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

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

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

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

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

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

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

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

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!

Jury Out on Value for Running Performance

Runners will attempt to conquer 26.2 miles from Forest City to downtown Scranton in the 26th Annual Steamtown Marathon this Sunday. Participants may want to consider new research that suggests the use of compression socks may prevent post race blood clots.

Completing the long and arduous 26.2 mile journey is not an easy task. In fact, the mechanical and physiological toll on your body is tremendous; from painful joints, muscles, tendons, to black and blue toes. Not so obvious, however, is the damage to your deep veins and tissues of the circulatory system. New research indicates that strenuous endurance exercise, such as marathon running, stimulates the clotting mechanisms in your body in response to the multiple micro traumas sustained over 2 or more hours. While most healthy athletes will naturally heal from post exercise clot formation, others may be at risk…those traveling more than 1 hour (by car, bus, train or plane). The risk increases substantially for those with a longer period of travel/sitting post-race, history of previous trauma, blood clots or have the genetic predisposition for clot formation.

What Are Compression Socks? How Do They Work?

Compression socks are familiar to most people as the tight knee-high support stockings worn after a surgical procedure such as a knee or hip replacement to prevent blood clots. They are made with a special fabric and weave design to provide graduated compression (stronger compression at foot and ankle and less at the top of the sock) to promote better circulation and movement of fluids from the foot, ankle and calf back to the upper leg and ultimately the heart. Compression socks work similarly in runners. As the stagnant fluid with lactic acid and other byproducts of exercise is removed from the space, fresh blood, nutrients and oxygen is replaced to foster healing of micro damage to tissue and promote more efficient use of the muscles.

Is There Any Research?

The Journal of Strength and Conditioning Research published a study that found wearing compression socks improved running performance. However, similar studies have failed to support this claim. One finding that has been repeatedly supported in the literature, including The British Journal of Sports Medicine, found that compression socks worn in soccer players and runners improved the rate and magnitude of recovery. Moreover, recent studies, including a study with the Boston Marathon, have demonstrated the reduction in clotting mechanisms in those wearing compression socks AFTER the marathon, as compared with those wearing “sham” socks. Benefits seem to be less obvious for short duration activities or when running 10km or less.

Conclusion

In conclusion, only time will tell if compression socks will improve performance in runners will or be merely a fad based on placebo or true fact supported by scientific research. Based on current wisdom, these socks may offer value and benefit AFTER activities of long duration (more than 1 hour) or long distance running (more than 10km) to expedite the recovery from exercise-induced blood clot formation, muscle soreness from the accumulation of lactic acid and other muscle damage byproducts.

It is this author’s opinion that this product is worth a try. However, whenever you try something new for your sport, trials should occur during practice and if successful used during competition. Consider trying a lower compression to begin (the socks come in different degrees of compression). Even if one is hesitant to use the product while running, it appears the greatest value of the sock is after a prolonged training session or competition to reduce exercise-induced muscle soreness and prevent blood clots, especially in athletes at risk for clotting and those traveling for an hour or more after the race. Additionally, in view of the fact that some studies which showed only minimal to moderate improvement in well-trained athletes, it may be that those in greater need, such as deconditioned individuals attempting to begin a fitness program and novice weekend athletes, may benefit more from compression socks than elite athletes.   

TAKE HOME: Runners, cyclists, triathletes, soccer players and others participating in endurance sports should consider compression socks, if not during the activity, certainly following the activity for 24 to 48 hours…especially those at risk for blood clots and those traveling for more than one hour after the race.

Sunday consider trying compression socks and see if they work for you during and more importantly, after your long training runs.

Where to find compression socks:

2XU Compression Racing Sock – www.2XU.com

Scranton Running Company – Olive Street - Scranton

Visit your family 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 orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!