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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 19th and early 20th 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:

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 19th and early 20th centuries. The basis for most current yoga practices is The Yoga Sutras of Patanjali.  In The Yoga Sutras, eight limbs of yoga are specified. The three most common limbs are meditation, pranayama or breathing exercises, and asana which are the physical poses.  Yoga classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures.

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!

While I fully expect to be at the “butt end” of many comments for this column, I feel compelled to address this topic at the request of several patients. It seems that many geriatric physical therapists commonly encounter patients that suffer from constipation which limits their participation in rehabilitation. Ironically, research demonstrates that exercise and activity actually help relieve constipation. 

The National Digestive Diseases Information Clearinghouse (NDDIC) reports that 3.1 million people in the United States suffer from constipation. The NDDIC further reports that this problem leads to almost 400,000 hospitalizations, 1.4 million visits to emergency rooms, 1 million prescriptions and 121 deaths each year. Constipation is defined by the Ohio University College of Osteopathic Medicine as three or less bowel movements per week. It is also estimated that more than 27 percent of the elderly are affected.

Severe constipation can result in immediate medical attention in some cases due to intestinal obstruction. In addition to infrequent bowel movements, some symptoms include: feeling poorly, weight loss, loss of appetite, abdominal distention and/or pain, and vomiting.

Risk Factors for Constipation:

Prevention of Constipation:

Healthy people must continue to keep active. Get into good exercise habits at a young age and continue through life. Maintaining a consistent schedule of eating and exercise is also helpful. Some simple suggestions for beginning an exercise program for prevention of constipation in the healthy population are:

Depending on your general health and ambulatory status, these endurance exercises may be appropriate for you. Therefore, consider one or two of the following as a good starting point:

IN CONCLUSION: KEEP MOVING YOUR BODY AND YOU WILL KEEP MOVING YOUR BOWELS!  

  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!

The number one health and wellness goal shared by most patients is …to lose weight! Today, this column will offer some sage and practical advice on satisfying hunger with healthy snacks and to help avoid unhealthy carbs. You have probably noticed a lot of attention being paid to sugar lately. In fact, some people have decided to avoid all refined sugars with the goal of improving their health and wellness. Terms like simple sugars and simple carbs, which are purported to be bad, and complex carbs, suggested to be good, are being used ad nauseam. While medical research does not support the value of a short term “sugar cleanse,” it may have value for another reason. For example, it would be very beneficial if one engages in a “sugar cleanse” for the purpose of changing their palate with the hope of developing long term healthy eating habits.

While I am an advocate of moderation, I decided to provide my readers with some answers to some simple questions about the fuss over sugar. What is simple sugar? What is complex sugar? Which sugars are good for you? What are some good low-carb snacks?

WHAT IS A SIMPLE SUGAR (CARBOHYDRATE)?

Sugars, along with starches and fibers, are one of three types of carbohydrates (also referred to as a carb). A carb is “simple” or “complex,” based on its chemical composition and how it is processed in the body. It gets a little complicated because some foods have both simple and complex carbs.  Typically, simple carbs are chemically “simpler” and more basic. Therefore they are broken down more easily and serve as a quick source of energy. Some of these carbs are naturally simple (like fruit and milk) while others are processed or refined sugars such as those used in candy, soda and baked goods.

To determine if a food product has good or bad simple sugar, you must also know how much fiber, vitamins and minerals are in the food. A food with a higher sugar content combined with a low fiber, vitamin or mineral content will be worse than a food with the same sugar content but high fiber and vitamins or minerals. For example: a candy bar, which is high in sugar without fiber or vitamins or minerals, is not as healthy as a fresh orange, which contains fiber, vitamins and minerals along with its simple sugar (fructose).

Examples of simple carbs:

Most candy products, non-diet soft drinks, cookies and cakes, iced tea and lemonade with sugar, energy drinks, and ice cream.

WHAT IS A COMPLEX SUGAR (CARBOHYDRATE)?

Complex carbs have a more complicated chemical makeup and take more time for the body to break down for use as energy. Therefore, these are considered “good” carbs because they provide a more even distribution of energy for the body to use during activity. They cause a more consistent and gradual release of sugar into the blood stream (as opposed to peaks and valleys caused by simple carbs) and provide energy to function throughout the day. Additionally, “good” carbs have the added benefit of providing vitamins, fiber, and minerals that are missing from simple carbs.

Examples of complex (carbs):

WHY EAT COMPLEX CARBS INSTEAD OF SIMPLE CARBS?

Remember that carbohydrates fuel the body and are an important source of energy, especially for active and athletic people. However, carefully selecting the type of carb you eat is critical to peak function and performance.

Simple carbs taste great (according to our modern brain raised on simple sugars) and are easy to break down into a quick source of energy. However, the sensation of hunger is quick to return because the sugar is released and used up in the body quickly, giving the sensation of needing more.

Simple carbs are often “refined.” Therefore stripped of their fiber, vitamins and minerals, which is why they are often referred to “empty” calories.

Simple carbs lead to rapid spikes in blood sugar and insulin levels after meals. When these levels are not controlled over time, it can lead to obesity. Ultimately relates to adult-onset diabetes and high blood pressure. 

10 Healthy Low-Carb Snacks:

Sources: webMD, NIH, CDC

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!

STAY ACTIVE & HAVE FUN IN THE SUN!

After such a long, cold and wet spring, we are all grateful that the 4th of July holiday weekend is here! There is still plenty of time to be outdoors in NEPA and experience so many activities such as: biking, hiking, running, walking, swimming, boating, golfing, and playing tennis to name a few. It is a wonderful opportunity to discover your inner child, mix it up and try something new! Below are some new and exciting ways to stay active and have fun in the sun:

Sunset or Moonlight Kayaking

Spending time on any of the beautiful lakes in NEPA is time well spent. From an exercise standpoint, rowing, canoeing and kayaking offer a very special experience. Most kayaks are light weight, easy to use and maneuverable on a lake. Sitting low on the water offers a unique perspective as you feel yourself gliding across the lake. The Countryside Conservancy, in partnership with Lackawanna State Park, sponsors moonlight kayak events on the lake at the park. With a bright full moon, you can begin at 8 pm and return at 10 pm. Bring bug spray and headlights to enjoy the sunset and moon rise on the lake. You will feel like a kid breaking the rules of the park by being on the water after dark!

NOTE: Try kayaking in the daytime first and then advance to sunset trips before staying on the water for the moonlight. Rentals are available at the park.

Gear:

Website: www.countrysideconservancy.org; www.dcnr.state.pa.us/stateparks.org  
 

Stand Up Paddleboarding:

Stand up paddleboarding (SUP) is becoming a fast-growing sport among water enthusiasts. It is a fun way to exercise your core, improve balance, and tone your upper body. Stand Up Paddleboarding requires minimal equipment; a board that is essentially a long and wide surfboard and a long paddle to use while standing on the board. It can be done in the ocean surf, bay, lakes, or rivers; however, beginners would be wise to stay in calm water. Rentals are available at most beaches.

Check out the video for more information: REI paddleboard basics

Elliptical Pedalboarding:

What is it? Imagine a standup paddleboard with a handlebar and pedals like a exercise stepper machine. Instead of using a paddle, you step up and down on the pedals and fins under the board propel you through the water.

Check it out…Hobie Mirage Eclipse Stand Up Pedalboard; Dick’s Sporting Goods

Aqua Zumba:

Zumba is a very popular form of dance aerobics spiced up with Latin music. When adding water and sun to this already cool activity, you are assured to have fun while exercising. As with any aquatic exercise, the added resistance from the water gives arm rows and leg kicks more challenge. Female participants report an additional benefit; they are uninhibited to “shake that thing” to the music under the cover of the water. So, beat the heat, let loose and get some fun in the sun while you exercise.

NOTE: Consider trying regular Zumba first to get the hang of it. Amy Sekol is a local certified Zumba instructor and also offers Aqua Zumba. (amys.zumba.com)

Website: www.zumba.com

Elliptical Biking:

I love this idea…why didn’t I think of it first! In the gym I enjoy the elliptical machine because it simulates running without the impact on my joints but of course, I would rather be outdoors. Well, this is the answer to my prayers…an elliptical machine that is attached to a bike with handle bars and brakes included. I think it will probably be difficult on steep hills but it is something I MUST TRY!

Website: www.elliptigo.com;  www.mywingflyer.com

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!

Recently, a reader shared with me their concern about the aging process. They were not happy with the changes in their body, despite exercising regularly. New research suggests that there may be some forms of exercise that are better than others to counteract the aging process. With the accumulation of more and more birthdays, I too, am concerned about the changes in my body!

The deterioration and degeneration of the body associated with the aging process is well-documented and the musculoskeletal system is no exception. As we age, weight bearing joints of the lower body (hips and knees) frequently suffer from wear and tear degeneration. Loss of muscle mass and strength is also common with age. Specifically, damage to older muscles has been found to regenerate slowly and incompletely and the problem runs as deep as the cellular level as the mitochondria diminish in quality and quantity. However, there is good news: a recent study published this spring in Cell Metabolism suggests that certain types of exercise can actually regenerate and reverse the aging mitochondria.  

As popular and common as exercise is, little is known about the influence and impact it has on the cellular level. A research team at the Mayo Clinic decided to answer this question and conducted an experiment to determine the cellular effects of different types of exercise on aging muscles.

THE STUDY

The Mayo team chose 72 men and women and separated them into two groups: 30 and under and older than 64. All subjects were healthy but sedentary. Pretest analysis was performed for blood sugar levels, gene activity, muscle cell mitochondrial health, and aerobic fitness level. Subjects from the 30 and under group and the over 64 group were randomly assigned to one of four research groups.

Group One: Vigorous weight training 3-5 times per week, Group Two: Interval aerobic exercise on a stationary bike (pedaling hard and fast for four minutes followed by a recovery at a slow pace for three minutes then repeating the sequence 3 or more times) 3 times per week, Group Three: Moderate aerobic exercise on a stationary bike for 30 minutes 2-3 days per week and light weight lifting on the other 2-3 days, Group Four: Control group who did not exercise. After 12 weeks, lab tests were repeated and data compiled and analyzed.   

THE RESULTS

In the 30 and under group as well as the over 64 group, all three experimental groups improved in fitness level and blood sugar regulation. As expected, Group One, the vigorous weight training group, showed the greatest gains in muscle mass and strength. Also, not surprisingly, Group Two, the interval training group, had the greatest gains in endurance. However, the most unexpected results came when retesting the muscle cells by biopsy. Only group two, the interval aerobic exercise group demonstrated the most significant improvement in the activity levels of their genes in both the young and older groups, when compared to the vigorous weight training and moderate exercise groups.

Moreover, the positive improvements in the genes of the older group far surpassed that found in the younger group. For example, in the younger group, 274 genes improved compared to 170 genes in the moderate exercise group and 74 in the vigorous weight training. In the older group, 400 genes were improved in the interval aerobic group while 33 for weight training and 19 for moderate exercise groups.

CONCLUSION

It is well known that loss of muscle mass and strength is common with age. Specifically, older muscles have been found to regenerate slowly and incompletely, and the problem runs as deep as the cellular level as the mitochondria diminishes in quality and quantity. However, this study suggests that interval aerobic exercise can regenerate and reverse the aging mitochondria. Healthier mitochondria can produce energy for muscle cells to function at a higher level.

TAKE HOME

Interval aerobic exercise can have anti-aging effects. In fact, the older your muscles, the more you will benefit from, not just moderate exercise, but more vigorous interval aerobic exercise. Furthermore, interval training may be applied, not only to aerobic exercise, but to weight training for the upper and lower body. According to the American College of Sports Medicine, high intensity interval training, also called HIIT workouts, involves a repetition of a series of high-intensity exercise (aerobic or weight training) for a specific period of time (3-5 minutes) followed by a specific period of rest or low-intensity exercise (1-3 minutes).

The intensity can be increased by speed or resistance. HIIT workouts have been associated with increased caloric expenditure with less exercise time, as well as improved strength and endurance. Most recently, it has been found to improve cell energy in the aging population. However, do not attempt to increase the intensity of your exercise program without consulting with your physician first. Once medially approved, consult with a Doctor of Physical Therapy to create a program specifically designed for you.    

Therefore, if your gene pool is questionable like most of us, don’t use that as an excuse.  There are things you can do to have a positive impact on your DNA to live longer and healthier…one of them is EXERCISE!

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!

Part II of II

Last week’s column was dedicated to Rosie Malloy as we discussed the importance of laughter for health and wellness. In this column, I will discuss one of the most understated benefits of exercise – mental health! Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness by helping reduce depression.

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

Depression is the most common mental disorder and is twice as common among women as in men. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician. Unfortunately, depression is on the increase in the United States. According to the National Ambulatory Medical Care Survey, in the 1990’s, 7 million visits to a primary care physician were for the treatment of depression. 10 years later the number doubled.

HOW EXERCISE REDUCES DEPRESSION:

According to copious amounts of scientific research, exercise improves health and wellness and reduces depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Depression:

Physiological or Physical Benefits of Exercise on Depression:

HOW TO BEGIN EXERCISE FOR DEPRESSION:

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

SOURCES: British Journal of Medicine: Journal of Exercise and Sports Science

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.comPaul 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!

This column is dedicated to the family and friends of Rosemay “Rosie” Malloy and her wonderful disposition and laughter. Losing Rosie this past fall has left a painful void for those among us who were fortunate to know her and call her friend. Moreover, Rosie was an inspiration and role model for all who were paying attention…she was the embodiment of a quote by Dr. Paul Mercer, “laughter is the best medicine!”

Despite having her share of serious health problems that would wipe the smile off any reasonable face Rosie smiled her way to health and happiness. And, if she wasn’t up to the smiling task, she was always surrounded by her laughing and smiling family….it was contagious and infectious!

*Scientific evidence supports the notion that “laughter is the best medicine” as studies of tens of thousands of seniors found that those who find it difficult to laugh and smile have a much higher risk of developing functional disabilities. The biological explanation of how laughter reduces stress, anxiety and depression has to do with the stress-reducing effects of suppressing epinephrine and cortisol while enhancing the levels of dopamine and serotonin which are hormones linked to happiness. In fact, deficiencies in both dopamine and serotonin are linked to depression.

While laughter has been found to decrease stress and improve mood, it has also been linked to improved physical and mental resilience. It is good for relationships and a powerful tool for dealing with conflict and tension.

BENEFITS OF LAUGHTER:

  1. Relieve Pain – Laughter releases natural pain hormones such as endorphins.
  2. Improve Mood, Decrease Depression and Anxiety – Laughing releases hormones (endorphin, serotonin, and others) that are related to happiness and comfort.
  3. Improves Relationships – Laughing with others binds people together. It is a contagious behavior that benefits all participating parties.
  4. Offers an Alternative Perspective – Laughter fosters a different perspective to a situation or problem which can be less threatening or difficult.
  5. Reduce Stress and Tension – Laughter, especially a hearty “belly laugh,” promotes blood circulation and muscle relaxation by reducing the production of the stress hormone, cortisol.
  6. Improve Immune System – A positive outlook associated with laughter can release neuropeptides that are associated with a boost to the immune system.
  7. Improve Resilience – Laughing at our mistakes and problems helps us realize that mistakes and problems are just a normal part of life.

Recent research is very encouraging and supports the use of laughter and exercise to prevent and treat depression as a powerful adjunct to therapy and medication. While it is important to state that depression is no laughing matter, many mental health professionals support it as a method to confront an unpleasant situation and gain some level of control over it. One study showed that elderly people who used humor on a regular basis, reported improved satisfaction in life as compared to their less humorous contemporaries.

4 Tips to Improve Your Sense of Humor:

  1. Hang Around With Fun and Funny People - Whenever possible, try to associate with good people who “pick you up” and have good karma. Avoid people who are “downers” and tend to “such the oxygen” out of the room.
  2. Listen to Jokes & Learn to Enjoy Them - While this may be difficult to do when your down, but it will go a long way to pick you up.
  3. Learn to Tell a Joke - This is also not easy but very important to improve your sense of humor. It will help you rediscover your “inner child.” Ease into it and start slowly. Practice in front of a mirror in the privacy of your home. Begin using it on family and good friends.
  4. Joke About Your Depression - It will be cathartic. For example, “oh my God, that would be so funny if I wasn’t depressed!” “Don’t tell my shrink I laughed so hard because he will take away my meds!” Don’t put yourself down but laugh at yourself if you mess up telling a joke or trying to be funny. Then, try again.

*Sources: NIH, Japanese Gerontological Evaluation Study, LifeScript.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!

Part II of II

Last week, this column discussed the many benefits of snowshoeing as an option for those in NEPA to get outdoors and enjoy the winter. Today’s column will present another option for outdoor exercise when the weather is inclement…winter walking or running.

We live in such a beautiful environment. Each season brings its own unique beauty and winter is no different. Most will not have to abandon outdoor activities, but you must make some adjustments in equipment, clothing and food for each season and temperature changes that go with it. These tips are also appropriate for those who qualified for the Boston Marathon in the spring and will be training all winter, as well as those who enjoy walking and running throughout the winter for exercise. Consider the importance of making changes and adjustments in training as well as clothing and equipment, according to the weather and temperature.

SHOES AND EQUIPMENT for WINTER:

There are running shoes specifically designed for use in wet, cold and sloppy winter conditions. These running shoes, which can also be used for walking, are considered “winterized” because they offer waterproofing, sealed seams, gaiter collars to keep out snow and slop, slip resistant fabric, anti-roll stability features, anti-microbial material and aggressive tread patterns for traction on slippery surfaces. Some shoe recommendations for both walkers and runners include:

Additionally, I am a strong proponent of walking with trekking poles for improved balance and safety when brisk walking in winter conditions. They are light weight, adjustable, and collapsible. Some examples are:  Trekology Trek Z 2.0 – 45. and REI Co-op Trailmade $79.00. Also, an old pair of ski poles will work just fine.

Winter CLOTHING AND TRAINING:

Over the past several years great strides have been made on understanding the effects of extreme temperatures on performance. Current wisdom from the University of Otago in New Zealand has found:

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!

Part I of II

When I was a young boy growing up in NEPA, one of my favorite winter things was to walk in the freshly fallen snow. I loved the feel of fresh crisp air through my lungs, the mesmerizing sparkle of snow falling in the moonlight, the peaceful sound of silence as pedestrian and motor traffic came to a halt and only thing audible was the muffled sound of my boots as they crunched the snow beneath… for me, if it is sizzling hot in hell, it snows in heaven! Well, I am happy to share with you, as I struggle to hold on tightly to my “inner child,” I am as excited and inspired by a walk in the snow today, as I was 45 years ago. It is my hope, that this column will inspire my readers to consider a beautiful walk in the snow to rediscover their “inner child.”  

While there are many options and opportunities available to enjoy winter in NEPA such as downhill skiing, cross country skiing, winter mountain biking, ice skating, and sled riding, none is as easy and natural as snowshoeing.

The advantages are many:

As a result, the popularity of snowshoeing is growing rapidly. According to the Outdoor Industry Association, the number of snowshoe participants have increased by 7.5% to 4.1 million in 2011 and 40.7% overall since 2008.  

History (Raquettes GV, Quebec, Canada  info@gvsnowshoes.com)

While the advent of the wheel is estimated to have been approximately 3,500 BC, the snowshoe had already been established and developed by 6,000 BC according to Stone Age engravings found in Norway. The snowshoe was an instrumental tool used by early humans to cross the Bering Strait into North America.

Some historians feel the snowshoe developed, like many great inventions, as an imitation of nature. For example, animals such as the snowshoe hare use expansive feet to increase their surface area, limit sinking and move more efficiently through the deep snow. Hardwood frames with leather webbed lacing comprised the early snowshoes used by fur trappers, traders, and Native Americans. More recently, materials have advanced and light but durable aluminum frames comprise snowshoes that are used by park rangers and winter recreation enthusiasts.    

Equipment - Choosing the right snowshoe

3 Types:
  1. Recreational Hiking Snowshoes - Recreation shoes are a good choice for beginners to be used on easy terrain, paths and    trails.
  2. Aerobic/Fitness Snowshoes - Aerobic shoes offer a sleeker and lighter design for those interested in running or cross-training.
  3. Hiking/Backpacking Snowshoes - Hiking shoes offer a strong and durable frame, slightly wider base of support and strong flexible bindings for difficult terrain.

Cost of Snowshoeing:

Like all sporting equipment, you usually get what you pay for. Snowshoes range in cost from $50.00 to $300.00. Most people will be fine in a good pair for under $100.00. LL Bean and Dick’s Sporting Goods and Sierra Store offer several affordable options.

Some equipment examples are Tubbs Wayfinder Flat - $199 and Redfeather  - $82.00. Ski poles are recommended for efficiency when snowshoeing. Traditional ski poles or adjustable hiking poles can be used. Warm and supportive winter boots or hiking shoes are essential.

Now you are ready to go! The next time a snow storm dumps 8 – 10 inches on NEPA, get outside BEFORE the streets are plowed. Put on you warm winter boots, strap them into the bindings of your new snowshoes and walk out your front door and explore your neighborhood as you have never seen it before...white, clean, glistening, crisp and quiet. Let your mind wander, enjoy winter and rediscover your inner child!

Next Week: Part II of II...Winter Walking and Running

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!