Standing while studying, working, reading … good for children and adults to learn, work and be healthier!

I think we would all agree, technology is a wonderful thing. However, like all good things, it comes at a price. Students and workers alike are suffering from the many physical effects of sitting for too many hours. Studies show the impact of prolonged sitting, especially with proper posture, are multifaceted: pain, headaches, vision problems, poor concentration, excess fat storage with weight gain. Studies strongly support the use of good posture, ergonomic workstations, posture stretches, frequent changes of positions, including the use of standing desks to prevent pain and injury. In fact, standing desks are not a new invention; they have been used by many to promote health and stimulate thought…Hemingway, Franklin and Jefferson all stood while they worked.

The Problem is Gravity!

The average head weighs 10 to 12 pounds and when tilted down at a 45 degree angle the forces of gravity are multiplied by 5. While reading, studying or working on the computer with poor posture, one must support 50 or more pounds of pressure on the neck, middle and lower back for hours on end. It is no wonder why this activity is associated with headaches, neck and back pain, numbness and tingling in arms and legs, muscle spasms etc.  Some studies report the lifetime prevalence of neck and shoulder pain in office workers as high as 80%.

Recent research has also correlated the amount of time an individual sits to a decrease in their average life expectancy. Seriously, watching television and sitting is literally killing us. The Heart and Diabetes Institute of Australia conducted extensive research on sedentary behavior, including a review of almost one million people. They used actuary science, adjusted for smoking, waist circumference, and diet and exercise habits to assess the specific effects that the hours of sitting in a day impacts a person’s life span. They found that sitting too long results in a decrease in muscle contraction of the big leg muscles and because these unused muscles need less fuel, more unused glucose (fuel) is stored in the muscle. High glucose levels result in high blood sugar, which leads to adult-onset diabetes and other health issues.

Sitting in the Classroom…

The deleterious effects of sitting in children have also come under scrutiny and it may impact the classroom. Due to technology, today’s classroom is more advanced in many ways. However, the traditional hard chair and desk remain unchanged. Not only are these, “one size fits all,” desks uncomfortable, current research suggests that they may also limit learning.

Recent studies show that standing desks promote not only a physically healthier child by expending more calories and lowering obesity but also improves focus and concentration to improve academic outcomes.

Research from Texas A&M Health Science Center found two landmark things about children who worked at standing desks such as Stand2Learn^R, when compared to those seated: One, children burned more calories and obese children burned more than normal-weight peers. Two, children were more attentive in the classroom and engaged more with their teacher and their work when allowed to stand. Teachers in the study not only found the results to be favorable for fidgety, high-energy kids, but those who tend to be overweight and tired benefited greatly.

Researchers were quick to point out that there may be many ways to promote movement and limit sitting in the classroom that may also promote learning in a healthy way such as sitting on exercise balls or inflatable discs.

Sitting in the Office …

The average office worker sits for more than 10 hours per day between office work, sitting at lunch, checking email and social media at home. Amazingly, studies suggest that even vigorous exercise before and after work cannot overcome the damage from prolonged sitting. New products such as the “TrekDesk^R,” allows a worker to work on a computer, phone, or do paperwork, while walking on a treadmill, has great health value. Also, other products such as VariDesk^R, allows for frequent positional changes from sitting to standing while working. Even without using a standing desk, changing positions, such as standing during phone calls or meetings has proven to be valuable. Current Wisdom: Alternate standing (30-45 minutes) and sitting (15-30 minutes)

Prevention:

Spine problems can be prevented with good posture and proper body mechanics. Poor posture and improper body mechanics subject the spine to abnormal stresses that, over time, can lead to degeneration and pain. Good posture and proper body mechanics and frequent changes in positions, can minimize current spine pain and prevent recurrent episodes. Posture is the position in which you hold your body upright against gravity. Good posture involves positions that place the least amount of stress on the spine. Good posture maintains the spine in a “neutral” position. In a neutral spine, the three normal curves are preserved (a small hollow at the base of the neck, a small roundness at the midback and a small hollow in the low back). When viewed from the side, the upper back appears straight with a small hollow in the lower back.

Good Posture:

• Standing: Feet should be shoulder width apart. Distribute body weight evenly through feet. Do not lock knees. Maintain a small hollow in lower back with  “tailbone” slightly tucked down. Lift the breastbone by drawing shoulder blades back and down. Make chin level. Earlobes should be in line with the middle of shoulders. Relax jaw and neck muscles by resting tongue on the roof of mouth.
• Sitting: Sit in a firm, high-back, straight-back chair. Buttocks should touch the back of chair while maintaining a small space between the back of knees and the seat of the chair. Distribute body weight evenly on both hips. Maintain an arch in the low back.
  • A lumbar roll is recommended. It is a foam roll, 4” to 5” in diameter and 12” long, placed at belt level. Place feet flat on the floor with hips and knees bent at a right angle. Keep knees even with or slightly higher than hips. Use a footstool or footrest if necessary. Do not cross legs! Lift the breastbone by drawing shoulder blades back and down. Earlobes should be in line with the middle of shoulders. Position the armrests properly allowing elbows and forearms to rest with shoulders relaxed. If armrests are too high shoulders will shrug up and if too low will cause slouching.

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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Exercise is Important in 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.

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:

• 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.
• 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. 
• 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
• 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.

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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Recently, a young woman came to my office with complaints of severe middle and lower back pain. On her first visit, I noticed her beautiful pink purse (big bag) and asked her permission to weigh the bag and discovered that it weighed 8 pounds. While 8 pounds does not seem excessive, the woman weighed 120 pounds and based on the research, would be advised to carry a 2.5-to-3.5-pound bag, (2-3% of her body weight).

A recent study shows that the average weight of a woman’s purse has increased by 38% and now exceeds 6 pounds. Despite technological advances, women have not found a way to simplify their lives, or at least what they think they need in their lives. High tech gadgets have only added weight to a purse already filled to the brim.

On a whim, I decided to ask permission to examine the contents of some of my patient’s purses. A typical purse includes the following: hairbrush, cosmetic bag, mirror, feminine products, keys, and sunglasses, reading glasses, checkbook, wallet, coupons, water bottle, and medications. Additionally, I discovered heavy high-tech products such as cellular phones, tablets, digital Bluetooth earpieces, and rechargers. Lastly, some women add the weight of a book or Kindle to the bag. Studies also show that the larger the bag and stronger the straps, the more items are stuffed in, resulting in a very heavy purse.

It is a pervasive attitude that a woman should never be stranded without her purse full of essentials. So, where is the problem? The problem is that carrying a heavy bag, usually on one side of the body, forces the body to tilt forward and to the opposite direction to compensate. Over time, this change in posture leads to neck, middle and lower back pain.

SIGNS THAT YOUR PURSE IS TOO HEAVY:

• Change in posture when carrying the purse. The weight forces you to tip forward or to the opposite side to compensate.
• Struggling when putting on or taking off the purse. Due to a purse that is too heavy or straps that don’t fit properly.
• Pain when carrying or after carrying the purse. Due to a that is too heavy or straps that don’t fit properly
  • Neck, middle and lower back pain, headaches and muscle spasms.
  • Shoulder or arm pain can also be associated with a heavy bag.
• Tingling or numbness – in the arms or hands
• Red marks – on the shoulder

Consider the following suggestions to promote healthy use of a purse and prevent injury:

10 Suggestions:

• Limit Weight of Purse to 2% of Body Weight
  • (135 lb person = 2.7 lb purse)
  • Get on a scale without your purse and then get on with your purse to see the difference.
• Clean It Out!
  • Makeup, keys, planner, date book, address book, brush, cell phone, recharger, MP3 player, etc. Clean it out! Get rid of heavy coins. Use technology and consider getting a cellular phone that is also an MP3 player with a calendar and contact list. Recharge your phone in the car. Use a separate purse for some nonessential items and leave it in the car.
• Buy a Small Purse
  • Weigh your purse when it is completely empty. Some purses are too heavy, even without contents. Buy a small and lightweight purse.
• Ergonomic Bags: Padded Adjustable Shoulder Straps – Messenger Bag Style
  • If carrying a big bag, use a strap that is long enough to distribute weight evenly across the side of your hip like a messenger bag.
• Purse Weight Distributed to Small of Back/Hips – using adjustable straps
  • Not all the weight on shoulders and upper back
• Remove The Purse When Possible
  • While waiting for bus, etc
• Change Shoulders
  • Every 15 -20 minutes, change the purse strap from one shoulder to the other to balance out the stress on the spine.
• Stand Erect and Arch Small of Back
  • The correct posture while carrying heavy items is to make a hollow or arch the small of your back
• Perform Posture/Stretching Exercises
  • Pinch shoulder blades together and extend and arch your spine backwards intermittently throughout the day – especially every time you take your pack off

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

NEPA has experienced more than its share of bitter cold temperatures this winter. And, as much as I enjoy skiing, ice skating and snowshoeing, I have noticed a few achy joints when the mercury plummets! Osteoarthritis, the most common type of arthritis, is often considered to be a normal part of aging. Usually by the age of forty our joints, especially those which are weight bearing (lower spine, hips, knees, ankles, feet) begin to show signs of wear and tear. The cartilage begins to thin, the joint surfaces are not as smooth, and fluid which lubricates the joint becomes diluted, dehydrated and less protective.

Consequently, these aging joints become stiff, sore, weak, and sometimes swollen. Most people with osteoarthritis report additional pain and stiffness in the winter and early spring due to cold, damp weather and NEPA has plenty of it! The cold, for example, restricts the flow of blood to the joints, leading to more pain and stiffness. While moving to a warmer and less humid climate is one solution, it is not practical for most. But all is not lost because there are other alternatives to protect and keep your joints healthier this winter and early spring.

• Parafin Bath and Hot Packs: A paraffin bath is one of the best methods to apply heat to your hand and feet joints to ease pain and stiffness associated with osteoarthritis. A special heating unit works like a crock pot to melt the wax to liquid form. The hands and/or feet are dipped into the wax several times to create a warm coating around the entire area. A 20-to-30-minute treatment while watching TV or listening to good music will provide pain relief, improve mobility in the joints and bring life back to winter damaged skin. $39.99 to $159.99 (www.bedbathandbeyond.com).
  • Hot packs, electric and microwavable, offer heat to bring blood flow and lessen joint pain and stiffness. They are great for neck and lower back pain, depending on the shape of the pad. Consider rectangle for lower back and cylinder/round to wrap around neck and joints of arms and legs. SourceMed.com offers an electric pad which creates moist heat for $59.95 and a microwave “bed buddy” (herbal or nonherbal) can be found for $9.99 to $43.95 at TheWarmingStore.   
• Hand and Toe Warmers: Hand and toe warmers are small packets placed in the gloves or boots of skiers, campers and hikers to keep the hands and feet warm. These throw away warmers can also be used by anyone with cold hands or feet whether you are shoveling snow, attending an outdoor event in the cold or sitting in a cold, drafty room watching TV. (Walmart, Dick’s, Gander Mountain, www.amazon.com)

• Knee, Ankle, Wrist, Elbow, Wrist Sleeves: Supportive sleeves for the joints can provide protection and warmth year-round, but especially during the cold winter and early spring. Those made with neoprene material offer warmth and compression and can be valuable when participating in activities such as skiing, walking, running, basketball, to name a few. Additionally, it can be helpful for those having joint pain with daily activities such as grocery shopping or housework. These devices should not be used when sitting for prolonged periods of time or sleeping. There is no scientific evidence that supports the use of cooper or magnets weaved into the sleeves for additional pain relief. (available at most pharmacies and medical equipment stores)
• Compression Shorts and Shirts: Similar to neoprene sleeves, compression shorts, pants and shirts can be invaluable to those participating in outdoor activities in cold temps. UnderArmor, Reebok, Nike, and others make these products which can also be worn indoors for those working in cool, drafty environments.
• Hot Tub: It seems obvious how and why hot water and massaging water jets can soothe sore joints and muscles. To ensure additional pain and stress relief, add a candle, soft music and a cocktail!

• Low Impact Exercise for Legs/ Low Impact Exercise for Arms: If you suffer from osteoarthritis to the joints of your lower body, you would be well-advised to limit impact activities such as running and basketball. Instead, walk, swim, use the elliptical and bike to protect your joints. As above, if you have arthritis in the joints of the upper body, use low weights, avoid push-ups and dips, which transfer your body weight through the arms.  
• Heat Vest or Jacket: As many of you know, I love outdoor activities year-round. However, with age I have become a little more sensitive to the cold…which can be a problem when you are skiing, skating, snowshoeing, or hiking. Fortunately, technology has made it possible to be “warm in the cold!” I love my heated vest because it not only keeps me warm, but I require less layers and less bulk to be toasty. These products come with a rechargeable battery. Heated gloves are also available. Vests and jackets range in price from $60.00 to $200.00 but you don’t have to by the most expensive to get a good result. Visit www.ororowwear.com; www.ihoodwarm.com; www.amazon.com
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These over-the-counter, non prescription drugs include aspirin and ibuprofen (Advil, Motrin) which are very effective in the treatment of the pain and inflammation associated with arthritis. A topical NSAID, Voltaren, is also available over-the-counter. However, like all drugs, they are not without their risks so one must consult with their primary care physician and pharmacist before using them. For example, NSAIDs can thin the blood, irritate the stomach and may interact with other medications.

• Topical Creams: Lidocane, Capsacian: Topical analgesics or pain relievers can be rubbed into or sprayed on the skin over the affected area. Some products are counterirritants using menthol, methylsalicylate and camphor which provide a sensation on the skin other than pain. Salicylate based products can work like aspirin to provide relief from mild pain and inflammation. Capsaicin based products can also provide temporary relief due to the counter stimulation of warmth and tingling. A few things to keep in mind when using these products: one, discuss it with your physician or pharmacist. Two, topical agents are more effective in superficial joints such as the fingers, toes, wrist, elbow, knee and shoulder than in the deep tissues of the hip, buttocks, or lower back. Three, wash your skin thoroughly after using these products and before using heat, cold or electric stimulation.
• Massage: The therapeutic benefits of massage are well documented. However, like most treatments, it is important to find a qualified professional that meets your needs. Licensed physical therapists, physical therapist assistants and massage therapists are the best choice. Benefits include relief from pain, headaches, muscle spasm, and stress, improved relaxation, posture, and breathing.

SOURCES: www.apta.org; www.webmd.com

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Many Health Benefits of Love and Valentine's!

This year, Valentine’s Day is Valentine’s Weekend! And, while you may wonder what that has to do with health and wellness, you might be surprised to learn that love can be good for your health! Studies show that it is in our DNA to seek out good relationships and that these solid relationships can lead to a happier, safer and healthier life. Conversely, infatuation and less committed, volatile relationships that are “on and off,” are very stressful and unhealthy. But those fortunate to participate in a stable and satisfying long-term relationship are the beneficiaries of many health benefits! Whether you have spouse, partner, or close friend, (love is love is love), feeling connected, respected, valued, and loved is critically important to your health and wellness! So celebrate Valentine's Day and enjoy all the love that surrounds you!

10 Ways Love and Valentine's are Good for You!

1. Less Sick Visits to your Physician - The US Department of Human Services found that couples in a committed long-term relationship are less likely to require sick visits to their physician. And, when hospitalized, these “love birds,” have shorter hospital stays. One theory for this health benefit is that couples in good relationships watch after each other to ensure regular healthy visits for routine care and testing. Consequently, they are less likely to have unexpected serious illnesses.
2. Less Depression & Substance Abuse - Experts feel that social isolation is associated with unhealthy behavior and depression. Happy, loving and committed couples are far less likely to suffer from depression. Furthermore, these couples are less likely to engage in risky and unhealthy behaviors such as excessive drinking and drug abuse.
3. Lower Blood Pressure - Researchers have found a strong relationship between marital status and blood pressure. Happily married couples have the lowest, while unhappily married couples have the highest. Happy singles scored somewhere in between. It is also interesting to note that non-married committed couples and well-adjusted singles with strong support groups had lower blood pressure.
4. Less Anxiety - Studies show that long-term committed couples have far less anxiety than new romance. MRI brain scans found both groups showed high activation in areas of the brain related to romance, but only new couples had activation of the area of the brain associated with anxiety.
5. Pain Control - A CDC report on pain included a study of more than 127,000 adults and found that married people were less likely to complain of headaches and lower back pain. In fact, one study showed, when a happily married couple held hands, pain thresholds improved and, the happier the marriage, the greater the effect.
6. Better Stress Management - Similar to the findings on pain, there is a strong link between happy and committed couples and stress management. The support and love from a strong and healthy relationship provides good coping methods to help overcome adversity…job loss, illness etc. 
7. Boosted Immune System - Solid loving relationships can boost your immune system. In fact, researchers at Carnegie Mellon University found that people who exhibit positive emotions are less likely to get sick after exposure to cold or flu viruses.
8. Quicker Healing Time - It may be that a wound from “Cupid’s Arrow” will heal faster when you are in a loving relationship. Researchers at Ohio State University Medical Center gave married couples superficial wounds and followed their healing time. The wounds healed nearly twice as fast in spouses who interacted warmly compared with those who behaved with hostility.
9. Longevity - Strong research indicates that married people live longer. Researchers found that people who had never been married were 58% more likely to die than married people. Some reasons purported were mutual financial, emotional and physical support and assistance from children. One common denominator for a short life span is loneliness and those in a healthy relationship may live longer because they feel loved and connected.
10. Happiness - A study in the Journal of Family Psychology showed that happiness depends more on the quality of family relationships than on the level of income.  So, according to the research, when it comes to a long, happy and healthy life…love is more important than money!

SOURCES: WebMD

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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Part II of II

Last week’s column was dedicated to Rosie Malloy as we discussed the importance of laughter for health and wellness. In this column, I will discuss one of the most understated benefits of exercise – mental health! Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness by helping reduce depression.

Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that depression scores were significantly reduced in groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks, when compared to a control group and a psychotherapy counseling group.

Depression is the most common mental disorder and is twice as common among women as in men. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician. Unfortunately, depression is on the increase in the United States. According to the National Ambulatory Medical Care Survey, in the 1990’s, 7 million visits to a primary care physician were for the treatment of depression. 10 years later the number doubled.

HOW EXERCISE REDUCES DEPRESSION:

According to copious amounts of scientific research, exercise improves health and wellness and reduces depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Depression:

• Helps a person gain control over their lives
• Increases self-esteem
• Diverts attention away from worry, concern or guilt
• Improves mood – with visible signs of improvement in physique & body weight
• Increases sense of pleasure and satisfaction
• Anger management – release pent-up frustration, anger and hostility

Physiological or Physical Benefits of Exercise on Depression:

• Increase in brain serotonin (natural mood elevator chemical in brain)
• Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
• Improvement in natural sleep patterns

HOW TO BEGIN EXERCISE FOR DEPRESSION:

1. First and most importantly, consult your primary care physician to confirm the diagnosis of depression. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressants or other medications discuss the impact it may have on your exercise program with your physician.
2. Recognize and fight depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills. Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.
3. Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure.
4. Begin with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and more routine in 3-4 weeks so JUST DO IT !
5. Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton). Use a mall in inclement weather.
6. Find a friendly, uplifting group of people to enjoy a good walk and talk. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
7. Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
8. Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
9. BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

SOURCES: British Journal of Medicine: Journal of Exercise and Sports Science

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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.comPaul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

This column is dedicated to the family and friends of Rosemay “Rosie” Malloy and her wonderful disposition and laughter. Losing Rosie this past fall has left a painful void for those among us who were fortunate to know her and call her friend. Moreover, Rosie was an inspiration and role model for all who were paying attention…she was the embodiment of a quote by Dr. Paul Mercer, “laughter is the best medicine!”

Despite having her share of serious health problems that would wipe the smile off any reasonable face Rosie smiled her way to health and happiness. And, if she wasn’t up to the smiling task, she was always surrounded by her laughing and smiling family….it was contagious and infectious!

*Scientific evidence supports the notion that “laughter is the best medicine” as studies of tens of thousands of seniors found that those who find it difficult to laugh and smile have a much higher risk of developing functional disabilities. The biological explanation of how laughter reduces stress, anxiety and depression has to do with the stress-reducing effects of suppressing epinephrine and cortisol while enhancing the levels of dopamine and serotonin which are hormones linked to happiness. In fact, deficiencies in both dopamine and serotonin are linked to depression.

While laughter has been found to decrease stress and improve mood, it has also been linked to improved physical and mental resilience. It is good for relationships and a powerful tool for dealing with conflict and tension.

BENEFITS OF LAUGHTER:

1. Relieve Pain – Laughter releases natural pain hormones such as endorphins.
2. Improve Mood, Decrease Depression and Anxiety – Laughing releases hormones (endorphin, serotonin, and others) that are related to happiness and comfort.
3. Improves Relationships – Laughing with others binds people together. It is a contagious behavior that benefits all participating parties.
4. Offers an Alternative Perspective – Laughter fosters a different perspective to a situation or problem which can be less threatening or difficult.
5. Reduce Stress and Tension – Laughter, especially a hearty “belly laugh,” promotes blood circulation and muscle relaxation by reducing the production of the stress hormone, cortisol.
6. Improve Immune System – A positive outlook associated with laughter can release neuropeptides that are associated with a boost to the immune system.
7. Improve Resilience – Laughing at our mistakes and problems helps us realize that mistakes and problems are just a normal part of life.

Recent research is very encouraging and supports the use of laughter and exercise to prevent and treat depression as a powerful adjunct to therapy and medication. While it is important to state that depression is no laughing matter, many mental health professionals support it as a method to confront an unpleasant situation and gain some level of control over it. One study showed that elderly people who used humor on a regular basis, reported improved satisfaction in life as compared to their less humorous contemporaries.

4 Tips to Improve Your Sense of Humor:

1. Hang Around With Fun and Funny People - Whenever possible, try to associate with good people who “pick you up” and have good karma. Avoid people who are “downers” and tend to “such the oxygen” out of the room.
2. Listen to Jokes & Learn to Enjoy Them - While this may be difficult to do when your down, but it will go a long way to pick you up.
3. Learn to Tell a Joke - This is also not easy but very important to improve your sense of humor. It will help you rediscover your “inner child.” Ease into it and start slowly. Practice in front of a mirror in the privacy of your home. Begin using it on family and good friends.
4. Joke About Your Depression - It will be cathartic. For example, “oh my God, that would be so funny if I wasn’t depressed!” “Don’t tell my shrink I laughed so hard because he will take away my meds!” Don’t put yourself down but laugh at yourself if you mess up telling a joke or trying to be funny. Then, try again.

*Sources: NIH, Japanese Gerontological Evaluation Study, LifeScript.com

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Part II of II

Last week, this column discussed the many benefits of snowshoeing as an option for those in NEPA to get outdoors and enjoy the winter. Today’s column will present another option for outdoor exercise when the weather is inclement…winter walking or running.

We live in such a beautiful environment. Each season brings its own unique beauty and winter is no different. Most will not have to abandon outdoor activities, but you must make some adjustments in equipment, clothing and food for each season and temperature changes that go with it. These tips are also appropriate for those who qualified for the Boston Marathon in the spring and will be training all winter, as well as those who enjoy walking and running throughout the winter for exercise. Consider the importance of making changes and adjustments in training as well as clothing and equipment, according to the weather and temperature.

SHOES AND EQUIPMENT for WINTER:

There are running shoes specifically designed for use in wet, cold and sloppy winter conditions. These running shoes, which can also be used for walking, are considered “winterized” because they offer waterproofing, sealed seams, gaiter collars to keep out snow and slop, slip resistant fabric, anti-roll stability features, anti-microbial material and aggressive tread patterns for traction on slippery surfaces. Some shoe recommendations for both walkers and runners include:

• Salomon – SpeedCross or SpikeCross - $ 200.
• Topo MTN Racer 3 - $150.
• Brooks – Ghost 16 GTX - $170

Additionally, I am a strong proponent of walking with trekking poles for improved balance and safety when brisk walking in winter conditions. They are light weight, adjustable, and collapsible. Some examples are:  Trekology Trek Z 2.0 – 45. and REI Co-op Trailmade $79.00. Also, an old pair of ski poles will work just fine.

Winter CLOTHING AND TRAINING:

Over the past several years great strides have been made on understanding the effects of extreme temperatures on performance. Current wisdom from the University of Otago in New Zealand has found:

• WARM-UP - Spend more time warming up followed by slow gentle stretching in cold temps.
• THE BRAIN - Can anticipate changes in body temperature, with feedback from the skin, and will adjust the intensity automatically. Subconsciously, the brain calculates the outside temperature and the duration of the activity and will automatically slow down the performance even before fatigue occurs. If the performer attempts to override the brain, the cerebrum responds by creating severe symptoms and sensations of exhaustion such as those associated with heat strain or hypothermia. Therefore, the temperature in which you intensely perform will overpower even the fittest athletes.
• STRATEGIES FOR OPTMIMAL PERFORMANCE IN COLD TEMPERATURE -
• Researchers developed various strategies for athletes to stabilize their core temperatures in extreme hot or extreme cold conditions.
  • BELOW 45 DEGREES FAHRENHEIT – CAUTION/COLD: Humans possess limited physiological defenses against the cold.
    • Clothing – it is important to layer clothing. Use performance apparel such as UnderArmor (headgear, gloves, shirts and pants) to allow sweat to breath away from the skin to the next layer of clothing. Use a facemask to cover your mouth and nose to prevent frost bite and warm air before it enters the lungs. Chemical hand and toe warmers are great. Wear running shoes designed for winter conditions when surfaces are slippery.
      • Warm-Up – gently warm up inside but don’t break a sweat. Wait for your running partner in the warm car or house until they arrive. The best warm up in very cold weather is to begin your activity SLOWLY! Runner’s, for example, should run a ¼ the normal pace for 3-5 minutes, then ½ pace for 3-5 minutes, then ¾ pace for 3-5 minutes to prevent injuries. After 10 to 15 minutes, you may open up the throttle.
      • Safety – is important. Be alert for icy patches and poor visibility for cars. Wear fluorescent and reflective colors running in fog, dusk or dawn. Run in daylight with the warmth of the sun when possible.
      • Cross-Train- if it is very snowy, skip the run and try cross-country skiing or snowshoe walking or jogging for a change. It is a great running substitute and vigorous workout!
      • Food & Drink – is different for activities in the cold. For short-term exposure (1-4 hours) make sure you fill your muscles with lots of glycogen by getting 4 grams of carbohydrates for every pound of body weight. During exercise consume extra carbs by drinking 5 to 6 ounces of sports drink every 15-20 minutes. Hikers and campers performing vigorous activity in the cold for days at a time will require extra fat in their diet and on their bodies to store for energy. This is no time to count calories or fat intake, as anyone who has climbed the high peak knows!
  • 45 TO 50 DEGREES FAHRENHEIT – OPTIMAL Many physiologists and outdoor enthusiasts consider this temperature range to be optimal. It still requires 10 minutes of slow warm-up by ½ to ¾ pace running or cycling. Also, layers are advisable to start off warm, keep warm and shed before you become overheated. Food and drink requirements are still important as with all long duration activities but may be ¼ to ½ the above requirements.

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Part I of II

When I was a young boy growing up in NEPA, one of my favorite winter things was to walk in the freshly fallen snow. I loved the feel of fresh crisp air through my lungs, the mesmerizing sparkle of snow falling in the moonlight, the peaceful sound of silence as pedestrian and motor traffic came to a halt and only thing audible was the muffled sound of my boots as they crunched the snow beneath… for me, if it is sizzling hot in hell, it snows in heaven! Well, I am happy to share with you, as I struggle to hold on tightly to my “inner child,” I am as excited and inspired by a walk in the snow today, as I was 45 years ago. It is my hope, that this column will inspire my readers to consider a beautiful walk in the snow to rediscover their “inner child.”  

While there are many options and opportunities available to enjoy winter in NEPA such as downhill skiing, cross country skiing, winter mountain biking, ice skating, and sled riding, none is as easy and natural as snowshoeing.

The advantages are many:

• There is NO learning curve - if you can walk, you can shoe
• There is little to no risk of injury - it requires more endurance than coordination
• The equipment is inexpensive - as compared to skis
• The walking and hiking trails are free - Lackawanna State Park, Rails to Trails or the snow covered streets of your neighborhood
• The aerobic exercise is great and caloric expenditure tremendous. According to Weightwatchers, a person weighing 150 pounds will burn approximately 650 to 700 calories per hour of snowshoeing

As a result, the popularity of snowshoeing is growing rapidly. According to the Outdoor Industry Association, the number of snowshoe participants have increased by 7.5% to 4.1 million in 2011 and 40.7% overall since 2008.  

History (Raquettes GV, Quebec, Canada  info@gvsnowshoes.com)

While the advent of the wheel is estimated to have been approximately 3,500 BC, the snowshoe had already been established and developed by 6,000 BC according to Stone Age engravings found in Norway. The snowshoe was an instrumental tool used by early humans to cross the Bering Strait into North America.

Some historians feel the snowshoe developed, like many great inventions, as an imitation of nature. For example, animals such as the snowshoe hare use expansive feet to increase their surface area, limit sinking and move more efficiently through the deep snow. Hardwood frames with leather webbed lacing comprised the early snowshoes used by fur trappers, traders, and Native Americans. More recently, materials have advanced and light but durable aluminum frames comprise snowshoes that are used by park rangers and winter recreation enthusiasts.    

Equipment - Choosing the right snowshoe

3 Types:

1. Recreational Hiking Snowshoes - Recreation shoes are a good choice for beginners to be used on easy terrain, paths and    trails.
2. Aerobic/Fitness Snowshoes - Aerobic shoes offer a sleeker and lighter design for those interested in running or cross-training.
3. Hiking/Backpacking Snowshoes - Hiking shoes offer a strong and durable frame, slightly wider base of support and strong flexible bindings for difficult terrain.

Cost of Snowshoeing:

Like all sporting equipment, you usually get what you pay for. Snowshoes range in cost from $50.00 to $300.00. Most people will be fine in a good pair for under $100.00. LL Bean and Dick’s Sporting Goods and Sierra Store offer several affordable options.

Some equipment examples are Tubbs Wayfinder Flat - $199 and Redfeather  - $82.00. Ski poles are recommended for efficiency when snowshoeing. Traditional ski poles or adjustable hiking poles can be used. Warm and supportive winter boots or hiking shoes are essential.

Now you are ready to go! The next time a snow storm dumps 8 – 10 inches on NEPA, get outside BEFORE the streets are plowed. Put on you warm winter boots, strap them into the bindings of your new snowshoes and walk out your front door and explore your neighborhood as you have never seen it before...white, clean, glistening, crisp and quiet. Let your mind wander, enjoy winter and rediscover your inner child!

Next Week: Part II of II...Winter Walking and Running

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!

Weeks into the New Year…Are You Holding on to Your Resolutions?!

I am sure that many of you feel as I do…it is hard to believe that I am living in the year 2025! Moreover, I hope you share my sentiments that each year, despite the trials and challenges of each month, week, day, and minute, is a gift, not to be taken for granted and 2025 is no different. And that is why we resolve at this time each year to make a concerted effort to improve ourselves; mentally, physically and spiritually, so that we may live a longer and healthier life, to spend more time with the friends and family we love.  

Not surprisingly, getting physically fit and losing weight are the top resolutions to begin each New Year, even 2025. According to the University of Pittsburgh Medical Center, 10 million Americans choose to join one of the 45,000 health clubs and hope to get fit and healthy for life. Unfortunately, if starting an exercise program is the hard part, than sticking to it is the hardest part.

Once the initial excitement and enthusiasm wears off after the 2025 new year, so does the discipline and determination necessary to overcome the many distractions in our lives to make exercise a priority for life. Diane Klein, PhD polled long-term exercisers (those exercising at least 3 times per week for more than 13 years) what motivated them to “stick with the program.” The answers are in order of importance. Please note that “appearance” was NOT at the top of the list.

10 Motivators to Stick to an Exercise Program in 2025:

• Fitness
• Feelings of well-being
• Pep and energy
• Enjoyment of the exercise
• Making exercise a priority
• Sleeping better
• Feeling alert
• Being relaxed
• Weight management
• Appearance

Tips to Stick to an Exercise Program:

1. Add variety to your program – stick to your basic program to meet your goals but add variety to stick to your program. On off days walk in the woods, snowshoe, play tennis or pickleball, ride a bike, and swim. One day do upper body and the next lower body.
2. Find an exercise buddy – no one wants to let their buddy down so the likelihood of compliance is much greater when you have someone depending on you. Make sure it is a good match…someone with positive energy!
3. Make exercise a priority – friends and family must understand that this is important to you. It is a non-negotiable part of your day, like taking a vitamin or brushing your teeth.
4. Exercise first thing in the morning – For many people it is best to exercise before all the demands of the day come into play
5. Exercise on the way home from work – For others, it is best to exercise after they fulfill their other obligations but before they get home, eat and settle in. Some days it will vary.
6. Exercise even when you are tired – keep in mind that you will be energized after you exercise.
7. Keep a log of your exercise – writing down the dates, times, speed, distance, reps and sets can help you monitor your progress.
8. Look for signs of progress – the scale is only one sign of progress. Make note of how your clothes fit, how much energy you have, the pep in your step and the improvement in your exercise log.
9. Walk – incorporate walking into your daily routine. Walk to the store, walk the dog, walk when you play golf and take the stairs.
10. Reward yourself – this is an individual preference but try to avoid a food overdose. For example, buy a new dress when you lose 10 pounds, go awayfor the weekend for the next 10 pounds. Do whatever works for you.
11. Monitor Progress – Use Technology – Fitness Apps, Smart Watches, Electronic Fitness Monitors or Wearable Tech Monitor provide feedback and motivation.These devices use GPS technology to help the user track their activity to get more out of their exercise routines. They monitor activity, heart rate, distance, location, calories, and more. Some examples are: Pedometers , Activity Trackers, Running Watches, and Heart Rate Monitors
12. Personal Trainer Gift Certificate or Home Virtual Trainers - This can be an opportunity for someone to either get the proper advice from a professional (in person or virtually) to begin a fitness program or to revamp and tune up an old stale program. Word of mouth is a good way to find a reputable certified trainer. Virtual Examples are: Peloton – (bike, treadmill); Mirror Exercise and FightCamp

Source: WebMD, Mayo Clinic

     Visit your doctor regularly and listen to your body.     

     Keep moving, eat healthy foods, exercise regularly, and live long and well!

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

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 orthopedic and sports physical therapy in Scranton and Clarks Summit. 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 our exercise forum!