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Despite a recent surge in Covid cases from the new variant, more than 70 percent of Americans anticipate high levels of enthusiasm for travel this summer. Moreover, travel abroad in 2022 is expected to exceed pre-pandemic levels, as isolation weary Americans take to the air!

Confession; I recently was on a long trip that required sitting on an airplane for more than six hours…and I wore compression stockings … guess I’m getting older (and wiser)!

Have you noticed that being in a car or on an airplane for more than three hours leads to neck and back pain? Soreness, stiffness and swelling in your legs? With a little planning preventing or limiting these problems on long trips, is possible. Also, as people age and/or develop other health problems, they are more vulnerable to develop a more serious problem associated with long trips; deep vein thrombosis (DVT) or blood clots. But problems from long-distance travel can be avoided. The following tips, based research and personal experience, can prevent neck, back and leg pain and stiffness and DVT.

Deep Vein Thrombosis  (DVT)

A DVT is a blood clot that forms in a deep vein. The deep veins pass through the muscles and cannot be seen like the veins just under your skin. While it may occur in your arms, it is much more common in the legs, especially the calf muscle when traveling. When a blood clot forms in a leg vein it usually sticks to the vein wall. Often, pain and swelling lead you to the doctor and treatment is rendered before serious complications develop. However, there are two possible complications. One, a pulmonary embolus, occurs when a part of the clot logged in your deep vein of the calf breaks off and gets lodged in the lung. This is a very serious problem that can be fatal. Two, post-thrombotic syndrome, occurs when you have pain and swelling in the calf after a DVT.

Risk Factors for Travel Related DVT?

The following risk factors for DVT significantly increase the potential for problems when traveling on long trips by air more than 5 hours. Trains, cars and buses also create a risk, but air travel creates a greater risk for the following reasons: reduced cabin pressure, reduced cabin oxygen levels, dehydration and alcoholic drinks, which may increase dehydration and immobility.

health

Risk Factors For Travel Related Neck and Back Pain

Prevention of Travel Related DVT and Leg Pain/Stiffness

Prevention of Travel Related Neck and Back Pain

Airplane seats are “C” shaped and force you to round your neck and back forwards. These exercises are designed to stretch and extend your back in the opposite direction. Please perform slowly, hold for 3-5 seconds and repeat 10 times each hour.

Sitting

When sitting in an airplane seat, take the neck pillow in the overhead compartment and place it in the small of your lower back. While sitting or standing up, perform postural exercises every 30-45 minutes.

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.

Part I or II

May is National Bike Month! In fact, Saturday, May 7, 2022 Lackawanna Heritage Valley’s Heritage Explorer Bike Tour is returning in person for the first time since 2019. For those who have a bike, now might be a good time to dust it off and enjoy the many beautiful and well-maintained trails that are available at the Countryside Conservancy at Lackawanna State Park, other locations in the Abingtons or the Lackawanna Heritage Valley Authority. For those who don’t have a bike, it might be a good time to get one!

WHY BIKE?

There are many obvious reasons to bike…cardiovascular fitness, burn calories, improve leg strength and others. But, the real question is, “what are the advantages of biking over other forms of exercise?” Glad you asked…

BENEFITS OF BIKING:

  1. INEXPENSIVE – while not as cheap as running, biking can be much cheaper than other sports. Starter bikes can be less expensive than high end running shoes.
  2. EASY – most people can learn to ride a bike. Kids begin with training wheels and adult tricycles are available.
  3. FAMILY FUN – something the whole family can enjoy in your neighborhood, at the beach or on one of the trails.
  4. PRACTICAL EXERCISE – it is an opportunity to exercise while traveling to work, store, lunch etc…bike it!
  5. CARDIOVASCULAR FITNESS – good for the heart and all that goes with it: burns calories, lowers blood pressure, lowers LDL, and elevates HDL and boosts the immune system.
  6. LEG STRENGTH – pedaling a bike is a great way to improve leg strength.
  7. CORE STRENGTH – core muscles of the neck, middle and lower back and the associated arm strength will improve while biking in order to maintain your torso on a bike on hills and turns.
  8. IMPROVES BALANCE/COORDINATION/FALLS PREVENTION – riding a bike requires some balance and coordination and therefore will improve balance as a form of falls prevention.
  9. GOOD FOR YOUR JOINTS – bike riding only requires partial weight bearing to the spine and lower body joints so it is more comfortable and gentle to your joints than walking or running. For this reason, it is often recommended to pregnant women suffering from leg or lower back pain as a safe alternative to running.   
  10. MENTAL WELLNESS – biking, like all aerobic exercise, is a great source of stress management as it releases endorphins and serotonin which improves mental health. With the added feature of being outdoors in the sunshine and fresh air, biking keeps you smiling!

INJURY MANAGEMENT:

Prevention is the best management of musculoskeletal problems associated with biking. First, many of the problems associated with biking such as knee pain, buttock soreness, and tendonitis can be prevented through proper fitting. Furthermore, it is important that your equipment be in good working order such as tires, chain, brakes and pedals. Next, be sure to maintain a fairly good fitness level in order to bike safely. If you are a beginner, start slowly. Warm up and slowly bike for 10 to 15 minutes and build up over time. Practice the coordination of stopping, starting, shifting and braking. Work on good strength and flexibility of the hamstrings, quadriceps, calves and gluteal muscles. All of these muscles are necessary to generate pedal force. Balance is also important to safety and can be practiced on and off the bike. Be aware that adaptive equipment can modify your bike for added comfort and safety such as soft handlebar tape, seat post and front fork shock absorbers, padded biking shorts, c-out and gel pad saddle seats, and wider tires.

Be careful not to progress too quickly because inactivity to over activity in a short period of time can create problems. Overuse injuries such as tendonitis, can be avoided by cross training. Bike every other day and walk, run or swim on off days. Make sure to take time off to recover after a long ride. Use ice and massage to sore muscles and joints after riding.

Remember, cycling should be fun! Pain from improperly fitted and poorly maintained equipment is preventable. Excessive workouts and training rides should be kept to a minimum and consider cross-training in between.  

SAFETY:

EQUIPMENT: Helmets are a must! Also, keep your bike in good condition. Road bikes should have mirrors and reflectors. Use hand signals and obey traffic rules. Dress for weather and visibility. Have a first aid and tire patch kit, tire pump and tools. Seat comfort can be improved with gel cushion or split seat.

BE ALERT: for traffic, parked cars, pedestrians loose gravel and cracks in the road. 

SOURCES: American Physical Therapy Association

Health Benefits of Dancing

The last two columns in “Health & Exercise Forum” have been dedicated to the health benefits of exercise for Parkinson’s disease. Specifically, the use of dance was featured as a method to promote strength, balance, coordination and agility in this population. However, dance as a form of exercise and for the promotion of balance, coordination and agility, is not limited to those with neurological conditions…it is beneficial for everyone! In fact, my wife, Esther and I, have always enjoyed our dance classes with Vince Brust!

Like most forms of exercise, if done regularly, dance can have multiple health benefits. If dance is your only form of exercise, make it your goal to sustain the activity for about 30 minutes a day, 3-4 days per week for the most value.

If you have any doubt or reservations about the ability of dance to improve your health and wellness, take notice of the muscle tone, flexibility, agility and coordination of a professional dancer...ballet, modern, hip hop, jazz, etc. They are incredible athletes and artists!

10 Benefits of Dancing

1. Improved Agility and Flexibility

It is common to lose agility and flexibility with age especially if you regularly perform the same limited movements throughout your day and lifetime. This will lead to stiffness and lack of flexibility, especially for new or season activities which can make you more vulnerable for injury and pain. Lower back pain and calf or hamstring strains are most common. Research suggests that dance can help.

For example, in one study it was found that cross-country skiers who received months of dance training showed improvements in joint mobility and muscle flexibility of the spine, as well as their speed and agility.

2. Balance and Coordination

It is also expected that balance and coordination are also compromised with age. It’s one of the reasons that older adults are so prone to falls. The research also supports the value of dance to offset this problem.

One particular study found that in people over the age of 80 years, social dancing helped improve balance and walking speed, as well as contributing to a more stable walking pattern.

3. Cardiovascular Health

Moderate-intensity dance, performed continuously for at least 30 minutes on a regular basis has been found to reduce the risk of death from cardiovascular disease in some studies. Moreover, it has been more effective in prevention than average-pace walking ...and is less boring!

4. Muscle Tone and Strength

Most activities of daily living (walking, climbing stairs) occur in a linear and forward directon. However, dance has not set direction and can move in multiple planes (forwards, backwards, and sideways with diagonal and rotational components.

These unlimited movements, not only improves agility, coordination, and balance, but also strengthens muscles that often get forgotten like your core and abdominals.

5. Weight Loss and Maintenance

As with any cardiovascular exercise, dance is a form of aerobic exercise which burns calories. This is especially true if performed a minimum of moderate-intensity for 30 minutes or longer.

According to the American Diabetes Association, aerobic exercise can support weight loss.

6. Osteoporosis Prevention

Weight-bearing exercise is the cornerstone for any osteoporosis prevention program and dance is a prime example.

According to the National Osteoporosis Foundation, high-impact, weight-bearing exercises, such as certain forms of dance, can help maintain bone strength and even build new bone mass. This slows the development and progression of osteoporosis. It is also well established that low-impact weight-bearing exercise (dancing with the impact of jumping etc.) is effective in bone loss prevention. Dance can be whatever intensity you want it to be, depending on your mood, energy level, and physical limitations.

7. Learning, Memory and Cognition

Like most forms of exercise, especially aerobic, dance can improve cognitive health. In addition to releasing special hormones, it can also improve circulation and oxygenation to the brain to enhance brain health.

Some research suggests that dance can help create new connections between brain regions involved in long-term memory and improve mood, cognitive acuity and mental energy.

Physicians and physical therapists often recommend dance as a form of rehabilitation following brain injury, stroke or dementia.

One study found that out of many different types of exercise (including dance, swimming, golf, cycling, tennis, and others) dance was the only one associated with a lower risk of dementia for people in the study. Experts believe the benefit was due to a combo of social interaction and mental focus...that is not to say that the aforementioned types of exercise do not have value.

8. Emotional and Mental Health

Dancing can contribute to your mental health by improving mood and reducing stress. As Morrie advised in Mitch Albom’s best-selling book, Tuesdays with Mori, “dance like nobody’s watching”...it can be very invigorating!

Dance participants ranked mood enhancement as the number one reason for participation! One study examining people’s motivation for dancing, “mood enhancement” ranked top on the list.  The dancers felt that the activity is expressive and allows you to escape and “let your hair down.”

Some studies also suggest that dance therapy might also reduce depression, especially in those who have serious illnesses, such as breast cancer or Parkinson’s (read last week’s column). Researchers feel that this may be due to increased endorphins and lower cortisol levels.

9. Socialization

The pandemic has taught most of us a valuable lesson ... some of us have a serious need to socialize and some do not. For those like me, who thrive on being among others, dance classes and dance-style workouts often take place in groups, which allows for social bonding in a fun, light and breezy environment.

Depending on your marital status and the specific style of dance you choose (salsa, tango or swing dancing), you may even be paired up with a partner every week!

10. Boosts self-esteem

While exercise on treadmill, bike or elliptical can be great exercise, it also can be boring and repetitive. Research suggests that any form of exercise can boost self-esteem.

When dancing, however, you get all the benefits of exercise, while simultaneously learning a new skill. It can be incredibly rewarding and satisfying to master the skill, especially with others such as learning the tango.

SOURCE: “Greatest”  Debra Sullivan, Ph.D., MSN, R.N., CNE, COI

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.comPaul 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 GCSOM.

For all of Dr. Mackarey's articles visit www.mackareyphysicaltherapy.com/forum

Dance Like Nobody’s Watching!

“Dance like nobody’s watching!” This is one of my favorite quotes from Mitch Albom’s book, Tuesdays With Mori, because it represents interesting facts about human behavior. One, of course, is the ability to be comfortable in your own skin. The other, maybe less obvious benefit is that challenging your balance through dancing, even if it’s not pretty, is very effective in maintaining or improving quality of life for those with challenges in gait and balance, as found in Parkinson’s disease (PD). In fact, “Dance for PDR”, a new and popular treatment for PD, has recently been validated in the scientific literature as a valuable treatment tool for those with PD. 

Research published in the Journal of Neural Transmission, shows that dancing is shown to help people with PD improve their ability to walk and enhances their quality of life. The program was applicable to those at various stages of PD, including those using walkers. Moreover, the results found that, in addition to physical improvements, participants also had psychological and social benefits through camaraderie, joy of movement and less isolation.

Participants, none of whom had ever engaged in a dance class before, performed a structured dance program for 16 sessions over 8 weeks. Each class was 75 minutes long with seated warm-up activities 50% of the time.  Results showed: 10%improvement in overall movement, 26% improvement in walking and 18% improvement in tremor.

Parkinson’s disease is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD.  PD typically affects those over 65 years of age and only 15% are under 50.

While there is no current cure for PD, exercise is well documented to relieve some of its symptoms. Specifically, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing, but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise may benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.  

Exercise to improve strength, balance, and flexibility can be performed independently at home or supervised at a rehab or exercise facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi. Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. PT can also incorporate leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Tai Chi, a total mind and body workout, is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.

According to Dance for PDR,their programoffers internationally acclaimed dance classes for people with Parkinson’s disease in Brooklyn, New York and, through a network of partners and associates, in more than 120 other communities and 16 countries. In Dance for PD classes, participants are empowered to explore movement and music in ways that are refreshing, enjoyable, stimulating and creative. For more information visit: www.danceforpd.org

So, if you like to dance, “keep on dancing!” If you don’t dance and notice some changes in balance and coordination, or if you have PD…it’s a good time to start!  “Dance like nobody’s watching!”

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 www.mackareyphysicaltherapy.com/forum

April is National Parkinson’s Awareness Month

Part I of II

Parkinson’s disease (PD) is a chronic, degenerative disease that leads to slowness of movement, balance disorders, tremors, and difficulty walking. PD results from the loss of dopamine-producing nerve cells in the brain. Dopamine is critical to stimulate the nerves of the muscular system in the body. PD affects approximately 1.5 million people in the USA with 60,000 new cases each year according to the National Parkinson Foundation. Most people know someone affected by PD.  PD typically affects those over 65 years of age and only 15% are under 50. However, actor, Michael J. Fox brought national attention to the disease in 1991 when he was only 30 years old. Juvenile Parkinson’s, those diagnosed under the age of 40, is rare and only represents 7% of all those with PD.

While there is no current cure for PD, exercise can relieve some of its symptoms. Although PD affects an individual’s ability to move, exercise can help keep muscles strong, joints mobile, and tissues flexible. Exercise will not stop PD from progressing, but it will improve balance, enhance walking ability, reduce muscle weakness, and minimize joint stiffness. In 2007, a study published in the Journal of Neuroscience revealed that exercise will benefit individuals with PD because exercise encourages the remaining dopamine cells to work harder to produce more dopamine. Also, the researchers discovered that exercise decreases the rate at which dopamine is removed from the brain.  

Depending on the stage of the disease and the level of assistance required, exercise to improve strength, balance, flexibility and ambulation for those with PD, can be performed independently at home or supervised at a rehab or fitness facility. Supervised exercise can include physical therapy, recreational therapy, water therapy, yoga, and Tai Chi… AND DANCE! Physical therapy can improve walking ability, enhance balance, reduce fatigue, increase strength, promote flexibility and minimize pain. Physical therapy uses movement techniques and strategies as well as various pieces of equipment to enhance an individual’s level of independence and improve his quality of life. Recreational therapy incorporates leisure activities (e.g. golfing and ballroom dancing) to reduce the symptoms and associated limitations of PD. Recreational therapy adapts these activities to meet the specific needs of the person with PD. The modified activities are taught by professionals who have significant knowledge and experience in this area. Water therapy is especially helpful to people with PD because the water provides enough buoyancy to lessen the amount of balance required to perform essential exercises. The cushioning effect of the water allows for freedom of movement while providing the appropriate level of resistance necessary to achieve the desired results. Using a combination of physical and mental exercises, yoga promotes flexibility, reduces stress levels, and increases stamina and strength in individuals with PD. Tai Chi, a total mind and body workout, and is a series of individual dance-like movements linked together in a continuous flowing sequence. Particular benefits for people with PD include reduced stress, increased energy, improved concentration and focus, better circulation and muscle tone, and significant improvements in balance.

If you choose the convenience of a home exercise program, consult your physician or physical therapist for recommendations regarding: (1) the types of exercise best suited for you and those which you should avoid, (2) the intensity of the workout, (3) the duration of your workout, and (4) any physical limitations you may have.

The type of exercise that works best for you depends on your symptoms, fitness level, and overall health.  Your exercise program should address not only strength but also flexibility and endurance and should include all body parts: face, mouth, neck, torso, arms, legs, hands, and feet. Some general exercise suggestions include:

Since individuals with PD are at risk for falling and freezing (becoming rigid), work out in a safe environment and, if possible, when someone is present. Avoid slippery floors, poor lighting, throw rugs, and other potential dangers (e.g., watch out for the pooch because he might want to join in the fun).  If you have difficulty balancing, exercise sitting down, lying on the bed or within reach of a grab bar or securely installed rail. Stop and rest if you feel tired during your exercise program since overexertion can make your PD symptoms worse.

Contributions: Janet Caputo, DPT, OCS,

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part II of II: Dance for Parkinson ’s Disease.

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.comPaul 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: http://www.mackareyphysicaltherapy.com/forum

Exercise is Important in 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 150,000 new cases of colorectal cancer in 2021. Of these, 52,980 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.

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:

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.

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.

Spring is just around the corner so it is time for running enthusiasts to lace up their sneakers, get outside and run! Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. For example, the caloric expenditure while running is higher than for most other exercises, including biking. Also, it allows for fresh air and beautiful scenery with a minimal investment in clothing or equipment.  It requires little skill and time to learn. Runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphine release (natural chemical in the brain associated with euphoria and pain control) that is greater than found in other sports and activities. These are some of the motives that cause people to run every day, in spite of the constant loading and wear and tear on the joints.

To be a competitive runner and have longevity in the sport, optimal form is necessary. Moreover, a recent study shows that a runner can decrease the stresses on the lower body and reduce the incidence of stress fractures when trained to run with proper form using visual feedback while on a treadmill. The application of this information has significant implications for training programs for runners for the prevention and recovery from injury. One such low impact method is called the “Pose Running Technique,” by Dr. Nicholas Romanov. It is a “soft landing” method which promotes; an S-like body position with slightly bent knees, a slightly forward lean at the ankles to employ gravity and momentum, lifting the feet up under the hips, and landing on the ball of the foot under the body to absorb the center of mass.

It is my opinion, that the best runners, with the least injuries, such as Jordan Hoyt, speedster from Abington Heights, employ these techniques naturally. Additionally, many of the world’s best runners use coaches and trainers to assist them in their quest for success and injury prevention by using perfect form. However, for the rest of us, we must learn to maximize the efficient use of the body as it works with, not against gravity. We must learn to run “soft” to prevent injuries.

PROPER FORM

Head Position

A slight upward tilt of the head to allow a view of the horizon ahead should be most comfortable. Avoid looking down or up to extremes. Do not rock or rotate the head while running.

Shoulder Position

Loose and relaxed shoulders set the tone for a good run. Keep them level without tilting side to side or rotating left to right.  Avoid holding the shoulders in a tight and high position.  

Arms

Loose and relaxed arms also set the tone for a good run. A good arm swing is always in forward motion in a linear direction and stays between the waist and lower chest. Never clench the fist. Do not rotate or twist the arms across the body.

Torso

If the head, shoulders and arms are in correct position, then the torso will be upright. An erect running posture is necessary to promote efficient movement and breathing. The posture that you assume when taking a deep breath is the correct torso position for good breathing while running. 

Hips

The hips will follow the position of the parts above in a linear forward direction. However, if the torso leans forward because the head hangs down then the hips will tilt downward. If the arms swing and torso rotates side to side, then the hips will also rotate.

Legs/Stride

Sprinters need to lift the knees high to thrust the lower legs forward. Long distance runners cannot maintain a high knee lift for a long period of time, however, a slight knee lift with a shorter but quicker stride is more efficient. Proper running requires the foot to softly strike the ground with the knee slightly bent. If the knee is fully extended in front of the body upon impact, the stride is too long and the force too great.

Ankles/Feet

To excel as a runner, when the foot hits the ground it should land lightly, between the heel and the midfoot. The ankle is flexed and rolls quickly forward to the toes to push off the ground with maximum force. The calf muscle propels the runner forward. Efficient running has a quiet and springy landing. A loud foot slap on impact is a sign of poor form and results in excessive force transferred to the lower leg. The foot should spend as little time as possible in contact with the ground…thus a soft runner “floats” when they run.

SOURCES: Runner’s World, Pose Running Technique (www.posetech.com), Journal of Orthopaedic and Sports Physical Therapy.

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.

Injuries due to falling are a very common problem in the elderly. Hip fractures are the most common injury due to falling in the seniors. According to the American Academy of Orthopaedic Surgeons, each year more than 300,000 people are hospitalized for hip fractures in the United States. These fractures represent 72% of all fracture costs, totaling more than 12 billion dollars in 2005 and, not surprisingly, 90% occurred in those 65 and older. Most hip fracture patients who previously lived independently will require family assistance, home or long term care and 50% will require a cane or walker.

A recent study by the American Physical Therapy Association found that patients benefited from a physical therapy evaluation to determine their risk level for falling. If a high-risk level is found on a falls assessment, physical therapy interventions can be successfully employed to improve strength, balance, and coordination and falls prevention. Also, a well-balanced diet, exercise, Calcium with vitamin D supplements and medications can help prevent or retard osteoporosis and prevent hip fractures.

Exercises to Prevent Hip Fractures

***Always perform slowly, alternate right and left sides, limit other distractions and concentrate on the exercise to retrain the brain, 10-20 times each 2-3 times per day.

***Caution: Do not do standing exercises without assistance or supervision if needed

Standing Hip Hikes (photo 1)

Face a countertop and hold onto it with both hands. Hike your hip and knee up to 90 degrees as if you are marching. Hold the position for 3-5 seconds on one leg and lower slowly. Repeat this on the other leg and alternate 10 times.

Photo 1

Standing Hip Scissor Kicks (photo 2)

Face a countertop and hold onto it with both hands. Lift your leg up 30 degrees as if you are spreading your legs apart. Hold the position for 3-5 seconds on one leg and lower slowly to cross over the middle. Repeat this on the other leg and alternate 10 times.

Photo 2

Standing Squats (photo 3)

Face a countertop and hold onto it with both hands. Bend your hip and knee down to 45 degrees to a squatting position. Hold the position for 3-5 seconds on both legs and return to standing slowly. Repeat this 10 times. Once strong enough try on one leg at a time and alternate.

Photo 3

Chair Squats (photo 4)

Sit in a chair with arm rests. Get out of chair only using your legs. Hold the position for 3-5 seconds and return to sitting. If necessary, use 1 or 2 arms to assist. Repeat this 10 times. Focus on trunk core stabilization and leg strength. Use more leg muscles and less arm muscles as strength improves.

Photo 4

Line Walk (photo 5)

Place a straight line on the floor and practice “walking the line” with the right then left foot on the line.

Photo 5

Single Leg Stance (photo 6)

Hold onto a chair while bending one knee and shifting your weight to the other leg. Hold for 3-5 seconds and repeat with the other leg. Increase time 10 -15 -20 seconds as tolerated.

Photo 6

If you feel you or a loved one may be at risk for falling or a hip fracture, ask your family physician if a physical therapy consultation for a falls prevention program to prevent hip fractures may benefit you.

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 www.mackareyphysicaltherapy.com/forum

6 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 two thousand and TWENTY-TWO! Moreover, I hope you share my sentiments that each year, despite the trials and challenges of the pandemic, each month, week, day, and minute is a gift, not to be taken for granted. 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, in order 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. 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 (in non pandemic years). Unfortunately, if starting an exercise program is the hard part, than sticking to it is the hardest part. And, with the Omicron surge limiting access to indoor gyms and fitness centers, compliance may be even more challenging this year.

Once the initial excitement and enthusiasm wears off, so too 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

Tips to Stick to an Exercise Program

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: mackareyphysicaltherapy.com

Part II of II

You are never too old to exercise! This is the second of two columns dedicated to appropriate exercise for the elderly. Last week I discussed basic strengthening exercises. This column will address three additional components necessary for independence in the elderly: flexibility, balance and endurance. While it may not be as valuable for those fortunate to be over 75 years of age and capable of running, skiing and playing tennis, you may still find a noteworthy pearl of wisdom.

Why would someone 75 or 80 be interested in a basic exercise program? Well, one must maintain adequate flexibility, strength, balance and endurance to safely function in daily activities around the house. For example, the most common goals of elderly patients are: climbing stairs, getting in and out of a shower, putting on shoes and socks, tucking in a shirt or fastening a bra, cooking, cleaning, and carrying groceries or laundry.

Remember, for most people it is more harmful not to exercise, so contact you physician to discuss whether independent exercise is appropriate for you. You may need to consult with a physical therapist to get started.

FLEXIBILITY EXERCISES

Flexibility Exercises involve moving the arms, legs and trunk through comfortable range of motion to give you more mobility in order to improve your ability to perform daily activities such as tucking in a shirt, tying shoes or fastening a bra. Best if performed after strength exercises because the muscles and joints will be warm and limber. Always perform slowly with slight stretch sensation and no pain. No bouncing or over stretching!

Examples of Flexibility Exercises for the Upper Body in Sitting

These exercises are to be performed while sitting in a chair with a backrest, slowly, 5 repetitions, 3-5 times per week.

Examples of Flexibility Exercises for the Lower Body in Lying on Back

BALANCE EXERCISES

Balance Exercises involve strengthening muscles that keep the body upright and stable in standing in order to improve your ability to perform daily activities without falling. According to the NIH, 300,000 US hospital admissions for broken hips occur each year due to falls. Check with your physician if you have a history of dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Always use a countertop or back of chair to hold onto for support.

Examples of Balance Exercises

ENDURANCE EXERCISES

Endurance Exercises involve any activity such as walking, swimming, biking or raking leaves that elevates your heart rate and breathing for an extended period of time. Check with your physician if you have a history of heart problems or dizziness before performing these exercises on your own. Best if performed with someone at home or some assistance. Start off slowly for only 5 minutes and add 1-2 minutes each week or 2. Wear good and comfortable shoes – no heels!

Examples of Endurance Exercises

While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.

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 profession of clinical medicine at Geisinger Commonwealth School of Medicine.

For all of Dr. Mackarey's articles visit mackareyphysicaltherapy.com