“I was nervous and forgot to ask my doctor questions about my diagnosis!” “When the nurse asked me, I could not remember my medications!” These are two examples of the many frustrations patients have when visiting their physicians. Research shows, those who prepare in advance for their physician visits, have more satisfaction than those who just show up for their appointment. Moreover, for patients seeing multiple physicians, such as specialists, often communication is poor and your participation in the process can be invaluable. There are things you can do to prepare for your physician visits...
Remember, your health is too important to rely on memory for accuracy…so be a proactive participant. With technology, it has never been easier to keep a medical journal to improve accuracy and communication. There are several “Apps” such as “mymedicalapp.com” that allow you to do this on your phone, tablet or lap-top computer and offer privacy code features.
SOURCES: www.webmd.com; National Institutes of Health – National Institute on Aging “A Guide for Older People - Talking With Your Doctor”
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 https://mackareyphysicaltherapy.com/forum/
As the country prepares to return to school and work this fall during a new wave of infections from the Delta variant of COVID-19, it is more important than ever to find healthy ways to control stress and anxiety. While exercise is important to trim our waistline or to speed up our metabolism, there may be more benefit to lacing up those sneakers than you’d think. Recent studies have established a link between exercise, stress and cognition, making physical activity even more important.
Exercise has been shown to improve sleep and mood, decrease stress, and even increase libido. It also can bolster our self-esteem and ability to problem-solve and to remember details. In fact, strength training has even been shown to reverse cognitive decline to a degree in aging adults with mild impairment. Though the medical community is still trying to elucidate exactly how exercise boosts our brains physiologically, increased circulation to the brain and modulation of the hypothalamus-pituitary-adrenal axis that regulates the body’s response to stress have been implicated as the bearers of benefit. While exercise can be advantageous for everyone, it perhaps is even more valuable to those struggling with mood disorders. Exercise can help combat anxiety and depression and quell the symptoms of Attention Deficit Hyperactivity Disorder and Post Traumatic Stress Disorder as it helps the brain to pump out neurotransmitters and pain-fighting endorphins. Exercise makes addiction management easier, as well, and has recently been shown to help alcoholics lessen consumption.
So, how much exercise exactly is enough to illicit tangible cognitive benefit, you ask? Any amount of weight lifting, running, walking, or yoga helps, but habitual activity helps the most. Studies cite that a few consecutive weeks of participation in a fitness regimen yielded notable, positive results in subjects. Try to make exercise part of your daily routine to encourage good fitness habits. If you find the idea of adopting a strenuous new fitness program intimidating or off-putting, have no fear. Moderate exercise is enough to do the trick. The Mayo Clinic cites both brisk walking and mowing the lawn as examples of moderate activity, so an average fitness level is adequate for yielding positive mental results.
If you’re thinking about beginning an exercise program for the first time, start gradually. Begin with walking for 10 to 15 minutes twice daily, and add 1 or 2 minutes to your session every time you walk until you can walk continuously for 45 to 60 minutes. The same principle can be used when beginning other fitness routines involving biking, swimming, running, etc. Begin a weight training program to strengthen bones and tendons using 3 to 5 pound dumbbells, and increase the weight you use by a pound once you can easily perform 30 consecutive repetitions. Be careful to pay close attention to posture and form. Contact your physical therapist or a personal trainer for assistance with designing an appropriate exercise program. Don’t hesitate to contact your physician, either, if you have questions about whether a particular exercise program is safe and suitable for your age group or current fitness level.
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 Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's Articles visit: https://mackareyphysicaltherapy.com/forum/
It is August and summer is rapidly passing! So, get outdoors and have fun in the sun. However, please be mindful of how your body reacts to high humidity and heat and take appropriate precautions. Athletes are particularly vulnerable this time of year due to daytime practice sessions. (August 9, 2021, first day of acclimatization and August 16, 2021, first day of practice for fall sports according to PIAA), However, you don’t have to be running a marathon or playing football in full uniform to suffer from heat stroke.
Heat stroke, one of the most serious heat-related illnesses, is the result of long-term exposure to the sun to the point which a person cannot sweat enough to lower the body temperature. The elderly and infants are most susceptible, and it can be fatal if not managed properly and immediately. Believe it or not, the exact cause of heatstroke is unclear. Prevention is the best treatment because it can strike suddenly and without warning. It can also occur in non athletes at outdoor concerts, outdoor carnivals, or backyard activities.
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 and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's Articles: https://mackareyphysicaltherapy.com/forum/
It is August and summer is rapidly passing! So, get outdoors and have fun in the sun. However, please be mindful of how your body reacts to high humidity and heat and take appropriate precautions. Athletes are particularly vulnerable this time of year due to daytime practice sessions. (August 9, 2021, first day of acclimatization and August 16, 2021, first day of practice for fall sports according to PIAA), However, you don’t have to be running a marathon or playing football in full uniform to suffer from heat stroke.
Heat stroke, one of the most serious heat-related illnesses, is the result of long term exposure to the sun to the point which a person cannot sweat enough to lower the body temperature. The elderly and infants are most susceptible and it can be fatal if not managed properly and immediately. Believe it or not, the exact cause of heatstroke is unclear. Prevention is the best treatment because it can strike suddenly and without warning. It can also occur in non athletes at outdoor concerts, outdoor carnivals, or backyard activities.
Some “old school” folks think that wearing extra clothing and “breaking a good sweat” is an optimal goal for exercise. However, it may be potentially very dangerous in hot and humid conditions. When exercising in hot weather, the body is under additional stress. As the activity and the hot air increases your core temperature your body will to deliver more blood to your skin to cool it down. In doing so, your heart rate is increased and less blood is available for your muscles, which leads to cramping and other more serious problems. In humid conditions, problems are magnified as sweat cannot be evaporated from the skin to assist in cooling the body.
The American Academy of Pediatrics and The American College of Sports Medicine has the following recommendations which are appropriate for both the competitive athlete and weekend warrior:
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Heat Stroke Part II”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's Articles visit: https://mackareyphysicaltherapy.com/forum/
According to the Centers of Disease Control (CDC), Hypertension (HTN), also known as high blood pressure (HBP), affects one in three adults (67 million people) in the USA. Unfortunately, only one-half of those with high blood pressure control the problem and, as a result, are at great risk for heart disease and stroke.
Blood pressure numbers represent the force against the walls of your arteries. Normal blood pressure (BP) is defined as a systolic pressure (the top number) of 120 mm Hg and a diastolic pressure (the bottom number) of 80 mm Hg (120/80). The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has classified blood pressure as follows:
Normal: lower than 120/80 mm Hg
Prehypertension: 120-139/ 80-89 mm Hg
Stage 1 Hypertension: 140-159/90-99 mm Hg
Stage 2 Hypertension: 160+/100+ mm Hg
For most people with HBP, there are no obvious symptoms. HBP is usually detected at a health fair, or a routine visit with a physician. However, over time, HBP can cause problems with the heart and kidneys. Sometimes, a more serious condition can develop from very high blood pressure called malignant hypertension. Symptoms include severe headache, nausea and vomiting, confusion, vision changes and nosebleeds. Notify your physician immediately if you develop these symptoms.
Almost everyone has had their blood pressure checked with a standard or automatic blood pressure cuff. Sometimes, when a problem is detected, a home blood pressure unit is recommended to track BP throughout the day.
According to a recent long-term study, both men and women without a history of coronary artery disease or high blood pressure suffered from both diseases when they did not manage stress well. Those who allowed stress to upset them, (short fused and easily frustrated) had significant increases in cholesterol and blood pressure when compared with those who were more even-tempered and easygoing under stress.
Exercise combats HBP and maintains a healthy body weight. The key to success when it comes to improving your life with exercise is to develop a regular, consistent program. A good program must include aerobic exercise (walking, jogging, biking) for 30 minutes (or 15 minutes twice a day) 4-5 days per week and mild/moderated weight training 2- 3 times per week.
A low salt, low fat diet which includes fish, fiber, grains, fruits and vegetables is essential. Moreover, take care to avoid the “Seven Deadly Sins for High Blood Pressure” (Zee News):
Table Salt- Don’t add salt to your food because most foods have enough. Limit total salt consumption to 1,500mg per day.
Deli Meat – These foods are loaded with salt as an additional preservative.
Red Meat – In excess, the trans and saturated fats in red meat can also damage the blood vessels of the heart over time. Limit consumption to 1 -2 times per week.
Alcohol – It causes the blood pressure to rise and in excess, can damage the blood vessel walls. Limit intake to 12 oz of beer, 8 oz of red wine daily.
Whole Milk – similar to red meat, the high concentration of saturated fats can damage blood vessels over time. A low fat substitute is a better option.
Pickles – Just 3 of these tasty cucumbers have more than the 2,300mg of recommended sodium for an entire day.
Coffee – Caffeine can cause a temporary spike in blood pressure and should be consumed in moderation, especially for those at risk or with high blood pressure.
In conclusion, while HBP is a potentially serious medical condition, for most it is a controllable and preventable problem. Lifestyle changes such as diet, exercise and stress reduction have been found to be most effective.
SOURCES: Centers For Disease Control (CDC); American Heart Association (AHA), University of Pittsburgh Medical Center (UPMC), National Institutes of Health (NIH), Medline Plus, Zee News
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 Geisinger Commonwealth School of Medicine.
For all of Dr. Mackarey's Articles visit: https://mackareyphysicaltherapy.com/forum/
“Health & Exercise Forum” regularly promotes active lifestyles and outdoor activities. However, being one with nature is not without its risks and attracting ticks which can lead to Lyme disease is one of them. Over the last few years, I have been amazed by how many ticks I find on my clothing and skin after being outdoors…year round! Last winter, for example, we had an unexpected warm-up in February, and with temperatures ranging from 30 degrees in the morning to 60 degrees in the afternoon, I decided to ski in the morning and snow-shoe on the trails at Lackawanna State Park in the afternoon. Due to snow cover, I occasionally wandered off the trail and hiked through some brush. Later that evening, I discovered a tick on my neck, despite showering, wearing winter clothing and it being outdoors in FEBRUARY! It is no small wonder why some experts blame climate change on the dramatic increase in cases of Lyme disease…the research supports it! Later that summer, while I was not formally diagnosed with Lyme disease, I did suffer from symptoms associated with the disease for about 8 weeks. This experience has caused me to pause and take precautions when I garden, kayak, hike, mountain bike or engage in any outdoor activity that takes place near brush or wooded areas.
According to the Centers for Disease Control (CDC), approximately 300,000 cases of Lyme disease occur each year in the United States. Lyme disease is a bacterial infection caused by the bite of an infected deer tick and most prevalent in wooded and grassy areas of the New England, Mid-Atlantic and upper Midwest States. A heightened awareness and preventative measures are recommended for those who live, work, play, camp, hike, or bike in these areas.
Ticks thrive in moist and humid environments, especially in and near wooded and grassy areas. Wear long sleeve shirts and long pants with socks when spending extended periods of time in risky environments.
When walking, hiking, or biking, stay in the middle of the trail and avoid the brush.
The CDC recommends repellent containing 20% or more DEET, Picaridin, or IR3535 on exposed skin. Use products with 0.5% permethrin on clothing, boots, pants, socks, tents and other gear. Visit the Environmental Protection Agency (EPA) for more information about product safety.
Keep your yard free of tall grasses and brush and use gravel or wood chips as a barrier. Mow the grass often and remove leaves quickly. Place playground equipment and toys in dry sunny area and away from brush and high grasses. Don’t feed or encourage deer to visit your living area. Chemical treatment for your yard and outdoor living space is available but should be used with caution and as a last resort.
Use flea and tick treatments regularly on your pets such as Advantage IIR or Frontline PlusR and others. Ask your veterinarian for recommendations.
After being outdoors, perform a tick check. Use a mirror or family member to help you check hard to view areas. Also, carefully examine your clothing and pets for ticks before entering your home. Drying your clothing in the dryer on high heat will kill ticks.
The CDC recommends that you closely check these areas for ticks:
As soon as you enter your home (preferably through a mud room or basement), remove your clothes and take a shower.
If you find an attached tick use a fine-tipped tweezers and carefully remove it as soon as possible. If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is very unlikely.
If you find a tick, keep an eye on the area for a few weeks. Look for signs or symptoms of Lyme disease such as rash or fever and contact a healthcare professional if you are suspicious.
Some or all of these symptoms can be associated with Lyme disease and you should contact your physician if you are suspicious: Skin Rash, Fever and Chills, Fatigue, Muscle and Joint Pain/Ache, Headache.
In conclusion, it is well-documented that Lyme disease is on the increase, due in part to warmer winters in the mid-Atlantic and northeast US. However, while experts are encouraging people in risky areas to take precautions during the spring and summer months, they are also encouraging parents not to limit outdoor activities for children and others. Keep in mind that spending too much time indoors is far worse for your health than the risk of contracting Lyme disease in the long run. And, even if you are bitten by a tick, you only have a 100 to 1000 chance of contracting the disease.
SOURCES:
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.
For all of Dr. Mackarey's articles visit https://mackareyphysicaltherapy.com/forum/
According to the United States Environmental Protection Agency, NEPA and all of Pennsylvania is experiencing a change in climate as indicated by a half a degree (F) in temperature, more frequent and heavy rainstorms and the tidal portion of the Delaware River is rising one inch every eight years. Last summer was one of our hottest on record and this summer has produced a several heat waves with more expected. For those without air conditioning or access to a lake or pool, it will also be remembered as record setting warm temperatures. A local reader who cares for her elderly mother wrote to express her concern about dehydration in the elderly. Age, diet, illness and medications are some of the many reasons why elders suffer from dehydration not only in the summer heat, but year-round.
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.
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. More than 18% of those hospitalized for dehydration will die within 30 days, and associated mortality increases with age. Men appear to dehydrate more often than women and dehydration is often masked by other conditions.
Elderly individuals are at heightened risk for dehydration for several reasons. Compared to younger individuals, their regulatory system (i.e. kidneys and hormones) does not work as well and their bodies have lower water contents. Older adults often have a depressed thirst drive due to a decrease in a particular hormone. They do not feel thirsty when they are dehydrated. This is especially true in hot, humid weather, when they have a fever, are taking medications, or have vomiting or diarrhea. They have decreased taste, smell, and appetite which contribute to the muted perception of thirst. Because of dementia, depression, visual deficits, or motor impairments, elderly persons may have difficulty getting fluids for themselves. Many elderly individuals limit their fluid intake in the belief that they will prevent incontinence and decrease the number of trips to the bathroom. The medications that they are taking (e.g. diuretics, laxatives, hypnotics) contribute to dehydration.
Elders may suffer headaches, fainting, disorientation, nausea, a seizure, a stroke, or a heart attack as a result of dehydration. The minimum daily requirement to avoid dehydration is between 1,500 (6.34 cups) and 2,000 ml of fluid intake per day. Six to eight good-sized glasses of water a day should provide this amount. Better hydration improves well-being and medications work more effectively when an individual is properly hydrated.
By the way, plain old tap water is a good way to replenish fluid loss. Keep in mind that some energy drinks not only have excess and unneeded calories but also contain sugar that slows down the rate at which water can be absorbed form the stomach. Consuming alcoholic and caffeinated beverages actually have an opposite, diuretic effect!
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: https://mackareyphysicaltherapy.com/forum/
Crying is a normal and valuable part of human communication and emotional expression. No doubt, some use this form of expression more than others and being of Mediterranean descent, my family will tell you not to sit next to me in the movie theater if a “tearjerker” is playing. “The Notebook” really got me! While not comfortable to do in public and may be viewed as a sign of weakness, current research shows that at appropriate times it may be healthy.
We cry for many reasons. Babies cry to communicate, adults cry when they are overwhelmed with positive emotions like a wedding, or negative emotions like a funeral. Crying too easily or too often can be a sign of an underlying emotional or physical problem. However, recent research has suggested that letting out a good cry at times of intense emotional build up, may be healthy.
Crying has intrigued scientists and medical professionals for centuries. Darwin, for example, purported that crying may have a role in evolution and natural selection. If tears can be a sign of emotional vulnerability and bonding, then it may keep communities together for the purpose of procreation.
According to research conducted by Dr. William Frey, humans may be the only species engineered to have such strong emotions that provokes the production of tears. Studies show that the fluid in a tear produced by emotion has a very different chemical makeup than the normal fluid that protects and lubricates the eye or the tears produced when peeling an onion. Recent research has found that a woman’s tears produced in response to sadness may counteract aggressive behavior in men. In the study, men were able to distinguish tears produced from a woman after watching a sad movie compared to saline tears by smell. Simultaneously, scans of the men’s brains while smelling the actual tears found decreased activity in areas of the brain associated with aggression.
Research on the health benefits of crying support the notion that a “good cry” is good for you. Nine out of 10 people report that after a “good cry” they feel better and are less stressful. The best thing about crying for good health is that it is free, almost everyone can do it, and except for a runny nose, red eyes, and runny mascara, it has no side effects. While not a miracle, some of the recent research suggests crying is highly effective at healing, and that it improves the mood of almost 90% of weepers, with less than 10% feeling worse. Some of the researchers go as far as suggesting that there may be a case for inducing crying in those who find it difficult to let go and cry, especially in people with clinical depression or mood disorders.
For some, the emotional build up prior to the cry was so stressful when trying to hold back the tears, crying served as a good emotional release. For others, while the emotional build up was stressful, the embarrassment of crying in public was more stressful. Overall, 60% of those who cried experienced a physiological response. The emotional buildup prior to the cry and the physical act of crying releases adrenaline to create a “flight or fight” response. This is immediately followed by a post-adrenaline period in which the person experiences a physical and emotional release as the heart rate and blood pressure decreases when compared to the suppression of the cry.
Crying is a normal response to stress, emotional or physical trauma in both men and women. Not surprisingly, research has confirmed a long-held belief that those suffering from depression cry more than others. However, more concerning is the fact that those suffering from severe and debilitating depression with mood disorders have lost the ability to cry. Consequently, these individuals have lost the ability to derive the health benefits of crying such as the emotional release and physiological response. While both men and women cry equally when suffering from depressive mood disorders, men who are unable to cry tend to become more aggressive and irritable.
Crying is much more common among those suffering from a feeling of being overworked, overstressed and a loss of control. For these reasons, 71% of 3rd year medical students admitted to crying at least once in the past year. Among this group, most reported that crying was a valuable way of communicating and stress release.
So, the next time someone calls you a “cry baby” when you express your emotions by crying, tell them your “working out” by having a “good cry” to release stress, lower your heart rate and blood pressure and you don’t have time to go to the gym!
Source: Harvard Health Letter
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
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 GCSOM.
Happy Independence Day! Summer activities are in high gear…playing games, jumping, walking and running on grass, pavement and sand! And, with that, foot and heel pain is not unusual, especially for those who are not in shape, new to exercise, wear summer flats, sandals or shoes with poor support.
While man has spend thousands of years evolving to walk on two feet, some problems of bipedal weight bearing has not been worked out. Heel pain is a common complaint among adults over 40. Plantar fasciitis is the most common cause of heel pain but the diagnosis can be difficult and treatment approaches vary widely! In my experience, plantar fasciitis can be difficult to treat and the research on this condition has failed to provide sufficient evidence to determine the BEST treatment regime. Stretching, strengthening, icing, activity modification, oral and topical anti-inflammatory medications, steroid injections, orthoses, immobilization, extra-corporeal shock wave therapy, and surgery are all potential treatments mentioned in the literature. While all of these treatments have benefits, some have risks, and no single treatment has been the “proven winner”. It may be that an appropriate combination of treatments specifically tailored to the individual problem may be the best approach.
The correct diagnosis is essential. Other conditions such as tarsal tunnel syndrome, calcaneal stress fracture, and lumbar radiculopathy (sciatic nerve pain radiating down the leg) can mimic the symptoms of plantar fasciitis and must be ruled out as causes of your heel pain. People with plantar fasciitis typically report severe heel pain with the first few steps out of bed in the morning. Called “first step pain”, this classic symptom also occurs upon standing and walking after any period of recumbence such as sitting or reclining on the couch. Female gender, activities (occupational or recreational) involving prolonged periods of weight bearing (e.g. standing, walking, or running), improper foot and leg alignment, calf tightness, obesity, and age between 40 and 60 years old are factors that increase your risk of developing plantar fasciitis.
Even with the correct diagnosis, treatment of plantar fasciitis can be controversial because of differences in opinion regarding the CAUSE of plantar fasciitis. Amongst the medical community, there is continued debate about whether plantar fasciitis is an inflammatory condition of the fascia or the periosteum (i.e. the outer covering of the bone to which the fascia attaches) and whether the condition is inflammatory at all! Researchers discovered degenerative changes rather than inflammatory components in tissue samples taken from people with plantar fasciitis. Typically, treatments for degenerative and inflammatory conditions differ.
Despite the cause of plantar fasciitis, many remedies have been employed in various combinations and with varying degrees of success. First, many clinicians advocate calf and plantar fascia stretching. An inflexible calf muscle increases the tensile stress within the plantar fascia and a shortened plantar fascia, as in high arched people, builds up more tension in the heel. Also, strengthening muscles that provide dynamic support for the flat foot complements the stretching exercises. Some researchers believe that wearing shoes has made our foot muscles lazy! In addition, most practitioners consider an anti-inflammatory strategy as first-line defense and will typically prescribe an oral medication or topical application. If the pain does not respond or is severe, a steroid injection may be advised. A study from 2010 concluded that properly placed steroid injections for plantar fasciitis are safe and effective with minimal risk of complications (e.g. atrophy of the calcaneal fat pad) or fascial rupture. Moreover, because faulty foot mechanics are typically associated with plantar fasciitis, physicians and podiatrists often recommend orthotics (i.e. shoe inserts; over-the-counter or custom) and proper footwear, to either correct the mal-alignment or accommodate the deformity. Furthermore, to properly position the plantar fascia at night for optimal healing, some researchers advocate the use of a night splint to place the ankle at 90° and the toes at 30°. Finally, some stubborn cases of plantar fasciitis may require immobilization, and, as a last resort, surgery.
Despite differences, most clinicians advise stretching, strengthening, icing, orthotics, and anti-inflammatory medication as part of the initial management of plantar fasciitis. Some podiatrists recommend physical therapy so that their patients have access to all of these treatments at once, including manual techniques.
Websites: Plantar Fasciitis Night Socks: www.braceability.com www.orthoticshop.com
Source: Lower Extremity Review
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in the Times-Tribune.
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
For all of Dr. Mackarey's articles visit: 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 in Scranton, PA. He is an associate clinical professor of medicine at GCSOM.
Age-related changes to your body are normal and expected. For example, loss of muscle tone, stiffness in joints, and loss of balance. With effort, some of these changes can be retarded and managed. The brain is no different…it can slow down and lead to memory lapses. However, for most of us, it too can be managed and with a little effort, be kept sharp and clear.
Many experts feel that exercise is the best method to maintain not only physical health but mental health. Regular exercise can prevent the things that contribute to memory loss with age such as; diabetes, high blood pressure, high cholesterol, obesity and stroke.
Specifically, aerobic exercise may be most beneficial. Aerobic exercise is any type of sustained exercise that strengthens the heart and lungs to improve the body’s use of oxygen. This may include running/jogging, brisk walking, cycling, swimming, rowing, and the use of a treadmill, elliptical, stepper or similar device, at light to moderate intensity which requires the use of oxygen to adequately meet the oxygen demands of the body for an extended period of time. The generally accepted time and frequency is at least 30 minute sessions performed three or more times per week. Two 15 minute or three 10 minute sessions are also valuable. For those with back, hip, knee and other lower body pain, consider low-impact or partial weight-bearing activities such as a recumbent bike or stepper or upright bike instead of a treadmill.
The benefits of a healthy diet are well-documented. Specifically, a Mediterranean-style diet is highly recommended. It focuses on plenty of fruits and vegetables with fish instead of red meat and olive oil instead of butter. Researchers found people who closely adhered to a Mediterranean diet were nearly 20% less likely to have thinking and memory problems.
Exercise your brain just as you do your body. Make time each day to challenge your brain. Learn something new to keep your mind sharp. Play cards, read a book, do crossword puzzles or other word games, take a class or learn play a musical instrument.
Human beings are social animals and in the right setting, we stimulate and challenge each other. Join a book club, fitness center, or a community center. Consider volunteering, taking an art or photography class. Social interaction can prevent isolation which can lead to depression and depression is associated with dementia.
Without adequate sleep, attention and concentration is compromised. Studies show that those who have normal restful sleep outperform those who are restless and sleep deprived. Some tips for better sleep are: avoid big meals before bed, keep a consistent sleep and wake up time, avoid nicotine, caffeine and alcohol close to bedtime. “
Consider an afternoon “power nap!” Recent studies show that an afternoon nap was rejuvenating to the mind and body. Participants improved on mental skills such as memory, calculation, orientation and attention.
Cortisol is the hormone associated with stress. Recent studies have found that elevated cortisol levels were associated with poorer overall cognitive functioning, including memory, language, and processing speed.
Try yoga, massage, breathing techniques to relax. Progressive muscle relaxation (PMR) techniques can be very effective…try it on YouTube!
Smoking is clearly one of the worst things you can do to your body AND MIND! Smoking can lead to early memory lose in part due to small strokes in the brain. Do whatever it takes to quit; nicotine replacement, medication, or counseling.
There are many medical conditions and medications associated with memory loss. Regular medical check-ups can prevent, diagnose and treat some of these conditions such as; depression, diabetes, thyroid disease, vitamin deficiencies, and drug interactions or side effects. For example, sleep aid and anxiety drugs are commonly associated with memory loss.
In addition to common tricks such as word association, sticky notes, use your smart phone for appointments and reminders. If you don’t know how to use a smart phone, than you can help your memory by exercising your brain to “learn something new!”
SOURCES: WebMD; Harvard Health
Read “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
For all of Dr. Mackarey's articles visit: 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 GCSOM.
