Congratulations to more than 1,000 courageous runners who finished the 29th Annual Steamtown Marathon today. Most, if not all of you, will wake up tomorrow morning with a little less jump in your step than you had yesterday as your body begins it's recovery.
As active people by nature, many of you will resist the logic of rest, despite the pain and stiffness in your muscles and joints. Therefore, I would like to offer some words of wisdom. Based on science, to encourage you to adequately rest and allow your body to recover.
GREAT EXAMPLE OF REST AND RECOVERY:
With adequate rest and recovery, an elite runner can quickly regain full form in 3-4 weeks. While an average runner may require 4-6 weeks. Meb Keflezighi, an elite American runner and winner of the 2014 Boston Marathon, is an excellent example of the merits of rest and recovery. However, he discovered it by accident. Following the 2012 New York City Marathon, Meb developed a foot infection which required three weeks rest. With the Olympic Trials just 70 days away, Meb quickly regained his pre-injury fitness level to win the 2012 US Olympic Marathon Trials and join the US Olympic Team in London. It may be that his injury was fortuitous and allowed him adequate recovery time, (that he might not have otherwise allowed), preparing him for intensive training leading up to the trials.
RESPECT THE DAMAGE TO YOUR BODY:
The Effects of Running 26.2 Miles on the Body: (RunNow.com - Jim Peskett)
Muscle-Skeletal System:
One of the most obvious effects of running a marathon is significant muscle and joint pain and stiffness. It will set in after you sit for a while and attempt to get up and move around. For most, it will be more pronounced the day after the marathon, as you get out of bed and limp to the bathroom. Studies show that the leg muscles, (especially the calf muscles) display significant inflammation and necrosis (dead tissue) in the fibers of the muscle. In other words, the trauma to the muscles is so severe that tissue damage causes muscle cells to die. Consequently, studies found that muscle strength, power and endurance is compromised and required significant time to recover… sometimes as long as 4-6 weeks!
Additionally, many runners report severe bone and joint pain following the race. Some studies report findings of microfractures or bone bruising from the repeated and prolonged pounding of the marathon. It is purported that the stress on the joints may be related to: weight and body type, running shoes, running style and mechanics. While not dangerous, again, it is important to respect the stress placed on the body and allow adequate healing…LISTEN TO YOUR BODY!
Cellular Damage:
Creatine kinase is an enzyme found in the brain, skeletal muscles and heart. It is found in elevated levels in the presence of cellular damage to these tissues, for example, following a heart attack. Similarly, significantly elevated creatine kinase levels are found in the blood of runners up to 4 days post marathon, demonstrating extensive tissue damage at the cellular level. It is important to note, that these enzyme markers are present, even if a runner does not experience muscle soreness. So, adequate rest for healing and recovery is required, regardless of soreness.
Immune System:
It is not a coincidence that the runners are more likely to contract colds and flu after intensive training or running 26.2 miles. The immune system is severely compromised after a marathon and without adequate recovery; a runner can become ill and ultimately lose more training time or will underperform.
3 MYTHS THAT PREVENT REST AND RECOVERY IN RUNNERS:
If I don’t have pain, then I did not damage my body.I can run again soon after the marathon.
FALSE: As stated above, enzyme levels that indicate cellular damage to the tissues are present in the post-marathon runner, even in those without significant pain.
Energy drinks with caffeine are the best way to reenergize my body and speed up my recovery.
FALSE: In addition to rest, drink, drink, drink - 24 ounces of water for every 2 pounds you lose after the marathon. This is based on pre and post exercise weight. You just burned 2,600 calories so avoid diet soft drinks. You need the glucose (sugar) boost. Also, don’t drink alcohol and use minimal amounts of caffeine (the equivalent of 1-2 cups of coffee). First, drink plenty of water and sports drinks (Gatorade) to prevent a diuretic like caffeine from messing up your fluid balance.
If I don’t run, I will lose all of my conditioning in one week.
FALSE: Studies clearly show that the VO2 Max, (the best measurement of a runner’s endurance and fitness), is unchanged after one week of inactivity. And, after two weeks, the loss is less than 6% and can be regained quickly. Moreover, it is important to remember, without adequate rest and recovery, performance is comprised, not by the loss of VO2 Max, but by muscle-skeletal tissue damage, which renders the leg muscles of the runner weaker. Remember Meb Keflezighi!
Expedite Your Recovery:
Rest – Take it easy for a few days. Let you muscles/body heal. Take short walks.
Elevate – Elevating your legs to allow blood/fluid in you muscles to return to the heart without using gravity.
Massage – This can be an effective method of relaxing muscle spasms, cramps and mobilizing fluids from your muscles to your heart after the marathon. It should be very comfortable. You may find even more benefit from massage 24-48 hours after the race to assist in the recovery of delayed onset muscle soreness from lactic acid build-up in your muscles.
Slowly Reintroduce Exercise and Running – Gradually introduce longer walks and slow jogging after a few weeks. Cross-training is good for less joint compression and allows the use of other muscles. (Elliptical, bike, swim)
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!
Provisional Bag/First Aide Kit
It is one week away from the 29th Steamtown Marathon. This column is dedicated to all the runners preparing for the big day. One small piece of advice; start slowly, avoid the first mile adrenaline sprint downhill, and enjoy the journey! Remember, only one Olympic marathon winner (Juan Zabala, Argentina, 1932) was in the lead at the 5 mile mark. Lesson: The last miles matter more than the first!
Today, I hope to address some common questions for the novice marathon runner or for those coming from other locations to run in the race. What should you pack? How should I dress? What supplies will I need?
Elite runners are so experienced that they know exactly what to pack in preparation for the big day. However, those, running in marathon for the first or second time usually have lots of questions. First, what you need and what you can bring will depend on your support team. If you are running alone and will not have family or friends meeting you along the way, then you are limited to a fanny pack and a few supplies. If you have a support team, then they can carry a bag with supplies, meet you along the course and you can have a sense of security.
Remember; do not do anything different on race day. Try out special clothing, water with supplements and snacks on a practice run. Also, experiment with your best pre-race meal. You will be getting up at 5-6:00am to catch the bus from Scranton to Forest City. You may want to pack breakfast to eat in the high school gym such as; bagel, peanut butter, jelly, banana and coffee or Gatorade. Moving your bowels before the race is a must.
Marathon Musts:
Dress:
Columbus Day Weekend in NEPA could bring 30 to 40 degree temperatures when you catch the bus in Scranton and at the 8:00 am race starting time in Forest City.
Clothing:
Hat and Gloves: Wearing a hat, light gloves can be a good idea. DryTech materials are best to prevent retention of sweat.
Long Sleeve Shirt and Light Jacket may be necessary. Wearing old items are best so they can be discarded along the way once you are warmed up.
Remember, any extra items can be placed in a labeled bag at the starting line and will be transported to the finish line for your convenience. So, if it’s a cold morning, wear a jacket and warm up pants on the bus to the starting line and “bag it!”
Accessories:
Sunglasses and Sunscreen: If sun and warm temps are forecasted, sunglasses are best placed on top of your hat until needed and sunscreen applied before the race.
Skin Lubrication: Lubricate your skin with petroleum jelly in areas of potential friction such as arm pits, nipples, thighs and feet.
Dry Tech Clothing: Wear dry tech protects, including shirt, underwear and socks, to prevent excessive moisture and friction.
Favorite Water Source and Snack: Water and light snacks will be provided every 2 miles but sometimes it is good to have your own favorites, especially in the high school gym before the race.
FANNY PACK – Especially for those running without a support team
If you don’t mind the little pack on your butt, a fanny pack can be valuable. In it, you will want supplies such as: small bandages, small roll of medical tape, ibuprofen, antacid tablets, small tube of lubricant, favorite running snack, and extra shoe laces. One might also consider packing a little money, credit card, ID, emergency contact numbers and medical insurance cards. A cell phone is optional.
SUPPLY BAG – For those with support team
Have your support team meet you at prearrange locations along the race route and bring your supply bag. In the bag, you might consider all of the above fanny pack items and: A change of clothes such as: extra running shoes, socks, shorts, shirt, water proof wind breaker, according to the weather, especially if rain is predicted. Towels, ace bandages, gauze pads and wrap, antibiotic cream, mole skin, sunscreen, petroleum jelly, safety pins, extra water and favorite sport drink, favorite sport snacks, extra ibuprofen, antacid, anti diarrhea medicine, chemical ice pack, mobile phone, money, credit cards, ID, medical insurance cards.
For those with allergic reactions, remember to pack: epinephrine, antihistamine, and other important medications.
Don’t Forget: Map and directions to the bus or starting line, course map, race number, and get your timing chip.
Enjoy! Enjoy! Smell the roses, take in the fall foliage and chat with a fellow racer. Savor the marathon moment and enjoy the day…you are doing something very special!
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!
Weight Training and Aerobic Exercise for GLP-1 Users
The popularity of glucagon-like peptide-1 (GLP-1) medications, such as semaglutide (Ozempic, Wegovy, Mounjaro) for weight loss, have increased exponentially over the past few years. Many medical experts predict that it is only the beginning. Medicare recently announced that it will begin a pilot program for those who qualify for GLP-1. If approved and covered by Medicare, GLP-1 use will become widespread. While the potential benefits of these weight-loss drugs exceed the risk for those suffering from obesity, it is not without some risk and side effects such as gastrointestinal problems and loss of muscle mass. Following a healthy diet and engaging in an exercise program to maximize the benefits and minimize the side effects from GLP-1 medications is necessary.
GLP-1
Glucagon-like peptide-1 (GLP-1) medications, when used for weight loss, reduce food cravings, increase fullness, slow digestion and control blood glucose. However, gastrointestinal (GI) side effects and maintaining muscle mass and energy levels are common concerns. These medications are designed to mimic the action of a natural hormone GLP-1, which is produced in the intestines after eating. This hormone regulates appetite, blood sugar levels and digestion. Ultimately, by slowing digestion, GLP-1 users feel fuller for longer periods of time.
A recent study published in Journal of the American Medical Association (JAMA) strongly recommends that people using GLP-1 medications eat more protein, consume smaller meals and snacks, avoid certain foods to reduce constipation, nausea and heartburn, stay hydrated, and engage in regular exercise including aerobic exercise and strength training to minimize muscle and bone loss.
Benefits of a Well-Designed Weight Training Program for GLP Users
Increased Strength
Prevent Loss of Muscle Mass & Bone Density
Improved Performance in daily tasks and activities
Improved Endurance
Improved Injury Prevention
Improved Mental Health
Improved Overall Health & Wellness
Risks From Poorly Designed or Unsupervised Program
Risk level increases if the program is not developed or supervised by a qualified professional for technique, safety, intensity and frequency
Lower Back Pain – from poor technique and overload
Muscle/Tendon Strain – from overuse and overload
Tendonitis – from overuse and overload
How to Begin A Weight Training Program for GLP Users
Primary Care/Family Physician – get medical clearance to make sure that you are not at risk, especially if you have medical issues such as heart disease, hypertension, diabetes.
Orthopedic Physical Therapist – your doctor may think you would benefit from a few visits with an orthopedic PT to make sure your program is well-designed for your specific goals and your specific needs or activities (gardening, walking, golf, tennis)
Avoid Getting Competitive – it sets you up for injury! No Clean-Jerk, Overhead Press, Full Squats. Don’t compete to lift to your maximum. Make Exercise FUN!
Technique
Slowly lift and lower weight 4 seconds up, 4 seconds down
Breath – inhale lifting weight up and exhale down
Never hold breath!
Exercise Major Muscle Groups
Upper body: shrugs, rows, lats, biceps, triceps, chest press, wrist curls – all with light dumbbells and bands to start
Lower Body: hip hike, leg extension, ham curl, step ups, 45 degree squat, calf raise – all light with sandbags and dumbbells to start
Lift 3 times per week on alternating days – 30 to 45 minute sessions
Warm up
Cool down
Work upper body/lower body
Can alternate days for upper body and lower body
INCLUDE AEROBIC EXERCISE:
Can alternate days for weight lifting with aerobic exercise (elliptical, swim, walk, run, bike)
Concentrate on low weights (5-10#)/high repetitions(10-15 times)
Once you master the technique add 1-2 # and 3-5 reps
Never advance weight or reps if you overstrain and compromise technique
**STOP:
If you have pain
If you get lightheaded or dizzy
If you experience lower back pain or joint pain
If you have muscle or joint pain that lasts more than 2 days
SOURCES: Journal of the American Medical Association, Trimrx.com, National Institutes of Health
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 1 of 2
The popularity of glucagon-like peptide-1 (GLP-1) medications, such as semaglutide (Ozempic, Wegovy, Mounjaro) for weight loss, have increased exponentially over the past few years. Many medical experts predict that it is only the beginning. Medicare recently announced that it will begin a pilot program for those who qualify for GLP-1. If approved and covered by Medicare, GLP-1 use will become widespread. While the potential benefits of these weight-loss drugs exceed the risk for those suffering from obesity, it is not without some risk and side effects such as gastrointestinal problems and loss of muscle mass. Following a healthy diet and engaging in an exercise program to maximize the benefits and minimize the side effects from GLP-1 medications is necessary.
GLP-1
Glucagon-like peptide-1 (GLP-1) medications, when used for weight loss, reduce food cravings, increase fullness, slow digestion and control blood glucose. However, gastrointestinal (GI) side effects and maintaining muscle mass and energy levels are common concerns. These medications are designed to mimic the action of a natural hormone GLP-1, which is produced in the intestines after eating. This hormone regulates appetite, blood sugar levels and digestion. Ultimately, by slowing digestion, GLP-1 users feel fuller for longer periods of time. A recent study published in Journal of the American Medical Association (JAMA) strongly recommends that people using GLP-1 medications eat more protein, consume smaller meals and snacks, avoid certain foods to reduce constipation, nausea and heartburn, stay hydrated, and engage in regular exercise including aerobic exercise and strength training to minimize muscle and bone loss.
Diet and Nutrition Considerations for GLP-1 Users
FOOD TO AVOID
High-Fat Foods
High-fat foods can increase nausea and bloating.
Fried foods: French fries, fried chicken, and doughnuts.
Fatty Meats: Bacon, sausage and fatty meats
Creamy Sauces and Dressings
Sugary Foods and Beverages
Foods with high sugar content can spike blood sugar levels which counteracts the benefits of GLP-1 medications without significant nutritional value. Some include candy, sweets, pastries, desserts, sodas, sweet teas, fruit juices which can also contribute to GI issues.
Starchy Vegetables and Fruits
Some starchy vegetables and fruits have a high glycemic index which causes spikes in blood sugar. However, due to the nutritional value that this food group provides, moderation, not elimination, is the best approach when eating potatoes, corn, and peas. High sugar fruits such as very ripe bananas, mangos, and grapes must be consumed prudently.
Highly Processed Foods
Highly processed foods are never a healthy choice and more so for GLP-1’s. They often contain unhealthy fats, sugars and preservatives that can contribute to side effects. Some examples are; fast foods, prepackaged snacks (chips, cookies), and instant meals.
Alcohol
Overuse of alcohol can contribute to GLP-1 side effects…so drink in moderation and discuss it further with your physician.
Alternative Food Choices for GLP-1 Users
While it is important to eliminate unhealthy foods from your diet as previously discussed, it is equally important to include a diet rich in nutritious and wholesome foods to prevent the loss of muscle mass associated with GLP-1 use.
Lean Proteins
Chicken, fish, and plant-based proteins such as lentils, chickpeas, and tofu.
Non-Starchy Vegetables (low in carbohydrates and calories)
Be Mindful - Listen to your body - stay focused and listen to your body…don’t eat if you’re not hungry. GLP-1’s will make you feel full if you are paying attention.
Regular Meal Times – try to eat meals at consistent times to avoid blood sugar spikes.
Consult with a Dietitian – get professional advice from a registered dietitian to tailor a plan for your specific needs.
SOURCES: Journal of the American Medical Association, Trimrx.com, National Institutes of Health
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
NEXT WEEK: Part II of II “Diet & Exercise Considerations for GLP-1 Users”
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 III OF III
This is the third of three columns dedicated to healthcare for college students. Please find these “10 Tips to Keep Yourself Healthy in College” helpful. However, no discussion regarding the health and wellness of college students would be complete and thorough without addressing what health care and university experts consider the two most dangerous behaviors on college campuses across the nation: binge drinking and unprotected sexual activity.
While it is not my intent to offend the religious and moral values of any reader, it is my purpose to provoke direct and meaningful conversation between parents, religious leaders and students. To prevent serious health problems in college, parents must share their experience and discuss their values regarding sexual activity and alcohol consumption with children before they leave home to live independently in college. If you are unable to have a direct conversation about these issues, consider doing what several readers have done; mail a copy of this column to your child!
10 Tips to Keep Yourself Healthy in College: (American Academy of Pediatrics)
Sleep – somehow, despite a busy academic and social schedule, you MUST get enough rest. Lack of sleep may be the single unhealthiest habit of a college student. It can lead to many negative consequences such as lack of concentration, poor emotional stability, and vulnerability to germs and disease. While one may get by on 3-4 hours sleep for short periods of time, eventually, your body will take control and shut down. Do your best to develop a regular sleep pattern and factor in short naps to catch up on needed rest if necessary.
Diet – the “freshman fifteen” is no joke, it is the real thing. Skipping breakfast, “pigging out” on junk food, late night eating, and drinking high calorie soda and beer all factor into weight gain and poor dietary habits. Make time to eat breakfast, snack on yogurt, fruit and nuts. Fill up on a healthy salad. Avoid a constant diet of fried foods and sweets.
Water – even adults forget to drink plenty of water throughout the day. Carry a water bottle and skip the soda.
Get regular check-ups – see your doctor when home on semester break for an annual check-up or more often if needed. Many college health centers offer this service. Many serious problems can be avoided with early detection.
Get a flu shot, vaccines and mask up – remember, college campuses breed germs and most schools offer inexpensive flu shots and Covid vaccines.
Exercise – make time to exercise regularly (30-45 minutes 3-5 days per week). Walk, run, bike, lift weights, play tennis, racquetball or swim. Colleges have the best facilities for sports and exercise. Just DO SOMETHING! It will help you sleep, relax and feel better.
Relax – make time to relax. Read a book, go for a run, meditate, do yoga, or walk and have good conversations with friends. Mental health is important on a stressful college campus.
Emotional Health – is a vital component of a healthy person. College life can be very stressful. Depression, anxiety, addiction, eating disorders, and homesickness are some examples of emotional problems common among college students. If you feel emotionally unhealthy, get professional help. All colleges have trained counselors equipped to assist you.
Drink Sensibly – binge drinking might be one of the most dangerous behaviors on a college campus. Studies show 44% of U.S. College students engage in binge drinking uniformly among freshman through seniors. Of these, 50% binged 3-4 times in a two-week period. Binge drinking is defined as 5 drinks in a row for men and 4 for women. Binge drinkers are more likely to be victims of poor academic performance, addiction, trauma, auto accidents, assault, unprotected sex, sexual assault, and death. Some of the most common reasons reported for binging are: to get drunk, status, campus culture, peer pressure, academic stress. TALK TO YOUR CHILDREN!
Safe Sex – promiscuous sex is physically and emotionally unhealthy. Unprotected sex can be LIFE ALTERING! Studies by the Center for Disease Control found that almost 80% of college students 18 to 24 years old had sexual intercourse at least one time during college. 73% reported having unprotected sex and 68% of this group did not believe that they were at risk of contracting a sexually transmitted disease. TALK TO YOUR CHILDREN! GET THE HPV VACCINE!
SOURCES: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly.
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 III
This is the second of three columns dedicated to healthcare for college students. As part of the preparation, think about a first aid kit, health care history, and insurance file. For parents without other children at home, once you finish with these preparations and your child departs for college away from home, plan to take dance, art history and conversational Italian classes to occupy your time without children. Resist the temptation to be a helicopter parent…life goes on!
Remember, living in a large community and sharing close quarters makes the development and spread of disease a natural progression. College life can be very unhealthy for many reasons: lack of sleep, poor eating habits, poor hygiene and stress.
10 Symptoms College Students Should Not Ignore: (American Academy of Pediatrics)
Last week we discussed common illnesses among college students, how to manage and when to seek professional help. Below you will find a list of symptoms that should never be ignored. The college health services department should be contacted if you have any of the following symptoms:
Fever – 102 degrees F or higher
Headache – if accompanied by a stiff neck
Pain with urination
Unusual discharge from penis or vagina
Change in menstrual cycle
Abdominal pain – that will not go away
Persistent cough
Persistent chest pain
Persistent difficulty breathing
Persistent pain or any other symptoms that last longer than you think it should
10 Must-Have Health Care Items For College: (American Academy of Pediatrics)
Get a small/medium plastic storage box and use it to keep all the following health care items together in one place.
Health Care Record – keep a copy of the required health care record required by the school in your health box. You may need it for the health services department or for an unexpected visit to the hospital.
Medication List – with names and dosages
Allergy List – with medication used for each allergy. For example, bee sting kit.
Past Medical History List – write down previous surgeries (appendectomy), diseases (Mono) and dates
Special Needs List – for example breathing inhaler for sudden asthma
Mental Health Problem List – problem and dates
Immunization Record – list shots/vaccines you have had and dates. For example, meningococcal disease vaccine.
Health Insurance Card – keep a photo copy of your health insurance card in your wallet and another in this college health care box
Hand Sanitizer
First Aid Kit
Bandages to dress wounds
Gauze and adhesive tape to dress wounds
Elastic bandage to support and compress sprains
Antibacterial towel packets
Antibacterial/antibiotic ointment
Digital thermometer
Chemical ice pack/Microwave heating pack for sprains/strains
Acetaminophen and ibuprofen for aches/pains/fever
Other prescribed medications
Vitamins
SOURCES: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
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. Next Week: “Health Tips for College Students – Part III of III”
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 III
It is hard to believe it is that time of year when parents and students are preparing to return to school. Many will leave home for the first time as college freshmen. Over the past month I have received several requests for a copy of my three-part series of columns on health tips for college students. In view of this, I thought other parents preparing to send a child off to college this fall might also find this information valuable.
To fully appreciate the importance of this topic, one must keep in mind that living in a large community and sharing close quarters is the first ingredient in the development and spread of disease. College life can be very unhealthy for many reasons. Lack of sleep, poor eating habits and stress add spice to the recipe for disease. Lastly, poor hygiene added to the equation will really get the Petri dish cooking up some nasty germs.
Common Health Problems for College Students (American Academy of Pediatrics)
Colds, Flu, Covid - These are caused by viruses. While both are similar, flu symptoms are typically more severe.
Flu Symptoms: high fever (above 102 degrees), body aches, dry cough, upset stomach or vomiting
Covid Symptoms: can appear 2-14 days after exposure and can vary from
Mild to severe; fever, chills, cough, shortness of breath, fatigue,
Muscle or body aches, headache, loss of taste or smell, sore
Throat, congestion or runny nose, nausea or vomiting, diarrhea
Treatment: rest, plenty of fluids, and treat symptoms. Consult your physician or college health services for the best medicines to control your symptoms. Caution should be used when taking excessive flu meds containing aspirin because an increase in complications (Reye Syndrome) are associated with the flu in college students.
Covid-19: get tested and isolate if positive. Contact the college health services to discuss isolation and treatment protocols. If you have mild to moderate symptoms an antiviral may be recommended. Otherwise, over-the-counter nonsteroidal anti-inflammatory drugs may be adequate with rest and fluids.
Prevention: While it is not possible to prevent getting a cold or flu, you can take precautions, such as washing your hands and getting a flu shot. Get full vaccinated for Covid-19. And, depending on school protocols and infection rates, MASK UP!
Strep Throat, Sinus Infections, Ear Infections - caused by bacteria
Symptoms: very sore throat, pain in the ears or sinuses, persistent fever
Treatment: These symptoms require a visit to the college health services department. You may need to take antibiotics. If so, take as directed and take all of them or you may have a relapse.
Prevention: Avoid close contact with infected people – no kissing, sharing drinks or eating utensils. Wash your hands, get plenty of rest.
Meningococcal Disease the brain, spinal cord and/or blood
Symptoms: high fever, stiff neck, severe headache, a flat, pink or purple rash, nausea and vomiting, as well as sensitivity to light
Treatment: Immediate medical treatment is required. This disease is serious. It can be fatal or cause permanent brain damage.
Prevention: It is strongly recommended that all teens, especially incoming freshman college students, receive a vaccine to prevent the infection of most, but not all, strains of bacteria that cause this disease.
Mononucleosis (Mono) - It is very common among college students.
Symptoms: fever, sore throat, headache, swollen lymph nodes (glands) in the neck, extreme fatique.
Treatment: If a sore throat or flu symptoms do not resolve in 7- 10 days, see your doctor for a blood test called the “monospot.” While there is no specific treatment, plenty of rest and a healthy diet are essential. Medication to control symptoms can also be used.
Prevention: Plenty of rest, healthy diet, good hygiene
Bruises, Sprains and Strains - These are very common in healthy, active college students and are rarely serious.
Symptoms: Bruises: a bump or bruise can cause the skin to turn purple, brown or red in color.
Strains: are injuries to muscles or tendons from overuse or sudden overstretching.
Sprains: are injuries to the ligaments which connect the bones. It can be caused by a twist or fall or awkward sudden movement.
Ice – use ice or cold gel packs on the injury for 20-30 minutes several times per day
Compression – to the area with an elastic bandage
Elevation – elevate the injury on pillows, etc to limit swelling. If the pain or swelling is not improved in 1-2 days, or if you cannot bear weight on the extremity, visit the college health services dept.
Prevention: While it is important to be physically active, one must do so intelligently:
Use Proper Equipment – eye protection, helmets, mouth guard, etc
Warm up/Cool Down – take time to warm up, stretch and cool down
Take Breaks – ease into activity and rest when necessary.
SOURCES: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
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!
Human beings were designed to move…walk, run, climb, lift, hunt, and gather. Contemporary man has suffered greatly from a technologically driven inactive and sedentary lifestyle. Inactivity is associated with many health problems; obesity, adult-onset diabetes, high blood pressure to name a few. Other problems associated with lack of movement are;
Constipation
The more you move your body, the more your colon moves! A regular and consistent exercise and activity regime results in a more consistent bowel schedule, especially with age. Healthy muscle tone in your abdominal muscles and diaphragm is also the key to moving waste through your digestive tract.
Stiff Joints
Osteoarthritis, rheumatoid arthritis and many inflammatory or auto-immune diseases can cause achy and stiff joints. However, even healthy joints can also stiffen when you don’t use them enough. Put them to work so they get tight and cause pain.
Shortness of Breath
All muscles get weak from lack of use, including the muscles that help your lungs expand and contract as you breathe if you don’t work them out regularly. The less exercise or activity you do, the more you experience shortness of breath, even during easy daily tasks.
Depression or Moody
Physical problems are not the only complication of inactivity. A lack of movement can also increase feelings of anxiety and depression. Aerobic exercises like walking, biking, swimming, or running, have been proven to stimulate endorphins to boost and steady your mood, and even improve your self-esteem.
Lack of Energy
Many studies have found that regular movement improves energy. Exercise helps deliver oxygen and nutrients to your tissues. When you sit or are inactive, tissues are not getting the same amount of fuel they need to keep you going.
Slow Metabolism
Movement stimulates your metabolism. Hyperactive people burn more calories…just by fidgeting! Even if you are not hyperactive, the more active you are, the more calories you burn each time you move.
Difficulty Sleeping
One of the first recommendations sleep doctors make to their patients suffering from insomnia is exercise. When you keep a regular exercise routine, you fall asleep faster, and you sleep deeper once you drift off.
Brain Fog
Regular exercise tells your body to make more chemicals called growth factors. They boost blood vessel production in your brain. The more blood that gets to your brain, the better you can think, remember, and make decisions.
High Blood Pressure
Spending most of your time sitting raises your risk of heart disease, in great part because you’re more likely to have high blood pressure. This is a big risk factor for heart issues like coronary artery disease and heart attack.
High Blood Glucose
When physical activity is a regular part of your life, your body has an easier time keeping your blood glucose under control. Exercise can stabilize blood sugar levels and keep you out of the type 2 diabetes danger zone.
Lower Back Pain
When your core muscles are weak from lack of use, they can’t support your back the way they should. This makes it much easier to tweak your back muscles during everyday movements like standing or reaching. Pilates, yoga, and other exercises that use stretching are good for building a stronger back. Schedule an appointment with a good orthopedic and sports PT.
Hunger Pains … “Hangry”
Logically, one might think that you’d be hungry more often if you exercised more, but the opposite is usually true. Aerobic exercise like biking, swimming, walking, and running can decrease your appetite because it changes the levels of certain “hunger hormones” in your body.
Sick Often
Studies show the more moderate activity you get, the lower your chance of catching a cold or other germs. When you make exercise a habit, your immune system gets stronger.
Dull and Pasty Skin
If your skin looks duller than usual, a lack of movement may be to blame. Some studies show that moderate exercise boosts your circulation and your immune system, which helps your skin keep that youthful glow.
SOURCE: WebMD
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!
Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what type of exercise is best for those suffering from osteoarthritis (OA). Osteoarthritis is also known as degenerative arthritis. It is the most common form of arthritis in the knee. Osteoarthritis is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface. It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the involved joint, especially after increased activity and weakness with loss of function due to disuse.
However, OA is not an excuse to avoid exercise, but it is important to be smart about it. Regular exercise is essential to maintain a normal lifestyle for those with OA. However, if you do the wrong exercise, use poor technique, or are too aggressive, you could flare up your joints and do more harm than good.
Benefits of Exercise for Those with Osteoarthritis:
When performed correctly, exercise for those with Osteoarthritis has many benefits:
Pain Control
Exercise controls OA pain by releasing natural pain control chemicals in the body called endorphins. It also controls pain by assisting in weight loss and improving range of motion.
Weight Control
We all know how well exercise burns calories and that increased body weight creates increased stress on the joints.
Prevention of Joint Stiffness
Exercise will help maintain joint range of motion. A stiff joint is a painful joint.
Prevention of Muscle Weakness
Exercise will help maintain muscle strength. Weak muscles will allow or increase in joint wear and tear.
Maintain Lifestyle
If a joint is stiff and weak, then they become painful which negatively impacts your lifestyle. Exercise can prevent this problem.
Tips How To Exercise With Osteoarthritis:
Start Slowly
Wean into exercise because if you advance too quickly, you will flare up the joint and have increased pain. For example, walk for 5-10 minutes the first session. If you do not have pain, add 1-2 minutes each session.
Lose Weight
Every pound lost equates to less stress on your joints. For example, a loss of 5 pounds of body weight translates to 20-30 pounds of stress through the knee, according to David Borenstein, MD, President of the American College of Rheumatology. Also, body weight has a direct impact on daily activities. For example, walking upstairs creates stress through the knee equal to 4 times body weight and seven times body weight going downstairs. Therefore, less body weight equals less stress.
Low Impact Workouts
Low impact exercise creates less stress on the joints while strengthening leg muscles and those who maintain leg muscle strength have less stress on their joints. It is even important not to load your arms with heavy objects when walking or using stairs to limit joint stress.
Some examples of low-impact exercises are walking, swimming, elliptical trainer, and biking. Strength training is also low-impact and should be performed with low weight and high repetitions. Water therapy is great for those with OA, especially in a heated pool. It is a great low-impact exercise with less gravity and stress on the joints. Walk, swim and do mild resistance exercises in the water. Use a snorkel and mask for swimming to limit excessive neck turning and back extension.
Walking is a great form of exercise; however, walking softly is important for those with OA. Wear good running shoes and orthotics if necessary. Discuss this with your physical therapist or podiatrist. When possible, use soft surfaces like cinder, mulch or rubber. Avoid grass and soft stand due to instability and torsion that may irritate your joints.
Warm-Up
Warming up your body is critical to prevent injury to the muscles and tendons. This can be done by marching in place or using aerobic equipment such as a bike for 5 to 10 minutes before exercise. Always perform the warm-up activity at ½ your normal pace.
Balance & Relaxation Techniques
Tai Chi and ballroom dancing are two good examples of activities which promote balance and relaxation. Studies showed that those with OA who participated in Tia Chi two times a week for eight weeks reported less pain, increased range of motion and improved daily activities and function. They also noted less low back pain and better sleep.
Proper Clothing
Stay warm in winter and consider wearing compression shorts. Be cool in the summer months with DrytechR type material.
Pre/Post Exercise First Aid
If you are sore for longer than 12 to 24 hours after exercise, then you overdid it and must adjust next time. Otherwise, use hot packs, bath or shower before you exercise to loosen up and apply ice to your joints after exercise, especially if they are sore.
Post Exercise Stretch
Gentle, active range of motion stretches after exercise is important to maintain mobility. Do not bounce or cause pain. For example: Low Back – knees to chest; Arms – row –the – boat, arms behind head, arms behind back; Legs – wall lean calf stretch, bend and extend knees, open and close hips.
SOURCES: Rothman Institute, Philadelphia, PA and American Academy of Orthopaedic Surgeons; www.lifescript.com
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!
It is hard to believe that August is here but don’t panic, there is plenty of time to get outdoors and enjoy some sunny Vitamin D!
While protection from the sun is very important, too much time indoors playing computer games and watching television can lead to potential problems from lack of exposure to the sun. One must use good judgment and have balance as the potential exists for Vitamin D deficiency due to lack of sun exposure. This problem may be true for individuals who use too much protection or spend most of their day indoors due to occupation or poor health. Therefore, the purpose of this column will be to discuss the importance of Vitamin D for health and wellness.
Vitamin D, a fat-soluble vitamin, is found in food and can be made by your body after exposure to ultraviolet (UV) rays from the sun. The liver and kidney help convert Vitamin D to its active form. It assists with calcium absorption, which is essential for normal development and in forming and maintaining strong bones and teeth. Without it, bones can become thin, brittle and soft. The classic deficiency diseases are rickets in children and osteomalacia in adults. Rickets results in skeletal deformities. Osteomalacia is the softening of bones. Vitamin D is essential for normal bone health and may diminish or prevent the onset of osteoporosis in the elderly.
The requirement for Vitamin D is dependent on age, sex, degree of sun exposure and the amount of pigmentation in the skin. Since it can be produced by the body and retained for long periods of time by the body’s tissues, the precise daily requirement has been difficult to determine. Instead, an Adequate Intake (AI) level has been established. AI is a level of intake sufficient to maintain healthy blood levels of an active form of Vitamin D.
AIs are similar for males and females but increase with age:
Ages 19-50: 200 International Units (IU)
Ages 51-69: 400 IU
Age 70 and older: 600 IU
Sources of Vitamin D:
Food Sources
Fortified foods are a major dietary source of Vitamin D
One cup of Vitamin D fortified milk: 98 IU
Dairy products (e.g. cheese, yogurt, ice cream) are generally not fortified
Orange juice, cereals, pastries, breads, crackers, cereal grain bars may be fortified; read the nutrition label for more information.
Only a few foods naturally contain significant amounts of Vitamin D
Salmon, cooked, 3 ½ oz: 360 IU
Mackerel, cooked, 3 ½ oz: 345 IU
Sardines, canned in oil, drained, 3 ½ oz: 270 IU
Liver, beef, cooked, 3 ½ oz: 30 IU
Egg yolk, one: 25 IU
Exposure to sunlight
Regular ultraviolet exposure stimulates the skin to produce Vitamin D.
Exposure to ultraviolet light or ambient sunlight
Exposing the face and hands for 20 minutes, 3 times a week can be sufficient
Exposing the hands, legs and arms for 5 to 10 minutes, 2 to 3 times a week, is more than adequate to satisfy requirements.
Vitamin D deficiency can occur when dietary intake of it is inadequate, when there is limited sunlight exposure, when the kidney cannot convert Vitamin D to its active form or when it is inadequately absorbed from the gastrointestinal tract. Season, geographic location, time of day, cloud cover, air pollution, sunscreens, living indoors and living in cities where tall buildings block adequate sunlight from reaching the ground affect UV ray exposure. Individuals with limited sun exposure are at risk of Vitamin D deficiency.
Homebound individuals, people living in northern latitudes (e.g. New England, Alaska), individuals who cover their bodies for religious reasons and people whose occupations prevent exposure to sunlight may need to supplement with Vitamin D. Sunscreens with a sun protection factor of 8 or greater will block UV rays that produce it. Older adults have a higher risk for deficiency because the skin’s ability to convert Vitamin D to its active form decreases with age and the kidneys, which help convert it to its active form, do not work as well when people age.
Individuals with pancreatic enzyme deficiency, Chron’s disease, cystic fibrosis, sprue, liver disease, surgical removal of part or all of the stomach or small bowel disease may need extra Vitamin D because it is a fat-soluble vitamin and they have reduced ability to absorb dietary fat. Vitamin D supplements are often recommended for exclusively breast-fed infants because human milk may not contain adequate amount. Consult with your pediatrician on this issue.
SOURCES: The National Institutes of Health; CDC
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!
