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Studies have shown a recent escalation of joint replacements in a much younger and more active group than previously noted…the baby boomer! While the end result is mostly physical, the cause is often psychological. We all know the personality type: type A, hyperactive, goal-oriented, driven, possessed and highly organized – almost at all costs! Many of you have seen fitness enthusiasts running through the streets at 5:30 AM for 5-10-15 miles each day. Moreover, many of these runners have more activities planned later in the day: golf, tennis, ski, swim, play sports with their kids. Well, after 20 years of this behavior, many of these enthusiasts are now suffering the effects of long term multiple micro traumas. They are suffering from what orthopedic surgeons at the University of Pennsylvania call “Boomeritis! Boomeritis is inflammation of the baby boomer from overuse. Lower back pain, hip, groin, and knee pain is almost a daily event.

As baby boomers continue to enjoy sports with the same vigor and intensity as when they were younger, they are finding that their older bodies just can’t keep up. While these individuals often succeed in finding the balance of fitness and craziness, they have had times when they took it too far. Furthermore, nearly all compulsive exercisers suffer from over training syndrome. When take too far compulsive behavior is rationalized by insisting that if they didn’t work to extreme then their performance would suffer.

10 Warning Signs of a Compulsive Exerciser (E. Quinn):

*Each sign is worth 1 point:

10 Warning Signs of Overtraining (E. Quinn):

Managing Overtraining

If you have two or more of the warning sings, consult your family physician to rule out potentially serious problems.


Avoid weight bearing exercises two days in a row. Run one day, walk, swim or bike the next.

Use the elliptical instead of the treadmill.    

Avoid squatting…deep squatting is bad for your hips and knees. Even when gardening, use a kneeling pad instead of bending down and squatting.

Visit your family doctor regularly and listen to your body.     

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

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

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

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!


There are many reasons why losing weight, the number one health goal in America, is the most elusive. Not the least of these reasons is the psychology of eating…because in the land of plenty, we eat mindlessly! Consider the facts; first, we blamed it on the fact that the food was unhealthy…but when we chemically modify the food such as removing or altering the fat or sugar and removing the calories, it failed to reduce our weight. In fact, it has been discovered that “fake sugar,” even thought it does not have calories, can still increase blood glucose levels. Next, we decided fat cells were the enemy but we failed to control our weight when we removed fat cells from our body through liposuction. Then, we decided the problem was our digestive system so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, without a change in behavior, it failed as a long-term solution. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND! 


Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings in which focus is placed on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier based on his time spent in a Buddhist monastery. He discovered that mindful eating practitioners ate in silence and chew small pieces of food very slowly and deliberately to experience its taste, texture and smell. It requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is not right or wrong way to eat but rather varying degrees of awareness about WHAT WE EAT AND WHY. Furthermore, the goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?


One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Research shows that, even when not perfectly relaxed, the simple act of the family meal can have a powerful impact on mindfulness, health and wellness.   

In a country that thrives on a fast pace with over-book schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult find time to sit and relax for a family meal even once a week. Additionally, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Despite the family conflict, studies strongly support the health values of the family meal.

A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that the there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis. 


6 Ways to Practice Mindful Eating

Mindless EatingMindful Eating
1. Eating past full and ignoring body signals1. Listening to your body and stopping when full
2. Eating when emotions tell us to eat2. Eating when our bodies tell us eat
3. Eating alone, at random times and places3. Eating with others, set times and places
4. Eating emotionally comfort foods4. Eating nutritious and healthy foods
5. Eating and multitasking5. When eating, just eat
6. Considering a meal an end product6. Considering where food comes from

– by Christopher Willard PsyD

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

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

Read all of Dr. Mackarey's Articles at:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.

Tips on Low Back Pain

Covid-19 has certainly redefined the workplace as many employees continue to work from home. Prolonged hours sitting at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.

Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.   

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

Prevention of Lower Back Pain

Maintain Fitness Level

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

Practice Good Posture & Body Mechanics

Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.

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

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

Shoulder Blade Pinch: Pinch your shoulder blades together.

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

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

When bending to lift an object think about safety:

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

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

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This week IS MEMORIAL DAY 2021…THE UNOFFICIAL FIRST DAY OF SUMMER! IT IS 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.

Consider the following benefits of spending time 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.

Read “Health & Exercise Forum” – Every Monday.  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:

For all of Dr. Mackarey's articles visit:

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.

After a long, cold and snowy winter, complicated by COVID 19, we look to spring as a time of renewal. It is a time for great hope and optimism; trees are budding, flowers blooming and more people are doing their civic duty and receiving vaccinations…all contributing to a sense of promise for a fresh start!

Spring can also be a time of personal renewal…a time to reestablish goals for health and wellness. However, to be completely healthy, one must have a healthy mind, body and spirit. A healthy mind requires intellectual stimulation, a healthy body requires eating well and engaging in physical activity and a healthy spirit, requires faith, hope and prayer and meditation. This spring, consider the following tips to promote a healthy mind, body and spirit throughout the year.

Eat Healthy 

Begin your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge in high-fat, high-calorie foods. Drinking plenty of water throughout the day is also very important for good health.

Exercise, Exercise, Exercise Your Body

Physical activity is one of the most important factors in improving a lifestyle in a positive way. But, it does not have to be complicated. A minimum of 30 minutes of physical activity, 3-5 days per week will have many positive effects on your body.  

Suggestions for beginning an exercise program are:

Exercise, Exercise, Exercise Your Mind

One cannot be completely healthy without a healthy mind. Like your body, you must continue to challenge your mind in order for it to remain strong, learn, expand, and grow. Read a good book, do crossword puzzles or try something new...piano lessons! Emulate my mentor, Dr. Gino Mori, who has been taking classes (and takes the exams) in art, science and history since his retirement more than 20 years ago!

Exercise, Exercise, Exercise Your Spirit

Prayer, meditation, or chanting has been known to reduce your heart rate, blood pressure and stress level. These activities can lead to a sense of peace, serenity, joy, and faith. Remember, those who are spiritual and faithful live longer.

Be Comfortable in Your Own Skin.

Learn to Love Who You Are Not Who You Want to Be!

Those who love themselves are more likely to take care of their bodies. People who are not comfortable in their own skin are never satisfied with their appearance and often attempt to change their body. For example, men use steroids to appear “bigger and better” or women have cosmetic surgery to appear “younger and better.” It is impossible to love others if you don’t love yourself. You must learn to accept and embrace change in your body and life in order to have a healthy mind, body and spirit.

Get Adequate Rest

Get the appropriate amount of uninterrupted sleep. A good sleep promotes healing and refueling for your body. When needed, sit, rest, or take a short nap to recharge.

Enjoy the Moment

Countless hours are wasted on feelings of anxiety, regret or worry about a past or upcoming event. This can be a waste of precious life time and adds stress to the body, which makes you more susceptible to disease.  Stay focused on the beauty of the present moment!

Spend Time With Healthy People

When you associate with healthy people, you take on their healthy habits. You will drink less, eat healthier and exercise more if you are hanging around with those who engage in these habits...they will have a positive influence on you! Bob Knowles, local insurance broker, is my health and wellness role model. He has tremendous discipline; exercises every morning before work, eats and drinks in moderation and makes time to reflect for self-improvement.

Spend Time With Positive People

The camaraderie of good friends is essential for a healthy mind, body and spirit. Make it a priority to associate with people who “celebrate life!” The health benefits from these positive-minded, healthy people who appreciate you for who you are will provide you with the support, love, and respect necessary to survive any challenge. Find people who know how they celebrate life! My role model for optimism is Steven Scheinman, MD, President and Dean of Geisinger Commonwealth School of Medicine. He demonstrates a keen instinct to find good in others and maintain a positive and optimistic attitude in challenging situations.

Spend Time With People Who Make You Laugh

Studies show that laughter has health benefits and assist the body in healing. Laughter is contagious, so hanging around with people who are fun and funny, will bring fun and laughter into your life. Try to look for humor in every situation and keep laughing.  Spend more time with people that spread joy and laughter. Silly sisters, Rosemary Quinn Malloy, Melissa Quinn LeStrange and Rebecca Quinn Walsh bring a smile to my face whenever I see them or hear their names!

Read Dr. Mackarey’s Health & Exercise Forum – Every Monday. 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:

See all of Dr. Mackarey's articles at:

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.

While Living With COVID-19

New Year’s Resolutions are very predictable. While most 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. Moreover, after living with the COVID-19 virus in 2020, perspectives and priorities may have changed for all of us and forever. As such, before any other health tip can be followed, the number one, two and three health tips for 2021 are:

Wear a MASK, Wash your HANDS, Remain Socially DISTANT!

1. 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. However, until we are all vaccinated we must do so with great care and precaution; Zoom, FaceTime, phone calls, drive-by visits, outdoor visits or activities, etc. Be Creative and be careful!

2. 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! While a gym may not be the best option for those at risk, buy indoor home equipment or dress appropriately and use Mother Nature for healthy and inspirational walks.

3. 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.

4. 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.

5. Find Your Smile

Due in great part to our hectic and stressful work and family demands, long before COVID-19, 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 virtual dance, exercise or enrichment class. One hint, smiles are often found in something simple and inexpensive. And, be sure to associate with upbeat, fun-loving and genuine people when possible.

6. Moderate Drinking

This is one tip for a healthier New Year that I expect to receive plenty of flack about! This is especially true now because more alcohol is being consumed with the stress of COVID-19. But, I would be remiss if I did not mention this potentially harmful habit…excessive drinking. 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. For those with a problem and have decided to stop drinking altogether, there are plenty 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.

7. 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 (adult and child) with less stress for a longer life!  For those suffering from economic hardship due to COVID-19, contact social services and government agencies to determine if assistance is available to you and your family.

8. 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 virtual course at local college or read a new book. Take a tour of some of the world’s greatest museums. Listen to a TED talk. It will enrich your life and make you a more interesting person. Most local colleges and universities offer virtual and adult education programs

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

Read all of Dr. Mackarey's articles at

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:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.