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Part I of II

According to the National Institutes of Health, an estimated 19.1% of U.S. adults 18 and older had an anxiety disorder in the past year. Anxiety disorders were higher for females (23.4%) than for males (14.3%). An estimated 31.1% of U.S. adults experience an anxiety disorder at some time in their lives.

There are a wide variety of anxiety disorders and will vary by the objects or situations that induce them. However, the features of excessive anxiety and related behavioral disturbances are similar. Anxiety disorders can interfere with daily activities such as job performance, school work, and relationships. Symptoms include: distress, nausea, shortness of breath, bowel pattern changes, excessive perspiration, frequent laughing or crying, restlessness, and is often associated with depression. While there are many types and degrees of anxiety and there is no substitute for medical and psychological care, there are some simple and basic tools to help manage the problem…daily exercise is one easy, affordable and accessible suggestion for most. 

Multiple studies have discussed the incidence of unhealthy self management of anxiety, including the use of alcohol and recreational drugs. The University of Pittsburgh Medical Center (UPMC) recommends the following healthy tips for coping with anxiety:

Healthy Coping Tips

1. Get Enough Sleep 
Adequate sleep is critical for mental health. Unfortunately, anxiety can lead to sleeping problems and, according to the Anxiety and Depression Association of America (ADAA) inadequate sleep can worsen anxiety.

Seven to nine hours of sleep each night is recommended for most adults. The National Sleep Foundation recommends maintaining a regular schedule that includes going to bed at the same time each night and waking up at the same time each morning.

2. Practice Mindfulness Meditation 
Incorporating meditation into your life can help you cope with anxiety, according to the National Center for Complementary and Integrative Health.

Research shows mindfulness meditation programs are effective in reducing anxiety and depression. UPMC offers a Mindfulness-Based Stress Reduction Course and a Beginners Guide to Meditation that have been proven to be very effective. Another option for reduction of anxiety and stress is Progressive Muscle Relaxation. This mind-body technique can be found in 5, 10, 15 or 20 minute videos.

3. Spend Time in Nature 
How you deal with anxiety should include a walk in the forest or even a tree-lined park. In NEPA we are very fortunate to have access to beautiful walking and biking trails and state parks. Make time to enjoy them.

Research shows that “forest bathing,” long, slow walks in nature for health purposes, can lower blood pressure and relieve anxiety. A review of clinical trials published in the International Journal of Biometeorology found that salivary cortisol levels, biomarkers for stress, were significantly lower in groups who participated in forest bathing versus the control group.

4. Take up Yoga or Tai Chi 
Yoga does more than increase your flexibility. It incorporates exercise, deep breathing, and meditation. Yoga is an all-in-one anti-anxiety activity, as shown in a review of body-centered interventions published in Frontiers in Psychology. Tai chi, a mix of meditation and martial arts, works much the same way.

5. Dance Therapy 
That same research found that dance therapy, also known as movement therapy, reduces anxiety by engaging the body’s nervous system, which regulates how the body reacts to stress. In addition, dance/movement therapy increases production of serotonin, a chemical produced by the cells that’s responsible for mood.

6. Breathe Through It 
When you begin to feel anxiety or a panic attack with symptoms such as: sweating, trembling, dizziness, rapid heartbeat and nausea, start to come on, “take a deep breath.” Research shows that slow deep breaths can calm you down and lower your heart rate while quick, shallow breaths  can induce or worsen anxiety.

One breathing technique shown to reduce anxiety is diaphragmatic breathing. Using your diaphragm for deep breathing requires you to fill your lungs to capacity.

Breathe in slowly through your nose so that your stomach rises. Then, tighten the stomach muscles and exhale slowly through pursed lips. Repeat several times.

7. Limit Caffeine and Alcohol 
Too much caffeine restricts blood vessels, which can increase blood pressure and contribute to anxiety. Coping with anxiety also doesn’t mean masking it with alcohol. Studies show that there is a complex relationship between alcohol and anxiety. While some may use alcohol and recreational drugs to mask the symptoms of anxiety (often leading to substance abuse disorder), some studies show that alcohol can interfere with the neurotransmitters that manage anxiety and prevent you from getting a good night’s sleep. Drinking to cope creates a sort of feedback loop, which makes the anxiety worse and can lead to alcohol dependence.

8. Check Your Medicine 
Certain medicines, such as corticosteroids, asthma drugs, and others, can cause anxiety. Ask your doctor if any medicines you take may be a contributing factor.

9. Eat Healthy Foods 
Keeping the body nourished is essential for all functions of life. New research shows that a healthy diet may affect more than just weight and energy levels. One example is a Mediterranean Diet, with lots of vegetables, fruits, beans, lentils, nuts, whole grains, extra virgin olive oil and a moderate amount of fish (especially those rich in omega-3 fatty acids), with limited use of red meat.

10. Keep a Journal 
Keeping a journal can be a great way to keep track of your progress with anxiety and how your body responds to such situations. Tracing the triggers of anxiety can help you develop the skills to properly respond when put in anxious conditions.

11. Exercise Regularly 
Exercise promotes the release of endorphins. These brain chemicals reduce the body’s reaction to pain and stress. They also produce a feeling of euphoria, or happiness, that’s comparable to morphine. Just five minutes of aerobic exercise can kick start these anti-anxiety effects, according to some studies.  Next week in “Health & Exercise Forum” specific details about exercise for anxiety will be presented.

Talk to a Mental Health Professional

Chronic anxiety also can point to an underlying mental health issue. When your anxiety causes extreme distress or interrupts your ability to function on a daily basis, or when panic attacks are frequent and debilitating, it’s important to talk to your physician and ask for a referral to a mental health professional. They can provide a treatment plan, which may include specialized anti-anxiety medicine, psychotherapy, or both.

Visit your doctor regularly and listen to your body.     

SOURCES: University of Pittsburgh Medical Center (UPMC); National Institutes of Health (NIH);

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next week: Coping with Anxiety Part II 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!

“The woods are lovely, dark, and deep,

But I have promises to keep,

And miles to go before I sleep,

And miles to go before I sleep.”  Robert Frost

The purpose of this column is to present an alternative to traditional running that will allow training on more interesting and less stressful surfaces such as those used when hiking, mountain biking and horse riding trails in the beautiful woods of Northeast Pennsylvania…”trail running!”

I remember my trail running days with fondness. One day, when the temperatures soared above 90 and my wife pleaded with me to avoid running in the heat (she was wise), as a typical runner, I needed hit the road. As I set out on State Road 348 just on the periphery of Lackawanna State Park in Dalton, the sun was beating down on me. I happened to see a sign that read, “Orchard Trail, Bull Hill Trail, Tree Line Trail.” I thought it might be a good idea to find some shade and decided to run on this path normally used for hiking, mountain biking and horseback riding. It turned out to be a great decision. While I was forced to run 25% slower due to the uneven terrain (rocks, tree roots, stumps), I was able to practice “light running” techniques by running with short strides on the balls of my feet. I felt much more refreshed as I avoided the direct sunlight under the cover of the trees.

Furthermore, I enjoyed the up close view of nature as I ran by cool streams and wet mossy rocks. I saw beautiful flowers, rhododendron, and mountain laurel. I observed deer, chipmunks and birds. In my quest to avoid the hot sun, I discovered the beautiful underworld of “trail running” – a growing trend in today’s running community. If you, like me, enjoyed pounding the pavement for many years, trail running can help you rediscover why you love to run. It is beautiful, peaceful, natural and unique. It is fun to get in touch with your inner child as you run in the woods and get muddy. Trail running makes running fun…and it’s good for your joints!

The trail running community purports that trail running is popular because it satisfies a primal need for man to move through nature, derived from hunter/gatherer days. Others who promote trail running feel the popularity is due to the many advantages it offers. One, trail running prevents impact injuries due to soft surfaces. Two, the training style of running with shorter strides on the ball of the foot, lessens impact. Three, this type of running will develop stronger ankles and trunk core muscles while improving balance, coordination and proprioception from running on uneven surfaces. Lastly, the ability to release copious amounts of endorphins while breathing fresh air instead of roadside fumes is invaluable.

Trail Running Gear

Tips to Begin Trail Running

Sources: American Trail Running Association, Trailspace.com

Visit your doctor regularly and listen to your body.     

NEXT MONDAY – 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!

Since 1949 May has been designated as National Mental Health Month for the purpose of eliminating the stigma associated with mental illness by raising awareness. One of the most common mental health conditions is depression. New research from Boston University School of Public Health has found that depression has been increasing in the United States and life with COVID for more than two years has accelerated it rapidly. In 2021 the number of people suffering from depression increased more than 32 percent, affecting 1 in every 3 American adults. However, research also has good news to offer: one of the most understated benefits of exercise is mental health! Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness.

Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that depression scores were significantly reduced in groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks when compared to a control group and a psychotherapy counseling group.

Depression is the most common mental disorder and is twice as common among women as in men. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician.

HOW EXERCISE REDUCES DEPRESSION

According to research, exercise reduces depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Depression:

Physiological or Physical Benefits of Exercise on Depression:

HOW TO BEGIN EXERCISE FOR DEPRESSION

  1. Consult your primary care physician to confirm the diagnosis of depression. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressant or other medications discuss the impact it may have on your exercise program with your physician.
  2. Recognize and fight depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills. *Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.
  3. Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure. The studies that demonstrated benefits took place over 12 weeks.
  4. Begin slowly with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and routine in 3-4 weeks so JUST DO IT !
  5. Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton). Use a mall in inclement weather.
  6. Find a friendly, uplifting group to walk, talk and exercise with. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
  7. Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
  8. Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
  9. BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

NEXT MONDAY - Read Dr. Paul J. Mackarey’s "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. Mackarey's Articles, check out our Health and Exercise Forum!

Part II of II

After a long winter, spring is finally in the air as indicated by the warm (summer-like) temperatures last week. While your mind may be ready to play golf (and other outdoor activities), however, it is important to remember that without proper warmup and preparation, the risk of injury can increase substantially. PGA professionals benefit tremendously from sport science, physical therapy and fitness programs on tour year round. Amateur golfers in northern climates require diligence and planning to prepare for the game after 4-6 months off to avoid injury.  

 Muscle strains, ligament sprains, neck and LBP is prevalent in the early season for golfers, especially for the amateur. The reasons are many: general deconditioning after winter inactivity, poor golf swing mechanics, excessive practice, inadequate warm-up and poor flexibility and conditioning. The very nature of the golf swing can create great stress on the body, especially after time off.

PRESEASON TIPS FOR GOLF

Keep Fit and Trim

Core Tips- A Strong Core is Critical for a Healthy Golf Swing

Photo 2
Photo 1
MODELS: Ross Zanghi, Physical Therapy Student; Ashley Ottaviani, Physical Therapist Assistant
Visit your doctor regularly and listen to your body.     

NEXT MONDAY – 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

Access all of Dr. Mackarey's articles at our Health and Exercise Forum

Part I of II

After a long winter, spring is finally in the air as indicated by the warm (summer-like) temperatures last week. While your mind may be ready to play golf (and other outdoor activities), however, it is important to remember that without proper warmup and preparation, the risk of injury can increase substantially. PGA professionals benefit tremendously from sport science, physical therapy and fitness programs on tour year round. Amateurs in northern climates require diligence and planning to prepare for the game after 4-6 months off to avoid injury.   

Muscle strains, ligament sprains, neck and LBP is prevalent in the early season for golfers, especially for the amateur. The reasons are many: general deconditioning after winter inactivity, poor golf swing mechanics, excessive practice, inadequate warm-up and poor flexibility and conditioning. The very nature of the golf swing can create great stress on the body, especially after time off.

PRESEASON/GENERAL WARM-UP TIPS FOR GOLF

Best to begin 4 -6 weeks before the season

Get to the course early enough to make time to stretch before you play and hit a few balls at the range. Always start with low irons and work up to driver. Take a hot shower before an early morning round and use compression shorts and shirts on cool days. Do Not Bounce or Overstretch! Stretch slowly, holding for 10-20 seconds:

Visit your doctor regularly and listen to your body.     

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II - Preseason Golf Tips.

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 Health and Exercise Forum

Part II of II

According to the American Diabetes Association (ADA), 32.2 million adults and children, 10.5% of the population in the United States, have diabetes. Unfortunately, one-third of these people are not aware that they have the disease. It will be the purpose of this column to raise the level of consciousness through education and offer recommendations for lowering blood sugar levels naturally.  

Perhaps no goal is more important to a person with diabetes than maintaining a healthy blood sugar level. When managed over time, healthy blood sugar levels can slow the onset of complications associated with the disease. According to the ADA, pre-diabetes, or impaired glucose tolerance, occurs when blood glucose levels are higher than normal (110 to 125mg/dl) but below type 2 diabetes levels (126mg/dl). 54 million Americans have pre-diabetes in addition to the 20.8 million with diabetes.

While medications are effective in maintaining blood sugar levels, for those who are borderline, there are effective ways to lower your blood sugar naturally. Your physician will determine which treatment is most appropriate for your problem. Also, maintaining your ideal body weight is always important.

10 Tips to Lower Your Blood Sugar Naturally

**This column is based on information from local physicians Kenneth Rudolph, MD, Gregory Borowski, MD, the American Diabetes Association L (ADA), and Lifescript

NEXT MONDAY – 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. Mackarey's articles, visit our Health and Exercise Forum

1. No Pain, No Gain

Pain is different than discomfort! Muscle soreness and “feeling the burn” can occur during a normal healthy exercise routine. However, you should never experience a sharp, deep, intense, or lingering pain during or after exercise. In fact, if the soreness lasts more than 24-48 hours, than you did more damage than benefit to your muscles and other tissues and it is time to scale back and take time off. If necessary, use RICE (rest, ice compression and elevation). It is important to get in tune with your body and learn the difference between muscle strain and fatigue discomfort and pain from soft tissue damage from overuse and overload. Find the proper amount of weight and repetitions and gradually increase over time.

2. Always Stretch Before You Exercise

There is no solid evidence that stretching alone before a sport or activity prevents injury. In fact, over stretching may be counterproductive before a sport as it may weaken the muscle. The current wisdom on the matter is; never stretch a cold muscle. Instead, warm up for 5-10 minutes by actively moving the extremities and light jogging or biking and THEN lightly stretch the arms, legs, back etc. More vigorous stretching should be performed to improve the flexibility of tight muscles (ie calf and hamstring muscles) and best done after your workout but not before a sporting activity (tennis, basketball, etc.).

3. Lifting Weights Will Make You Bulky

It depends on your body type and hormones! It is very unlikely that women and prepubescent males will bulk up from lifting weights…especially light weights (blame or thank hormones). It will, however, increase metabolism and fat burning efficiency which can lead to weight loss and good muscle tone. Stick with low resistance and high repetitions for best results.

4. With the Correct Program, Spot Reduction Can be Achieved

It is not possible to target an area of the body to burn more fat! It is very common for women to ask for a specific exercise to reduce the fat in their buttocks, thighs, and abdomen. Regretfully, it is not possible to target weight loss in these areas or other body parts. In fact, when you lose weight through diet and exercise, the caloric expenditure will be evenly distributed throughout the body. However, once the adipose tissue in a specific part of the body such as the abdomen is reduced from general weight loss, targeting the area with exercises specific to that muscle group will improve the tone and definition for a leaner look in that region.

5. If you don’t have 45-60 Minutes to Exercise, Don’t Bother

Sure, it would be great to dedicate 60 minutes 5 -6 days a week for exercise. But for most of us who work and raise a family it is not practical. The good news is that the research supports 30 minutes of exercise 3-5 days a week. Moreover, evidence shows that 10 minutes, three times a day, 5 days per week will help you attain the 150 minutes a week supported in most exercise studies.

6. If you have Arthritis, Exercise Will Make it Worse

Most people with the most common form of arthritis, osteoarthritis, feel better when they are moving. That is not to say that they don’t have increased symptoms when they OVERDO it. An exercise program specifically designed for a person’s problem and limitations will improve their symptoms and function. For example, if an individual has arthritis in their knees, they should use an exercise bike (partial weight bearing) or swim (buoyancy effect of water) instead of walk or run (full weight bearing) for aerobic exercise.

Furthermore, they would do far better with light cuff weights in a sitting or lying position to strengthen their legs than performing squats or lunges. It is important to remember, the weight gain and joint weakness and stiffness associated with a sedentary lifestyle will do more harm to an arthritic joint than a proper exercise program.

7. You Need a Sports Drink When you Exercise

Not unless you are planning a killer workout! The number one reason most of us exercise is to lose or control body weight. High calorie sports drinks are counterproductive and unnecessary. If you do not plan on exercising for more than 60 minutes, good old fashion H2O is more than adequate. However, if you plan to do a “killer” workout for more than 60 minutes and may incorporate a high intensity interval training (HIIT) program, than a sports drink with electrolytes and other nutrients, may be of value.  

8. Exercise Machines are Better than Free Weights

For most of us, effective resistance training is not about the equipment. It is safe to say, caveman was pretty fit and strong despite the fact that he never went to a gym and lifted weights. He did however, lift, push, pull, and carry heavy stones, timber, and animals for day-to-day survival. So too, it is for modern man, the body does not distinguish between the resistance provided by a elastic band, dumbbell, or cable with pulleys and weight stacks. As long as the basic principles of strength training are applied, (isolating a muscle or muscle group, loading the muscle with enough force to bring it to fatigue without causing tissue damage, and allowing for adequate rest and recover) than the muscle will gain strength regardless of the type of resistance.

9. Running is Better Than any Other Form of Aerobic Exercise

First, let me confess that I love to run and up until recently, ran almost daily. However, now that I am over 60, I had to find new forms of aerobic exercise which would be kinder and gentler to my joints. So, I mix it up between biking (indoors and outdoors, recumbent and upright), brisk walking or hiking, elliptical and stepper and swimming laps. Again, like the caveman weightlifting example, the body (heart and lungs) does not know what is causing an increase in heart rate for 30, 45 or 60 minutes, it only knows that it must respond to allow the body to function under this stress. And, in the process it becomes conditioned to the point that it will work much more efficiently when not under stress with a lower heart and respiratory rate and blood pressure at rest.

Those over 50 would be well-advised to engage in low-impact aerobics on a regular basis. For example, if you want to run two to three days per week, do not run two days in a row and consider performing low impact exercise in between. Some examples of low impact aerobics are walking, treadmill walking, swimming, elliptical trainer, and an exercise or road bike.

10. Continual Exercise Never Needs to be Adjusted

Change is necessary with age! For many years, I have repeatedly preached about the value of engaging in an active lifestyle throughout life. It is especially important to be active as one gets older to maintain mobility and independence. However, many take this advice to an extreme and refuse to accept the inevitable changes that occur in the body with age. They run, jump, lift and throw like a teenager and often fail to modify their activity or exercise regimen appropriately for their age. Consequently, they suffer from multiple injuries, including muscle tears, tendonitis, bursitis, impingement, and advanced osteoarthritis.

Keep in mind, everyone ages differently. One person at 60 years of age may be the equivalent of another at 50. However, change with age is inevitable, so be kind to your body…it’s the only one you have! It is always prudent to consult your physician and physical therapist for a program designed specifically for your needs.

NEXT MONDAY – 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.

Access all of Dr. Mackarey's articles in our Health Care Forum!

Exercise is important for prevention!

In 2000, President Bill Clinton dedicated March as National Colorectal Cancer Awareness Month. The purpose of this designation is to increase public awareness of the facts about colon cancer – a cancer that is preventable, treatable and has a high survival rate. Regular screening tests, expert medical care and a healthy lifestyle, which includes a proper diet and exercise, are essential for prevention. Several studies have demonstrated that exercise can also help prevent colon cancer. 

The American Cancer Society estimates that there will be approximately 107,000 new cases of colorectal cancer in 2023. Of these, 52,550 men and women will succumb to the disease. It is the second-leading cause of U.S. cancer deaths for both men and women combined. The good news is incidence and mortality rates are dropping both nationally as well as in northeast Pennsylvania. The bad news is northeast Pennsylvania still has increased incidence and mortality rates when compared to the national average.

Colon Cancer Facts:

Studies show that prevention of this disease is multifaceted and includes: engaging in daily exercise, eating a low-fat diet with little red meat, avoiding smoking, drinking in moderation and having regular colonoscopy screenings.

Early detection is the key to survival. Death from colorectal cancer can be eliminated if caught at the earliest signs of disease. Colorectal cancer progresses very slowly, usually over years. It often begins as non-cancerous polyps in the lining of the colon. In some cases, these polyps can grow and become cancerous, often without any symptoms. Some symptoms that may develop are: blood in stool, changes in bowel movement, feeling bloated, unexplained weight loss, feeling tired easily, abdominal pain or cramps, and vomiting. Contact your physician if you have any of these symptoms.

The risk of colon cancer increases with age, as 90 percent of those diagnosed are older than age 50. A family history of colon cancer increases risk. Also, those with benign polyps, inflammatory bowel disease, ulcerative colitis or Crohn’s disease are at greater risk and should be screened more frequently.

Prevention of Colon Cancer:

  1. Colonoscopy – The colonoscopy is the most accurate screening test for detecting polyps and colorectal cancer. A long, thin, flexible tube with a camera is used to visually examine the lining of the colon. Polyps can be removed at the time of the exam if necessary. Most people should have this test starting at age 50, although high-risk populations (i.e. those with genetic predisposition or inflammatory bowel disease) may begin at age 40 to 45 or even younger.
  2. Diet & Nutrition – Diets rich in fiber are generally considered beneficial for overall health, including colorectal health. Limit high-fat foods especially from animal sources. Limit red meat and dairy. A diet consisting of fish, fruit and vegetables is valuable. Some researchers theorize that Brussels sprouts, broccoli and cabbage may trigger a chemical process to turn on a gene to suppress tumors. Sunlight and vitamin D are thought to be important too. 
  3. Lifestyle & Personal Habits – Smoking and excessive alcohol use increases risk for colorectal cancer and other forms of cancer. Stress and anxiety can be cancer triggers.
  4. Exercise – While there have been many studies about the benefits of exercise for colon cancer, none have been more encouraging than a recent study from the Hutchinson Cancer Institute in Seattle. Patients with abnormal cells on the lining of their colons, as found by colonoscopy, demonstrated positive changes and reversal of these cells after engaging in four hours of exercise per week for one year. Some studies have shown that exercise can reduce the risk of colon cancer by 50 percent.

How Exercise Prevents Colon Cancer:

The intestine works like a sewage plant, recycling the food and liquid needed by your body. However, it also stores waste prior to disposal. The longer the wastes remain idle in your colon or rectum, the more time toxins have to be absorbed from you waste into the surrounding tissues. One method in which exercise may help prevent colon cancer is to get your body moving, including your intestines. Exercise stimulates muscular contraction called peristalsis to promote movement of waste through your colon.

Exercise to prevent colon cancer does not have to be extreme. A simple increase in daily activity for 15 minutes, two times per day or 30 minutes, once per day is adequate to improve the movement of waste through your colon. This can be simply accomplished by walking, swimming, biking or playing golf, tennis or basketball. For those interested in a more traditional exercise regimen, perform aerobic exercise for 30-45 minutes four to five days per week, with additional sports and activities for the remainder of the time. For those in poor physical condition, begin slowly. Start walking for five to 10 minutes, two to three times per day. Then, add one to two minutes each week until you attain a 30-45 minute goal. 

Medical Contributor: Christopher A. Peters, M.D

Dr. Christopher Peters is a partner of Radiation Medicine Associates of Scranton (RAMAS) and serves as medical director of Northeast Radiation Oncology Centers (NROC). He is an associate professor of clinical medicine at GCSOM. Sources: American Cancer Society/Northeast Regional Cancer Institute, and CA Cancer J Clin.

EVERY MONDAY - 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. Mackarey's Articles, visit our Healthcare Forum!

Part II of II

PEOPLE WILL OFTEN ASK ME, “IS THERE SUCH A THING AS AN EXERCISE RUT?” THEY WANT TO KNOW WHY THEY DO NOT SEEM TO BE IMPROVING WITH THEIR EXERCISE PROGRAM…they exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut.

The purpose of this column will be to offer suggestions on how to improve or get more out of a “stale” exercise program. Last week’s column offered tips to improve a stale cardiovascular and strength program. This week we will discuss flexibility and functional training tips and include the components necessary for a healthy mind, body and spirit connection.

1. Flexibility Training

Flexibility training involves the careful stretching of the muscles, tendons and joints to improve the range of motion in order to safely perform daily activities and sports without injuring or tearing soft tissues. It is probably the most neglected part of the fitness program. However, while the amount of inherent flexibility varies for each person, a minimal range is necessary as it relates to daily activities and sports. For example, as you age it is important to have enough flexibility in your back, hips and knees to wash your feet, put shoes and socks on. Flexibility exercises should always be performed after a warm –up activity and done slowly and gently.

The Two Types

There are two types of flexibility exercises; dynamic and static. Dynamic stretching is performed with movement such as pushing the ankle up and down like a gas pedal. Passive stretching is performed using an outside force such as using a towel to pull the ankle up in order to stretch the calf. Dynamic should be performed before an activity (before running or playing tennis) and static performed after the activity is over in order to increase range of motion for future activities.

Improving a Flexibility Training Program:

2. Mind, Body, Spirit

Conclusion

In conclusion, it is easy for fitness enthusiasts to get so focused on maintaining a routine that they allow their program to become stale and ineffective. It is essential to reassess and update your program to prevent stagnation.

Make sure the routine has all three fundamental components of a well-balanced exercise program; cardiovascular, strength and flexibility training. Moreover, to be truly healthy, one must work toward a “Healthy Mind, Body, and Spirit. Therefore, in addition to traditional exercise one must incorporate the following: nutrition; meditation, relaxation techniques, yoga, core fitness; functional/sports specific training; leisure sports and activities

In order to prevent an exercise program from getting stale, one must incorporate all aspects of wellness…a healthy mind, body and spirit!

While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED.

Sources: National Institutes of Health; American Council on Exercise

EVERY MONDAY – 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 Geisinger Commonwealth School of Medicine

For all of Dr. Mackarey's articles our Health Care Forum

Part I of II

People will often ask me, "Is there such a thing as an exercise rut?" They want to know why they do not seem, to be improving with their exercise program?... they exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut. While initially responding favorably to exercise, after 6 -9 months or more, they do not notice progress in weight loss, strength, tone, endurance or daily function.

Here are a few suggestions on how to improve or get more out of a “stale” exercise program.

Step one is to build an exercise program that is grounded in the basics. Next, Step two, which begins after the basics have been mastered, includes the components necessary for a healthy mind, body and spirit connection and translates into functional activities of daily living including work and leisure sports.

STEP ONE: CARDIOVASCULAR, STRENGTH, FLEXIBILITY

Make sure your routine has all three fundamental components of a well-balanced exercise program:

  1. Cardiovascular
  2. Strength
  3. Flexibility Training

While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED. A well-balanced program includes what you like and need!

In fact, recent studies show that those performing all three components surpassed those performing one or any combination of two of the training types when tested for efficient:

CARDIOVASCULAR EXERCISE

Cardiovascular exercise is any activity that raises your heart rate and respiratory rate. This type of exercise strengthens the heart muscle and the muscles that assist in breathing. When these muscles are stronger, they in turn work more efficiently to deliver oxygen to your muscles and other parts of the body. Ultimately, these oxygenated muscles can work harder and longer to burn fat during exercise and at rest.

  • Examples of Cardiovascular Exercises: 
    • Running
    • Brisk Walking
    • Swimming
    • Biking
    • Rowing
    • Elliptical Training
    • Stepper Training

*Most experts recommend at least 30 minutes of sustained cardio, 3-4 days per week. However, recent studies support the notion of performing 10-15 minutes, twice daily, 4 days per week. For those “stuck” in a fitness rut, to advance your program, cardio should be performed 5-6 days per week for 45-60 minutes.

Improving a Cardio Exercise Program:

STRENGTH TRAINING EXERCISE

Strength training is an activity that provides any type of resistance to muscle contraction to build strength in the muscle. The resistance can be without movement against an immovable object such as pushing against a wall (isometric) or with movement such as lifting up or lowering a weight down against gravity (isotonic/dynamic). There are two types of isotonic muscle contraction; concentric, which involves raising the weight against gravity as the muscle shortens and eccentric which involves lowering a weight against gravity as the muscle lengthens.

A standing biceps curl is an example that incorporates both concentric and eccentric contractions. A progressive strength training program includes all three types of muscle contraction. By using the classic bicep muscle curl these photos will demonstrate all three types of muscle contraction:

Isometric Bicep Muscle Curl – pull up on door knob without allowing any movement of the arm.
Concentric Bicep Muscle Curl – raise a dumbbell up against gravity as the muscle shortens.

Eccentric Bicep Muscle Curl – lower a dumbbell slowly (4-6 seconds) against gravity as the muscle lengthens.

Improving a Strengthening Exercise Program:

Sources: National Institutes of Health; American Council on Exercise

Model: Heather Holzman

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Read Stuck in an Exercise Rut…Part II of II!

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 Geisinger Commonwealth School of Medicine

For all of Dr. Mackarey's articles visit: Mackarey's Health and Exercise Forum!