Gretchen graduated from Philadelphia College of Pharmacy and Science, The University of Scranton, and received a Doctor of Pharmacy degree from Temple University.
Gretchen has been teaching for over 25 years at Rutgers University, Keystone College, Lackawanna College, The University of Scranton, and Marywood University. She has earned certifications in Pilates, yoga, barre and teaches all three locally. She has a Wellness and Lifestyle coaching certification from Harvard University.
Gretchen resides in Scranton with her husband, Timothy Welby, MD, and has three daughters – Casey, Kate, and Caroline.
Lifestyle Medicine, is not just a fad or buzzword that is overused in a plethora of health, fitness and wellness magazines, but is actually a medical specialty. It is the practice of using diet and exercise, along with other lifestyle modifications to prevent and manage disease. Lifestyle Medicine focuses on six pillars: healthy eating, physical activity, restorative sleep, stress management, positive social connections, and avoidance of risky substances.
The American College of Lifestyle Medicine was established in 2004. Since then, its membership and outreach have grown exponentially. Lifestyle medicine is currently the fastest-growing specialty in medicine. Its primary aim is to utilize evidence-based therapeutic lifestyle interventions to prevent/control chronic diseases such as cardiovascular disease, type II diabetes, and obesity. However, new data is emerging which expands the role of Lifestyle Medicine into many other areas, including chronic low back pain, sleep, hormonal disorders, Alzheimer’s Disease, chronic inflammatory conditions, and mental health, to name a few.
Lifestyle Medicine differs from conventional medicine in that its approach is not disease specific. Following the six pillars of Lifestyle medicine improves overall health. Conventional medicine targets and treats a specific disease process with medication or surgical intervention in a reactionary approach. Lifestyle medicine prevents or reverses the disease process through behavioral and dietary changes. In a perfect world, Lifestyle medicine and Conventional medicine can be combined to achieve the best results for some patients.
A JAMA study, published in 1993, linked unhealthy lifestyles with premature death. Since this study was published, the rates of cardiovascular disease and Type II diabetes have continued to climb. Obesity rates are at an epidemic level. 70% of American adults, and 22% of children fall into overweight/obese Body Mass Index (BMI) categories. According to the American Academy of Cardiology, only 6.8% of adult Americans meet the criteria for ideal cardiometabolic health, something the Academy calls a “Population Level Code Blue.”
In 2020, the American Heart Association issued a Presidential Advisory for 2030 Impact Goals. The overall goal is to improve morbidity and mortality through preventative measures. Interventions should be targeted earlier in childhood and young adulthood, where healthy habits can be formed with greater success and maximum outcomes. For example, physical activity is well established for its positive effects on cardiovascular health. Physical activity prevents clot and plaque build-up, is antiarrhythmic, and provides hemodynamic stability. Physical activity has also been shown to have psychological, emotional, and social benefits. The American Heart Association categorizes physical activity as a Level 1 (highest) intervention for primary prevention.
Lifestyle Medicine is rooted in evidence-based findings, and its efficacy is supported in scientific literature. A study published in the New England Journal of Medicine in 2002 examined the prevention of the onset of Type II Diabetes in prediabetic patients. Patients were divided into three groups: a placebo group, a metformin group (a type 2 diabetes medication), and a lifestyle intervention group. The metformin group received daily metformin (medication intervention). The lifestyle intervention group received education and prescriptive interventions/instructions on diet, exercise, and stress reduction. Patients were followed for three years. At the end of the study period, the metformin group saw a 31% incidence reduction of type II diabetes, and the lifestyle intervention group saw a 58% incidence reduction in type II diabetes (almost double that of the medication group).
Many examples abound, highlighting the ability of lifestyle medicine interventions for healthy outcomes. The advantages of lifestyle medicine over conventional medicine interventions are numerous. Medications come with side effects. Medication costs are rising and are often not fully covered by insurance programs. Often, current medications are not completely effective for treating disease. For example, Alzheimer’s Disease treatments are lacking. The Alzheimer’s Association International Conference emphasizes healthy lifestyle interventions. They stress adopting 4 or 5 healthy lifestyle factors to reduce the risk of Alzheimer’s dementia by 60%.
Healthy eating habits do not lead to serious side effects. Lifestyle interventions are within the patients’ control and may result in cost savings, potentially lowering food and medical bills. Because lifestyle intervention involves behavioral changes, the process requires time and effort, as well as investment in education and reinforcement to sustain healthy patterns. Motivating clients to make necessary changes and stick with those changes can be the biggest challenge. A Lifestyle/Wellness Coach may be employed to start the client on their journey. The coach works with the client to make choices that are adaptable to the client while fitting within the six pillars. The role of the coach is to hold space and provide guidance for the client, but not to “fix”, “rescue,” or “judge”. Coaching sessions last 30-60 minutes. Coaches and clients may meet 10 times over 3-12 months to establish patterns.
If you, like so many others, have not achieved your health and wellness goals using traditional methods, it may be worth considering Lifestyle Medicine. Focus on healthy eating (minimizing processed foods and sugar intake), physical activity (minimum 300 minutes per week), restorative sleep (between 7-9 hours per night), stress management (controlling anxiety and depression), positive social connections (consistent interactions with friends) and avoidance of risky substances (alcohol, tobacco/nicotine, illicit drugs) have evidence-based positive outcomes to prevent, manage and reverse chronic diseases.
Sources: More information about the six pillars of Lifestyle Medicine and specific intervention outcomes can be found @Balanced Living 570 on Facebook and Instagram!
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!
Spring has finally arrived in NEPA as we get outdoors to enjoy sunshine and blue skies. It is also time to dust off your hiking shoes and hit the trails to enjoy fresh air and exercise…but don’t forget the trekking poles. I have been recommending walking or trekking poles to my patients for many years. These poles are an essential part of hiking or distance walking gear, for the novice and expert alike.
Specifically, for those over 50 who have degenerative arthritis and pain in their lower back, hips, knees, ankles or feet, these simple devices have been shown to improve the efficiency of the exercise and lessen the impact on the spine and lower extremities. Additionally, using poles reduces the likelihood of ankle sprains and falls during walking. Trekking poles are also a safe option for those with compromised balance. If you want to walk distances for exercise and need a little stability but don’t want the stigma of a cane, trekking poles are for you.
Early explorers, Europeans and Native Americans have been using walking sticks for centuries. More recently, in the 1968 classic hiker’s bible, “The Complete Walker,” Colin Fletcher praised his “walking staff” for its multipurpose use: for balance and assistance with walking and climbing, protection from rattlesnakes, and for use as a fishing rod. Today, these sticks are now versatile poles made from light-weight materials.
Trekking poles are made of light-weight aluminum and vary in cost and quality. But, like most things, “you get what you pay for!” These hollow tubes can telescope to fit any person and collapse to pack in luggage for travel. Better poles offer multiple removable tips for various uses, conditions and terrains. For example, a basket to prevent sinking too deeply in snow, mud or sand; a blunt rubber tip for hard surfaces like asphalt or concrete, or the pointed metal tip to grip ice or hard dirt/gravel. Better quality poles offer an ergonomic hand grip and strap and a spring system to absorb shock through your hands, wrists and arms upon impact.
The poles should be properly adjusted to fit each individual. When your hand is griping the handle the elbow should be at a 90 degree angle. Proper use is simple; just walk with a normal gait pattern of opposite arm and leg swing. For example, left leg and right arm/pole swings forward to plant while the left arm/pole remain behind with the right leg (PHOTO 1). This pattern is reciprocated with as normal=ait advances (opposite arm and leg). I have been very pleased with my moderately priced poles (Cascade Mountain Tech from Dick’s Sporting Goods ($34.99 per pole). Prices range from $19.99 to 79.95 per pole. dickssportinggoods.com; montem.com; leki.com; rei.com. However, if you travel frequently to hike the State and National Parks, you may want to purchase more expensive poles that collapse and retighten more efficiently. (montem.com; leki.com;)
There are numerous studies to support the use of trekking poles, especially research that supports their use for health and safety. One study compared hikers in 3 different conditions; no backpack, a pack with 15% body weight and a pack with 30% body weight. Biomechanical analysis was performed blindly on the three groups and a significant reduction in forces on lower extremity joints (hip, knee, and ankle) was noted for all three groups when using poles compared to those not using poles.
Another study confirmed that trekking poles reduced the incidence of ankle fractures through improved balance and stability. Additional studies support the theory that trekking poles reduce exercise induced muscle soreness from hiking or walking steep terrain and another study found that while less energy is expended in the lower body muscles using poles, increase energy is used in the upper body; therefore, the net caloric expenditure is equal as it is simply transferred from the legs to the arms.
Sources: Medicine and Science in Sports and Exercise. The Complete Walker, by Colin Fletcher
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!
Allergies affect 30 % of adults and 40% of children in the United States. Avoiding the outdoors is often not an option…especially if you enjoy outdoor activities and sports. Not long ago, it was unthinkable that an athlete with serious allergies could compete at a high level, such as the Olympics. Now, in great part due to advanced research, medications and proper management, an Olympic gold medal for those suffering from allergies is a reality. Recently, the National Institute of Allergy and Infectious Disease at the National Institutes of Health have published research on this topic to provide a better understanding and make recommendations.
The most common allergic reactions which athletes suffer from are sneezing, itchy and watery eyes, runny nose and coughing. Moreover, 67% of those with these symptoms also suffer from asthma. The athlete in NEPA is particularly vulnerable when the pollen count is high during spring and fall for several reasons. One, after being indoors all winter, one might develop a heightened sensitivity to allergens. Also, increased rapid and deep breathing during exercise makes athletes more susceptible to significant symptoms when exposed to allergens such as tree, grass and weed pollens.
Sources: American College of Allergy, Asthma, and Immunology. National Athletic Trainers Association.
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!
Guest Author: Andrea Molitoris Kozlowski, PT, DPT - Andrea is a doctor of physical therapy and an associate at Mackarey Physical Therapy in Scranton and Clarks Summit.
May is national pet month! As we take a moment to celebrate our pets it is important to acknowledge the many contributions having a pet brings to our lives, not the least of which is improving our health and wellness. Pets have a long history of helping humans navigate daily life. In fact, the oldest record of having a pet date back 15,800 years ago in Turkey where archaeologists found dog remains buried with humans.
Pets come in many different shapes, sizes, and species. Whether you are a cat/dog person, a reptilian lover, or marine life enthusiast, having a pet that is right for you can enrich you life in many ways. If you have never had a pet before or might be thinking about adopting a new addition to the house, it is important to research first and know the right ways to care for your new friend in the best way possible. Being a responsible pet owner will help to flourish your relationship with your pet and make the time and bond you share a stronger and more positive experience.
Making an informed and thoughtful decision about getting a pet is important. Don’t be afraid to ask questions, do some research, or simply take some time to figure out the logistics of how adding a pet can influence your life. From personal experience, I could not imagine my life without my four-legged friends by my side to share, enjoy, and enrich my every day. Having a pet can be one of the best parts of life. Remember, although having a pet can be a small part of your life; to them, you are their whole life, so make sure it can be the best life possible. Together, you will form of a bond that in enhances you life in many ways, including your health and wellness!
Sources: https://newsinhealth.nih.gov/2018/02/power-pets
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!
Spring has sprung in NEPA and summer is just around the corner... great news for outdoor enthusiasts! It is also good news for those who need walk for health reasons. However, for many who have not maintained an active lifestyle or have health issues, it is challenging to know where to begin. Moreover, 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 into it will most likely lead to problems.
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, that 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!
“There’s no question that increasing exercise, even moderately, reduces the risks of many diseases, including coronary heart disease, breast and colon cancer, and Type 2 diabetes,” said Dr. Jennifer Joyce, MD, professor of family medicine at GCSOM. “Research has even shown that you could gain two hours of life for each hour that you exercise regularly.” A recent study demonstrated that a 15 minute walk after a meal is very effective in reducing blood sugar levels.
According to the American Heart Association, walking as little as 30 minutes a day can provide the following benefits:
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.
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.
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!
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!
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
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!
Have you ever noticed high level athletes warming up before a game or competition walking or running backwards? You may also see fitness enthusiasts in gyms emulating these athletes to improve their fitness or performance. I found the concept of backward walking (also called retro walking) interesting and decided to research the topic for more information and validation. Walking backward does have many therapeutic benefits, however, before you attempt this activity on a treadmill or elliptical, please consult your physician and physical therapist and have a spotter nearby.
At a recent meeting of The American College of Sports Medicine, several studies were presented on the topic of backward waking. Most of the research was conducted while moving backward on a treadmill and an elliptical machine. When comparing two groups recovering from knee injuries, the backward motion group showed significant improvement in strength in the quadriceps (front thigh) and hamstring (back thigh) muscles when compared to the traditional forward walking group. Furthermore, the muscles of the front (tibialis anterior) and back (gastro/achilles) of the shin/ankle also demonstrated an increase in strength and endurance with backward walking. One explanation is that forward motion is routine in daily living that it has become very efficient and does not tax or stress the muscles the body. While this efficiency prevents fatigue in daily activities, it may not stress the muscles enough to gain strength as quickly as an unfamiliar exercise.
Due in great part to the increased strain of performing unfamiliar exercise, backward walking on a treadmill or backward pedaling on an elliptical, offered a greater cardiovascular benefit and caloric expenditure than forward motion at all levels. Specifically, walking backward on a treadmill at 2.5 mph at grades of 5% - 10% has been found to significantly increase cardiovascular endurance than walking forward under the same conditions. This knowledge is useful for healthy individuals in need of greater cardio exercise. However, it may also serve as a precaution for those with cardio problems and should consult their physician prior to engaging in this activity.
A recent study in the International Journal of Obesity, found that those who performed new activities or increased the intensity of an activity, even if for a short duration (interval training) expended more energy and burned more calories than those who worked out at the same pace consistently for a longer duration. Moreover, when engaging in a new activity such as backward walking, even more calories were burned. This phenomenon may be due to the fact that routine activities such as forward walking are performed more efficiently and easily.
We challenge our body when we inefficiently perform a new motor skill such as backward walking and burn more calories. In other words, if you want to burn more calories without exercising for longer periods of time, then try a new activity and engage in higher intensity, intermittently, for part of the time. For example, walk backward on the treadmill for 30 minutes at 2.5 mph, but do so at a 5 – 10% incline for 1-2 minutes every 5 minutes.
Some studies show that using other muscle groups by performing different exercises not only prevents boredom but also protects your muscles and tendons from overuse and joints from wear and tear. Specifically, the knee joint and the patella joint (the joint where the knee cap glides on the knee), benefit from backward walking due to less stress and compression forces on the joint. The thigh and ankle/foot muscles benefit from using a different form of contraction while lengthening the muscle. Some authors propose that this may also prevent strains and pulls and may be valuable to strengthen those with a history of shin splints and flat feet (pronation).
Mixing up your program prevents boredom. As a rule, those willing to change their exercise routine are more compliant and continue to exercise longer than those stuck in the same routine. A new challenge to improve distance, speed, and resistance while exercising in a different direction will be refreshing to your program.
Prevention of falls by improvement in balance and coordination has received a great deal of attention in the past few years. This is not only valuable to the athlete but may be even more important to those over 50. With age, balance centers are slow to react to changes in inclination, elevation, rotation and lateral movements. This slow reaction time leads to falls that may cause fractures, head injuries and more. Working on this problem by challenging the vestibular and balance centers before it is seriously compromised is important and backward walking is one way for this to be effectively accomplished.
Treadmill Backward Walking MODEL: Lexi DiGregorio, PTA
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!
Spring sports and outdoor activities are here…tennis, pickleball, baseball, soccer, running, walking, hiking, golfing, etc. One of the most common injuries associated with physical activity, especially after a sedentary winter or change in temperature is a “pulled hamstring.” This painful injury is not only for the weekend warrior. Well-trained, healthy and fit professional athletes often have their season interrupted for weeks and months due to a hamstring injury. What is the hamstring? How is it injured? What is the best treatment?
A hamstring strain is a tear of the muscle fibers of the muscle group in the back of the thigh called the hamstring. The hamstring muscle is a group of three muscles that run from the back of the hip (lower pelvis), crossing the back of the knee and attaches to the knee bone (tibia). The hamstring muscles work to extend the hip and bend the knee during running and walking activities. They are very active when an athlete changes direction, especially forwards and backwards or decelerating. This injury, like others muscle strains, varies in intensity.
Severe hamstring strain occurs when many muscle fibers are torn. The athlete may experience a sudden onset of severe pain in the back of the thigh and occasionally report a popping sensation. Pain, swelling and black and blue skin from tissue damage and bleeding is often reported. Also, pain is reproduced when attempting to bend the knee. In very severe cases, the boney attachment can be pulled so strongly that a small fracture can occur. Healing time can be as short as a few days or as long as weeks or even months.
Your family physician will examine the back of your leg to determine if you have hamstring strain. Sometimes, pain in the buttocks and back of the leg can be referred from your lower back if the sciatic nerve is inflamed. In more advanced cases, you may be referred to an orthopedic surgeon for further examination and treatment. An X-ray, MRI or bone scan will show the extent of the tear and if the bone is involved. The diagnosis will determine if your problem is minor, moderate or severe.
There are many conservative options. Your family physician or orthopedic surgeon will help you decide which choices are best.
Recent studies have determined that a training program specifically designed to prevent hamstring injuries is effective, especially for the competitive athlete. This program includes:
SOURCES: Journal of Physical Medicine & Rehabilitation and 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!
Spring is in the air. The temps are rising and the days are longer, so get outside and walk! Walking can change the world…from Mahatma Gandhi and the Indian independence movement to Martin Luther King, Jr., and the civil rights movement, walking and protest have been interrelated. Moreover, walking has been associated with fostering good health and stimulating creativity.
Walking is about more than walking and always has been. Walking soothes. Walking inspires and sharpens the mind. WE CAN WALK!
It might be said that with the right mindset, every walk is a pilgrimage. Many breakthroughs has been stumbled upon while putting one foot in front of the other. We run from problems. We walk toward solutions. While working on A Christmas Carol, Charles Dickens would walk 15 or 20 miles through the back streets of London, turning over the plot in his mind as the city slept. Beethoven found inspiration while ambling in the verdant Wienerwald outside Vienna.
Recent studies suggest that walking stimulates our creative mind is at its most creative at three miles per hour, the speed of a moderately paced stroll. Stanford University researchers divided participants into two groups: walkers and sitters. They then administered a test designed to measure creativity. They found that creative thinking was “consistently and significantly” higher for the walkers than the sitters. It didn’t take a lot of walking to boost creativity, either—anywhere from 5 to 16 minutes.
Studies have also shown that people who walk regularly are healthier and live longer than those who don’t. Surprisingly, you don’t have to walk very fast or far to enjoy this benefit. One recent study, published in JAMA Internal Medicine, put the 10,000-step myth to rest. It is an arbitrary number. People—older adults in particular—accrue health benefits by taking only a few thousand steps each day, and at a leisurely pace.
In addition to stimulating creativity and reducing stress, walking has many benefits. “There’s no question that increasing exercise, even moderately, reduces the risks of many diseases, including coronary heart disease, breast and colon cancer, and Type 2 diabetes,” said Dr. Jennifer Joyce, MD, professor of family medicine at GCSOM. “Research has even shown that you could gain two hours of life for each hour that you exercise regularly.”
According to the American Heart Association, walking as little as 30 minutes a day can provide the following benefits:
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:
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. Even small amounts of physical activity are helpful, and accumulated activity throughout the day adds up to provide health benefits.
Remember it's OK to start slowly — especially if you haven't been exercising regularly. You might start with five minutes a day in 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.
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 pedometer or fitness tracker to calculate steps and distance.
Sources: National Geographic; Mayo Clinic
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’s that time of year…after a long winter of nights that come early and last too long there is LIGHT at the end of the tunnel! In the fall and winter, especially this far north, many people start to feel the gloom of their surroundings creep into their psyche and spring cannot arrive too soon...Is this normal, or a sign of something more serious?
Seasonal affective disorder, or SAD, is at the far end of a spectrum of seasonal mood changes. The mildest of these, “seasonality”, is a normal response to cyclical changes in weather and light exposure. However, when symptoms like depressed mood, lack of motivation, or a shift to more vegetative daily habits become severe and debilitating, SAD may be the cause. In fact, one study found that SAD affects up to 10% of primary-care patients, and that those with a previous diagnosis of depression are even more at risk. Fortunately, though, there are well established therapies that can help those afflicted with SAD to get through the dark winter months.
The American Psychiatric Association defines SAD as a subtype of either Major Depressive Disorder or Bipolar Disorder, depending on the symptoms. It can consist of episodes that onset during either fall/winter or spring/summer, or have symptoms characteristic of either “major depressive” or “manic” episodes. The vast majority of those with SAD, however, experience a persistent overall depressed mood during the shorter days of fall and winter.
In more serious cases:
If enough of these symptoms are present for a long enough time and onset in a seasonal pattern, that can mean Seasonal Affective Disorder. Most people with the disorder find themselves sleeping more and eating more (especially carbs), and report that their symptoms can even resolve with relocation to a sunnier environment. Along the spectrum of disease is a less severe form called “subsyndromal” SAD, which can still be effectively treated. Periods of SAD tend to resolve with the coming of spring, but they can be immensely distressing and always deserve medical intervention.
No one knows exactly why Seasonal Affective Disorder happens, but it appears to be associated with decreased exposure to natural light during the fall and winter months. One possible explanation is the “phase-shift” hypothesis. It states that your body’s circadian rhythms, which are regulated by hormones and the brain, become out-of-step with environmental sleep/wake cues as the days shorten. In other words, the light levels around you and your body’s internal clock are telling you two different things about when to sleep. This disruption of circadian rhythms, or “phase-delay”, likely contributes to the symptoms of SAD, although precisely how it induces changes in mood remains unclear.
Another hypothesis for the mechanism underlying SAD involves abnormalities in the activity of serotonin, a neurotransmitter in the brain. Normally, serotonin regulates mood and attention. However, studies have found that people with SAD clear serotonin out of their brains faster, giving the hormone less of a chance to provide a boost in mood.
Current medical treatment of SAD targets the changes in both circadian rhythms and serotonin metabolism. This can be accomplished with light therapy, antidepressant medications or a combination of both.
Medical Contributor:
Brendan Bormes, MD, GCSM 2019: This column was previously featured in “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine.
Visit your doctor regularly and listen to your body.
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
NEPA has experienced more than its share of bitter cold temperatures this winter. And, as much as I enjoy skiing, ice skating and snowshoeing, I have noticed a few achy joints when the mercury plummets! Osteoarthritis, the most common type of arthritis, is often considered to be a normal part of aging. Usually by the age of forty our joints, especially those which are weight bearing (lower spine, hips, knees, ankles, feet) begin to show signs of wear and tear. The cartilage begins to thin, the joint surfaces are not as smooth, and fluid which lubricates the joint becomes diluted, dehydrated and less protective.
Consequently, these aging joints become stiff, sore, weak, and sometimes swollen. Most people with osteoarthritis report additional pain and stiffness in the winter and early spring due to cold, damp weather and NEPA has plenty of it! The cold, for example, restricts the flow of blood to the joints, leading to more pain and stiffness. While moving to a warmer and less humid climate is one solution, it is not practical for most. But all is not lost because there are other alternatives to protect and keep your joints healthier this winter and early spring.
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!
