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As summer fads and cool fall nights are upon us, many of us will prepare to put away some of our warm weather toys…closing the pool, storing kayaks and boats and packing up the “slip and slide.” However, one activity that can last well into the fresh breeze of fall is cycling. In fact, many feel that fall is the best time of year to jump on a bike and enjoy the ride! If you are looking for a kick start to riding your bike this fall, consider the 20th and final Tour de Scranton on Sunday, April 15, 2024. It is a fun-filled, noncompetitive bike ride through Scranton and neighboring communities. Tom and Betty Moreken, with the help of dedicated friends and countless supporters have raised over $400,000.00 to benefit addiction treatment and prevention in honor of their daughter Erin, a victim of drug addiction. I have had the privilege to know Tom and Betty and have always admired their resilience and selflessness to turn a negative into a positive and do something good for others. They and their friends truly represent everything that is good about the people of NEPA!

So dust off your bikes and join the fun at Tour de Scranton. Hopefully, it will entice you to ride the many beautiful and well-maintained trails that are available at the Countryside Conservancy and other locations in the Abingtons and the Lackawanna Heritage Valley Authority.

Tour de Scranton is the official “kick off” to biking season in NEPA. This year, on Sunday, September 15th, the 20th annual and final Tour de Scranton will offer a selection of several routes and distances for the novice and experienced rider at its non-competitive bike ride for riders of every age and skill level. This event supports “The Erin Jessica Moreken Drug & Alcohol Treatment Fund” which provides charitable gifts to qualified local organizations or individuals struggling with the disease of addiction. For more information visit: www.tourdescranton.com.

WHY BIKE?

There are many obvious reasons to bike…cardiovascular fitness, burn calories, improve leg strength and others. But, the real question is, “what are the advantages of biking over other forms of exercise?” Glad you asked…

BENEFITS OF BIKING:

  1. INEXPENSIVE – while not as cheap as running, biking can be much cheaper than other sports. Starter bikes can be less expensive than high end running shoes.
  2. EASY – most people can learn to ride a bike. Kids begin with training wheels and adult tricycles are available.
  3. FAMILY FUN – something the whole family can enjoy in your neighborhood, at the beach or on one of the trails.
  4. PRACTICAL EXERCISE – it is an opportunity to exercise while traveling to work, store, lunch etc…bike it!
  5. CARDIOVASCULAR FITNESS – good for the heart and all that goes with it: burns calories, lowers blood pressure, lowers LDL, and elevates HDL and boosts the immune system.
  6. LEG STRENGTH – pedaling a bike is a great way to improve leg strength.
  7. CORE STRENGTH – core muscles of the neck, middle and lower back and the associated arm strength will improve while biking in order to maintain your torso on a bike on hills and turns.
  8. IMPROVES BALANCE/COORDINATION/FALLS PREVENTION – riding a bike requires some balance and coordination and therefore will improve balance as a form of falls prevention.
  9. GOOD FOR YOUR JOINTS – bike riding only requires partial weight bearing to the spine and lower body joints so it is more comfortable and gentle to your joints than walking or running. For this reason, it is often recommended to pregnant women suffering from leg or lower back pain as a safe alternative to running.   
  10. MENTAL WELLNESS – biking, like all aerobic exercise, is a great source of stress management as it releases endorphins and serotonin which improves mental health. With the added feature of being outdoors in the sunshine and fresh air, biking keeps you smiling!

INJURY MANAGEMENT:

Prevention is the best management of musculoskeletal problems associated with biking. First, many of the problems associated with biking such as knee pain, buttock soreness, and tendonitis can be prevented through proper fitting. Furthermore, it is important that your equipment be in good working order such as tires, chain, brakes and pedals. Next, be sure to maintain a fairly good fitness level in order to bike safely. If you are a beginner, start slowly. Warm up and slowly bike for 10 to 15 minutes and build up over time. Practice the coordination of stopping, starting, shifting and braking. Work on good strength and flexibility of the hamstrings, quadriceps, calves and gluteal muscles. All of these muscles are necessary to generate pedal force. Balance is also important to safety and can be practiced on and off the bike. Be aware that adaptive equipment can modify your bike for added comfort and safety such as soft handlebar tape, seat post and front fork shock absorbers, padded biking shorts, c-out and gel pad saddle seats, and wider tires.

Be careful not to progress too quickly because inactivity to over activity in a short period of time can create problems. Overuse injuries such as tendonitis, can be avoided by cross training. Bike every other day and walk, run or swim on off days. Make sure to take time off to recover after a long ride. Use ice and massage to sore muscles and joints after riding.

Remember, cycling should be fun! Pain from improperly fitted and poorly maintained equipment is preventable. Excessive workouts and training rides should be kept to a minimum and consider cross-training in between.  

BIKING SAFETY:

EQUIPMENT: Helmets are a must! Also, keep your bike in good condition. Road bikes should have mirrors and reflectors. Use hand signals and obey traffic rules. Dress for weather and visibility. Have a first aid and tire patch kit, tire pump and tools. Seat comfort can be improved with gel cushion or split seat.

BE ALERT: for traffic, parked cars, pedestrians loose gravel and cracks in the road. 

SOURCES: American Physical Therapy Association

Visit your doctor regularly and listen to your body.     

Keep moving, eat healthy foods, and exercise regularly

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!

In addition to lowering blood pressure, this gentle form of exercise can help maintain strength, balance, flexibility and mental health and is an ideal activity for all ages!

This research was brought to my attention by my friend and mentor from Dalton, Peter Frieder, Chairman,Gentex Corporation and current Board Chair at WVIA. Peter is celebrating his birthday today with a number of years that clearly does not represent his physiological age, in great part due to his dedication to health and wellness. Happy Birthday and thank you!

According to a new study by the China Academy of Chinese Medical Sciences (CACMS), the ancient martial art practice of Tai Chi is effective in lowering blood pressure as much, if not more, than traditional aerobic exercise. For those with prehypertension or hypertension and are unable to tolerate the repetitive and prolonged weight bearing stresses of running, walking or cycling, these results have tremendous implications. The slow, gentle and controlled movements and positions of Tai Chi coupled with controlled breathing and meditation may be a valuable alternative, especially for those with aging muscles and joints. Improved strength, flexibility balance, posture and mental health are additional bonuses.

WHAT IS TAI CHI?

Tai Chi is multifaceted in that it combines martial arts, slow gentle and controlled movements, sustained postures, a focused and meditative mind, and controlled breathing. It is considered by many to be “meditation or medication in motion.”

Tai Chi involves slow-motion movements transitioning with control from one position to another. The positions have historically been named for the actions of animals, for example:

“White Crane Spreads its Wings”

Deep and purposeful breathing, mental focus, body awareness and meditation are integral components of the exercise. The beauty of Tai Chi is not only in the physical form, but also in its safety for all levels of fitness. It is helpful for individuals from high level athletes to those with physical disabilities. The movements are natural and gentle without forcing the muscles and joints to extreme or uncomfortable positions. It is often used as an adjunct therapy in the wellness as well as rehabilitation of a variety of athletic (ACL surgery, joint replacements) and neurological conditions (Parkinson’s, MS, head trauma), to name a few. Based on the aforementioned Chinese study, Tia Chi can be applied as a technique to control or lower blood pressure, especially for those who cannot utilize traditional aerobic exercise.

HEALTH BENEFITS OF TAI CHI

Tai Chi has been found to offer many physical and mental benefits. Some of these include:

Muscle Strength – upper and lower body, trunk and core strength

Flexibility – participants report improved range of motion and flexibility of the spine and extremities

Balance and Proprioception – some studies report a reduction of falls due to a variety of sustained positionsand improved awareness of one’s body in space

Aerobic Conditioning  -  recent studies have found that participants have lower heart rate and blood pressure

Mental Health – through improved balance, strength, and flexibility, studies show participants have gained confidence and control as well as lower blood pressure and stress reduction.

HOW TO BEGIN TAI CHI

All Tai Chi classes begin with four basic principles: warm-up, instruction, practice and breathing.

Warm-up- gentle easy motions to warm-up and loosen the joints and muscles to prevent injury.

Tai Chi Forms – “Short Forms” are beginner movements which are gentle, slow, and short in duration while “Long Forms” are more advanced.

Breath Work – gentle breathing combined with movement to relax the mind and focus energy

GETTING STARTED (HarvardHealth):

Don’t be intimidated by the language or history – Yang, Wu, Cheng are only brands of movements with a history of martial arts but this in no way impacts participation.

Get medical clearance – check with your physician to see if Tai Chi is safe for you. Some orthopedic or vestibular problems might require special attention.

Observe or take a beginner class – often available at local fitness clubs or senior centers. Research options in your area and find a friend to join you. Consider an introductory instructional video to get a feel for Tai Chi. (See local Tia Chi classes below)

Meet with an instructor – if it makes you more comfortable, make time to talk to an instructor before enrolling in a class.

Dress for success – wear loose-fitting clothes that allow for range of motion and comfortable shoes for balance and support.

Track your progress – use an app or keep a journal of your progress. Heart rate, blood pressure and endurance (the time you can hold a pose or tolerate a class) are easy to monitor.

Model: Lily Smith, University of Scranton Physical Therapy Student and PT aide at Mackarey Physical Therapy.

Sources: HarvardHealthPublishing; New Atlas; China Academy of Chinese Medical Sciences (CACMS); National Institutes of Health

Local Tai Chi Classes: Steamtown Yoga, Scranton, PA; Mission Yoga, Scranton, PA;Dragon’s Heart Tai Chi & Kung Fu, Clarks Summit, PA; Rothrocks Kung Fu & Tai Chi, Duryea, PA

For more information: HarvardHealth; www.taichihealth.com; www.treeoflifetaichi.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 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!

February is American Heart Month!

American Heart Month is not just for lovers. Long after the Valentine’s roses wilt, our hearts will require special attention for a long healthy life. It is the goal of The National Heart, Lung, and Blood Institute to motivate Americans to adopt healthy lifestyles to prevent heart disease.

Not So Young at Heart!

A recent study by the Center for Disease Control (CDC) found that while many Americans believe that they are “young at heart”, it turns out that many have hearts older than their actual age. For example, the study found that the average American male heart is eight years older and the average American female heart is five years older than their chronological age.

What does this mean?

The CDC’s findings may offer some explanation for the fact that many Americans die from heart attacks, strokes, and heart failure when compared to other people around the globe. Furthermore, while more Americans use heart medications more than other people in the world, heart attack and stroke continue to be the leading cause of death in the US, killing more than 80,000 each year.

What Can You Do?

The CDC has developed a new test to determine “Heart Age,” which has been found to be a much more reliable indicator of a person’s risk for heart disease. The heart age test will determine if your heart is older, younger or average for your age, which can be much more important for longevity than chronological age.

The CDC is encouraging people to take matters into their own hands …be proactive. In addition to calculating your Body Mass Index ((BMI), the CDC is asking people to use an online calculator to determine their heart age. The calculator will give a person a more accurate percentage of risk for heart attack or stroke. Based on the outcome, one must see their family physician or cardiologist to discuss the results and implement a plan.    

The Calculator - For Example:

Heart Age is very easy to use: You just need to enter your age, sex, blood pressure, whether you are treated for high blood pressure, whether you smoke or have diabetes, and your body mass index (BMI), with a handy calculator if you don’t know it. The tool gives you your risk for heart disease in the next ten years, compared with normal.

The CDC “Heart Age Test” is simple:

Visit: www.framinghamheartstudy.org or www.heartfoundation.org

Enter: sex, blood pressure, (list if controlled), diabetes (list if controlled), smoking history, and body mass index (BMI), a simple height/weight calculation found on-line at www.bmicalculator.cc

Example: A 53 year old women with an acceptable BMI, may actually find that she is at great risk for suffering a heart attack or stroke because she smokes cigarettes and has uncontrolled high blood pressure. The calculator includes all the significant factors proven by science to affect a person’s risk of heart attack or stroke. These include: blood pressure, weight, BMI, blood sugar, cholesterol, age, sex and smoking history.

Example: 50 year old male smoker has uncontrolled high blood pressure of 140/96, no history of diabetes, and a BMI of 30 has a predicted heart age of 72 years. A female with a similar profile would have a heart age of 74 years.

The Solution

To some, the solution may be obvious and for others it may be impossible. In the previous example of the 50 year old smoker, if he quit smoking for one year, he would halve reduced his heart age by 14 years (15 years for a woman). If he would reduce his blood pressure to 120, he would reduce his heart age by 6 years (10 years for a woman). And, if both risk factors were removed, he would reduce his heart age by 19 years (23 for a woman).

In the above examples, the 53 year old man does not have to take his 72 year old heart age as a death sentence.

What Individuals can do…

What Public Health Policy Can do…

BY THE WAY…I took the test:

Male: 65

Systolic Blood Pressure: 110

No high blood pressure or diabetes; non smoker

BMI: 22.5

HEART AGE: 62

SOURCES: WWW.CDC.GOV

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 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!

Heart Rate, or pulse, is the speed or number of times the heart beats (measured by the number of contractions of the heart) per minute. It can be detected in areas of the body where the artery is close to the skin: the palm side of the wrist, side of the neck, groin, back of the knee, or top of the foot. In healthy adults, a resting heart rate is between 60 and 100 beats per minute, however, in conditioned athletes, it is often well below 60. When the heart rate is not within normal parameters, it can be an indication of what is happening around you…fear, anxiety, fatigue, contentment, or a medical problem.

Determine Your Resting Heart Rate

The first step to determine the status of your heart rate (HR) is to measure your resting heart rate. A normal resting heart rate for a healthy adult is between 60 and 100 beats per minute. The best time to measure it is immediately after you wake up in the morning before you get out of bed (or when sitting and relaxing). Place your index and middle fingers on the side of your neck or on the palm side of your wrist. Then, count the number of beats you feel for 60 seconds. 

Interpreting Results

Whether you determine that your HR is too high or too low don’t panic. Take your HR repeatedly and document results so you can discuss it with your primary care physician. It is not unusual to find a wide range of numbers which varies individually. For example, it is not unusual for a conditioned athlete (marathon runner) to have a resting HR of mid to high forties or low fifties. More common in the general population, however, is a high resting HR and this can be an indication of a potential health problem. When your resting HR is high it indicates that your heart is working harder than it needs to…especially if you are at rest! Remember, your heart is a muscle and it doesn’t work very efficiently when it is deconditioned…it has to work harder than it should to pump blood through your body, even at rest!

Some reasons for a high resting heart rate:

Tips to Lower Your Resting Heart Rate

All is not lost! The good news is that you can lower your resting heart rate and improve heart health with a few lifestyle changes.

Exercise

Probably the best way to lower your resting HR is to avoid a sedentary lifestyle and get moving. Inactivity leads to a downward spiral of poor health …obesity and its associated problems of high blood pressure, and diabetes.   

Remember, you don’t have to run 26.2 miles to be fit and healthy. The American Heart Association recommends 150 minutes of moderate-intensity aerobic exercise per week. And, it can be broken down into 10-15-20 minute sessions once, twice or three times per day.

Stress Management

The negative impact of stress and anxiety on health and wellness is well document. While avoiding stress may not be possible, one can learn to manage it. Exercise is one effective way but there are others. Meditation, breathing exercises and yoga are a few. Visit a YouTube video on Progressive Muscle Relaxation (PMR).

Limit Caffeine and Avoid Nicotine

Caffeine and nicotine are stimulants and can raise your heart rate.

Maintain a healthy body weight

Losing weight will lower your HR. A healthy diet that maintains a body mass index (BMI) between 18 and 25 for adults is an essential component to a lower HR and overall good health. A BMI over 25 is considered overweight and over 30 obese. Use the BMI calculator from the CDC at: www.cdc.gov>adult_bmi

Hydration

Dehydration can lead to thicker blood. Thicker blood requires the heart to work harder to circulate blood throughout the body. Drinking plenty of water, (15.5 cups for men and 11.5 cups per day for women), will adequately hydrate the body.

Sleep

For many, getting 8 hours of sleep per night is easier said than done. But, adequate sleep contributes to overall good health and a lower heart rate.

Lowering your resting heart rate is an essential component to good health. The steps necessary to attain a lower heart rate such as exercise, eating healthy, maintaining a healthy BMI, hydrating, and getting adequate sleep will also contribute to overall physical and mental health and wellness. Discuss how you might begin your journey to a healthier lifestyle with your primary care physician or health care professional.

SOURCES: Cleveland Clinic; Johns Hopkins University, Centers for Disease Control

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: drpmackarey@msn.com

For all of Dr. Mackarey's articles visit https://mackareyphysicaltherapy.com/forum/

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.

February is American Heart Month!

American Heart Month is not just for lovers. Long after the Valentine’s roses wilt, our hearts will require special attention for a long healthy life. It is the goal of The National Heart, Lung, and Blood Institute to motivate Americans to adopt healthy lifestyles to prevent heart disease. And, in 2021, a healthy heart may be more important than ever to reduce the risk of severe illness from COVID-19.

Not So Young at Heart!

A recent study by the Center for Disease Control (CDC) found that while many Americans believe that they are “young at heart”, it turns out that many have hearts older than their actual age. For example, the study found that the average American male heart is eight years older and the average American female heart is five years older than their chronological age.

What does this mean?

The CDC’s findings may offer some explanation for the fact that many Americans die from heart attacks, strokes, and heart failure when compared to other people around the globe. Furthermore, while more Americans use heart medications more than other people in the world, heart attack and stroke continue to be the leading cause of death in the US, killing more than 80,000 each year.

What Can You Do?

The CDC has developed a new test to determine “Heart Age,” which has been found to be a much more reliable indicator of a person’s risk for heart disease. The heart age test will determine if your heart is older, younger or average for your age, which can be much more important for longevity than chronological age.

The CDC is encouraging people to take matters into their own hands …be proactive. In addition to calculating your Body Mass Index ((BMI), the CDC is asking people to use an online calculator to determine their heart age. The calculator will give a person a more accurate percentage of risk for heart attack or stroke. Based on the outcome, one must see their family physician or cardiologist to discuss the results and implement a plan.    

The Calculator - For Example:

Heart Age is very easy to use: You just need to enter your age, sex, blood pressure, whether you are treated for high blood pressure, whether you smoke or have diabetes, and your body mass index (BMI), with a handy calculator if you don’t know it. The tool gives you your risk for heart disease in the next ten years, compared with normal.

The CDC “Heart Age Test” is simple:

Visit: www.framinghamheartstudy.org

Enter: sex, blood pressure, (list if controlled), diabetes (list if controlled), smoking history, and body mass index (BMI), a simple height/weight calculation found on-line at www.bmicalculator.cc

Example: A 53 year old women with an acceptable BMI, may actually find that she is at great risk for suffering a heart attack or stroke because she smokes cigarettes and has uncontrolled high blood pressure. The calculator includes all the significant factors proven by science to affect a person’s risk of heart attack or stroke. These include: blood pressure, weight, BMI, blood sugar, cholesterol, age, sex and smoking history.

Example: 50 year old male smoker has uncontrolled high blood pressure of 140/96, no history of diabetes, and a BMI of 30 has a predicted heart age of 72 years. A female with a similar profile would have a heart age of 74 years.

The Solution

To some, the solution may be obvious and for others it may be impossible. In the previous example of the 50 year old smoker, if he quit smoking for one year, he would halve reduced his heart age by 14 years (15 years for a woman). If he would reduce his blood pressure to 120, he would reduce his heart age by 6 years (10 years for a woman). And, if both risk factors were removed, he would reduce his heart age by 19 years (23 for a woman).

In the above examples, the 53 year old man does not have to take his 72 year old heart age as a death sentence.

What Individuals can do…

What Public Health Policy Can do…

Require health plans to cover, with limited co pays or deductibles, preventative services such as blood pressure screening nutritional counseling, prescription exercise and tobacco cessation products.

Promote health, wellness through diet and exercise by sponsoring health fairs and establishing bike lanes and walking trails in the community.

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: drpmackarey@msn.com

See all of Dr. Mackarey's content at: https://mackareyphysicaltherapy.com/forum/

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.