Get Started
Get Started
570-558-0290

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!

“When is it safe for my child to start weight training?” This is a very common question asked by parents of young athletes who are looking for advice regarding their children’s participation in weight training. This month, for example, I received three such inquiries. While some who are eager to get a “competitive edge” may not be satisfied with the answer, these recommendations are grounded in the scientific literature and medical specialist with the hope to prevent injury and dispel fear and fallacy.

Weight training, weight lifting or resistive training all describes the use of a resistive force on a muscle to improve strength. While much attention has been given to the benefits of weight training in adults, much less has been written about its application in children.

Optimal Age to Begin Weight Training:

According to the Journal of Pediatric Orthopedics, children less than 12 years old are considered prepubescent or before puberty. Teenagers who are between 12 and 19 are considered to be adolescents. Studies consistently demonstrate that strength gains are much more significant in adolescents than in preadolescents. It is important to note that these strength gains are not only from the enlargement of muscle fibers (hypertrophy), but also from the improvement in the coordination and efficiency in muscle contraction and the recruitment of motor units and fibers within the muscle.

Preadolescents lack the hormones necessary to develop masculine characteristics. Adolescents begin to produce the hormones of testosterone and androsterone to develop secondary sexual characteristics such as pubic hair and enlarged genitalia. In view of this, age 13-14 is the optimal age to safely begin and benefit from a well-designed weight training program.

Benefits of a Well-Designed Weight Training Program for Adolescents:

Risks From Poorly Designed or Unsupervised Program:

How to Begin A Weight Training Program for Adolescents:

**STOP:

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!

...Labor Day is also the start of the school year

While many people celebrate the Labor Day holiday by firing up the grill, others will be shopping to get their students ready for the school year. One item on the shopping list should be a good quality and well-fitted backpack…to prevent lower back pain!

In 2018, the government of India announced a ban on homework and recently in Poland; the government ministers did the same. Can you imagine…a ban on homework? In an effort to promote student health and address recent surges in the incidence of back pain in the young, there will be no homework for students in grades one and two.

It was estimated that the majority of students ages 7 – 13 in India were carrying almost half their body weight. Not surprisingly, medical practitioners noticed a dramatic increase in reported cases of back pain among this group and decided to take action. In addition to the homework ban for grades one and two, Indian authorities have also implemented a limit of 10% of the student’s body weight.

Back pain in students seems to be universal. Each year, as students in the United States prepare to return to school from summer vacation, the subject of backpacks arises. The good news: when compared to purses, messenger bags, or shoulder bags, backpacks are the best option to prevent lower back pain. The bad news is, most of the 40 million students in the USA using backpacks, are doing so incorrectly.

Studies have found more than 33% of children had LBP that caused them to miss school, visit a doctor, or abstain from activity. Also, 55% of children surveyed carried backpacks heavier than the 10-15% of their body weight, which is the maximum weight recommended by experts. Additionally, the study noted that early onset of LBP leads to greater likelihood of recurrent or chronic problems. Backpacks that are too heavy are particularly harmful to the development of the musculoskeletal system of growing youngsters. It can lead to poor posture that may lead to chronic problems.

The following information on backpack safely is based, in part, by guidelines from The American Physical Therapy Association. Parents and teachers would be wise to observe the following warning signs of an overloaded and unsafe backpack:

WARNING SIGNS:

Consider the following suggestions to promote backpack safely and prevent back injury:

12 SUGGESTIONS for Backpack Usage:      

  1. Limit Weight of Pack to 10-15% of Body Weight (100lb child = 10-15lb pack)
  2. Padded Adjustable Shoulder Straps - Use both straps to distribute weight evenly. Using one strap may look cool but it will lead to back pain.
  3. Waist Belt – Proper Fit - An adjustable waist belt will distribute pack weight from back to hips and legs. Top of pack should be below the neck and bottom 2-3 inches above the waist
  4. Pack Weight Distributed to Small of Back/Hips – using adjustable straps - Not all the weight on shoulders and upper back
  5. Wheeled Backpack – if unable to make above adjustments - This is an option for some children; however, you may have problems     carrying/lifting it on the bus etc.
  6. Purchase Extra Set of Books And Use Your Locker - Get list from teachers and use the internet to buy extra books to leave at home. Teachers and students might consider downloading text books on the iPads or electronic tablets. Also, put unnecessary books in your locker between classes
  7. Remove Pack When Possible - While waiting for bus, hanging out between class, etc
  8. Put Pack On/Off From Chair/Table/Bench – Not Floor - It is much easier to lift a pack up from a table and put it on your back than bending over to get it from the floor
  9. Stand Erect and Arch Small of Back - The correct posture while carrying heavy items is to make a hollow or arch the small of your back
  10. Perform Posture/Stretching Exercises - Pinch shoulder blades together and extend and arch your spine backwards intermittently throughout the day – especially every time you take your pack off
  11. Consider a pack with multiple compartments - Use several compartments to carefully load your backpack and distribute the weight more evenly…and eliminate accumulated/unnecessary junk.
  12. Use a back with reflective material to enhance visibility.

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!

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 DrytechR 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.     

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!

Gardeners and Computer Mouse Users Be Aware!

Tennis elbow, also called lateral epicondylitis, is an inflammation of the lateral (outside) bony protuberance at the elbow. It is at this protuberance that the tendon of the long muscles of the hand, wrist and forearm attach to the bone. As the muscles repeatedly and forcefully contract, they pull on the bone, causing inflammation. The trauma is irritating when working the muscles in an awkward position with poor leverage like hitting a backhand in tennis.

It is not unusual for a patient to come to my office with severe pain on the outside of their elbow. Especially, after intensifying their tennis workouts or changing the racquet string tension. Others come to me with pain on the inside of the elbow (“golfer’s elbow”) from wrist action that advanced golfer’s use at impact. However, this problem is not only for tennis players and golfers. Laborers working with wrenches or screwdrivers with an awkward or extended arm can also develop tennis elbow. Others who are vulnerable are: those working for hours at a computer using a mouse as well as those working hard maintaining their lawns and gardens.

In a more chronic problem, lateral elbow pain may arise by a degenerative condition of the tendon fibers on the bony prominence at the lateral elbow. Sporadic scar tissue forms from a poor attempt by the body to overcompensate and heal without eliminating the cause.

Common characteristics of persons who develop tennis elbow:

Symptoms:

While symptoms may vary, pain on the outside of the elbow is almost universal. Patients also report severe burning pain that begins slowly and worsens over time when lifting, gripping or using fingers repetitively. In more severe cases, pain can radiate down the forearm.

Treatment Options:

Conservative treatment is almost always the first option and is successful in 85-90 percent of patients with tennis elbow. Your physician may prescribe anti-inflammatory medication (over the counter or prescribed). Physical/Occupational therapy, rest, ice, and a tennis elbow brace to protect and rest may be advised. Ergonomic changes in equipment, tools, technique and work-station may be necessary. Improvement should occur in 4-6 weeks. If not, a corticosteroid injection may be needed to apply the medication directly to the inflamed area. Physical therapy, range of motion, and stretching exercises may be necessary prior to a gradual return to activity. Deep friction massage can assist healing.

Passive Stretch in Wrist Flexion with Elbow Extension

Exercises performed in a particular manner to isometrically hold and eccentrically lengthen the muscle with contraction.

Isometric/Eccentric Wrist Extension with Elbow Extension

New Conservative Treatment: Platelet-Rich-Plasma (PRP) is a new treatment for the conservative management of degenerated soft tissues that has recently received great media attention. In great part, due to its success in several high profile athletes. According to the Journal of the American Academy of Orthopaedic Surgeons,(JAAOS), platelet-rich plasma (PRP) is autologous (self-donated) blood with an above normal concentration of platelets. Normal blood contains both red and white blood cells, platelets and plasma. Platelets promote the production and revitalization of connective tissue by way of various growth factors on both a chemical and cellular level.

The actual PRP injection requires the patient to donate a small amount of their own blood. The blood is placed into a centrifuge (a machine that spins the blood at a high velocity to separate the different components of blood such as plasma, white and red blood cells), for approximately 15 minutes. Once separated, the physician draws the platelet-rich plasma to be injected directly into the damaged tissue. In theory, the high concentration of platelets, with its inherent ability to stimulate growth and regeneration of connective tissue, will promote and expedite healing.  

Surgery for tennis elbow is only considered in patients with severe pain for longer than 6 months without improvement from conservative treatment. One surgical technique involves removing the degenerated portion of the tendon and reattaching the healthy tendon to bone. Recently, arthroscopic surgery developed to perform this technique. However, research does not support the value of one over the other at this point. Physical/occupational therapy is used after surgery. Return to work or athletics may require 4-6 months. More recently, a surgical technique using ultrasound to guide a needle to debride (clean) the area of scar tissue has been developed. If eligible for this procedure, the time required for healing, rehabilitation and return to activity is much shorter.

If you feel you suffer from tennis elbow, ask your family physician which of these treatment options are best for you.

Visit your doctor regularly and listen to your body.     

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

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

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

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in 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!

It is four months since many people have made their health and fitness resolutions and hopefully some have stayed the course.  If you are looking for another reason to stick to your New Year’s Resolution to get fit and lose weight in 2024 try this…to improve or prevent hip and knee pain!

There are three major weight-bearing joints in the body, the hip, knee and ankle/foot. Consequently, wear and tear and arthritis are common among these joints. There are almost 800,000 knee replacements and 450,000 hip replacements annually in the United States alone. While there are many recommended methods to avoid or delay joint replacement, only a few are within our control. Genetics, trauma, degenerative diseases such as rheumatoid arthritis and osteoarthritis are difficult to control. However, body weight, aggressive weight bearing sports and overdoing exercises as you age like excessive running, jumping, lifting and squatting can be modified or eliminated to limit the progression of joint damage.  According to WebMD, “your knees are powerhouses. They’re the biggest, strongest, joints in your body, and most people use them throughout the day to sit, stand, walk, jump, and bend. They bear 80% of your body weight when you stand still and 150% or more when you walk across the room. In a 160-pound person, that’s 240 pounds of force!”

Body Weight and Hip & Knee Pain

According to the National Institutes of Health, body weight or body mass index (BMI) has a direct impact on hip and knee degeneration, pain and dysfunction. In fact, one study found that people with or at risk of significant hip/knee osteoarthritis had a 2-3% reduction in risk of hip or knee replacement for every 1% reduction in weight, regardless of the baseline BMI.

It is commonly known that the primary cause of osteoarthritis is normal wear and tear, especially for those over 50. However, extra body weight can accelerate this process. As the joint degenerates, the cartilage at the end and in between your joints gets compressed and dehydrated which leads to deterioration. Eventually, the bones rub directly on each other as the cushion wears away, leading to pain, swelling, and stiffness, loss of motion, strength and function.   

While it may seem obvious that extra weight will put more strain and stress on the hip and knee joints; another mechanism involved in this degenerative process. Excess body fat can increase chemicals in your blood stream that can cause inflammation in your joints.

How to Maintain a Healthy Body Weight

If you need a goal and a motive, how about this: losing even 10 pounds will equate to 40 pounds less force compressing and stressing your hips and knees. Moreover, reducing body fat will limit the hormones that cause inflammation in your joints. Talk to your primary care physician or visit www.cdc .gov to find a BMI calculator. Just plug in your height and weight and it calculates it for you. For example, a 155-pound male at 5 feet 8 inches tall has a BMI of 23.6. (A BMI of 18.5 to 24.9 is considered a healthy weight for this person).

Diet

The Mediterranean Diet is a solid start to eating healthy. It is less of a diet and more of a lifestyle. The foundation of this diet is plant foods built around vegetables, fruits, herbs, nuts, beans and whole grains. Moderate amounts of fish, dairy, poultry and eggs with limited consumption of red meat are paramount. The Mediterranean lifestyle also includes shared meals with family and friends, small portions, regular exercise, and wine in moderation with food and friends.

Exercise

Exercise has many more benefits than just losing weight. Physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to weight loss and longevity.  

Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:

Some simple suggestions for beginning an exercise program are:

 Visit your doctor regularly and listen to your body.     

  Keep moving, eat healthy foods, exercise regularly, and live long and well

SOURCES: WebMD, National Institutes of Health; CDC, American Council on Exercise

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!

What is a myth?

A myth is a traditional story, idea, or belief, especially one concerning early history of a people or explaining a natural or social phenomenon. It is a widely held but false belief or idea. In medicine, health myths are also widely held beliefs about health issues such as medicines, herbs, treatments, cures, antidotes, etc. which are partially or totally false and unsubstantiated in the scientific literature. This is a partial list of the most common health myths:

  1. 8 GLASSES OF WATER IS ESSENTIAL FOR GOOD HEALTH
    • You don’t need to search very long to find copious information purporting the value of water to maintain good health. Sources suggest between 8 and 15 cups of water per day! Despite the plethora of contradictory information, there is no research to support an exact amount. In fact, most scientifically validated research suggests that healthy adults do not need to count cups and those who drink water when thirsty receive adequate hydration for good health. Remember, there are many water-rich foods to provide hydration; soup, fruit, vegetables, juice, coffee, and tea. However, be aware that if your urine is dark yellow you need more hydration. And, if you are very physically active or live in a warm climate, you may require more water.
  2. EATING EGGS WILL LEAD TO HEART DISEASE
    • In the late 70’s, eggs received a bad reputation when high cholesterol in the blood could increase the risk of heart disease. The love-hate relationship with eggs and egg products has continued to grow since. However, recent findings suggest that eating an egg or two a day will not raise the risk of heart disease in healthy adults. While egg yolks do contain cholesterol, the amount is relatively small and is offset by the fact that eggs also have many nutrients such as omega-3’s, which are associated with lowering the risk of heart disease.
  3. ANTIPERSPIRANTS CAN LEAD TO BREAST CANCER
    • Some research attempted to link the preservatives (parabens) used in some deodorants and antiperspirants with the activity of estrogen in the body’s cells because these parabens are found in breast tumors. However, there is no scientific evidence that parabens cause breast cancer. So, don’t sweat it!
  4. SPENDING TOO MUCH TIME IN THE COLD AIR WILL LEAD TO A COLD
    • Sometimes “old wives tales” are true…but not this one! Grandparents and parents have been telling their grandchildren and children to button up and don’t spend too much time in the cold. In fact, one study found that healthy men who spent several hours a day in cold temperatures (just above freezing) had an increase in virus-fighting activity in their immune systems. Moreover, documentation supports that spending too much time indoors, especially during winter flu season, puts you at risk for getting the flu…so circulate fresh air or get outdoors!
  5. EVERYONE NEEDS A MULTIVITAMIN TO BE HEALTHY
    • Research does not support this theory that everyone needs a multivitamin to supplement for nutrients not in your diet. In fact, most medical experts agree that healthy adults receive all necessary nutrients and vitamins from a well-balanced diet including; fruits, vegetables, whole grains, nuts and healthy oils. However, if your physician recommends a vitamin, do so. It may be that you are insufficient or at risk due to other medical conditions. If you are pregnant, for example, you will need to take folic acid to lower the risk of birth defects. 
  6. EATING A GOOD BREAKFAST IS NECESSARY TO LOSE WEIGHT
    • Some diets purport that eating breakfast is necessary to stimulate your metabolism in order to lose weight. This theory is not confirmed, and for those who enjoy breakfast, it may limit hunger sensation and prevent unhealthy snacking. However, a study from Cornell University found that those who did not eat breakfast did not overeat at lunch and dinner and consumed approximately 400 fewer calories per day. So, for some healthy adults, eliminating breakfast can help lose weight…the premise of “intermittent fasting.”
  7. GREEN MUCUS IS A SURE SIGN OF INFECTION
    • Most would agree, the slimy green mucus in your tissue is disgusting. However, without a lab test, it is not a sure sign of an infection or need for antibiotics. Often, clear mucus indicates a sinus infection, while green mucus represents a common cold.
  8. TOO MUCH SUGAR MAKES KIDS HYPERACTIVE
    • Sugar making your kids hyper? Maybe it’s just kids being kids! It is widely accepted that sugar is not good for kids (unhealthy calories leading to obesity, etc). However, Research shows that it is not the cause of hyperactivity (caffeine or chocolate may). It may be that parents are so focused on their behavior after sugar intake that they expect their kids to be wired when it may just be attributed to the normal behavior of kids just being kids!
  9. A TOILET SEAT IS A COMMON AREA TO SPREAD DISEASE
    • Believe it or not, toilet seats are not the most unsanitary item in the bathroom. So, if you can’t cover it, don’t sweat it. Bugs such as E. coli, norovirus, and other flu viruses cover bathroom doors, door handles, and floors. Thorough hand washing is essential and use a paper towel for door handles.
  10. CRACKING YOUR KNUCKLES OR OTHER JOINTS WILL LEAD TO ARTHRITIS
    • One thing is certain…cracking your knuckles is annoying to everyone around you! But studies show that it is not harmful to your joints or causes arthritis. The popping noise is not because the bones are grinding together; it is due to movement of gas bubbles in the joint capsule.  
  11. ELIMINATING FAT FROM YOUR DIET WILL MAKE YOU HEALTHIER AND HELP YOU LOOSE WEIGHT
    • Total elimination of fat from your diet is not only unnecessary to be healthy and lose weight, but is unhealthy and harmful. Fat provides essential nutrients and is an important component of a healthy diet. Due to the fact that fats have more calories per gram than protein or carbohydrates, limiting fat intake is necessary to avoid extra calories. Instead, chose low fat dairy products (milk, yogurt, cheese) and consider eating small amounts of food with healthy fats, such as avocados, olives, or nuts. 
  12. CHILDHOOD VACCINES LEAD TO AUTISM
    • Vaccines do not cause autism. Despite much controversy, there is no scientific evidence that supports a connection between autism and childhood vaccines. In fact, the original study that started the debate years ago has been disproven and retracted. Fact: childhood vaccines protect children from a variety of serious or potentially fatal diseases.

SOURCES: WebMd; National Institutes of Health, Mayo Clinic

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 does not intend 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!

PEOPLE OFTEN ASK ME, “IS THERE SUCH A THING AS AN EXERCISE RUT?”. THEY WANT TO KNOW WHY THEY DO NOT SEEM TO BE IMPROVING WITH THEIR EXERCISE PROGRAM. They exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut.

The purpose of this column is to offer suggestions to improve or get more out of a “stale” exercise program. Last week’s column offered tips to improve a stale cardiovascular and strength program. We will discuss flexibility and functional training tips, including the components necessary for a healthy mind, body and spirit connection.

FLEXIBILITY TRAINING

Flexibility training involves the careful stretching of the muscles, tendons and joints to improve range of motion in order to safely perform daily activities and sports without injuring or tearing soft tissues. It is probably the most neglected part of the fitness program. However, while the amount of inherent flexibility varies for each person, a minimal range is necessary as it relates to daily activities and sports. For example, as you age it is important to have enough flexibility in your back, hips and knees to wash your feet, put shoes and socks on. After a warm –up activity, perform flexibility exercises slowly and gently. There are two types of flexibility exercises; dynamic and static. Perform dynamic stretching with movement such as pushing the ankle up and down like a gas pedal. Complete passive stretching using an outside force, such as a towel to pull the ankle up to stretch the calf. Dynamic should be performed before an activity (before running or playing tennis) and static performed after the activity is over in order to increase range of motion for future activities.

Improving a Flexibility Training Program:

Hamstring Wall Stretch
½ Cobra Lower Back Stretch

STEP TWO: Mind, Body, Spirit; Nutrition; Core Fitness; Functional/Sports Specific Training; Leisure Sports and Activities

In order to prevent an exercise program from getting stale, one must incorporate all aspects of wellness…a healthy mind, body and spirit!

Conclusion:

It is easy for fitness enthusiasts to get so focused on maintaining a routine that they allow their program to become stale and ineffective. It is essential to reassess and update your program to prevent stagnation.

Make sure the routine has all three fundamental components of a well-balanced exercise program; cardiovascular, strength and flexibility training. Moreover, to be truly healthy, one must work toward a “Healthy Mind, Body, and Spirit. Therefore, in addition to traditional exercise one must incorporate the following: nutrition; meditation, relaxation techniques, yoga, core fitness; functional/sports specific training; leisure sports and activities

In order to prevent an exercise program from getting stale, one must incorporate all aspects of wellness…a healthy mind, body and spirit!

While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED.

Sources: National Institutes of Health; American Council on Exercise

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

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

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

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

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in 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!

Part I of II

PEOPLE WILL OFTEN ASK ME, “IS THERE SUCH A THING AS AN EXERCISE RUT?” THEY WANT TO KNOW WHY THEY DO NOT SEEM TO BE IMPROVING WITH THEIR EXERCISE PROGRAM…they exercise 3-4 times a week for 30 to 45 minutes and they feel frustrated and STUCK in a rut. While initially responding favorably to exercise, after 6 -9 months or more, they do not notice progress in weight loss, strength, tone, endurance or daily function.

The purpose of this column will be to offer suggestions on how to improve or get more out of a “stale” exercise program or an exercise rut. Step one is to build an exercise program that is grounded in the basics. Next step two, which begins after the basics have been mastered, includes the components necessary for a healthy mind, body and spirit connection and translates into functional activities of daily living including work and leisure sports.

STEP ONE: CARDIOVASCULAR; STRENGTH; FLEXIBILITY

Make sure your routine has all three fundamental components of a well-balanced exercise program; cardiovascular, strength and flexibility training. While each component offers its own specific benefit, the combination of all three cooperatively provides unique value. Too often, fitness enthusiasts concentrate on the exercises they LIKE or are good at more than the ones they NEED. A well-balanced program includes what you like and need! In fact, recent studies show that those performing all three components surpassed those performing one or any combination of two of the training types when tested for efficient oxygen uptake (VO2 Max), production of HDL (good cholesterol), lower body fat percentage, and lower blood glucose levels.

CARDIOVASCULAR TRAINING:

Cardiovascular exercise is any activity that raises your heart rate and respiratory rate. This type of exercise strengthens the heart muscle and the muscles that assist in breathing. When these muscles are stronger, they in turn work more efficiently to deliver oxygen to your muscles and other parts of the body. Ultimately, these oxygenated muscles can work harder and longer to burn fat during exercise and at rest.

Examples of Cardiovascular Exercises:  Running, Brisk Walking, Swimming, Biking, Rowing, Elliptical Training and Stepper Training. Most experts recommend at least 30 minutes of sustained cardio, 3-4 days per week. However, recent studies support the notion of performing 10-15 minutes, twice daily, 4 days per week. For those “stuck” in a fitness or exercise rut, to advance your program, cardio should be performed 5-6 days per week for 45-60 minutes.

Improving a Cardio Training Program:
STRENGTH TRAINING:

Strength training is an activity that provides any type of resistance to muscle contraction to build strength in the muscle. The resistance can be without movement against an immovable object such as pushing against a wall (isometric) or with movement such as lifting up or lowering a weight down against gravity (isotonic/dynamic). There are two types of isotonic muscle contraction; concentric, which involves raising the weight against gravity as the muscle shortens and eccentric which involves lowering a weight against gravity as the muscle lengthens. A standing biceps curl is an example that incorporates both concentric and eccentric contractions. A progressive strength training program includes all three types of muscle contraction. By using the classic bicep muscle curl these photos will demonstrate all three types of muscle contraction:

-Isometric Bicep Muscle Curl – pull up on door knob without allowing any movement of the arm.

-Concentric Bicep Muscle Curl – raise a dumbbell up against gravity as the muscle shortens.

-Eccentric Bicep Muscle Curl – lower a dumbbell slowly (4-6 seconds) against gravity as the muscle lengthens.

Improving a Strength Training Program:

Sources: National Institutes of Health; American Council on Exercise

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

NEXT WEEK! Read Stuck in an Exercise Rut…Part II of II:

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!