refined carbs and fatty foods and eat fish or chicken instead of red meat.
Limit Alcohol Consumption – While no alcohol consumption may be optimal, up to one drink a day for women is acceptable.
Avoid or Limit Hormone Replacement Therapy – Studies show that menopausal hormone therapy increases the risk of breast cancer. For those who must take hormones to manage menopausal symptoms, limit the time period to less than three years and avoid progesterone.
Consider Estrogen-Blocking Drugs – For women with a family history of breast cancer or those over 60, consulting your physician about the pros and cons of these drugs.
Do Not Smoke – Studies show that smoking increases the risk of breast cancer. Visit: smokefree.gov for help with smoking cessation.
Breast Feed – According to the scientific literature, women who breast feed for at least a year in total have less risk of developing breast cancer. So, breast feed as long as possible.
Participate in Research – What can you do to help? Participate in clinical trials studying new and more effective ways to detect and treat breast cancer. Visit the National Cancer Institute
Limit - Manage Stress - According to a recent long-term study, both men and women have a higher incidence of cancer in those who did not manage chronic stress well. 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 options to explore. Try Progressive Muscle Relaxation (PMR) videos.
Exercise – A recent study in the Journal of the American Medical Association from Harvard has found that regular exercise can improve the survival of patients with breast cancer.
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 Wellness Page!
As more of us become more comfortable living with COVID 19, travel plans have exploded. For 2 ½ years many have put air travel for family vacations on hold and we are eager to get back to air travel. As you may have gathered from my previous columns, travel is one of my passions. My family and I have been fortunate to have visited many spiritual places of natural wonder and beauty that we call our National Parks. Many of the parks are on the west coast and require some preparation to endure the many hours of travel by airplane through different time zones. Moreover, travel to other countries and continents, often requiring 8, 10, 16 or more non-stop hours on a plane can really take a toll on your mind and body and gave new meaning to the term “jet lag.”
According to the Mayo Clinic, jet lag, also known as jet lag disorder, is a sleep disorder that can occur in people who travel through different time zones in a short period of time, such as a flight from New York City to Los Angeles. Obviously, the further the distance traveled and the more time zones entered, the more significant and drastic the symptoms, as found, for example, in those traveling from the United States to Asia.
Sunlight has a direct impact on our internal clock by regulating melatonin, a hormone that regulates sleep and wake cycles in the body. Travel through different time zones can affect the amount and duration of sunlight and therefore, impact the regulation of these cycles. The inability to regulate the cycles results in many symptoms.
Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck.
Read Dr. Mackarey’s Health & Exercise Forum – every Monday
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.
The 25th Steamtown Marathon is one month away! While the serious heat waves of summer may be behind us, any prolonged endurance activity in minimal to moderate heat can be dangerous if not prepared. Adequate hydration is critically important, not only to those training for a marathon but also for other outdoor endurance activities such as cycling, hiking, long distance power walking, etc
Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.
In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.
The risk of dehydration is not limited to endurance athletes and outdoor enthusiasts. Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years.
Is water adequate to prevent dehydration? Will a sports drink improve my performance? While some answers to these questions apply generally to all, others vary according to the temperature, humidity, length of time and intensity of the activity and condition of the athlete.
Proper hydration is essential for the comfort and safety of the recreational and serious athlete. Hydration is critical to maintain cardiovascular function, body temperature and muscle performance. As temperature, humidity, intensity, and duration of exercise increase, so too does the importance of proper hydration. Excessive sweating can lead to a loss of blood volume which requires the heart to work much harder to circulate you blood through your body.
Dehydration is a major cause of fatigue, loss of coordination, and muscle cramping leading to poor performance. Pre-hydration, (drinking before exercise) is the first step in preventing dehydration. Marathon runners, other long-distance runners, and cyclists often prehydrate1-2 days before a big event. Rehydration, (drinking during or after exercise) is the second step in preventing dehydration. While athletes may be more vulnerable to dehydration, all persons engaging in exercise would benefit from increased performance, delayed muscle fatigue and pain by maintaining adequate hydration. Proper pre-hydration would include drinking 12-16 ounces of water 1-2 hours before exercise. Athletes with other health issues should consult their family physician before engaging in long distance endurance sports.
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.
There are many reasons why losing weight, the number one health goal in America, is the most elusive. Not the least of these reasons is the psychology of eating…because in the land of plenty, we eat mindlessly! Consider the facts; first, we blamed it on the fact that the food was unhealthy…but when we chemically modify the food such as removing or altering the fat or sugar and removing the calories, it failed to reduce our weight. In fact, it has been discovered that “fake sugar,” even thought it does not have calories, can still increase blood glucose levels. Next, we decided fat cells were the enemy but we failed to control our weight when we removed fat cells from our body through liposuction. Then, we decided the problem was our digestive system so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, without a change in behavior, it failed as a long-term solution. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND!
Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings in which focus is placed on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier based on his time spent in a Buddhist monastery. He discovered that mindful eating practitioners ate in silence and chew small pieces of food very slowly and deliberately to experience its taste, texture and smell. It requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is not right or wrong way to eat but rather varying degrees of awareness about WHAT WE EAT AND WHY. Furthermore, the goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?
One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Research shows that, even when not perfectly relaxed, the simple act of the family meal can have a powerful impact on mindfulness, health and wellness.
In a country that thrives on a fast pace with over-book schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult find time to sit and relax for a family meal even once a week. Additionally, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Despite the family conflict, studies strongly support the health values of the family meal.
A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that the there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis.
| Mindless Eating | Mindful Eating |
| 1. Eating past full and ignoring body signals | 1. Listening to your body and stopping when full |
| 2. Eating when emotions tell us to eat | 2. Eating when our bodies tell us eat |
| 3. Eating alone, at random times and places | 3. Eating with others, set times and places |
| 4. Eating emotionally comfort foods | 4. Eating nutritious and healthy foods |
| 5. Eating and multitasking | 5. When eating, just eat |
| 6. Considering a meal an end product | 6. Considering where food comes from |
– by Christopher Willard PsyD
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
Read all of Dr. Mackarey's Articles at: https://mackareyphysicaltherapy.com/forum/
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.
Covid-19 has certainly redefined the workplace as many employees continue to work from home. Prolonged hours sitting at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.
Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.
Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics.
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.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com
