Health Archives - Mackarey & Mackarey PT

Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what type of exercise is best for those suffering from osteoarthritis (OA). Osteoarthritis is also known as degenerative arthritis. It is the most common form of arthritis in the knee. It is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface. It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the involved joint, especially after increased activity and weakness with loss of function due to disuse.

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

Benefits of Exercise for Those with OA:

When performed correctly, exercise for those with OA has many benefits:

Pain Control

Exercise controls OA pain by releasing natural pain control chemicals in the body called endorphins. It also controls pain by assisting in weight loss and improving range of motion.

Weight Control

We all know how well exercise burns calories and that increased body weight creates increase stress on the joints.

Prevention of Joint Stiffness

Exercise will help maintain joint range of motion. A stiff joint is a painful joint.

Prevention of Muscle Weakness

Exercise will help maintain muscle strength. Weak muscles will allow or increase in joint wear and tear.

Maintain Lifestyle

If a joint is stiff and weak, then they become painful which negatively impacts your lifestyle. Exercise can prevent this problem.

Tips How To Exercise With Osteoarthritis:

Start Slowly

Wean into exercise because if you advance too quickly, you will flare up the joint and have increased pain. For example, walk for 5-10 minutes the first session. If you do not have pain, add 1-2 minutes each session.

Lose Weight

Every pound lost equates to less stress on your joints. For example, a loss of 5 pounds of body weight translates to 20-30 pounds of stress through the knee, according to David Borenstein, MD, President of the American College of Rheumatology. Also, body weight has a direct impact on daily activities. For example, walking upstairs creates stress through the knee equal to 4 times body weight and seven times body weight going downstairs. Therefore, less body weight equals less stress.

Low Impact Workouts

Low impact exercise creates less stress on the joints while strengthening leg muscles and those who those who maintain leg muscle strength have less stress on their joints. It is even important not to load your arms with heavy objects when walking or using stairs to limit joint stress.

Some examples of low-impact exercises are: walking, swimming, elliptical trainer, and biking. Strength training is also low-impact and should be performed with low weight and high repetitions. Water therapy is great for those with OA, especially in a heated pool. It is a great low-impact exercise with less gravity and stress on the joints. Walk, swim and do mild resistance exercises in the water. Use a snorkel and mask for swimming to limit excessive neck turning and back extension.

Walking is a great form of exercise; however, walking softly is important for those with OA. Wear good running shoes and orthotics if necessary. Discuss this with your physical therapist or podiatrist. When possible, use soft surfaces like cinder, mulch or rubber. Avoid grass and soft stand due to instability and torsion that may irritate your joints.

Warm-Up

Warming up your body is critical to prevent injury to the muscles and tendons. This can be done by marching in place or using aerobic equipment such as a bike for 5 to 10 minutes before exercise. Always perform the warm-up activity at ½ your normal pace.

Balance & Relaxation Techniques

Tai Chi and ballroom dancing are two good examples of activities which promote balance and relaxation. Studies showed that those with OA who participated in Tia Chi two times a week for eight weeks reported less pain, increased range of motion and improved daily activities and function. They also noted less low back pain and better sleeping.

Proper Clothing

Stay warm in winter and consider wearing compression shorts. Be cool in the summer months with Drytech^R type material.

Pre/Post Exercise First Aid

If you are sore for longer than 12 to 24 hours after exercise, then you overdid it and must make adjustments next time. Otherwise, use hot packs, bath or shower before you exercise to loosen up and apply ice to your joints after exercise, especially if they are sore.

Post Exercise Stretch

Gentle, active range of motion stretches after exercise is important to maintain mobility. Do not bounce or cause pain. For example: Low Back – knees to chest; Arms – row –the – boat, arms behind head, arms behind back; Legs – wall lean calf stretch, bend and extend knees, open and close hips.

SOURCES: Rothman Institute, Philadelphia, PA and American Academy of Orthopaedic Surgeons; www.lifescript.com

Visit your doctor regularly and listen to your body.

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

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy 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!

There are Many Positives About Aging!

Ageism is prejudice or discrimination on the grounds of a person’s age…

While I hesitate to discuss politics, as an aging physical therapist, I feel that it is incumbent upon me to speak out against ageism, especially with so much attention being paid to the age of the candidates in the upcoming US presidential election. Interestingly enough, age seems to be of more concern for President Biden (age 81), than his opponent, former President Trump (age 78), even though there is only 4 years between them. By the way, “Corporate Sages,” Warren Buffett, CEO of Berkshire Hathaway is 93 years old and Rupert Murdock, CEO of News Corp is 86 years old and their stock holders seem very satisfied! Two local examples of aging with an “A Game” are my 92 year old mentor, Dr. Gino Mori, founder of Delta Medix, who took college classes for enrichment until the age of 90 and Fr. Bernard Mcllhenny, SJ, retired dean of admissions at the University of Scranton, who plays golf (competitively) at least once a week at the age of 98.

It is low hanging fruit to list all the problems associated with age; muscle and bone loss, balance deficits, delayed mental processing, and memory loss to name a few. However, the purpose of this column is to present the positive qualities of the “golden years!”

Wisdom, Wisdom, Wisdom

There are no shortcuts for the assimilation and accumulation of knowledge and wisdom that one acquires over a lifetime and it cannot be taught…only experienced! Not only do older adults know what they know, more importantly, they know what they DON’T know! Moreover, they know how to use this knowledge efficiently and effectively. This is referred to as “crystallized intelligence” and it keeps improving with age…even at 65-75 and more.

Steady Eddie

While the term “Grumpy Old Men/Women” makes for good TV, the reality is that most of us get more agreeable, likable and consistent with age. Older people are less volatile, control their emotions and tend to focus more on the important things in life.

Collegiality

With age, people tend to be less egocentric and more in tune with the feelings and emotions of others. Using this acquired insight, one can foster a more cooperative and productive solution to problems with friends, family and coworkers.

Improved Sex Life

Quality over quantity with age! Studies show that women over 40 and much older have improved sexual satisfaction when compared to their youth. Moreover, women over 80 were more satisfied with sex than those between 55 and 75! Go figure!

Enjoy the Sunrise

Whether you like it or not, there is a good chance that you will become a “morning person” with age. As sleeping patterns change, including sleep interruptions, we tend to go to bed earlier and rise and shine with the sun. The good news is that you can start your day early to “suck the marrow” out of the day.

Headaches Are Over

Most migraine sufferers report little to no headaches after age 70. And, for older adults who experience headaches, they tend to be less painful and debilitating.

Have a Purpose

Studies show that early retirement may not be good for your health. The Longevity Project that people who continue to be productive, have purpose, and enjoy their work, live the longest. So maybe, Biden and Trump want the POTUS job in order to stay healthy!

Fear Not

While older adults may fear falling and breaking a bone, they don’t have the same fears and concerns that distract many younger people. With age, self-esteem and confidence improves and with wealth, education, good health and a sense of purpose, these qualities increase exponentially. According to the American Psychological Association, while more young people report high stress levels, older Americans report less. And, even when encountering a stressful situation, older people have learned coping methods to manage it better than younger people.

Productivity

We can waste our time debating the potential problems with an aging POTUS, however, we must decide between two candidates that will be octogenarians while in office. With that in mind, we must focus on the potential for solid, honest, dedicated, effective and productive leadership to guide us through the next four years. Research has shown that the workforce is aging worldwide and older workers are a critical component to overall productivity in an age of worker shortages. A thorough assessment of the literature related to the productivity of an aging workforce shows that older workers are at least as productive and in some cases (that does not require heavy labor), are more productive than their younger coworkers. In great part, this is attributed to the aforementioned positive aspects of aging such as “crystallized intelligence”. In view of this, ageism has no place in the workplace because older workers can and do keep up.

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

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JUNE IS GREAT OUTDOORS MONTH! AS WE KICK OFF SUMMER AND CELEBRATE THE FOUR OF JULY, MAKE TIME TO GET THE HECK OUTSIDE! Research shows that spending time outdoors has many positive effects on your health. While there are many year-round activity options, in Northeastern Pennsylvania our short-lived summer is the inspiration to “suck the marrow out of a sunny day!” Summer in NEPA is enjoyed in many ways such as walking, running, hiking, biking, horseback riding, boating, kayaking, and swimming. Studies show that even less vigorous activities such as fishing, picnicking camping, barbequing, or reading a good book on the porch are healthier than being indoors.

It is reported that Americans spend 90% of their lives indoors and that number increases with age. Worse yet, for some, venturing outdoors is considered risky behavior with fear of the sun, ticks, wind, mosquitoes, and other creatures of God. Well, the truth of the matter is the risk of being one with nature is far less than the ill effects of a life stuck indoors. Please consider the following benefits of spending time outdoors.

Benefits of being Outdoors:

Nature’s Vitamin D – Current research suggests that Vitamin D (The Sunshine Vitamin), may offer significant disease prevention and healing powers for osteoporosis, some forms of cancer and heart disease. Of all the methods of getting an adequate amount of Vitamin D, none is more fun than spending time outdoors in the sunlight. It seems that the health concerns of ultraviolet light, sun burn, and skin cancer have created an overreaction to the point of Vitamin D deficiency in many. Balance and common sense go a long way. One can attain normal levels of Vitamin D by being outdoors in the sun and exposing their arms and legs for 10 -15 minutes a few times per week. Additional time in the sun warrants sunscreen and Vitamin D supplements can be used if necessary.

Increase Activity Level – While exercising indoors in a gym is valuable, research shows that time spent indoors is associated with being sedentary and being sedentary is associated with obesity, especially in children. Some studies show that children in the United States spend an average of 6 ½ hours per day with electronic devices such as computers, video games and television. It is also reported that a child’s activity level more than doubles when they are outdoors. So, get out of the office, house, and gym as often as possible. Consider weight training at the gym and doing cardio by walking, biking, or running outdoors.

Improved Mental Health – It is well documented that light affects mood. So, unless you live in a glass house or a light box, getting outdoors is important to your mental health. Furthermore, studies show that exercising outdoors in the presence of nature, even for as little as 5- 10 minutes has additional mental health benefits. For those less active, read or listen to music in a hammock or lying in the grass.

Improved Concentration – Richard Louv, author of the book, “Last Child in the Woods,” coined the term, nature-deficit disorder.” This term is supported by research that found children with ADHD focus better when outdoors. Furthermore, it was discovered that these children scored higher on concentration tests following a walk in the park than they did after a walk in their residential neighborhoods or downtown areas, showing the benefit of the “green outdoors.”

Improved Health and Healing – Researchers at the University of Pittsburgh found that patients recovering from surgery recovered faster with less pain and shorter hospital stays when they were exposed to natural light. Next time you’re recovering from an illness, discuss this with your physician.

Improved Breathing – In general, breathing fresh air is good for you. Some exceptions might be those with severe allergy problems when the pollen count is high. Despite this, it may be better to take allergy medicine and enjoy the benefits of being outdoors than to be stuck inside. Many pulmonologists believe people with pulmonary problems would benefit from outdoor activities such as a 10–15-minute walk because they are prone to osteoporosis and Vitamin D deficiency. Local pulmonologist, Dr. Gregory Cali, DO, agrees, and also adds that studies do not show that high humidity is dangerous for respiratory patients, but it may be uncomfortable. In cold temperatures, those with pulmonary problems must avoid directly breathing cold air by covering up their mouths when walking outdoors. Overall, the benefits far outweigh the risks.

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February is National Cancer Prevention Month and March is Colorectal Cancer Awareness Month. Unfortunately, according to a study conducted by Northeast Regional Cancer Institute (NRCI), our area has a higher rate of cancer compared to the rest of the United States. Residents of NEPA must be vigilant! While there is no fool-proof method for cancer prevention, scientific research does support the fact that healthy lifestyle choices are essential.

Important Tips to Reduce Your Risk of Cancer:

AVOID SMOKE AND SMOKING! - Perhaps the most important thing one can do to prevent cancer is to avoid smoking…first hand or second hand. It has been directly linked to cancer of the lung, head and neck, bladder and pancreas and others. Smoking increases the risk of lung cancer by 20 to 30 times.
Exercise, Exercise, Exercise - 30 -45 Minutes of moderate exercise or physical activity 4-5 days per week is recommended to reduce the risk of cancer. Walk, ride a bike, swim, or join a gym, just do something! However, individuals exercising for longer durations at higher intensities were shown to experience the greatest reduction in their risk cancer.
- Why Exercise Works - Various biological mechanisms including hormonal changes have been suggested as possible reasons for the reduction in cancer through exercise. However, current research has demonstrated a strong link between cancer and stress. Stress, which reduces our body’s natural defense mechanisms, such as adrenal cortical or stress hormones, increases our susceptibility to disease including cancer. Exercise and physical activity has been shown to not only reduce stress, anxiety, and depression but also to elevate mood. These psychological improvements may be the reason why exercise and physical activity are effective in preventing cancer.
  - Obesity as a risk factor for cancer has been demonstrated in the scientific literature for years. Individuals that are more physically active are usually not overweight. Exercise increases basal metabolic rate, expends calories, and burns fat to help control your weight and to help maintain a more normal lean body mass. Physical activity and exercise prevent obesity.
- Colorectal Cancer - Physical activity and exercise has been shown to have the greatest prevention against colorectal cancer. Colorectal cancer is the second leading cause of cancer death among American men and women combined. Physical activity reduced the risk of colorectal cancer up to 70% for both men and women.
- Breast Cancer - Research has been able to establish a similar relationship between physical activity and breast cancer. Approximately one out of every eight women in the United States can develop breast cancer at some point in their lifetime. Exercise has been shown to reduce the risk of breast cancer up to 40%.
- Prostate Cancer - Prostate cancer, the second most common cause of male death, will affect one in every five American males. However, the risk of prostate cancer can be reduced up to 30% through physical activity and exercise. Researchers hypothesize that exercise may have its greatest protective effect against prostate cancer when initiated early in a man’s life.
- Cancer of the Lung/Uterus/Cervix - Lung cancer is the leading cause of cancer death in the United States. Cancers of the uterus and cervix will accounts for 7,400 deaths annually in the United States. Exercise and physical activity can reduce the risk of lung and uterine/cervical cancer up to 40% and 90%, respectively.
Avoid Obesity and Stress - Both obesity and stress, as mentioned above, have been linked with cancer of various types. A healthy low-fat diet, limited in red meat, with moderate amounts of fish, rich in fruits, vegetables and nuts along with and regular exercise are essential components for prevention , especially for colorectal and prostate cancer.
Use a Water Filter - The use of a good home water filter has many healthy benefits. It may reduce your exposure to carcinogens and other harmful chemicals. Also, using a steel or glass container to store drinking water is important to avoid chemicals such as BPA found in plastic bottles.
Drink Plenty of Water - The American Cancer Society recommends drinking more than 8 cups of water per day to prevent bladder cancer by diluting the concentration of urine in the bladder.
Limit Consumption of Meat - Processed, charred, blackened, and well-done meats are associated with heterocyclic amines, which are cancer causing and formed when charcoal broiling meat. Marinating meat for an extended time prior to grilling has been recommended to improve safety according to some studies.
Eat Green Vegetables - Some studies suggest that the really dark greens such as spinach, kale, collards and broccoli are valuable in cancer preventions. Endive, arugula, and romaine must be added to this list.
Eat Nuts - Some studies show that snacking on Brazil nuts and other nuts high in antioxidants, lowers the risk of some cancers such as bladder, lung and colorectal.
Limit Sun Exposure - Take time to use adequate sun block and proper clothing to protect your skin from the sun to prevent skin cancer, especially if you are light skinned. At all costs, avoid sunburn!
Eat Organic and Natural Foods - When possible, buy fresh foods and meats free of antibiotic and hormones. Choose organic produce grown free of pesticides. Eat farm-raised fish and limit consumption of fish from waters high in mercury concentration
Visit Your Physician Regularly - Regular check-ups by your physician is essential to stay healthy and have early detection of disease. Many tests and vaccinations offer life saving information such as: PAP tests, mammograms, colonoscopies, PSA blood tests and others. Ask your physician about new vaccinations such as HPV, Human Papillomavirus. These are important for the prevention of cervical cancer in women and head and neck cancer in men.

Source: American Cancer Society

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

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Kick Start Your Wellness New Year’s Resolutions: PART II OF II

January is the time of year that many people set goals and resolve to be their very best. Not surprisingly, weight loss and fitness are the most common resolutions. It is also a time when many residents of NEPA will plan vacations and travel to warmer climates. Well, it may be that you can do both… This year consider visiting a “Fitness Resort.” According to “FitStays,” fitness resorts are rapidly gaining popularity for people of all sizes and shapes. Last week in Part I of “Fitness Resorts” we discussed value of fitness resorts. This week we will present “a typical day, how long you should stay, expected costs, and some recommended resorts.

What is a Fitness Resort? (fitstays.com)

A fitness resort is a vacation destination where travelers go to exercise and lose weight. Sometimes called a “weight loss resort”, “fitness retreat”, “wellness resort”, “weight loss boot camp”, or “adult fat camp”, fitness resorts around the United States cater to people of all shapes and sizes.

Most fitness resorts consist of pre-determined, calorie-limited menus to help travelers in their weight loss journey. Some resorts promote menus of 1,000 to 1,500 calories-per-day, which is fewer than most people burn naturally via their resting metabolic rate (RMR).

In addition to net-negative calories through nutrition, fitness resorts and retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to strength classes, cardio, sports, and other physical activities.

The combination of healthy nutrition and active exercise means that most visitors can expect to lose weight at a fitness resort. Specific weight loss goals are determined by which fitness resort you pick, how long you stay, and how strenuously you want to stick to the program.

Fitness Resort – What’s it all about?

Fitness resorts (fitness retreats) are not your average “Reality TV Fat Camp.” In fact, your do not have to be excessively overweight to attend as people of all shapes and sizes benefit and enjoy the experience. Thousands of people chose to visit fitness resorts and fitness retreats every year because they are looking for a healthy alternative to a typical vacation. Instead, many want to “kick-start” a healthy lifestyle in a controlled environment. The basic concept of combining a limited-calorie diet with daily exercise, most people will have net-negative calories every day, lose weight, and gain strength and endurance at a fitness resort—provided they stick to the program.

Length of Time/Cost

Typically, fitness resorts offer one week programs but multiple weeks with a variety of options are available. However, for the best outcomes and carryover, experts recommend 2-3 weeks for your first visit to a fitness resort.

Fitness resorts, like everything else, vary in cost. According to FitStay, programs cost as little as $1,500 per week (all-inclusive), while some are more than $7,000 per week.

To choose the best fit for you, your budget, and goals, visit fitstay.com. Remember, most fitness resorts are all-inclusive, meaning that you won’t need to budget any extra for food. The program includes meals. Also, when choosing a fitness resort consider: location (where would you like to travel?); cost (how much can you afford to spend?); how long can you stay (one, two or three weeks?)

FitStays – Top 20 Fitness Retreats (7 of these discussed below):

NOTE: One of these includes a fitness retreat in our very own Pocono Mountains!

Structure House - a residential weight loss center in Durham, North Carolina. This all-inclusive health resort promotes physical, nutritional, and behavioral principles for helping guests achieve their wellness goals. Packages at Structure House can be purchased for weekly, monthly, or longer stays.
Skyterra Wellness Retreat - an all-inclusive fitness resort and wellness retreat designed to help guests lose weight, gain muscle, and feel-better. Located in Pisgah Forest, North Carolina, Skyterra offers year-round packages in their lodge-style accommodations which include all meals, fitness classes, activities, and education.
Live In Fitness - Originally located in Long Beach, California, “Live In Fitness” has temporarily moved to a new location in Scottsdale, Arizona. It is an all-inclusive fat camp and promotes weight loss results rather than spa services.
Weight Crafters - a popular weight loss camp located in the Tampa-St. Petersburg Florida area. The all-inclusive retreat program is focused on helping guests relieve stress, maximize wellness, lose weight, and improve their physical fitness
Pocono Trails Adult Fitness Camps - offers fitness camps for young adults, moms, and families. Their young adult camp is designed for men and women ages 18 to 25. While the mom and family camps are open to those respective groups each summer. All camps take place at the Pocono Trails location in Reeders, Pennsylvania, along with their standard Camp Pocono Trails weight loss camp and Internet Habit Reversal Camp for kids and teens.
Biggest Loser Resort - a fitness resort in Java Center, NY. While the resort is named after the popular reality TV competition, the program itself is designed around healthy weight loss, rather than dramatic, short-term results.
The Biggest Loser Resort places a major emphasis on exercise and calorie-controlled meals, with programs designed to accommodate multiple fitness levels.
Hippocrates Health Institute - is located at the Hippocrates Health Institute in West Palm Beach, Florida. At this wellness resort, there is a heavy emphasis on diet and nutrition. Fitness may be a secondary focus, but you will still expect to exercise 4 hours every day, with a mix of strength and cardio classes.

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

Kick Start Your Wellness New Year’s Resolutions- Part I of II

What is a Fitness Resort? (fitstays.com)

In addition to net-negative calories through nutrition, fitness resorts and fitness retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to cardio and strength classes and assorted sports and other physical activities.

The combination of healthy nutrition and active exercise means that most visitors can expect to lose weight at a fitness resort. Specific weight loss goals will be determined by which fitness resort you pick, how long you stay, and how strenuously you want to stick to the program.

Fitness Resort – What’s it all about?

Fitness resorts (fitness retreats) are not your average “Reality TV Fat Camp.” In fact, you do not have to be excessively overweight to attend as people of all shapes and sizes benefit and enjoy the experience. Thousands of people chose to visit fitness resorts and fitness retreats every year because they are looking for a healthy alternative to a typical vacation. Instead, many want to “kick-start” a healthy lifestyle in a controlled environment.

Positive Results

Fitness resorts have been found to be effective for most attendees. The basic concept of combining a limited-calorie diet with daily exercise, most people will have net-negative calories every day, lose weight, and gain strength and endurance at a fitness resort—provided they stick to the program.

While some people report losing 1-3 pounds-per-week at a fitness resort, others experience much more success. Exactly how much you will lose will be dependent on a wide variety of factors, including the duration and intensity of your exercise and activities and the calories you consume. Inherently, men tend to lose weight more easily than women, and younger people typically have an easier time shedding pounds than older people.

Ideally, for long term success, a fitness resort program should be a part of a healthy lifestyle, rather than an absolute weight loss goal. Be aware that many “spas and wellness centers” entice people with lavish facilities in a beautiful environment but mostly offer passive modalities such as massage, meditation, acupuncture, manicures, pedicures and facials. While these modalities have value, if your goal is jump start on weight loss and physical fitness, a fitness resort may be a better option.

Frequently Asked Questions…“Will they starve me?” “How intense is the exercise?” “Will I be intimidated?”

Most fitness resorts are not “diet retreats” or painful “boot camps.” With a little effort, you can easily find the right fit for you. You will not starve! While you need to limit caloric intake, you also need enough energy for the 3-6 hours of exercise and activities (swimming, biking, hiking, Zumba, Yoga) offered. There is no need to be intimidated as most attendees are like-minded people with the same goals and needs. A good resort will not only provide the right amount of calories and exercise for your goals but also educate you how to prepare meals and engage in proper exercise once you return home.

A Typical Day at a Fitness Resort

According to FitStays, most fitness resorts offer a set schedule and a camp-like experience for adults with three meals every day, usually prepared by expert nutrition staff and/or dietitians, designed around healthy foods. A typical morning begins with extended cardio exercises, such as a run, bike or hike. The afternoon may have more intense exercise classes such as strength training classes as well as more fun activities such as sports and games. Educational classes are offered throughout the day, so you can carryover the lessons from your fitness resort experience when you return home. Evenings are usually lighter to allow for leisure, rest, or spa services, which are also offered at many resorts.

NEXT WEEK: FITNESS RESORTS - PART II – A typical day at a fitness resort, recommended length stay, cost and top 20 recommended resorts.

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

Last week we discussed the healthiest New Year’s Resolutions, however, given the fact that 80% of those who made resolutions will have failed by January 19^th, this week I will recommend the use of technology to improve the odds…there is an App for that!

While some apps can be a waste of time, when you find the right app for you most polls show that it can be extremely helpful. They can be used for learning, socializing, calculating, writing, graphing, news, weather, music, school, money AND HELPING YOU KEEP YOUR NEW YEAR’S RESOLUTIONS!

According to “Per Statista,” the most common resolutions are as follows: save money (59%), exercise more (50%), more time with family and friends (40%), lose weight (35%), spend less money (26%), less time on social media (19%), and less job stress.

Apps for Saving Money

Goodbudget, YNAB (You Need A Budget), PocketGuard, and Quapital are some of the better budget Apps. Some of these Apps are free, while others require a nominal fee. In addition to tracking spending and saving, most allow you to set you own parameters and goals. Some helpful features are: moving money from checking into savings every time you buy a coffee.

Apps for Tracking Exercise

In addition to wrist trackers like Fitbit and Smart Watches, there are exercise equipment options with programs and tracking like Peleton, Norditrack and exercise mirrors like Tonal. However, there are also specific Apps that help you set goals and see your progress. Some of these include: Fitness22, FitNotes, MyFitbnessPal and Strong. Some of these allow you to input your exercises and create graphs showing progress in body weight, fat percentage and more. These Apps are especially useful for those who dislike going to the gym.

Apps for Prioritizing Time with Family and Friends

While distance-base technology such as Skype, WhatsApp, and Zoom worked well to keep connected during the pandemic and after, there are other Apps that offer more personal ways. Cozi is one of the best as it offers a simple organizer that displays the schedule of the entire family to assist you in planning a get together. Cozi is a great option as a simple organizer that offers a clear visual representation of the entire family’s schedule. It not only shows when people are free but also tracks the amount of time you spend (or don’t spend) with these special people.

Apps for Losing Weight

There are so many weight loss apps available that it is easy to get confused or overwhelmed. Some of the most popular with the best reviews are: Noom, Reverse Health, Perfect Body, WeightWatchers and MyFitnessPal. MyFitnessPal has the added benefit of tracking exercise and activity with a calorie expenditure report. Simply set a goal, enter food intake and exercise/activity output and the app calculates the rest. A bar-code scanner makes it even easier!

App for Bill-Tracking

Keeping a better eye on finances and expenses is a common resolution, especially as the holiday bills come in. Stax Bill, NetSuite, Paystand and Rocket Money are highly rated. These apps help you budget, save, provide an income analysis and credit scores, and disclose recurring fees.

App for Reducing Stress at Work and Home

Reducing stress is another common resolution and learning stress management techniques and incorporating them into our daily lives is vital. Some of the highly rated apps are: Personal Zen, Sanvello, The Mindfulness App, Headspace and Moodfit. These apps not only give you the tools for managing stress but also provide insights into your mood patterns and stressors. In addition to a “blue mood” you can also track gratitude and other feelings. Also, nutrition, sleep, and medications, which can affect your mood, can also be tracked. Once a pattern is established, tools can be applied to reduce and manage stress.

App for Reducing Time on Social Media

While at first glance it may seem odd that one might use an app to stop using another app but…don’t rule it out! OneSec is an app that creates a 10 second delay after you open an app to allow you time to pause and take a deep breath before you indulge. It will also tell you how many times you have opened the app in the last 24 hours…you might be shocked!

SOURCE: LIFEHACKER

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

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

New Year’s Resolutions are very predictable. While most New Year Resolutions are health oriented, I purport that a healthy mind, body and spirit requires a healthy lifestyle. Interestingly, the ten most popular resolutions listed below, all have an impact on a healthy life.

More Time With Family And Friends
- Polls repeatedly show that one of the most consistent resolutions for the New Year is to make more time to spend with family and friends. Moreover, research shows that the comfort and camaraderie of these people whom we love is important to our health and well-being.
Begin or Improve a Fitness Program
- The benefits of regular exercise is no longer anecdotal, it is factual. Daily exercise, even in small doses, has been associated with more health benefits than anything else known to man. Studies clearly demonstrate that it reduces cholesterol and coronary artery disease and the risk of some cancers. Also, it increases longevity, helps achieve and maintain weight loss, enhances mood, lowers blood pressure, and even improves arthritis. In short, exercise keeps you healthy and makes you look and feel better. If done properly, there is no down side. So, make this year the year to do it!
Adhere to a Weight Loss Plan
- Recent studies report that more than 66 percent of adult Americans are considered overweight or obese. As a result, weight loss is one of the most popular New Year's resolutions. However, adhering to a weight loss program is not easy. It requires many things, including, setting reasonable goals and staying focused. Often, professional help is required. While this may be one of the most difficult goals to attain, the ultimate reward and value is well worth the effort.
Stop Smoking
- Second only to losing weight, this resolution, while extremely difficult, is another life-saving goal that must be attempted. Studies report that smokers try and fail four times on average before they are successful. SO, KEEP TRYING! Get help. Talk to your physician about using over-the-counter or prescription nicotine replacement therapy and proven quit-smoking aids. Consider smoking cessation classes, support groups and hotlines in addition to the meds. This is one goal that is worth the effort.
Find Your Smile
- Due in great part to our hectic and stressful work and family demands, the United States is home to millions of people requiring the use of mood elevators and antidepressants. As a result, it is important to learn what really makes you happy in order to FIND YOUR SMILE. It requires the balance of a healthy mind, body and spirit. It might be a walk in the snow, taking dance classes or a trip to the spa. One hint, it is often something simple and inexpensive.
Moderate Drinking
- This is one tip for a healthier New Year that I expect to receive plenty of flack about! But, I would be remise if I did not mention this potentially harmful habit. While many people use the New Year as an incentive to finally stop drinking, most are unable to adhere to such a rigid goal. Studies show that moderate drinking can offer many health benefits such as lowering cholesterol and coronary artery disease but that is defined as one or two 8 ounce drinks per day and red wine is preferred. However, many heavy drinkers would do well to taper off to a moderate level. Consider participating in “Dry January!” For those with a problem and have decided that you want to stop drinking, there is a world of help and support available such as Alcoholics Anonymous. There are also a number of treatment-based programs, as well as support groups for families of alcoholics.
Get Finances in Order
- This is one tip that few consider being health related. However, serious stress from financial problems affects millions of Americans every day. This cumulative stress can be very harmful to your health and can be lessened by initiating a plan. Get professional help and learn how to downsize and reevaluate your real needs…less toys with less stress for a longer life!
Try Something New
- There may be no one thing more important to gaining a new perspective on life that to have learned something new. It could be as drastic as returning to school to prepare for a career change or as simple as learning to play bridge. Have you vowed to make this year the year to learn something new? Take a course at local college or read a new book. Visit the Everhart Museum or take the free tour of the Scranton Cultural Center. It will enrich your life and make you a more interesting person. Most local colleges and universities offer distance and adult education programs.
Service To Others
- Service to others is service to you! There may not be anything more gratifying than providing a service to others in need. Volunteerism makes you a better and healthier person. It fits into any schedule. Donate clothes, time or resources. Locally, we have many charitable causes in need of help: Be a “Friend of the Poor,” or serve lunch at St. Frances Soup Kitchen.
Get Organized
- The goal of organization, like the goal of financial order, has similar health implications because it eliminates tremendous stress. There are many books and websites that offer suggestions on how to organize just about anything in your life. For this reason, I love my iPhone – there’s an App for that!

SOURCE: A. Powell, About.com Guide

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

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Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!

Every December, as we finish the last of the leftover turkey, patients begin to talk about the holiday season and gift shopping. This conversation invariably leads to suggestions for gift ideas related to health, exercise and fitness. The suggestions below offer a wide variety of fitness related gifts, some expensive and frivolous and others reasonably priced and practical. I hope it makes your shopping a little easier.

1. Dry Tech Exercise Clothing

Dry Tech is the best thing that has happened to exercise apparel since “jogging suit” was donned by all the “cool dudes” in the 70’s and 80’s . It is has great style and even better function. The specially made material is light weight and breathable and wicks moisture from the skin to the outer layers. Therefore, it will not get heavy with sweat which can weigh you down and cause friction with your skin which can lead to chaffing and blisters. The following exercise apparel is now available in Dry Tech:

Short sleeve tee with a matching long sleeve shirt
Shorts and compression under shorts
Colorful socks

NOTE: Shoes are a very important aspect to safe and comfortable exercise but are unique for running and other specific sports (tennis, basketball). Sneakers may be too difficult to buy for someone else. A gift certificate to an athletic shoe store (Scranton Running or Dick’s) may be a better choice.

2. Trekking Poles

For walking and hiking enthusiasts, trekking poles can be the perfect gift, especially for those over 50 and when on uneven terrain or inclement weather. The research is compelling…less stress on the lower back, hip, knee and ankle, as well as improved balance and safety. Leki, Black Diamond, and Trekology are good name brands while LL Bean and REI are reputable companies.

3. Exercise Mat

An exercise mat is helpful if you decide to exercise at home. Also, a required equipment for participating in yoga or Pilates classes is a mat.

4. Hand-Held Dumbbells and Sandbag Leg Weights

These are essential for those interested in home exercise. For the average beginner, 3-5-8-10 pound (two of each) weights will be adequate. Dumbbells are good for shrugs, biceps, and triceps, bent over rows and lats, and lunges. Incremented and stackable dumbbells are also available by Bowflex SelecTech 552 (5-52 pounds for $299). and NordicTrack $189. Sandbags, which can be purchased as graduated weights from 1 to 5 pounds, are good for leg extensions, hamstring curls, hip hikes and hip abduction.

5. Resistance Bands

These cheap and versatile bands are also essential for a home program. The bands come in different colors to represent the amount of resistance with yellow being the easiest and black the most difficult. They are useful for upper and lower body. For specific band exercises visit a previous column in “Health & Exercise Forum” at The Times Tribune or www.mackareyphysicaltherapy.com

6. Aerobic Equipment

Bike – Plus: upright or recumbent bikes are an effective and affordable method of aerobic exercise. It is very useful for those suffering from lower back, hip, knee or ankle/foot pain because it can be performed with partial weight bearing. Minus: must be able to bend your knees at least 110/115 degrees.
Treadmill – Plus: great for those who love to walk or run and need and indoor alternative in inclimate weather. Minus: large and expensive
Elliptical – Plus: a good alternative to the pounding of running. Minus: expensive, large, and require full weight bearing.

NOTE: Peloton, NordicTrack, SoulCycle are some of the companies that offer interactive exercise programs (usually through an internet subscription) for aerobic exercise using bikes, treadmills, ellipticals or rowing machines.

7. Fitness Club Membership

Location is important for convenience. The type of gym, such as, cross fit, exercise machines vs. traditional free weights, must be considered. Equipment and other services such as personal trainers, swimming pool, sauna, hot tubs, Pilates, and yoga classes are also important to some.
If the person you want to gift already belongs to a gym, consider purchasing a gift certificate for massage, Pilates, yoga, spin class or aquatic exercises at their gym (which usually costs extra) or another studio.

8. Personal Trainer Gift Certificate or Home Virtual Trainers

This can be an opportunity for someone to either get the proper advice from a professional to begin a fitness program or to revamp and tune up an old stale program. Word of mouth is a good way to find a reputable certified trainer.

Peloton – ($2,495 bike, $3,495 treadmill); Mirror Exercise – ($1,495); Tonal ($3,995.) FightCamp – ($1,219.); Forme Studio ($2,495.)

9. Electronic Fitness Monitors or Wearable Tech Monitor

These devices use GPS technology to help the user track their activity to get more out of their exercise routines. They monitor activity, heart rate, distance, location, calories, and more. Some examples are:

Pedometers – clips on a belt – best for tracking steps - tracks steps taken by walkers and runners and translates it to miles. Some also translate calories expended. Suggestions: “SteppyFit,” “ExeSteps” or Timex” $5-$25.
Activity Trackers – worn as wrist band – best for tracking general fitness, calories and sleep patterns 24/7. It can be connected wireless to your cell phone. Suggestions: “Fitbit” $119 to $149. “Garmin” Vivoactive 3 $159. “Apple” Series 8.
Running Watches – are worn as a wrist watch – best for timing workouts and counting laps - a rugged, waterproof watch to be worn while running to track laps, splits, countdown, intervals and training logs. However, it does not track distance, speed or heart rate. Suggestions: Timex Ironman $38.97. Garmin Forerunner 45S $129.
Heart Rate Monitors – worn as a chest-strap or wrist strap – monitors your heart rate in real time. Suggestions: Garmin Vivofit 4 $62.; Polar H10 $89.95, Apple Watch Series 8
WHOOP – this next generation fitness and health monitoring is smaller and faster with new biometric tracking, including skin temperature, blood oxygen, and more. Whoop.com $30/month.
Weight Loss – Suggestions: “Noom,” “Lose It”; “WeightWatchers,” “My Diet Coach” - helps you keep a journal, calculates calories for free. The App gives calorie credits if you exercise and provides ongoing feedback to help you stay on track to attain your optimal weight. Basic Apps are free and more advanced versions are under $10.
Activity Monitor – Suggestions: “Fitbit” “Apple Watch,” “Garmin,” “Endomodo”; “Human” – uses GPS to track your every step when you go for a hike, run, fitness walk, touring walk at Disney, or bike ride on trails, ski cross country or downhill. It will calculate distance, speed, location, total time and total calories

10. Nutritional Counselor Gift Certificate

Sometimes you need professional help to get started and stay focused. Just as with a personal trainer, a qualified and licensed nutritional counselor will assist you in establishing a safe and effective program to meet your nutritional and dietary goals. Again, ask around to see who has a good reputation or who may be a good fit for the recipient of your gift.

These gifts can be purchased at most local sporting goods stores or on-line.

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

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice, located in Scranton and Clarks Summit, and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, check out our exercise forum!

Since 1949 May has been designated as National Mental Health Month for the purpose of eliminating the stigma associated with mental illness by raising awareness. One of the most common mental health conditions is depression. New research from Boston University School of Public Health has found that depression has been increasing in the United States and life with COVID for more than two years has accelerated it rapidly. In 2021 the number of people suffering from depression increased more than 32 percent, affecting 1 in every 3 American adults. However, research also has good news to offer: one of the most understated benefits of exercise is 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.

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.

HOW EXERCISE REDUCES DEPRESSION

According to research, exercise reduces depression in two ways, psychologically (mentally) and physiological (physically).

Psychological or Mental Benefits of Exercise on Depression:

Helps a person gain control over their lives
Increases self-esteem
Diverts attention away from worry, concern or guilt
Improves mood – with visible signs of improvement in physique & body weight
Increases sense of pleasure and satisfaction
Anger management – release pent-up frustration, anger and hostility

Physiological or Physical Benefits of Exercise on Depression:

Increase in brain serotonin (natural mood elevator chemical in brain)
Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
Improvement in natural sleep patterns

HOW TO BEGIN EXERCISE FOR DEPRESSION

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 antidepressant or other medications discuss the impact it may have on your exercise program with your physician.
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.
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. The studies that demonstrated benefits took place over 12 weeks.
Begin slowly 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 routine in 3-4 weeks so JUST DO IT !
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.
Find a friendly, uplifting group to walk, talk and exercise with. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
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!
Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

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