The “First Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things, family, good friends, food, shelter, and health. I am also thankful for the dedicated scientists who develop vaccinations and medications so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is not only reflective and cleansing; it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful:

1. Being Grateful is Contagious!
   • Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
2. Being Grateful Improves Physical Health
   • Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
3. Being Grateful Improves Psychological Health
   • Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
4. Being Grateful Fosters Empathy and Reduces Aggression
   • Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
5. Being Grateful Promotes Better Sleep
   • A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
6. Being Grateful Improves Self-Esteem
   • When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
7. Being Grateful Improves Mental Strength
   • Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion:

Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!

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: Paul Mackarey, Jr. PT, DPT is clinic director and partner at Mackarey & Mackarey Physical Therapy Consultants, Scranton and Clarks Summit, PA.

The 2025 Pennsylvania rifle deer season begins November 30^th and continues through December 13, 2025. Opening day is considered a holiday in the state of Pennsylvania as approximately 750,000 hunters from age 12 to seniors (including myself) will hike through the woods in search of a whitetail.

I am a whitetail, turkey, small game hunter, and an avid outdoors enthusiast with great passion for mountain biking, kayaking, hiking and mountain climbing in our state and national parks. After an extended period away from hunting (in the off season), I am eager to be back in the woods. When possible, I try to make time to shed hunt and scout in preparation for the upcoming season. While I am active during the summer, I am not necessarily in “hunting shape” and certainly not acclimated to cold, wet and windy conditions. I offer health and safety tips for hunters based on the knowledge of experts in the field and my expertise as a health care provider. Good luck and be safe!

Common Health Problems for Hunters:

• Chest Pain/Shortness of Breath – overweight and deconditioned people must be very careful when overexerting themselves in the woods while hunting. This is especially true for those with a history of heart disease. Make sure you take your medication and drink plenty of fluids 24 hours before and while hunting. Eat a good breakfast with a balance of protein and carbohydrates. A bagel with peanut butter is a good quick start. Pack healthy snacks and water to sustain you.
• Knee Pain- in the front of the knee or kneecap is common with hunting. This can happen from excessive hiking on uneven or hilly terrain in the woods, especially if there is weakness in the leg muscles. When walking downhill try this simple trick to keep your knees safe. Slightly bend at the knees and bring your buttock back so your knees stay over (or slightly behind) your toes to reduce stress on the joint.
• Neck, Lower or Middle Back Pain- can be caused by prolonged hiking with a heavy load or prolonged sitting in a tree stand in slouched positions, especially if one has tight hamstrings. Field dressing and carrying the deer out of the woods is also very stressful on the back. Take multiple breaks and stretch backwards, (the opposite direction of bending over to drag the deer). Also, consider where you want to position your hunt, avoid large hills that you may have to drag the deer up on the way out.

• Shoulder Pain- can occur from recoil of a gun shot or the overhead activity of climbing a tree.
• Hamstring Pain- can occur if the muscle is tight or weak. Prolonged walking, bending over and large steps over fallen trees can contribute to this problem. When free walking in the woods, look for the path of least resistance.
• Ilio-Tibial Band Pain- when walking on the side of a hill there is a difference in the length of the legs. Overtime, this can lead to pain on the outside of the hip and leg.
• Foot Numbness or Pain- can occur from prolonged squatting or poor fitting shoes/boots. However, lower back pain can also be associated with these symptoms.
• Hand Numbness or Pain- can be caused by repeated recoil of the gun on the shoulder. Also, this may be associated with prolonged pressure of a shoulder strap or leaning on something under the arm.

Preparing Your Body for Hunting:

• Prevention is the best management of most musculoskeletal and safety problems associated with hunting. First, one can prevent many of the above problems through proper fitting of equipment, clothing and shoes/boots.
• Fitness - Be sure to maintain a fairly good fitness level in order to hunt safely. Begin an exercise and walking program 2-3 months before hunting season. If you are a beginner, start slowly. Warm up and slowly walk for 10 to 15 minutes and build up over time. Slowly add hills to your walking program.
• Clothing - Wear your hunting clothing, such as boots to break them in while walking for exercise. Drytech clothing instead of cotton can keep you warm and wick moisture away from the body.
• Move & Stretch - As hunters, we sit in our stand or blind and stay still for long periods of time in cold temperatures. This results in a cold and stiff body. When leaving your setup, give your body time to wake up before you start hiking out. Bend the knees or perform small squats repeatedly to get blood and warmth back into the legs. Stretch your spine backwards (the opposite of sitting) to prepare your spine for your heavy pack and do some heel raises for the ankles.
• Strength Exercises - Work on the strength and flexibility of the quadriceps, calf and gluteal muscles. Instead of using the elevator, climb stairs throughout the day to work these muscles. Be careful not to progress too quickly because a drastic change from inactivity to over activity in a short period of time can create problems.

• Be Aware - Know your limitations and adapt to them. Injuries most commonly occur when we overestimate what our body can do or choose to push through pain. Listen to your body, if you have pain, stop and modify your activity. In addition, scout areas that are more easily accessibly in the woods that will still attract deer. This will lead to less stress on your body and when successful, you have an easier drag!
• Use technology to your advantage. Using hunting apps and maps such as HuntWise, OnX or HuntStand, can help give you an idea of the terrain you will be exposed to prior to entering the woods. It will be easier to map out a less strenuous approach into the woods and minimize the load you place on your body.
• Remember, hunting should be fun! Pain from poorly fitted and improperly maintained equipment and clothing can be avoided with good planning. Moreover, injury and death from inactivity and poor fitness is also preventable. 

Sources: www.pgc.state.pa.us

Visit your doctor regularly and listen to your body.  Keep moving, eat healthy foods, exercise regularly, and live long and well!

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!

November is National Alzheimer’s Disease Awareness Month. It is appropriate that it is also National Family Caregivers Month, since many people afflicted with Alzheimer’s are physically well and often rely on caregivers. It would be very unusual to find a person whose life has not been affected by someone with Alzheimer’s disease (AD). AD is a form of dementia. It is sometimes referred to as Senile dementia/Alzheimer’s type (SDAT). Currently, more than 4 million people in the USA have AD. Approximately 10% of all people over 70 have significant memory deficits. The number doubles each decade after 70. The risk increases with age and family history for the disease.

AD is a progressive degenerative disease of the brain that affects memory and thought process. Memory impairment is the hallmark of this disease. Also, those suffering from AD present changes with the following: language, decision-making, judgment, attention, and other personality or aspects of mental function. AD progresses differently in each case.

Two types of AD have been identified, early onset and late onset. In early onset, symptoms appear before the age of 60 and progress very rapidly. It accounts for 5-10% of all cases. Autosomal dominant inherited mutations have been found in early onset AD.

The cause of AD is not completely understood; however, most experts agree that both genetic and environmental factors are involved. It is important to rule out other medical causes before a final diagnosis of AD can be made. Only a post-mortem microscopic examination of brain tissue can confirm the diagnosis. Structural and chemical parts of the brain disconnect as the brain tissue shows twisted fragments of protein that clogs up the nerve. Clusters of dead and dying nerve cells block the transmission of information and communication from one nerve cell to the next. AD causes a disconnection of areas of the brain that normally work together.

RISK FACTORS:

• Family History; Age
• High Blood Pressure – over a long period of time
• History of Head Trauma
• High Levels of Homocysteine (a chemical in the body related to heart disease and depression)
• Female Gender – as women live longer

The Greater Boston Physicians for Social Responsibility and the Science and Environmental Health Network offer the following guidelines to reduce the Risk of Developing AD:

• Practice Good Nutrition All of Your Life
  • Provide and teach youngsters good eating habits. High calorie foods and drinks should be discouraged to prevent obesity and diabetes.
• Eat Lots of Fresh Fruit and Vegetables
  • Fruits and vegetables, especially those that are deep green, provide essential antioxidants, vitamins, and other important micronutrients. Many contain healthy omega-3 fatty acids.
• Avoid Saturated and Trans Fat. Use Vegetable Oils Instead
  • A low-fat, plant-based diet with small amounts of dairy, lean meat and chicken is preferred. Avoid frequent use of oils high in omega-6 such as corn, safflower, sunflower, and peanut oils.
• Eat Foods High in Omega-3s
  • Eat fish at least once a week. For those who do not like fish, try fish oil. Limit use of fish that are high in mercury and PCB’s such as: swordfish, king mackerel, albacore and fresh tuna. Less contaminated fish are: haddock, Pollock and wild Alaskan salmon.
• Avoid Routine Consumption of Sugar
  • Table sugar, corn syrup, maple syrup, honey high in fructose cause rapid blood sugar elevation which is linked to obesity, type II diabetes, and heart disease.

• Consume Low-Glycemic Carbohydrates
  • Whole grains and legumes (chick peas and lentils) can help prevent sudden increases in blood sugar. Other examples are: brown rice, barley, oats, rye, buckwheat, fruits, non-starchy vegetables, pasta, winter squashes and tubers (yams, sweet potatoes).
• Get Food From Local and Organic Sources
  • Local growers and Co-ops tend to offer fresher foods with higher levels of nutrient and less pesticide use. NEPA has some great seasonal local farmer markets.
• Modest Consumption of Alcohol
  • Evidence supports the use of one-half to two drinks per day for adults. Red wine and green tea are recommended. Some studies show that caffeine may reduce the risk of Parkinson’s and AD.
• Avoid Food Additives, Such as Aluminum
  • While the evidence of the danger of cooking in aluminum pots may not be valid, recent evidence suggests that dietary aluminum may increase the risk of AD. For example, some baking powders, pancake and waffle mixes contain high levels of aluminum.
• Reduce Exposure to Toxicants
  • Toxic chemicals in the home, workplace and community can increase the risk of AD. Lead, solvents used in building and remodeling, and lawn and garden chemicals may be harmful.

• Increase Physical Activity
  • 30 minutes of moderate aerobic exercise each day is very beneficial for physical and emotional wellness. It improves blood flow, releases endorphins and prevents obesity.
• Increase Social Activity
  • Social activity on a regular basis has been found to reduce the risk of AD. Volunteer, join a club, play a sport or game with a group, take classes and keep in touch with friends and family.
• Reduce Stress
  • Technology has put us on sensory overload. We must learn a new technological skill every week to keep up. Demand for immediate communication increases daily. We cannot escape for a moment. Make time every day to relax, breathe deeply, listen to relaxing music, exercise or sit quietly.
• Exercise Your Brain
  • Some studies show that maintaining a healthy mind requires some work. Do crossword puzzles, word games, board games, and read books. Current wisdom suggests that learning something new is the most important thing to keep your mind healthy…time to learn to play the piano!

Source: The HealthCentralNetwork, Inc

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!

What is an Ice Bath?

Ice baths have become a new trend or fad in health and fitness, especially among elite athletes and some celebrities. In fact, it is impossible to scroll through social media without encountering someone “taking the frigid plunge!” However, it is far from a new treatment modality. The Ancient Greeks employed cold-water immersion for fever, pain relief, relaxation and socialization. In fact, Hippocrates documented the use of cold for medicinal purposes for its analgesic benefits. 

Ice baths, a type of cryotherapy, is also referred to as cold water immersion (CWI) or cold-water therapy, involves immersing your body in ice water for approximately 5-15 minutes from the neck down at a temperature of 50-59 degrees. The ice baths are commonly used for pain, delayed-onset muscle soreness (DOMS), and inflammation and mood elevation. 

In theory, the cold water lowers the temperature of your skin and body by vasoconstriction (narrow) of the blood vessels. When you get out of the cold water the vasodilatation (widen) of the blood vessels immediately brings fresh oxygen and nutrient-rich blood back to the tissues to warm the body and in the process, reduce pain, inflammation and promote healing.

Types of Cold Water Therapy:

• Ice Bath/Cold Water Immersion (CWI) - immersing your body in ice water for approximately 5-15 minutes from the neck down at a temperature of 50-59 degrees.
• Cold Showers – Standing under a cold shower at the coldest setting (as close to 50-59 degrees as possible) for 5-15 minutes. It is often recommended as a good introduction to CWI.
• Contrast Water Therapy (Contrast Baths) – Alternating between soaking or showering in hot water for a period of time followed by cold water for the same time (3-5 minutes). The period of time is flexible as some studies suggest alternating hot and cold at one-minute intervals.
• Wim Hof Method – established by a Dutch athlete who recommends incorporating breathing techniques and meditation with CWI.

Purported Ice Bath Benefits:

• Pain Management – cold water therapy leads to vasoconstriction (narrowing the blood vessels) which can reduce swelling and inflammation associated with pain. Moreover, cold creates an analgesic effect to the skin to aide in pain control.
• Reduces Muscle Soreness – cold water therapy has been found to reduce muscle soreness one hour after intense exercise including delayed-onset muscle soreness (DOMS0, however, strength was compromised following CWI. Moreover, it is important to note that studies showed heat therapy had similar results as CWI.
• Improves Mood and Alertness – Some studies with small sample sizes have demonstrated that CWI improved self-esteem and alertness, reduced muscle tension, anger and nervousness. However, there was no difference soaking in 55 degree water verses 68 degrees for 18 to 20 minutes. Also, the studies were exclusively performed on healthy individuals.

Potential Side Effects of Ice Baths:

Ice baths are not without risk and not everyone reacts the same way to ice immersion. It is recommended that one engages in ice exposure gradually, for short periods and in a controlled setting like a home shower. Furthermore, one must be mindful of age, general health, time of exposure, and water temperature. Remember, body temperature is 98.6 and water temperature of 65-70 degrees will feel very cold so 50-59 degrees can create problems such as:

• Cold-Induced Rash – an itchy, painful skin rash
• Cold Shock – sudden cold immersion can shock your body into rapid breathing, increased heart rate and blood pressure and is often associated with drowning.
• Hypothermia – cold immersion can lead to hypothermia and organ failure.
• Ice Burn – if your skin makes direct contact with the ice you can burn your skin or suffer from frostbite leading to skin and tissue damage.
• Nerve Damage – prolonged exposure to cold can reduce blood flow and lead to nerve and tissue damage.

Potential Risks of Ice Baths:

If you have the following health conditions, ice baths may not be the best therapeutic modality for you. Before you consider trying an ice bath, consult with your physician to avoid potentially serious problems:

• Cold Hives – itchy welts, swollen lips and throat when your skin comes in contact with something too cold.
• Heart or Lung Conditions – when vasoconstriction of the blood vessels occurs from the cold, your heart rate and blood pressure increase dramatically. The excess strain on your heart can be dangerous, especially if you have compromised cardiopulmonary function. It can also lead to an irregular electrical rhythm (arrhythmia), which can be serious.
• Raynaud’s Syndrome – lack of blood flow to the fingers and toes cause a hypersensitivity and cause them to turn white or blue. It can lead to tissue damage.

In Conclusion:

What the Science Says –

While some studies have shown that subjects report less muscle soreness following CWI when compared to rest, most studies suggest that the reported effects are placebo. Also, reports of improved circulation, reduced inflammation and improved recovery or performance has not been scientifically validated. In view of this, it is recommended that those considering the use of CWI for pain and inflammation management, reduced muscle soreness, and mood elevation, should consult their physician to determine if the potential risks are worth the purported benefits.

SOURCES: nih; health.com; health.clevelandclinic.org; prevention.com

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

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

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

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

October is National Physical Therapy Month! The American Physical Therapy Association (APTA) would like to recognize the thousands of physical therapists as dedicated health care providers. Moreover, physical therapists would like to thank the public for allowing us to participate in your health and wellness. While PT’s may not save lives…we do save LIFESYLES!

This column will address a question that is frequently asked by people of all ages and activity levels…stretching. First, it is important to keep in mind that stretching should NEVER be performed without warming up your body and muscles first. This can be done by running slowly in place or around the block for 5-10 minutes. Second, stretching should NEVER be painful. Third, a good stretch should be performed slowly and feel like slight tension in the muscle. NEVER bounce or jerk. First, perform the stretches by actively moving your muscles slowly and deliberately 5-10 times. Then, hold the stretch for 5-10 seconds, repeat 5-10 times, 2-4 times per week. 

Remember, flexibility is only one aspect of complete health and wellness. Strength training, cardiovascular fitness, meditation and stress management and proper nutrition are also necessary for a healthy lifestyle. Also, be careful not to overstretch before competition as it may weaken the muscle.

10 MOST COMMON STRETCHES:

• CALF STRETCH
  • Stand with your feet facing a wall shoulder width apart.
  • Step your right foot back keeping it facing forward.
  • Bend your left knee and keep the right knee straight
  • Lean forward and push against a wall for the best stretch, keeping heels on the floor.
  • Feel the stretch at the back of your right leg below the knee
  • Repeat on the left
• QUAD STRETCH
  • Stand with your left arm holding on to a stable object for balance.
  • Bend your right knee and bring the heel up toward your butt by pulling up/back with your right hand.
  • Feel the stretch at the front of your right thigh.
  • Repeat on the left

• HAMSTRING STRETCH
  • Lying on your back, clasp the back of your right knee
  • Straighten out your right knee slowly up toward the sky
  • Feel the stretch at the back of your right thigh.
  • Repeat with your left leg straight.

• GROIN STRETCH
  • Sit with your legs bent with heels together. (Indian Sit)
  • Hold your ankles or feet with both hands.
  • Keep your back straight and stomach in.
  • Push your knees toward the floor.
  • Feel the stretch on the inside of your thighs.
• LOW BACK FLEXION STRETCH
  • Lie on your back and raise your knees to your chest.
  • Hold the knees with both your hands.
  • Feel the stretch at the bottom of your back.

• LOW BACK EXTENSION STRETCH –
  • Lie on your belly and prop up on your forearms
  • Hold this position and inhale and exhale
  • Feel the stretch in the small of your back

• TRUNK SIDE STRETCH
  • Stand with your left hand on your left hip and your right arm above your head.
  • Bend to the left by sliding your left hand toward your left knee without leaning forward or back.
  • Feel the stretch on your right side.
  • Repeat with your left arm.
• TRUNK ROTATION STRETCH
  • Stand upright with feet shoulder width apart
  • Cross arms over chest and turn to the right with your upper trunk
  • Keep lower body facing straight
  • Feel the stretch on the left lower back and trunk
  • Repeat turning to the left
• SHOULDER STRETCH
  • Take your right arm across your chest.
  • Use your left hand to pull your right elbow across your chest.
  • Keep your body facing forward.
  • Feel the stretch on the back of your right shoulder.
  • Repeat with your left arm.

• CHEST STRETCH
  • Stand facing a corner with feet 12 inches away and put both arms up in a “T” position
  • Lean into wall with chest and keep feet away from wall
  • Feel the stretch in your biceps and chest.

MODEL: Sarah Singer, PTA, Mackarey Physical Therapy

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!

PREVENT STRESS FRACTURES

It is two weeks away from the 28^th Steamtown Marathon. After training all spring and summer for the first seven Steamtown Marathons, not a Columbus Day Weekend goes by without my thoughts of this great event.

I would like to introduce this topic with some marathon history. In 490 B.C. Athens was under attack by the Persians and was outnumbered more than two to one. The Athenians fought bravely and defeated the enemy in the town of Marathon. The victory kept the intruders 26 miles away from Athens. To keep the anxious citizens of Athens calm, leaders immediately ordered a foot soldier, Phedippides, to run to the capital city to share the news. Phedippides ran, in full armor, for 26 miles from Marathon to Athens, delivered the message and died immediately. Now, people do the same thing of their own free will!

Each year at this time, dozens of runners preparing for the Steamtown Marathon come to my office with severe shin pain known as shin splints. Unfortunately, in many of these athletes, this problem can lead to a much more severe and advanced problem with shin splints called a stress fracture.

What is a stress fracture?

A stress fracture is fatigue damage to bone with partial or complete disruption of the cortex of the bone from repetitive loading. While standard x-rays may not reveal the problem, a bone scan, and MRI will. It usually occurs in the long bones of the leg, mostly the tibia but also the femur (thigh) and foot. Occasionally, it occurs in the arm.

Who is at risk?

10-21% of all competitive athletes are at risk for stress fractures. Track, cross country and military recruits are at greatest risk. Females are twice as likely as males to have a stress fracture. Other athletes at risk are: sprinters, soccer and basketball players, jumpers, ballet dancers are at risk in the leg and foot. Gymnasts are also vulnerable in the spine while rowers, baseball pitchers, golfers and tennis players can experience the fracture with much less frequency in the ribs & arm.                                                              

The problem is much more prevalent in weight bearing repetitive, loading sports in which leanness is emphasized (ballet, cheerleading) or provides an advantage (distance running, gymnastics).

Stress fractures usually begin with a manageable, poorly localized pain with or immediately after activity such as a shin splint. Over time, pain becomes more localized and tender during activity and then progresses to pain with daily activity and at rest.

Causes of Stress Fractures:

• Overuse, Overload, Over training – is the number one cause. Running too many miles with too much intensity with too much frequency is the perfect formula.
• Inadequate Fitness Level – or activity level prior to the stress fracture. For example, the high school runner takes the summer off and then quickly accelerates his/her program to quickly for cross-country in August/September.
• Poor Biomechanics – when your feet hit the ground the forces are absorbed and transferred to the rest of the body. If the biomechanics of feet are not perfect, then the forces are not absorbed, and another body part bears too much force. For example, flat or pronated feet poorly absorb the shock and pull the tendons of the foot and shin.
• Recent Change in Training Schedule – sudden increased intensity or speed
• Recent Change in Running Surface – sudden change to a hard or soft surface
• Recent Change in Footwear – shoes too hard or too soft, too much control or too little control, too much pronation or too much supination
• Overweight – running with an extra 10 pounds and attempting to return to running as a method of weight loss
• Underweight – the underweight female athlete is at high risk for stress fractures. If underweight and have a history of menstral irregularities or and eating disorder, the risk of stress fracture increases significantly
• History of Stress Fractures – makes the athlete two times as likely to have another

Treatment & Management:

• Alternate Training – cross train with non-weight bearing activities: bike, swim, elliptical
• Gradually Build Up Fitness Level – wean into activity 1-2 miles, then add ½ mile at a time
• Correct Biomechanics - Orthotics, Running shoes, see a Podiatrist
• Gradual Change in Training Schedule
• Gradual Change in Surfaces – ½ run on soft surface, ½ run on hard surface
• Gradual Change in Footwear – walk in new shoes first, then run 1-2 miles
• If Overweight – gradual exercise with diet, not too much too quickly
  • Mix run & walk every 10 minutes
• If Underweight – improve diet maintain healthy body fat%
• Consult Family Physician – early management often involves immobilization, rest, pain medicine 4-6 weeks for healing.
  • non weight bearing cross training such as the recumbent bike, swimming, elliptical
  • physical therapy modalities such as ultrasound, cold with electrical stimulation, biomechanical taping or orthotic supports, and exercises for foot, ankle muscles.

Visit your doctor regularly and listen to your body.     

Read Health & Fitness Forum Next Monday/Sunday: Preparing Your First Aid Kit For the Steamtown Marathon

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!

Here are 10 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 sharp, deep, intense, or lingering pain during or after exercise. In fact, if the soreness lasts more than 24-48 hours, then 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 prepubescent males will bulk up from lifting weights…especially light weights (blame or thank hormones). It will, however, increase metabolism and fat burning efficiency which can lead to weight loss and good muscle tone. Stick with low resistance and high repetitions for best results.
4. With the Correct Program, Spot Reduction Can be Achieved
   • 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 problems 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 walking or running (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. 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 recovery) 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, I ran almost daily. However, now that I am over 60, I had to find new forms of aerobic exercise which would be kinder and gentler to my joints. So, I mix it up between biking (indoors and outdoors, recumbent and upright), brisk walking or hiking, elliptical and stepper and swimming laps. Again, like the caveman weightlifting example, the body (heart and lungs) does not know what is causing an increase in heart rate for 30, 45 or 60 minutes, it only knows that it must respond to allow the body to function under this stress. And, in the process it becomes conditioned to the point that it will work much more efficiently when not under stress with a lower heart and respiratory rate and blood pressure at rest.
     • Those over 50 would be well-advised to engage in low-impact aerobics on a regular basis. For example, if you want to run two to three days per week, do not run two days in a row and consider performing low impact exercise in between. Some examples of low impact aerobics are walking, treadmill walking, swimming, elliptical trainer, and an exercise or road bike.
10. 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 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.

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!

September is National Yoga Month - A Good Time to Begin!

 Healthy Mind, Body, and Spirit!

September is National Yoga Month! 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, it is meant to cultivate inner peace, enlightenment, and a strong relaxed body. In the past, only major cities housed yoga studios but over time it 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 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 it is a topic of debate.  However, it is said to have originated in India and was brought to the Western world by gurus in the late 19^th and early 20^th centuries. The basis for most current 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.  Classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures.

Types:

There are numerous styles of yoga.  If you are a newcomer, deciding on a 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 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 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 Poses:

Below you can find a few common 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.

Where to Practice:

There are a lot of options when it comes to where to start to practice. 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 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 Udomsak, PT, DPT | Model: Sarah Singer, PTA

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!

September is National Yoga Month - A Good Time to Begin!

Healthy Mind, Body, and Spirit!

Part I of II

September is National Yoga Month! 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 well-being. 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 19^th and early 20^th 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.

Benefits of Yoga

So what is with all the hype?  Why has yoga become so popular?  Many would say it is due to its numerous mental and physical health benefits.  Research has shown that yoga, when practiced regularly, can reduces stress levels and even boost one’s immune system. Regular stretching releases tension in the body and the controlled breathing and mediation decrease anxiety. Studies show that those who practice yoga habitually can have decreased blood pressure and cholesterol making them less prone to heart disease. Other ailments which are shown to be positively impacted by yoga include insomnia, depression, and chronic pain including low back pain and headaches. Yoga is an excellent way to combat the negative effects of stress on the body and cope with anxiety and angst.

In addition to stress reduction, yoga has many physical benefits.  These include increased flexibility, strength, and balance. Those who practice yoga regularly are often less prone to injury, such as a muscle strain or tear, due to their increased flexibility. Furthermore, yoga can be an effective way to strengthen one’s core which is crucial to maintaining ideal posture and protecting the back.  For athletes, yoga can be a great way to challenge one’s balance and improve stability.  In the elderly, it is a safe way to improve overall body awareness and decrease the risk of falling.  Yoga has also been shown to improve respiration and many report an overall increase in energy when incorporating yoga into their lives.

With all of the positive impacts yoga has on the body it is easy to see why it has become such a popular form of exercise.  There are classes to meet almost all needs and most poses can be modified based on ability. Yoga can be practiced by those of all ages and all fitness levels. Whether you’re looking for a way to loosen up tight muscles or you simply wish to quiet your mind for an hour, yoga is a tool to improve and maintain health. The only thing you need is a mat and an open mind. 

Is yoga right for me?

Yoga can be practiced by anyone. From children to adults to the elderly, there are classes for all ages and abilities.  It can be a form of cross training for athletes, especially runners who tend to have tight musculature.  It also promotes balance and core stability which may be beneficial to sportspersons including football players, soccer players, boxers, etc.  Furthermore, there are classes for the elderly which focus on balance and maintaining mobility. There are even prenatal yoga classes for pregnant women to promote deep breathing, flexibility and muscle tone. 

Next Week: Types of Yoga and Basic Poses

Guest Columnist: Catherine Udomsak, PT, DPT

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

STAY TUNED for Yoga: TYPES OF YOGA AND BASIC POSES: Part II of II!

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 Labor Day! There is little doubt that the workplace has been redefined since the pandemic as many employees continue to work from home. Sitting for many hours at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.

Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways.

For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.   

 Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics. 

Prevention of Lower Back Pain:

Maintain Fitness Level:

 As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of LBP and failure from lower back surgery.

Practice Good Posture & Body Mechanics:

Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back. Also, consider sitting on a physio ball, which promotes proper posture for part of the day.

Perform postural exercises throughout the day. Most of the day we sit, stand, and reaching forward and bend our spine. These exercises are designed to stretch your back in the opposite direction of flexion. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.

Chin Tuck: Tuck your chin back to bring your head over shoulders.

Shoulder Blade Pinch: Pinch your shoulder blades together.

Standing Extension: While standing, put your hands behind back and extend lower back 10-20 degrees.

Good Body Mechanics and ergonomics are also important in the prevention of LBP. When lifting, think twice. Think about the weight, shape and size of the object. Think about where the object is going and the surface resistance of the floor. Does it require two people to lift? Can I safely lift that high or bend that low?

When bending to lift an object think about safety:

 Proper Lifting Technique:

• Spread Legs Apart Shoulder Width
• Bend at the Knees and Limit Forward Bending the Spine
• Arch Lower Back Slightly
• Get and Maintain a Firm Grip
• Contract and Hold Abdominal (stomach) Muscles
• Lift With Legs (not back)
• Do Not Pivot or Rotate Spine With Load (use feet and step turn)
• Lift Slowly and Carefully (don’t hurry)
• Take Time to Perform Back Extension Stretches After the Lift
• Remember, Pushing is Better Than Pulling a Heavy Load

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!