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

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

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

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

10 Motivators to Stick to an Exercise Program in 2025:

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

Tips to Stick to an Exercise Program:

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

Source: WebMD, Mayo Clinic

     Visit your doctor regularly and listen to your body.     

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

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

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

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

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

Recently, two patients asked me when I thought it would be safe for them to return to their exercise programs after abdominal surgery. She stated that she was not sure how to properly and safely implement or return to her program.

This column will attempt to ensure a safe return to activity and exercise following general surgery such as gall bladder, appendix, hernia, etc. The post-operative patient has many questions: When is it safe to begin an exercise program? How do I begin? What is the best exercise? Which exercises are best? How do I know if the activity is too intense or not intense enough? Are there safe guidelines?

• Medical Clearance

Before you begin, discuss your intention to exercise with your surgeon and  primary care physician. Get medical clearance to make sure you can exercise safely. With the exception of short daily walks, don’t be disappointed if your surgeon requires you to wait at least until your 6 week post-op check-up to begin exercise.

• Time for a Standard Work-out

While a 60 minute workout would be the long term goal, begin slowly at 15-20-30 minutes and add a few minutes each week. Make time to warm up and cool down.

Warm-up                                 5-10 minutes

Strength Training                    10-15-20 minutes

Aerobic                                   10-15-20 minutes

Cool down                              5-10 minutes

• Exercise Routine

• If the individual does not exercise regularly, start slowly and then increase activity level
• Importance of exercising in comfortable temperatures
  • Example: in the summer if exercising outside --- recommendation: early morning or late evening NOT during the middle of the day in the summer heat
  • Hydration before, during, and after exercise is important
  • Cellular Phone – for emergencies - take to hotel gym – especially if unattended

• Warm Up
  1. 5-10 minutes
  • Ways to warm up:
    1. Walking on a treadmill / around gym area
    1. Bike
    1. Stretching – active and gentle

• Strength Training – begin with light weights and increase repetitions
  1. 20 minutes
  1. Can begin with one set of 8 to 12 reps
  1. 2-3 times a week (do not exercise the same muscles 2 days in a row)
  • Exercises (Perform 8-10 different exercises that train all major muscle groups)
    1. Shoulders – Bent over row with weights  
    1. Back – Seated rows with bands or bent over with weights
    1. Chest – Chest press with weights or Push-ups
    1. Biceps – Biceps curl with weights
    1. Triceps – Triceps extensions with weights or Push-ups
    1. Abdominals – pelvic tilts or core exercises on ball  
    1. Gluteals – Leg Press, 30 degree Wall Slides
    1. Quadriceps – Knee extensions with ankle weights, Lunges, Squats
    1. Hamstrings -  Hamstring Curl 
    1. Calves – Calf raises

• Aerobic
  1. 20 minutes
  • Exercise
    1. Treadmill / walking outside
    1. Elliptical
    1. Bike (recumbent bike is recommended)
    1. Stepper
    1. Stairmaster

• Cool Down
  • 5-10 minutes
    1. Walking on a treadmill / around gym area
    1. Bike
    1. Stretching

How to Monitor Your Exercise Program:

• Target Heart Rate

First, determine your resting heart rate by taking your HR (pulse) using your index finger on the thumb side of your wrist for 30 seconds and multiply it by two. 80 beats per minute is considered a normal HR but it varies. This is a good baseline to use as a goal to return to upon completion of your workout. For example, your HR may increase to 150 during exercise, but you want to return to your pre exercise HR (80) within 3-5 minutes after you complete the workout.

For those who are healthy, calculating your target heart rate (HR) is an easy and useful tool to monitor exercise intensity.

220 – Your Age = Maximum Heart Rate

EXAMPLE for a 45 year old: 220 – 45 = 175 beats per minute should not be exceeded during exercise.

• Metabolic Equivalent (MET) Intensity for Exercise - Energy Cost of Physical Exercise.

            For those concerned about calories expended during exercise.

NOTE: Keep the level at a light/moderate level for the first four to six weeks and advance to the moderate/heavy at week six. The Very Heavy Level may not be appropriate for 12 weeks post op is for those who have a reasonable fitness level and exercise 4-5 days per week.

Example of Data Found on Fitness Equipment

Remember, this is only accurate if you program your correct height, weight and age.

Level                          kCal/min                    MET

Light                              2 - 4.9                     1.6 – 3.9

Moderate                        5 - 7.4                     4 – 5.9

Heavy                          7.5 - 9.9                     6 - 7.9

Very Heavy                  10 - 12.4                   8 – 9.9

• Cardiac Patient on Beta Blockers

Always secure physician approval before engaging in an exercise program.
If the patient is on beta blockers (Atenolol, Bisoprolol, etc), it is important to use the Borg Rating of Perceived Exertion Scale (RPE) scale to determine safe exercise stress since exercise will not increase HR as expected:

• Borg (RPE) Scale = indicates exercise intensity

0 - Nothing at all
1 - Very light
2 - Light
3 - Moderate
4 - Somewhat intense
5 - Intense (heavy)
6
7 - Very intense
8
9 - Very, very intense
10 - Maximum Intensity

NOTE: Keep the RPE at 2-3 the first 6 weeks post op and advance to level 3-4 at 8-12 weeks post op. Levels 5-6-7 are for those with a reasonable fitness level and exercise 4-5 days per week. The advanced levels should not be attained until 2-3 months of exercise and 3-4 months post op.

MEDICAL CONTRIBUTOR: Timothy Farrell, MD, is a general surgeon at GCMC.

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!