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Dr. Mackarey's Health & Exercise Forum

One positive outcome of the home confinement during the pandemic is that many people are spending more time than usual getting fit. However, when it comes to exercise, like many things, there is a right way and a wrong way to do it. And, as with many topics in the health and fitness world, there are many, many misconceptions about exercise. Here are my top ten most common exercise myths!

  1. No Pain, No Gain.

FALSE – Why 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.

FALSE – This is not always the best advice

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.

FALSE – Depends on your hormones

It is very unlikely that women and pre pubescent 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

FALSE – 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.

FALSE – The research on this topic does not support it

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.

FALSE – There is no evidence to support this…but it supports the opposite.

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

FALSE – Not unless you are planning a killer workout

The number one reason most of us exercise is to lose or control body weight. With this in mind, 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

FALSE – 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

FALSE – Don’t tell that to competitive swimmers

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 weight lifting 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.

With this in mind, 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. If You Never Stop Exercising than you won’t have to adjust your exercise program as you age.

FALSE - Why 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 in order 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.

For more myths about exercise check out this youtube video! https://www.youtube.com/watch?v=yWLVsTWPcY0

For more of our Scranton Times articles check out our Health and Exercise Forum page: https://mackareyphysicaltherapy.com/forum/

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.

Guest Columnist: Catherine Udomsak, DPT

Dr. Catherine Heimrich, PT, DPT
Dr. Catherine Heimrich, PT, DPT

Read Part 1 here...

Patients frequently ask me about the merits of yoga, from relaxation to flexibility. Many say, they are too busy or they don’t know enough about it. Well, in light of the fact that everyone has been forced to spend more time indoors, slow down and try new things, now may be a good time to try yoga.

It is hard to believe that yoga, which is now a cultural mainstay, was once considered a foreign practice.  An ancient discipline that totes numerous health benefits, yoga is meant to cultivate inner peace, enlightenment, and a strong relaxed body. In the past, only major cities housed yoga studios but over time yoga has spread into small towns across the country.  Studios offer a variety of classes and each promotes their own unique philosophy. Whether you are looking for a new workout regime, compliment to your current program or simply to quiet your mind in a hectic world, yoga may be an option for you. 

What is yoga?

Yoga is a discipline that developed over 5,000 years ago and is generally recognized as an ancient system for wellbeing. The word yoga, from the Sanskrit word “yuj”, literally means to yoke or to bind together.  The primary focus of yoga is to harmonize or unite the mind, body, and spirit through a combination of poses, breathing techniques, and meditation. 

Where did it come from?

The specific origin of yoga is a topic of debate.  However, it is said to have originated in India and was brought to the Western world by yoga gurus in the late 19th and early 20th centuries. The basis for most current yoga practices is The Yoga Sutras of Patanjali.  In The Yoga Sutras, eight limbs of yoga are specified. The three most common limbs are meditation, pranayama or breathing exercises, and asana which are the physical poses.  Yoga classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures. 

Types of Yoga

There are numerous styles of yoga.  If you are a newcomer, deciding on a yoga class may be difficult.  It is always a smart idea to call a studio before attending a class to gain information and have any questions answered.  Furthermore, if you have any health concerns you may want to consult your doctor prior to trying a new form of exercise.  Some common forms of yoga include but are not limited to: 

Hatha - Hatha yoga is a general broad-based term referring to any type of yoga that teaches physical postures. Typically, one will find Hatha classes to be slow and gentle and a great option for beginners. 

Vinyasa - This type of yoga focuses on the coordination of breath with movement. In Vinyassa yoga classes you can expect a continuous flow of movement from one posture to the next.  Classes can be fast paced and are often appealing to those looking for a more strenuous workout.

Iyengar - Unlike Vinyassa, this type of yoga focuses on holding postures for a period of time to bring the body into it’s best alignment.  If you attend this type of yoga class you can expect to use props including yoga blocks, blankets, and straps. 

Ashtanga -  This type of yoga follows a specific sequencing of postures. This rigorous form of yoga always performs the same postures, in the same order at each class and is typically fast paced. 

Bikram - Typically performed in rooms heated to 105 degrees Fahrenheit and 40% humidity, the heat warms muscles and allows a deeper stretch. The difference between Bikram and Hot yoga is that Bikram follows a specific sequence of 26 poses from which hot yoga often deviates. 

Yin Yoga - This meditative practice is perfect for those who want to calm their mind. In this type of yoga, poses are held for 5 minutes or longer.  The purpose is to apply a deep stretch to the connective tissue (the tendons, fascia and ligaments) to improve flexibility. 

Restorative - Best for those who want to focus on relaxing and taking some time to slow down. Most restorative yoga classes will be slow moving with longer hold times to allow deep relaxation.   

Basic Yoga Poses

Below you can find a few common yoga poses or asanas that can be found in beginner classes.  These poses promote flexibility and strength and can be incorporated into your everyday workout routine. Remember, before you attempt the poses, begin by walking, biking or running to warm up. Don’t overstretch, perform slowly, and hold the position. You should feel  mild discomfort NOT pain.

Choosing a Yoga Studio

There are a lot of options when it comes to where to start to practice yoga. It is important that the studio you choose employs certified yoga instructors who have completed comprehensive training.  A good instructor can make all the difference in your yoga experience. The studio should provide a clean environment and offer a variety of classes including beginner level if you are a newcomer.  The best way to get a feel for a studio is to stop in for more information.  You may want to ask about pricing as there are often discount introductory rates.  Ask about rentals if you do not own a yoga mat and request to see the space.  Some yoga studios have a strong sense of community while others are more like a gym. Try out a few different places until you find a fit for you.

Guest Columnist: Catherine Heimrich, DPT is a doctor of physical therapy and is an associate at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton, where she works with outpatient orthopedic and neurological patients. She has a special interest in vestibular and balance problems. 

Model: Sarah Singer, PTA

Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.

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. 

Paul J. Mackarey, PT, DHSc, OCS

A healthy immune system may be the difference between recovery from illness and dying. While you may not be able to improve an otherwise healthy immune system, you can take steps to maintain its health and integrity. Exercise is one of the best ways to maintain a healthy immune system.

With the closing of fitness centers, school gyms and exercise classes due to COVID-19, it may be a good time to begin a home exercise program that is quick and easy. For some, home exercises can be done before or after working from home to gain or maintain muscle tone. For others, home exercises may help maintain independence and safety performing daily activities around the house such as; climbing stairs, getting in and out of a shower, putting on shoes and socks, cooking, cleaning, and carrying groceries or laundry. 

I have comprised 10 simple exercises including upper and lower body and balance and core. The only equipment you will need is a chair and resistance bands; yellow has the least resistance, black the most, red, green, blue in between. They can be purchased at any sporting goods or department store.

Remember, for most people it is more harmful not to exercise, so contact your physician to discuss whether independent exercise is appropriate for you. If you have special needs, you may need to consult with a physical therapist to get started. Good luck…I hope this helps you survive the COVID-19 quarantine!

Sitting Exercises with Resistance Band

These exercises are performed while sitting in a chair with a backrest, slowly. Hold the position for 3 seconds. Perform 5 -10 repetitions. Do these exercises 3-5 times per week. Begin with a yellow light resistance band. 

Row the Boat (PHOTO 1)

Saw Wood (Photo 2)

Elbow Extension (Photo 3)

Hip Spread (Photo 4)

Hip Hike (Photo 5)

Leg Kicks (Photo 6)

Standing Exercises with Resistance Band:

Shoulder Shrug (Photo 7)

Elbow Bend (Photo 8)

Standing Leg Curl (Photo 9)

Standing Walk Aways  - Backward (Photo 10)

Standing Walk Aways  - Forward 

Visit your doctor regularly and listen to your body.      

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

Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.

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. 

Paul J. Mackarey, PT, DHSc, OCS

The human body is designed to defend against foreign bodies such as germs, bacteria, and viruses, including COVID-19. A healthy immune system may foster a speedier recovery from illness. While you may not be able to improve an otherwise healthy immune system, you can take steps to maintain its health and integrity.

A healthy immune system protects us by creating a barrier that stops invaders or antigens, from entering the body. When an unwelcome invader slips through the barricade, the immune system responds by producing white blood cells and other chemicals and proteins that attack the foreign substances.

10 Tips to Maintain a Healthy Immune System

  1. Don’t Smoke – it is obvious why this tip is critically important 
  2. Eat a Mediterranean Diet – high in fruits and vegetables, fish/seafood, nuts, seeds, legumes, extra virgin olive oil and minimal amounts of red meat.
  3. Maintain a Healthy Body Weight – body mass index (BMI) between 18.5 and 24.9 is healthy. To calculate your BMI: www.nhlbi.nih.gov
  4. Drink Plenty of Water … and Drink Alcohol in Moderation 
  5. Get Adequate Sleep – 8 hours is a good goal but if not possible, supplement with a daytime nap
  6. Practice Good Hygiene – Avoid infection by washing hands often and thoroughly. Flossing and brushing your teeth is also important
  7. Prepare Foods Properly - clean meat/fish cutting surfaces and cook food thoroughly
  8. Limit stress and Be Positive - make time to reflect and meditate and, when possible, avoid people who “suck the oxygen out of the room!” YouTube “Progressive Muscle Relaxation” for easy to use relaxation techniques
  9. Be Active – physically and mentally – keep your body and mind moving and when possible spend time outdoors and enjoy the natural beauty of NEPA
  10. Exercise – BUT DO NOT OVER EXERCISE! While exercise is an essential part of a healthy immune system, over exercise can weaken your immune system. In fact, many marathoners report a mild fever and flu-like symptoms after running the 26.2 mile race.  

Prevent Cabin Fever While Confined to Your Home 

Is there a secret to a long and healthy life? Do genes control our destiny? How does lifestyle impact our health? According to the National Institutes of Health (NIH), while genes play an important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.

To maintain a healthy immune system, physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to longevity. Most experts agree that moderation is important. If you overindulge with exercise you will be at greater risk for musculoskeletal injuries. This is especially true for those who are newcomers. The goal is to gradually work into a fitness program and maintain it for life…now, during home confinement; it may be a good time to begin.  

Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:

    Simple suggestions for beginning an exercise program at home

Sources: WebMD.

     Visit your doctor regularly and listen to your body.      

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

Next Week: Learn some simple home exercises using Resistance Bands.

Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.

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. 

Prevention of Shoulder Injuries in Tennis: Strengthening. Part 1 of 2

HAPPY MEMORIAL DAY! You can tell that summer is in the air, not only by the arrival of the sunshine, warm air and longer days, but also by the beautiful sound of a tennis ball hitting a racquet hitting at Scranton Tennis Club and Birchwood Racquet and Fitness Club. So, get your racquets out and join the fun! However, take time to “tune up” in order to prevent injury, especially to the shoulder. In a sport that relies so heavily on the use of the shoulder, it is very common for tennis players to develop occasional shoulder pain or a more chronic problem such as shoulder rotator cuff tendinitis. That is exactly what happened to professional tennis star, Maria Sharapova and many others over the past few seasons.

For many, tennis is more of a seasonal sport. For example, in high school it is played in the fall for girls and spring for boys. In the off-season, a shoulder can lose much of its essential strength.  This loss will result in a deconditioned shoulder at the start of the season and making it more susceptible to injury.  Practicing with a deconditioned shoulder commonly results in sprain, strain and pain.  Pain and weakness will significantly interfere with the ability to perform at a high level.

To prevent shoulder problems, one must participate in an exercise program specifically designed for tennis. A well-balance shoulder strengthening program includes rotator cuff and scapular (shoulder blade) muscle exercises, reeducation, biomechanics, and a stretching program pre and post hitting. This column will discuss some of these principles to properly prepare your shoulder for the tennis season and avoid injury.

STRENGTHENING EXERCISES FOR TENNIS

To avoid shoulder pain it is necessary to maintain shoulder strength. Stretching exercises are also important and will be discussed in next week in, Prevention of Shoulder Injuries in Tennis - Part II. Strengthening exercises need to concentrate on three groups of muscles: power muscles (the large muscles of the shoulder), shoulder blade stabilizer muscles (the muscles which stabilize the shoulder blade, and the all important rotator cuff muscles (the muscles which move the shoulder and control the cocking and follow through phases of the tennis stroke, while keeping the joint in proper position).  Strengthening the power muscles of the shoulder is fairly easy; latissimus pull downs, pectoralis bench presses, and bicep curls will cover all bases.  While these exercises are important in maintaining strength and power of the throwing shoulder, they are not as important as the exercises for the shoulder stabilizers and rotator cuff muscles.

PHOTO 1 - Rotator Cuff Internal Rotation (Tennis Forehand Stroke): Holding a light or medium resistance band, imitate a forehand stroke with slight bend in the elbow…can be performed with band tied to tennis racket.

PHOTO 2- Rotator Cuff External Rotation (Tennis Backhand Stroke): Holding a light or medium resistance band, imitate a backhand stroke with slight bend in the elbow. can be performed with band tied to tennis racket.

PHOTO 3- Latissimus Pull downs – Kneeling or sitting:

PHOTO 4- Bench Press - Lying on back with knees bent

PHOTO 5- Biceps Curls - Sitting or standing

Models: Katherine Weaver, SPT & Lauren Calvey

Visit your doctor regularly and listen to your body.

Contributor: Gary E. Mattingly, PT, PhD: Professor Emeritus, University of Scranton, Dept. of Physical Therapy

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune. Part 2 “Prevention of Shoulder Injuries in Tennis” 

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.