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Walk Your Worries Away…and Stimulate Your Creative Brain!

Spring is in the air. The temps are rising and the days are longer, so get outside and walk! Walking can change the world…from Mahatma Gandhi and the Indian independence movement to Martin Luther King, Jr., and the civil rights movement, walking and protest have been interrelated. Moreover, walking has been associated with fostering good health and stimulating creativity. 

Walking is about more than walking and always has been. Walking soothes. Walking inspires and sharpens the mind. WE CAN WALK!

It might be said that with the right mindset, every walk is a pilgrimage. Many breakthroughs has been stumbled upon while putting one foot in front of the other. We run from problems. We walk toward solutions. While working on A Christmas Carol, Charles Dickens would walk 15 or 20 miles through the back streets of London, turning over the plot in his mind as the city slept. Beethoven found inspiration while ambling in the verdant Wienerwald outside Vienna.

Recent studies suggest that walking stimulates our creative mind is at its most creative at three miles per hour, the speed of a moderately paced stroll. Stanford University researchers divided participants into two groups: walkers and sitters. They then administered a test designed to measure creativity. They found that creative thinking was “consistently and significantly” higher for the walkers than the sitters. It didn’t take a lot of walking to boost creativity, either—anywhere from 5 to 16 minutes.

Studies have also shown that people who walk regularly are healthier and live longer than those who don’t. Surprisingly, you don’t have to walk very fast or far to enjoy this benefit. One recent study, published in JAMA Internal Medicine, put the 10,000-step myth to rest. It is an arbitrary number. People—older adults in particular—accrue health benefits by taking only a few thousand steps each day, and at a leisurely pace.

Benefits of Walking

In addition to stimulating creativity and reducing stress, walking has many benefits. “There’s no question that increasing exercise, even moderately, reduces the risks of many diseases, including coronary heart disease, breast and colon cancer, and Type 2 diabetes,” said Dr. Jennifer Joyce, MD, professor of family medicine at GCSOM. “Research has even shown that you could gain two hours of life for each hour that you exercise regularly.”

According to the American Heart Association, walking as little as 30 minutes a day can provide the following benefits:

Like everything, there is a right way of doing something, even walking. For efficiency and safety, walking with proper stride is important. A fitness stride requires good posture and purposeful movements. Ideally, here's how you'll look when you're walking:

Plan Ahead

Set Realistic Goals

Anything is better than nothing! However, for most healthy adults, the Department of Health and Human Services recommends at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity, or an equivalent combination of moderate and vigorous aerobic activity. The guidelines suggest that you spread out this exercise during the course of a week. Also aim to do strength training exercises of all major muscle groups at least two times a week.

As a general goal, aim for at least 30 minutes of physical activity a day. If you can't set aside that much time, try several short sessions of activity throughout the day. Even small amounts of physical activity are helpful, and accumulated activity throughout the day adds up to provide health benefits.

Remember it's OK to start slowly — especially if you haven't been exercising regularly. You might start with five minutes a day in the first week and then increase your time by five minutes each week until you reach at least 30 minutes.

For even more health benefits, aim for at least 60 minutes of physical activity most days of the week.

Track Your Progress

Keeping a record of how many steps you take, the distance you walk and how long it takes can help you see where you started from and serve as a source of inspiration. Record these numbers in a walking journal or log them in a spreadsheet or a physical activity app. Another option is to use an electronic device such as a pedometer or fitness tracker to calculate steps and distance.

Sources: National Geographic; Mayo Clinic

Visit your doctor regularly and listen to your body.

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

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

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

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

(and back, shoulders, etc)...

Germaphobes, cleaning zealots, neat freaks, and those with diagnosed or undiagnosed obsessive-compulsive disorder (OCD), this column is for you! If you would rather clean your bathroom floor than go for a walk on a beautiful sunny day, please read on.  If you use a toothbrush on tile grout on a regular basis and take pride in the sparkle of your toilet bowl than beware… studies show that performing these tasks with too much vigor and passion might lead to back, neck, and shoulder and wrist pain.

For some, and you know who you are, (I am related to a few) spring cleaning can be a particularly exciting sporting event. It is almost an exorcism to rid a home of all its evil spirits, smudges, dust, dirt, germs, and odors. Every April curtains come off the windows to be washed and carpets rolled up, removed and cleaned. The surfaces under the curtains and carpets are sterilized with cleaning detergents, disinfectants and chemicals that would make sterile techniques in most hospital operating rooms seem inadequate. And that doesn’t include the heavy work: moving furniture, bedding, including mattresses and box springs.    

As a physical therapist and survivor of childhood exposure to copious amounts of cleaning chemicals, I have come to learn that there are healthy and safe options for spring cleaning your home. Of course, the most obvious solution is to hire professional help if you can afford it. The other practical solutions are below:

10 Health Tips for Spring Cleaning:

  1. Have a Plan - Take your time
    • It doesn’t have to be done in one day or one weekend!
    • Make a list, follow a schedule and do it over the course of 3-4 weeks
  2. Do Not Move Heavy Furniture or Appliances by yourself
    • Get Help –
    • Use Sliders – to move heavy items like furniture
  3. Be Cautious on Ladders and Stools
    • Falls are a leading cause of injury mortality in the US and 43% of fatal falls have involved a ladder, according to the Centers for Disease Control (CDC).
    • Avoid Reaching or stepping on the top step
    • Open and lock the ladder properly instead of leaning it against a wall
  4. Use Proper Ergonomics
    • Lift Properly – back straight, knees bent
      • Incorrect Correct
    • Work at Eye Level – don’t work overhead for extended periods of time. Working overhead extends the neck and back and can lead to compression of the spine. This can cause pain, muscle spasms, headaches and pinched nerves which radiate symptoms into the arms and legs. Also, overextending and reaching with the shoulder, such as when cleaning windows, can lead to shoulder pain and stiffness from tendonitis or bursitis.
      • Incorrect Correct
    • Wear a support if needed: knee or back brace, tennis elbow strap, arch supports
    • Avoid Prolonged Squatting – instead, kneel on a kneeling pad or wear knee pads
  5. Use Caution Walking on Wet Surfaces
  6. Use Caution Working Around Water and Electricity
  7. Use Caution When Working with Household Cleaning Chemicals – provide adequate air circulation
  8. Wear a Mask – when using cleaning chemicals or around dust, mold etc
  9. Limit the Amount of Weight or Items You Carry – especially on the stairs
  10. Take Breaks
    • Hydrate, Eat, and Rest
    • Stretch – neck, back, shoulders with a wall stretch

7 Safety Tips for Spring Cleaning:

  1. Replace or Clean Filters for air and heat units
  2. Clean out Medicine Cabinet
  3. Get rid of unused and expired meds properly
    • Call your local pharmacist for details
  4. Clean Attic, Garage, Cabinets and Basement of Dangerous Chemicals or toxic trash
    • Old paint cans, paint thinner, soiled rags, brushes etc
    • Contact your local government agency or recycling center for details
  5. Remove mold and fungus from bathroom and laundry room
  6. Replace Batteries in Smoke, Fire and Carbon Monoxide Detectors
  7. Clean the Chimney – call a professional to protect you from carbon monoxide exposure

Model: Hannah Keane, Physical Therapy Aide, Mackarey PT

Sources: National Center for Injury Prevention and Control at the CDC, www.medicinenet.comwww.household-management-101

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

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

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

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

Spring, Summer, Winter or Fall…weather changes can cause joint pain!

It is not just a cold weather problem…

“Everybody talks about the weather, but nobody does anything about it,” said Mark Twain. Just ask 93% of the arthritis sufferers who believe that the weather affects their pain level. History tells us that Benjamin Franklin, Leonardo da Vinci, and Christopher Columbus also felt this way about the weather.

Patients at our clinic have been particularly sensitive to joint pain on cold, damp days, especially during the past few weeks. In my clinical practice of orthopedic and sports physical therapy, an informal survey found that 95 out of 100 patients (95%) with arthritis reported increased pain with weather changes. While most people report that the coldness and dampness seem to irritate their joints, they also report more pain with weather changes in the summer. There is a reasonable explanation…

Joints in the body have a lining called synovium that secretes a lubricating fluid called synovial fluid. In joints with arthritis, there is an overproduction of synovial fluid. In theory, when the barometric pressure changes, so to will the pressure inside your joints, especially if it is already overfull with extra fluid from arthritis. This added pressure stimulates the nerve endings in the joint to produce inflammation and pain.

Despite this overwhelming response from patients, scientific studies vary in their support of this claim. According to the Mayo Clinic, in 1961, a famous arthritis doctor (rheumatologist), built a climate chamber and discovered that when high humidity was combined with low barometric pressure, patients reported increased joint pain and stiffness. A recent study found that changes in barometric pressure and cooler temperatures are associated with joint pain. However, other studies have found increased joint pain with high barometric pressure in both warm and cold weather while another study found pain with low pressure.

What does this mean? It means that patients with arthritis consistently report pain with weather changes, but science has not found an accurate method to consistently support these claims. Some of these inconsistencies may be attributed to the fact that there are differences in sensitivity among individuals. For example, some patients have symptoms before the weather changes, while others notice symptoms during or after the weather changes. Still yet, some report more pain in colder conditions while others notice more pain in warmer weather. It appears that changes in the weather, such as a high to a low or warm dry to cold damp and vice versa is the culprit when it comes to irritating arthritis in a joint.

If I have arthritis, should you move to Arizona? Yes and no! Yes, the warm and dry climate of Arizona will probably make you feel better overall. However, it will not cure the degenerative changes in your joints, and you may still have pain when CHANGES in the weather occur. This is proven to be true by the fact that there are many very busy rheumatologists in Arizona!

In conclusion, it is safe to say that there is some evidence to support the claim that most patients with arthritis have increased symptoms of joint pain and stiffness with CHANGES in the weather:

Therefore, each patient must be individually evaluated by their physician to determine the extent of their arthritis and its relationship to the changes in the weather. While the cause of their increased symptoms with changes in the weather may not be completely understood, each patient must determine the adjustments in their lifestyle and/or medications according to the particular weather patterns that affect their problem most.

Visit your doctor regularly and listen to your body.     

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

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

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

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

Guest Author: Gretchen Welby, PharmD, MHA

Gretchen graduated from Philadelphia College of Pharmacy and Science, The University of Scranton, and received a Doctor of Pharmacy degree from Temple University.   

Gretchen has been teaching for over 25 years at Rutgers University, Keystone College, Lackawanna College, The University of Scranton, and Marywood University. She has earned certifications in Pilates, yoga, barre and teaches all three locally.  She has a Wellness and Lifestyle coaching certification from Harvard University.

Gretchen resides in Scranton with her husband, Timothy Welby, MD, and has three daughters – Casey, Kate, and Caroline.  

Introduction: (Dr. Paul Mackarey)

I have invited Gretchen Welby, PharmD, MHA to present the current wisdom on the very controversial topic of vaccination/immunization to raise awareness and dispel any myths and misunderstandings.

Scientific progress has rarely advanced by popular vote, and vaccination is no exception. While public sentiment deserves respect and thoughtful engagement, the evidence guiding immunization policy is built on decades of rigorous research, transparent testing and continuous review. These research processes are designed precisely to rise above fear, trend, politics or misinformation. Choosing to prioritize scientific findings over shifting opinion is not an act of dismissal, but of responsibility…it is a commitment to decisions that protect both individual lives and the collective good, even when those decisions challenge what feels comfortable or widely believed.

Vaccination Facts:

2024 marked the 50th anniversary of the World Health Organization’s Expanded Programme on Immunization (EPI).  An initiative to make life-saving vaccines available to all worldwide.  A modeling study done to mark the 50 years of EPI estimated that vaccination averted 154 million deaths, including 146 million deaths among children. Several additional studies on vaccine effectiveness show that vaccines improve infant safety, contribute to a healthy society, and even reduce cancer risk. Vaccines work for an individual and society.  The data show that many vaccines can reduce mortality by 99% or more. Unfortunately, global immunization has been a victim of its own success because people have forgotten how deadly and dangerous the diseases vaccines protect against can be.

Vaccine effectiveness is overshadowed today by misinformation about vaccine safety, changing vaccine administration timelines, and mixed public health messaging. What are the outcomes of the recent relaxed vaccine message? The number of measles cases has jumped.  Fifty-nine cases were reported in 2023.  In 2025, 2242 cases were reported.  For additional perspective, an article published in the 2007 edition of JAMA listed the number of deaths pre-vaccine release and the number of deaths post-vaccine release.  The findings are remarkable.

  • Peak year pre-vaccine deaths (year)
    Diphtheria 3065 (1936)
    Measles 554 (1958)
    Mumps 50 (1964)
    Pertussis 7518 (1934)
    Rubella 24 (1968)
    Smallpox 2510 (1902)
    Tetanus 601 (1947)
  • 2004 deaths
    0
    0
    0
    27
    0
    0
    4

The recent Centers for Disease Control and Prevention (CDC) change to the childhood vaccine schedule reduces routine protection against 13 childhood diseases to 7, with shared decision-making now required for the remaining 6.  Diphtheria, tetanus, acellular pertussis (DTaP; Tdap), Haemophilus influenzae type b (Hib), Pneumococcal (PCV), Inactivated poliovirus (IPV), Measles, mumps, rubella (MMR), Varicella (VAR), and Human papillomavirus (HPV – changing from 2 doses to 1 dose) are now part of the routine vaccine schedule. 

Rotavirus, COVID-19, Influenza, Hepatitis A, Hepatitis B, Meningococcal ACWY, and Meningococcal B are now grouped in a shared-decision-making model. Traditionally, when changes are made to the vaccine schedule, they are made with much deliberation, study, and expert input from multiple agencies and governing bodies.  However, this recent change, however, did not follow the normal study path.  This is concerning because changes are proposed without proper study of the immediate and long-term consequences.

Vaccines have been shown to be safe, with most patients experiencing very minor side effects. Normal reactions from vaccinations include low-grade fever for 24-48 hours.  A low-grade fever and minor muscle aches signal the body's immune response.  Tenderness and redness at the injection site are other normal reactions from immunization and should last from 24-48 hours.  There is no proof that thimerosal (a preservative historically used in vaccines) causes adverse reactions.  Additionally, thimerosal has been removed from most vaccine preparations used today.  Vaccines do not overwhelm a child’s immune system.  Children are exposed to hundreds of antigens daily.  A WHOLE pediatric vaccination schedule exposes them to around 50 antigens.  There is NO evidence to support altering or delaying the American Academy of Pediatrics vaccination schedule. This does NOT increase safety; it DECREASES protection at a time when infants and children are most vulnerable.

How can consumers of healthcare information, in particular, vaccine information, find reliable, trustworthy, educated guidance? Since the June 2025 changes in CDC personnel have resulted in less qualified members of the Advisory Committee on Immunization Practices (ACIP), it is generally best to rely on non-governmental sources such as the American Academy of Pediatrics, American College of Gynecologists, the Infectious Disease Society of America, and the Vaccine Integrity Project for vaccine advice.  Additionally, discuss vaccine efficacy and safety with your doctor.

For More Information:

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization - The Lancet

Vaccination greatly reduces disease, disability, death and inequity worldwide - PMC

The New Federal Vaccine Schedule for Children: What Changed and What Are the Implications? | KFF

JAMA 2007; 298:2155-2162 

Visit your doctor regularly and listen to your body.     

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

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

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

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

It’s that time of year…after a long winter of nights that come early and last too long there is LIGHT at the end of the tunnel! In the fall and winter, especially this far north, many people start to feel the gloom of their surroundings creep into their psyche and spring cannot arrive too soon...Is this normal, or a sign of something more serious?

Seasonal affective disorder, or SAD, is at the far end of a spectrum of seasonal mood changes. The mildest of these, “seasonality”, is a normal response to cyclical changes in weather and light exposure. However, when symptoms like depressed mood, lack of motivation, or a shift to more vegetative daily habits become severe and debilitating, SAD may be the cause. In fact, one study found that SAD affects up to 10% of primary-care patients, and that those with a previous diagnosis of depression are even more at risk. Fortunately, though, there are well established therapies that can help those afflicted with SAD to get through the dark winter months.

The American Psychiatric Association defines SAD as a subtype of either Major Depressive Disorder or Bipolar Disorder, depending on the symptoms. It can consist of episodes that onset during either fall/winter or spring/summer, or have symptoms characteristic of either “major depressive” or “manic” episodes. The vast majority of those with SAD, however, experience a persistent overall depressed mood during the shorter days of fall and winter.

Symptoms of SAD:

In more serious cases:

If enough of these symptoms are present for a long enough time and onset in a seasonal pattern, that can mean Seasonal Affective Disorder. Most people with the disorder find themselves sleeping more and eating more (especially carbs), and report that their symptoms can even resolve with relocation to a sunnier environment. Along the spectrum of disease is a less severe form called “subsyndromal” SAD, which can still be effectively treated. Periods of SAD tend to resolve with the coming of spring, but they can be immensely distressing and always deserve medical intervention.

No one knows exactly why Seasonal Affective Disorder happens, but it appears to be associated with decreased exposure to natural light during the fall and winter months. One possible explanation is the “phase-shift” hypothesis. It states that your body’s circadian rhythms, which are regulated by hormones and the brain, become out-of-step with environmental sleep/wake cues as the days shorten. In other words, the light levels around you and your body’s internal clock are telling you two different things about when to sleep. This disruption of circadian rhythms, or “phase-delay”, likely contributes to the symptoms of SAD, although precisely how it induces changes in mood remains unclear.

Another hypothesis for the mechanism underlying SAD involves abnormalities in the activity of serotonin, a neurotransmitter in the brain. Normally, serotonin regulates mood and attention. However, studies have found that people with SAD clear serotonin out of their brains faster, giving the hormone less of a chance to provide a boost in mood.

Treatment for SAD:

Current medical treatment of SAD targets the changes in both circadian rhythms and serotonin metabolism. This can be accomplished with light therapy, antidepressant medications or a combination of both.

Medical Contributor:

Brendan Bormes, MD, GCSM 2019: This column was previously featured in “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine.

Visit your doctor regularly and listen to your body.

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

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

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

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

Guest Columnist: Paul Mackarey, Jr. DPT

According to the Centers for Disease Control and Prevention (CDC), the 2025/26 flu season has been exceptional. Normally, elderly adults have the largest number of flu related hospitalizations while young children are second. This year, however, baby boomers between 50 and 64 years of age are the second most vulnerable. And, as of January 2026, the US flu season has resulted in an estimated 19 million illnesses, 250,000 hospitalizations, and 10,000 deaths. At the risk of creating an overreaction and promoting “germaphobic” behavior, if there is one time of year that diligent hygiene has merit, it is now…during flu season.

Contracting the cold or flu can make you feel run-down and under the weather for weeks. Unfortunately, your daily activities and responsibilities cannot take a sick day. The common cold and flu is most prevalent during late fall, winter and early spring. According to flufacts.com, “The influenza virus, more commonly known as the flu, is defined as a contagious respiratory infection that infects the nose, throat, and lungs. Thankfully, there are several easy and effective preventive measures that can reduce the probability of contracting the cold and flu.  These preventive measures are designed to help keep your immune system strong and healthy. A healthy immune system fights against pathogens, such as the cold and flu virus. This article will focus on the ten best ways to prevent the flu and cold this season.  

10 Ways to Prevent the Cold and Flu:

THE 10 MOST GERM-FILLED ITEMS YOU USE DAILY   (webMD)

Sources: www.flufacts.com; www.webmd.com; www.lifescript.com; www.cdc.gov

Guest Contributor: Paul Mackarey, Jr. DPT, is a Doctor of Physical Therapy and partner at Mackarey & Mackarey Physical Therapy Consultants, LLC in Scranton and Clarks Summit.

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

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

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

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

Part II of II

Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what they should avoid, how to prevent and what is recommended to prevent or limit the progression of arthritis. Osteoarthritis (OA) is also known as degenerative arthritis. It is the most common form of arthritis in the knee. OA is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface.

It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the joint involved, especially after increased activity. While diet and exercise help, some people are more likely to develop OA based on previous trauma or injury, labor intensive occupations and genetics. Either way, we all get OA to some degree but there are a few things you can do to limit wear and tear to your joints.

However, OA is not an excuse to avoid exercise, but it is important to be smart about it. Regular exercise is essential to maintain a normal lifestyle for those with OA. However, if you make poor lifestyle choices, do the wrong exercise, use poor technique, or are too aggressive, you could flare-up your joints and do more harm than good.

  1. Don’t Burn the Candle at Both Ends
    • Poor sleep can affect your joints. One study found that people with arthritis felt more pain after restless nights. One theory is that when you don’t sleep well, it triggers inflammation in your body, which may lead toOA over time.
  2. Don’t Slouch and Slump
    • Posture matters. Sit up straight. When you slump in your chair, it puts more stress on your muscles and joints and tires them out. Two good posture stretches are making a double chin by bringing your head over your shoulders and the second is pinching your shoulder blades together.
  3. Don’t Ignore Pain
    • The exercise mantra “no pain, no gain” may be appropriate for a young healthy athlete, however, it may prove counterproductive for most of us. It’s true that some muscle soreness is OK, but not if it lasts for days or if your muscles are swollen or too sore to move or to touch. Joint pain isn’t normal, so pay attention to it. If you think you overdid it, ease up on your exercises. If the pain won’t go away, check with your doctor.
  4. Don’t Overdo Computer Time
    • It can literally be a pain in your neck -- and your elbows, wrists, back, and shoulders. The problem isn’t just bad posture, but that you hold it for too long. That overworks your muscles. It also puts pressure on the discs in your back. Set up an ergonomic workstation. If you’re in a soft chair, prop up your arms with cushions to take the load off your shoulders and your neck. Be sure to get up and move every hour.
  5. Don’t Get Rigid and Repetitive in Your Exercise Routine
    • If you perform the same exercise, sport or activity every day, you use the same muscles and joints repeatedly. Remember, overtraining problems commonly occur in single sport athletes. Mix in fun sports and activities to break the monotony by adding fun activities such as golf, swimming, biking, skiing, hiking or playing tennis. Avoid weight bearing exercises two days in a row. Run one day, walk, swim or bike the next. Use the elliptical instead of the treadmill on various days. Limit intensity – only work out intensely 2-3 times out of 5 days per week.
  6. Don’t Squat
    • Avoid squatting…deep squatting is bad for your hips and knees. Even when gardening, use a kneeling pad instead of bending down and squatting.
  7. Don’t Smoke and Chew Tobacco
    • Nicotine from cigarettes and chewing tobacco cuts down on blood flow to your bones and to the cushioning discs in your back. It limits how much bone-building calcium your body can take in. It also breaks down estrogen, a hormone you need for bone health. And it slows new growth that thickens bones…which can lead to OA and osteoporosis.

SOURCES: WebMD, University of Pennsylvania

Visit your family doctor regularly and listen to your body.

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

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

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

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

Part I of II

Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what they should avoid, how to prevent and what is recommended to prevent or limit the progression of arthritis. Osteoarthritis (OA) is also known as degenerative arthritis. It is the most common form of arthritis in the knee. OA is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface.

It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the involved joint, especially after increased activity. While diet and exercise help, some people are more likely to develop OA based on previous trauma or injury, labor intensive occupations and genetics. Either way, we all get OA to some degree but there are a few things you can do to limit wear and tear to your joints.

  1. Don’t Carry Extra Weight
    • Your joints, which link your bones together, are sensitive to heavy loads. Every pound on your frame puts 4 pounds of stress on your knees. It also strains your back, hips, and feet.
    • That causes wear and tear that can lead to damage, aches, and pain. A poor diet, which can lead to being overweight, can also be the source of inflammation. That can make all your joints, including in your hands, stiff, painful, and swollen.
  2. Don’t Text Too Much
    • “Texting thumb” is a real thing. Your tendons can get irritated and lock your thumb in a curled position. All that looking down at your phone is just as bad for your neck and shoulders, too. Every inch your head drops forward raises the load on your muscles.
  3. Don’t Wear High Heels Too Often
    • While they might look styl”n, the higher the heel, the more your weight tips forward. Your leg muscles have to work harder to keep your balance and alignment, which can cause pain. When heels go up, so does the twisting force in your knees. If you wear them every day, you increase your odds of developing OA.
  4. Don’t Wear the Wrong Shoes
    • Old, worn-out shoes will not adequately support your feet and ankles. That’ll throw your knees, hips, and back out of whack. Also, make sure your sneakers are right for your sport. High tops for basketball, for example, can protect your ankles from sprains and flip flops or summer beach shoes are not meant for long distances…especially if you are over 50.
  5. Don’t Crack Your Knuckles
    • That satisfying pop comes from tiny bubbles bursting in the fluid around your joints, or from the ligaments snapping against the bone. While it might not cause OA directly, one study showed that this habit may cause your hands to swell and weaken your grip.
  6. Don’t Carry a Heavy Bag
    • Whether it’s a purse, backpack, or messenger bag, packing too much can cause neck, back and shoulder pain. Heavy weight on one shoulder throws off your balance and your walk. If you tend to carry things only on one side, the constant pull overstretches your muscles and tires out your joints.
  7. Don’t Use Wrong Muscles for the Job
    • When you put too much load on little muscles, your joints pay the price. If you need to open a heavy door, for example, push with your shoulder instead of your fingers. When you lift something off the floor, bend at your knees and push up with your strong leg muscles, instead of your arms.
  8. Don’t Sleep on Your Stomach
    • While it might help with snoring, it may not be best for the rest of your body. Lying on your belly pushes your head back, which compresses your spine. Your head also will face in one direction for longer stretches than if you sleep on your back.
  9. Don’t Skip Stretching
    • Gentle, comfortable, active stretching on a regular basis can help strengthen your muscles and tendons. It also can make them more flexible. That allows your joints to move more easily and helps the muscles around them work better.
  10. Don’t Skip Strength Training
    • Once you turn 40, your bones start to get a little thinner and more likely to break. If you build muscle with strength training, it slows bone loss and triggers new growth. So, you not only get stronger muscles, but denser bones, too. Together, they stabilize your joints so you’re less likely to get hurt. In fact, studies show that the stronger your leg muscles, the less stress on your knees.

SOURCES: WebMD, University of Pennsylvania,

Visit your family doctor regularly and listen to your body.     

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

Next Week: Part II of II “Save Your Joints”

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

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

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

It is no surprise that the most common New Year Resolution is to be healthier…eat less, exercise more, etc. However, health is multidimensional! To be truly healthy, one must have a healthy mind, body and spirit! It is well documented and established that exercise and diet contribute to your physical health, and mentally, the brain is healthier by avoiding toxins such as tobacco, drugs and alcohol, while the spirit is healthier by being mindful, spiritual and meditative. Unfortunately, less attention is paid to other critically important aspects of health: the unhealthy impact of negative visceral emotions such as hate, jealousy, and anger.

Considering our present divisive social and political climate in the United States and globally, I find myself in constant search to understand the pervasive hate and division which seems to be, not only prevalent, but acceptable. I have attempted to read books such as “The Science of Hate,” by Matthew Williams,  about the science of hate and survival, “Demon Copperhead,” by Barbara Kingsolver, about those marginalized and left behind, ”The Demon of Unrest,” by Erik Larson, about the history of our national political division preceding the Civil War and its relevance in the present, and watch TED Talks podcasts and television specials such as those presented by WVIA Public Media in a special series “We Stand Against Hate.”

All of this, to no avail! I failed in my effort to understand the unthinkable: We hate individuals whom we have NEVER even met. We hate groups of people through unfounded generalizations. We hate because of color, creed, stature, rank?!?! At the end of the day, I just don’t get it! Fortunately, I was not born with the “hate gene” and may never fully understand. But what I do understand is that HATE IS UNHEALTHY! So, if you want to be truly and completely healthy this new year, work on your hate!

What Is Hate? (Everydayhealth.com Laura Williams)

The word “hate” is thrown around more often than the actual emotion is felt. The statement “I hate broccoli” is rarely accompanied by the strong negative emotion of true hatred. Even strong feelings of anger or disgust are not the same as hate. According to Laura Williams, clinical psychologist “Hate is a profoundly intense and enduring dislike for someone or something. Hate can be tenacious, and often has roots in mistrust, fear, or (lack of) individual power, and vulnerability.”

It can be hard to distinguish hate from other powerful negative emotions that you may be feeling at the same time. Some psychologists say what makes hate different is that it’s directed toward who or what someone or something is, rather than what they’ve done.

The negative physiological, physical health, mental and emotional effects of hate are well documented by many sources including the National Institutes of Health.

Physiological Effects of Hate:

Physical Health Effects of Hate:

Mental & Emotional Effects of Hate:

Ultimately, hate creates an internal state of emergency which demands significant physical and mental resources and leads to wear-and-tear on your entire system. Letting go of hate is a form of self-care that promotes relaxation and long-term well-being.

Tips to Deal With Hatred: (PsychMatters, Joanna Kleovoulou, Clinical Psychologist)

2026 is a great opportunity to be truly healthy…eat well, exercise more and rid yourself of hate!

Visit your family doctor regularly and listen to your body.     

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

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

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

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

Happy Holidays Seniors! My gift to readers this holiday season is to offer some health tips for seniors. However, before I get accused of being a “Scrooge” about enjoying the food and drink associated with the season, please know that I was raised in an Italian kitchen. As such, it is fair to say that I have and will eat my fair share of the Italian Christmas Eve food celebration consisting of, but not limited to: Chianti wine, seafood antipasti, calamari, baccala, smelts, pasta with anchovies, seafood ravioli, cannoli, Italian cheesecake and Baci Perugina Dark Chocolate Hazelnut candy, cappuccino, espresso, sambuca and limoncello.

Overindulgence during the holidays causes many, including seniors, to make New Year's resolutions related to diet and exercise. But, this year, I propose that you incorporate healthy habits during the holiday season, and you may find that your resolutions are not as hard to keep. According to American Association of Retired Persons (AARP), seniors are considered those 50 years old and older. I will never forget how humbled I felt when I received my application to join AARP a few years ago. With this in mind, this year I offer healthy holiday tips for seniors, who are especially vulnerable to unhealthy holiday habits.

  1. Exercise every day.
    • Every day, get out of the house for a walk to view the outdoor Christmas lights and decorations. Dress for the weather, walk with a companion, and take along a flashlight if necessary to illuminate your path and use caution to avoid falls on slippery sidewalks.
  2. Remember to take your medications.
    • Routines are disrupted during the holidays and you may forget important medications. Make a special reminder to take your medications or order re-fills. If you are traveling, be sure to take enough medications with you in case of delays and have a copy of your prescriptions in case of loss. Be sure to bring a phone number for your doctor along with your health insurance cards, in case of emergency. Carry your medications in your carry-on luggage if you are flying.
  3. Eat your vegetables and salad first.
    • Beginning your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge on high-fat, high-calorie foods. Taste your holiday favorites in small amounts to satisfy your palate.
  4. Be aware of drug interactions.
    • According to Dr. Amy Anderson, internal medicine physician on the medical staff at Baylor University Medical Center," says holiday spices like cloves, thyme and sage can interfere by as much as 50 percent with the body's natural ability to utilize common drugs." Talk with your doctor or pharmacist about your medications and find out if there are any foods you should avoid while taking them.
  5. Know your food ingredients.
    • If you have food allergies, ask about ingredients before you indulge. Be especially careful of home-baked goods if you have an allergy to tree nuts or peanuts. Those ingredients can be deadly if you are affected by these types of allergies.
  6. Practice allergy-free decorating.
    • If you suffer from allergic rhinitis, holiday decorations stored in the attic and basement can build up a coating of dust and mold that can trigger allergies. Some people may also need to rethink Christmas tradition and substitute an artificial tree.
  7. Get a flu shot.
    • The holiday season includes plenty of kissing and hand shaking. Getting a yearly flu shot and frequent hand washing are your best defense for avoiding the flu. If you are sick with a cold or flu, limit contact with others until you are well so you don’t infect others.
  8. Get a good night's sleep.
    • Holiday preparations and helping Santa means less sleep. Do your best to get to get at least 6-7 hours of sleep every night and avoid heavy foods, chocolate, caffeine and alcoholic beverages before bedtime. If you need to recharge, take a nap during the day.

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

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

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

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