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As discussed last week in Part I of Cervical Pillows, studies on cervical or neck pillows have shown that those using a cervical pillow demonstrated a significant reduction in chronic neck pain and headaches. However, researchers cautioned that there are many different types of pillows and that, depending on the individual; some may be more effective than others. This week, I offer tips on choosing the best pillow for you.

  1. Get a Diagnosis –
    • If possible, visit your physician to find out why you have neck pain and headaches. For example, those with arthritis, osteoporosis, degenerative disk disease or other bone and joint problems have great difficulty finding a comfortable position to sleep due to pain, stiffness and headaches upon waking up in the morning and may benefit from a proper pillow.
  2. Try it Out in the Store -
    • Cervical or neck pillows are designed to provide support specifically to the cervical or neck area of the spine. In theory, the pillow attempts to align and support the natural shape of the neck while one is sleeping.
  3. One Size Does Not Fit All -
    • A traditional pillow is often designed as a one-size-fits-all rectangle that is more about form than function. Imagine that small-framed women (5 feet tall, weighing 100 pounds) may use the same pillow as a large male football player (6 feet 5 inches, weighing 350 pounds). It is obvious that these two individuals have very different head, neck and shoulder sizes and therefore require two very different pillows.  
  4. Age Matters –
    • Ages 16 to 40 have flexible and hydrated discs and benefit more from a contour pillow with a bump, core or butterfly shape. A thinner pillow that allows the neck to extend and distract while sleeping is helpful. Ages 65 and older often have arthritic and dehydrated discs with a more rigid spine and benefit more from a thicker pillow with comfortable material such as synthetic down or memory foam to keep the neck in a slightly elevated and flexed position to avoid hyperextension. Ages 40 to 65 are in between and may need to experiment with pillows that allow extension, flexion or neutral.  
  5. Special Circumstances –
    • There are exceptions to every rule. For example, those with allergies should always ask for hypoallergic materials. Those with respiratory conditions or hiatal hernias often require elevation for comfortable sleeping. Try an 8-to-10-inch wedge to elevate the head and chest with a full pillow.
  6. Standard Filled Pillows –
    • These pillows can be filled with hard or soft materials such as synthetic or real down and resemble a more traditional-looking pillow. They allow for individual manipulation and shaping.
  7. Memory Foam Pillow -
    • This unique material offers individualized support for almost all body types. However, it is expensive (there are cheap versions) and it retains heat, so it is warm in the summer. This type may not be suitable for very small-framed individuals may not be able to compress the material and fail to find benefit. (www.tempurpedic.com), (www.thergear.com).
  8. Contour Pillow –
    • These ergonomically designed pillows are contoured to support the “hollow” of the neck with a “bump” or “core.” Some offer a cut out for the side sleeper such as the” butterfly” pillow. They work best for younger, more flexible spines and small-framed people. Contour pillows can be found at: (www.coreproducts.com),  (www.bodyline.com).
  9. Travel Pillow –
    • These pillows offer proper support to prevent your head from bobbing up and down while sleeping in a car or on a airplane. Most are horseshoe collar shaped and I am partial to the inflatable version from BrookstoneR  due to its portability (www.brookstone.com).
  10. Keep Trying -
    • It is important to remember, there is no one pillow fit for everyone…they are unique to each person. Pillow type should be based on body type, head size, shoulder width, favorite position of sleep and medical conditions. Always try to sample a cheaper version of a product when possible.  

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!

Are you one of the millions of people who suffer from chronic neck (cervical) pain and headaches? Did you ever wonder if your pillow is right for you? Studies on cervical or neck pillows have shown that those with chronic neck pain showed a significant reduction in neck pain and headaches when using a cervical pillow for four weeks when compared to the control group. However, there are many types of cervical pillows, and there is no single best choice for everyone. This column will give you an overview of the different types of cervical pillows, and hopefully this information will help guide you to the right pillow for your individual size and shape.  

Introduction:

People who suffer from back and neck pain are always in search of something to lessen their pain and stiffness. Those with conditions such as arthritis, osteoporosis, or other bone and joint problems have great difficulty finding a comfortable position to sleep, and they often wake up with pain, stiffness and headaches in the morning. For these people, a cervical pillow may offer great comfort, because it is specifically designed to alleviate these symptoms.

Traditional pillows have drawbacks mainly because they are designed as a one-size-fits-all rectangle with greater emphasis placed on form than on function. Very often, a small-framed woman (5 feet tall, weighing 100 pounds) may find herself using the same style of pillow as a large male with the build of a football player (6 feet 5 inches weighing 350 pounds). It is obvious these two individuals have very different head, neck and shoulder sizes, and therefore they require two very different types of pillows.  

Cervical or neck pillows come in a variety of shapes and sizes, and they are designed to provide support specifically to the cervical area of the spine. In theory, a cervical pillow attempts to align and support the natural shape of the neck while one is sleeping. Those suffering from neck or shoulder pain, degenerative cervical disc disease, or conditions such as arthritis or osteoporosis may find these pillows valuable.

Types of Pillows:

Cervical pillows are made by many different manufacturers and come in a variety of sizes, designs and shapes. Manufacturers claim that these pillows offer the benefits of increased circulation, improved breathing, reduced snoring and lessened neck and shoulder muscle pain and stiffness. One manufacturer, Tempur-PedicR (www.tempurpedic.com), boasts special memory foam technology that, they claim, offers unique and individualized support to accommodate the weight of every body type.

When selecting a cervical pillow, it is important to remember several things. First, know that most manufacturer claims are not subject to validation by independent research studies. Second, remember that, regardless of what a manufacturer states, no single pillow is right for every person. Third, realize that the most expensive option is not necessarily the best. Although many people consider Tempur-PedicR to be the leader in the field, they are costly, ranging from $89 to $349. If you shop around, you can find several companies that offer alternatives—both of similar and alternative designs—that may actually be a better fit for your neck and your budget.

Other companies producing cervical pillows include CoreR, which offers support around the periphery with a special or dip (or “core”) in the middle in which your head rests (www.coreproducts.com),  MediflowR, which offers a water pillow with multiple options and BodyLineR, which offers a model with both a large and a small orthopedic “bump” in one pillow (www.bodyline.com). These pillows are economical, ranging in price from $35 to $100.

Regardless of what brand of pillow you select, it is likely to fall into one of the following three categories:

Conclusion:

It is important to remember that there is no one pillow fit for everyone, each person’s needs are unique. You should select your pillow type based on your body type, head size, shoulder width, favorite sleeping position, and medical conditions, such as neck or lower back pain, osteoarthritis, headaches, etc. When choosing a pillow, try to sample a cheaper version of the product when possible. For example, if you think you might like the “orthopedic bump” style from Tempur-PedicR that costs $200, consider trying the $50-60 version from TherGearR first. Better yet, if you have a friend or relative with a similar body type and problem who successfully uses a cervical pillow, try borrowing it! Finding the right pillow is a process of trial-and-error, so not get frustrated or give up. If you succeed in finding the right pillow for you, the result will be worth the search.

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: Tips to Select a Good Cervical Pillow For You.

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!Next Week, Part II of II: Tips to Select a Good Cervical Pillow For You.

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 Stand2LearnR, 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 “TrekDeskR,” 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 VariDeskR, 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:

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!

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:

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

10 Suggestions:

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!

While I normally do not address the topic of shoveling snow until January, considering recent weather events, I thought it might be valuable to present it sooner. Much has been written about the dangers of snow shoveling for your heart. However, while not fatal, low back pain is the most common injury sustained while shoveling snow. Heart attacks are also more common following wet and heavy snow.

Snow shoveling can place excessive stress on the structures of the spine. When overloaded and overstressed, these structures fail to support the spine properly. The lower back is at great risk of injury when bending forward, twisting, lifting a load, and lifting a load with a long lever. When all these factors are combined simultaneously, as in snow shoveling, the lower back is destined to fail. Low back pain from muscle strain or a herniated disc is very common following excessive snow shoveling.

Snow Shoveling as a Form of Exercise:

People at High Risk of Illness Due to Snow Shoveling:

10 TIPS FOR SAFE SNOW SHOVELING:

  1. MEDICAL CLEARANCE: If you have any medical condition or risk factors consult your physician.
  2. PAIN: Stop immediately if you experience any pain. Especially in the chest, left arm, jaw, face, neck, or lower back.
  3. ERGONOMICS: Choose a snow shovel that is right for you:
    1. An ergonomic shovel with a curved handle allows you to keep your back straighter or arched when shoveling
    1. An ergonomic shovel with a shorter or adjustable handle length allows you to keep your back straighter and knees bent when shoveling. The right handle length allows you to arch your back 10 degrees with your knees slightly bent when the shovel is on the ground.
    1. A plastic shovel blade is lighter than a metal one and will be better for your spine.
    1. A smaller blade is better than a larger blade. It may take longer but will stress your back less.
  4. PUSH: When possible, push the snow. Do not lift it. Lifting is much more stressful on the spine. You can find shovels that are ergonomically designed just for pushing snow.
  5. WARM – UP: Be sure your muscles are warm before you start to shovel. Cold and tight muscles are more likely to strain than warm, relaxed muscles. Layer and consider compression shirts or tights can help prevent cold and tight muscles.
  6. LEVERAGE: When you grip your shovel, spread your hands at least 12 inches apart. This will improve your leverage and reduce strain on your lower back.
  7. TECHNIQUE: Shoveling technique is very important. The American Academy of Orthopaedic Surgeons recommends:
    • Squat with your legs apart, knees bent and back straight.
    • Lift with your legs. Do not bend at the waist.
    • Scoop small amounts of snow into the shovel and walk when you want to dump it.
    • Do not hold the filled shovel with outstretched arms.
    • If snow is deep, remove in piecemeal, a few inches at a time.
    • Rest and repeat as necessary.
    • Move your feet and do not twist your back as you shovel or dump. Never throw snow over your shoulder
  8. CAUTION: Be cautious shoveling wet snow. One full shovel can weigh 25 pounds.
    • Shovel wet snow slowly in piecemeal.
  9. PACE YOURSELF: Take frequent breaks and stretch your back in the opposite direction of shoveling. For example: 1. Lean backwards and extend your lower back. 2. Pinch your shoulder blades together.
  10. TECHNOLOGY:
    • Snow Blower - Use a self-propelled snow blower. It will put much less stress on your lower back than shoveling snow if used correctly. For example, push the blower with your legs and keep your back straight or arched and knees bent.
    • Ergonomic Shovels:
    • 2 Handle Shovels: ErgieShovel or Snow Joe Shovelution
      • Push Shovels: Garant Yukon or Garant Sleigh Shovel
    • Snow Melting Alternatives:
    • www.warmlyyours.com - WarmlyYours - HeatTrak® portable snowmelting system for roofs, gutters, driveways, sidewalks, stairs and handicapped ramps uses electric mats or runners for home or office which can be customized.

Sources: The Colorado Comprehensive Spine Institute; American Academy of Orthopaedic Surgeons 

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!

New study recommends a 30 minute walk 3-5 times per week to reduce lower back pain!

Fall has arrived in NEPA and walking is a great way to enjoy the fall foliage. Moreover, a new study has found that walking can reduce lower back pain. Researchers in Australia followed more than 700 adults who had a recent onset of lower back pain (and were able to bear full weight without associated leg symptoms) and enrolled them in a walking program under the supervision of a physical therapist. One group walked for 30 minutes, 3-5 times per week and the control group remained inactive. Both groups were followed for more than three years and discovered that the inactive control group was twice as likely to suffer from repeated flare-ups of lower back pain when compared to the walking group.  

It is good news for those who enjoy walking, however, for many who have not maintained an active lifestyle or have health issues, it is challenging to know where to begin. Also, beginning without a good plan can lead to injury and leave you discouraged. For example, those overweight and de-conditioned should not start a walking program too aggressively. Walking at a fast pace and long distance without gradually weaning yourself into it will most likely lead to problems.

WALKING FOR HEALTH

There is probably nothing more natural to human beings than walking. Ever since Australopithecus, an early hominin (human ancestor) who evolved in Southern and Eastern Africa between 4 and 2 million years ago, our ancestors took their first steps as committed bipeds. With free hands, humans advanced in hunting, gathering, making tools etc. while modern man uses walking as, not only a form of locomotion, but also as a form of exercise and fitness. It is natural, easy and free...no equipment or fitness club membership required!

BENEFITS OF WALKING

Walking to reduce or control lower back pain is only one of many important reasons to begin a program. According to the American Heart Association, walking as little as 30 minutes a day can provide the following benefits:

PLAN AHEAD

SET REALISTIC GOALS

Anything is better than nothing! However, for most healthy adults, the Department of Health and Human Services recommends at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity, or an equivalent combination of moderate and vigorous aerobic activity. The guidelines suggest that you spread out this exercise during the course of a week. Also aim to do strength training exercises of all major muscle groups at least two times a week.

As a general goal, aim for at least 30 minutes of physical activity a day. If you can't set aside that much time, try several short sessions of activity throughout the day (3 ten or 2 fifteen-minute sessions). Even small amounts of physical activity are helpful, and accumulated activity throughout the day adds up to provide health benefit.

Remember it's OK to start slowly — especially if you haven't been exercising regularly. You might start with five minutes a day the first week, and then increase your time by five minutes each week until you reach at least 30 minutes.

For even more health benefits, aim for at least 60 minutes of physical activity most days of the week. Once you are ready for a challenge, add hills, increase speed and distance.

TRACK YOUR PROGRESS

Keeping a record of how many steps you take, the distance you walk and how long it takes can help you see where you started from and serve as a source of inspiration. Record these numbers in a walking journal or log them in a spreadsheet or a physical activity app. Another option is to use an electronic device such as a smart watch, pedometer or fitness tracker to calculate steps and distance.

MARK YOUR CALENDAR

Make walking part of your daily routine. Pick a time that works best for you. Some prefer early morning, others lunchtime or after work. Enter it in your smart phone with a reminder and get to it!

FIND A WALKING PARTNER

 Studies show that compliance with an exercise program is significantly improved when an exercise buddy is part of the equation. It is hard to let someone down or break plans when you commit to someone. Keep in mind that your exercise buddy can also include your dog!

USE EFFICIENT WALKING TECHNIQUE

Like everything, there is a right way of doing something, even walking. For efficiency and safety, walking with proper stride is important. A fitness stride requires good posture and purposeful movements. Ideally, here's how you'll look when you're walking:

Sources : Sapiens.org; WebMD; Mayo Clinic, “Health & Science New”

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!

...Labor Day is also the start of the school year

While many people celebrate the Labor Day holiday by firing up the grill, others will be shopping to get their students ready for the school year. One item on the shopping list should be a good quality and well-fitted backpack…to prevent lower back pain!

In 2018, the government of India announced a ban on homework and recently in Poland; the government ministers did the same. Can you imagine…a ban on homework? In an effort to promote student health and address recent surges in the incidence of back pain in the young, there will be no homework for students in grades one and two.

It was estimated that the majority of students ages 7 – 13 in India were carrying almost half their body weight. Not surprisingly, medical practitioners noticed a dramatic increase in reported cases of back pain among this group and decided to take action. In addition to the homework ban for grades one and two, Indian authorities have also implemented a limit of 10% of the student’s body weight.

Back pain in students seems to be universal. Each year, as students in the United States prepare to return to school from summer vacation, the subject of backpacks arises. The good news: when compared to purses, messenger bags, or shoulder bags, backpacks are the best option to prevent lower back pain. The bad news is, most of the 40 million students in the USA using backpacks, are doing so incorrectly.

Studies have found more than 33% of children had LBP that caused them to miss school, visit a doctor, or abstain from activity. Also, 55% of children surveyed carried backpacks heavier than the 10-15% of their body weight, which is the maximum weight recommended by experts. Additionally, the study noted that early onset of LBP leads to greater likelihood of recurrent or chronic problems. Backpacks that are too heavy are particularly harmful to the development of the musculoskeletal system of growing youngsters. It can lead to poor posture that may lead to chronic problems.

The following information on backpack safely is based, in part, by guidelines from The American Physical Therapy Association. Parents and teachers would be wise to observe the following warning signs of an overloaded and unsafe backpack:

WARNING SIGNS:

Consider the following suggestions to promote backpack safely and prevent back injury:

12 SUGGESTIONS for Backpack Usage:      

  1. Limit Weight of Pack to 10-15% of Body Weight (100lb child = 10-15lb pack)
  2. Padded Adjustable Shoulder Straps - Use both straps to distribute weight evenly. Using one strap may look cool but it will lead to back pain.
  3. Waist Belt – Proper Fit - An adjustable waist belt will distribute pack weight from back to hips and legs. Top of pack should be below the neck and bottom 2-3 inches above the waist
  4. Pack Weight Distributed to Small of Back/Hips – using adjustable straps - Not all the weight on shoulders and upper back
  5. Wheeled Backpack – if unable to make above adjustments - This is an option for some children; however, you may have problems     carrying/lifting it on the bus etc.
  6. Purchase Extra Set of Books And Use Your Locker - Get list from teachers and use the internet to buy extra books to leave at home. Teachers and students might consider downloading text books on the iPads or electronic tablets. Also, put unnecessary books in your locker between classes
  7. Remove Pack When Possible - While waiting for bus, hanging out between class, etc
  8. Put Pack On/Off From Chair/Table/Bench – Not Floor - It is much easier to lift a pack up from a table and put it on your back than bending over to get it from the floor
  9. 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
  10. 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
  11. Consider a pack with multiple compartments - Use several compartments to carefully load your backpack and distribute the weight more evenly…and eliminate accumulated/unnecessary junk.
  12. Use a back with reflective material to enhance visibility.

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 orthopaedic 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. The problems associated with lack of movement are many:

Constipation

The more you move your body, the more you 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 don't 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 due to the fact that partly 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 actually 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

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy 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!

There is little doubt that the workplace has been redefined since the pandemic as many employees continue to work from home. Sitting for many hours at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.

Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. De-conditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.  

Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics. 

Prevention of Lower Back Pain

1. Maintain Fitness Level

As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of LBP and failure from lower back surgery.

2. Practice Good Posture & Body Mechanics

Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back. Also, consider sitting on a physio ball, which promotes proper posture for part of the day.

Sitting at Workstation
Sitting at Workstation with Physioball

 Perform postural exercises throughout the day. Most of the day we sit, stand, and reaching forward and bend our spine. These exercises are designed to stretch your back in the opposite direction of flexion. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.

Chin Tuck: Tuck your chin back to bring your head over shoulders.

Shoulder Blade Pinch: Pinch your shoulder blades together.

Standing Extension: While standing, put your hands behind back and extend lower back 10-20 degrees.

Good Body Mechanics and ergonomics are also important in the prevention of LBP. When lifting, think twice. Think about the weight, shape and size of the object. Think about where the object is going and the surface resistance of the floor. Does it require two people to lift? Can I safely lift that high or bend that low?

When bending to lift an object think about safety:

Proper Lifting Technique:

Visit your doctor regularly and listen to your body.   

Model: Lexi DiGregorio, PTA  

NEXT SUNDAY IN THE PAPER AND EVERY MONDAY'S BLOG – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Paul's articles, check out our exercise forum!

Spring, Summer, Winter or Fall…weather changes can cause joint pain!

It is not just a cold weather problem…

“Everybody talks about the weather, but nobody does anything about it,” said Mark Twain. Just ask 93% of the arthritis sufferers who believe that the weather affects their pain level. History tells us that Benjamin Franklin, Leonardo da Vinci, and Christopher Columbus also felt this way about the weather.

Patients at our clinic have been particularly sensitive to joint pain on cold, damp days, especially during the past few weeks. In my clinical practice of orthopedic and sports physical therapy, an informal survey found that 95 out of 100 patients (95%) with arthritis reported increased pain with weather changes. While most people report that the coldness and dampness seem to irritate their joints, they also report more pain with weather changes in the summer. There is a reasonable explanation…

Joints in the body have a lining called synovium that secretes a lubricating fluid called synovial fluid. In joints with arthritis, there is an overproduction of synovial fluid. In theory, when the barometric pressure changes, so to will the pressure inside your joints, especially if it is already overfull with extra fluid from arthritis. This added pressure stimulates the nerve endings in the joint to produce inflammation and pain.

Despite this overwhelming response from patients, scientific studies vary in their support of this claim. According to the Mayo Clinic, in 1961, a famous arthritis doctor (rheumatologist), built a climate chamber and discovered that when high humidity was combined with low barometric pressure, patients reported increased joint pain and stiffness. A recent study found that changes in barometric pressure and cooler temperatures are associated with joint pain. However, other studies have found increased joint pain with high barometric pressure in both warm and cold weather while another study found pain with low pressure.

What does this mean? It means that patients with arthritis consistently report pain with weather changes but science has not found an accurate method to consistently support these claims. Some of these inconsistencies may be attributed to the fact that there are differences in sensitivity among individuals. For example, some patients have symptoms before the weather changes, while others notice symptoms during or after the weather changes. Still yet, some report more pain in colder conditions while others notice more pain in warmer weather. It appears that changes in the weather, such as a high to a low or warm dry to cold damp and vice versa is the culprit when it comes to irritating arthritis in a joint.

If I have arthritis, should you move to Arizona? Yes and no! Yes, the warm and dry climate of Arizona will probably make you feel better overall. However, it will not cure the degenerative changes in your joints and you may still have pain when CHANGES in the weather occur. This is proven to be true by the fact that there are many very busy rheumatologists in Arizona!

In conclusion, it is safe to say that there is some evidence to support the claim that most patients with arthritis have increased symptoms of joint pain and stiffness with CHANGES in the weather:

Therefore, each patient must be individually evaluated by their physician to determine the extent of their arthritis and its relationship to the changes in the weather. While the cause of their increased symptoms with changes in the weather may not be completely understood, each patient must determine the adjustments in their lifestyle and/or medications according to the particular weather patterns that affect their problem most.

Visit your doctor regularly and listen to your body.     

NEXT SUNDAY IN THE PAPER AND EVERY MONDAY'S BLOG – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!