STAY ACTIVE & HAVE FUN IN THE SUN!

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

Sunset or Moonlight Kayaking

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

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

Gear:

• Clothing – a DryTec type material for shirt and pants…bring along a light long sleeve in case the wind picks up or the bugs are out.
• Shoes – Aqua shoes are best…old sneakers will work
• Water – handheld water bottle or a water proof bag for money, keys, ID, and a granola bar.
• Insect Repellent - a must
• Headlamp – to see and be seen on the water and packing up.
• Change of Clothes – towel and change of clothes in your car…just in case

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

Stand Up Paddleboarding:

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

Check out the video for more information: REI paddleboard basics

Elliptical Pedalboarding:

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

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

Aqua Zumba:

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

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

Website: www.zumba.com

Elliptical Biking:

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

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

Visit your doctor regularly and listen to your body.     

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

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

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

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

Part II of II

Happy Father’s Day! It is my hope that this information will be helpful to all the fathers who enjoy working in the yard! It is not too late to buy dad a new cart or kneeling pads for the yard. Last week, Health & Fitness Forum presented tips for gardeners for preventing hand and arm injuries such as carpal tunnel syndrome. This week’s column is dedicated to prevention of lower back and lower body injuries when working in the yard and for gardeners with disabilities.

A relaxing and enjoyable activity for many, gardening can turn dangerous without proper precaution as repetitive stress injuries, back pain, muscle pulls, can stem from raking, weeding, digging and pruning, can turn into serious problems if not treated appropriately.  Since prevention is the best approach, the US Dept of Agriculture promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.

People with various disabilities enjoy gardening at different levels. For example, those suffering from neurological diseases with muscle weakness, paralysis and poor balance as well as those with musculoskeletal problems such as neck and LBP or hip and knee arthritis can safely enjoy gardening at some level. This outdoor labor of love is very therapeutic.

Warm up and stretching is important. Don’t garden first thing in the morning before you have a chance to warm up. Get up, go for a short walk, have breakfast and maybe warm up with a hot shower before working in the garden. Some stretches include;

• Corner Stretch: Stand facing a corner wall with arms and shoulders at 90 degrees. Lean into corner and stretch shoulders and back.
• Knees to Chest Back Stretch: While lying on your back, bring both knees up towards your chest.

Note:  These exercises should never be painful when completing them.  You should only feel a gentle stretch. Hold the stretch10 seconds and repeat 5 times before you garden and every 2-3 hours while working. Should you experience pain, please consult your family physician or physical therapist.

The following guidelines to prevent injury and foster healthy gardening for those with and without disability:

• Listen To Your Body – Aches and pains are signals from your body that you may be doing something wrong or overdoing it. Just like a baseball player in spring training, you must ease into a new activity slowly and stop before you get pain. Do not try to do it all in one day.
• Take Frequent Breaks – Perform work in short sessions, with a rest and stretch break between gardening sessions to reduce muscle fatigue and pain.
• Change Positions Often – Alternate positions from standing, sitting, bending, and kneeling every 15 to 20 minutes.
• Use Large Muscles- When possible use the large muscles of the body to do the work. For example, use your legs to push a shovel blade into the ground instead of your arms. Also, lift with your legs and not your back.
• Avoid Awkward Motions – Do not squat, twist and bend at the waist for prolonged periods or with repetition. 
• Use Supportive Devices and Braces – Remember to wear wrist and knee supports if you have a problem. A lower back brace or corset is also advisable when working in the garden to protect the spine and add support.
• Use Well Designed Tools.  Use the right tools for the job. Padded, ergonomic handles with extensions to add reach are helpful.   
• Use Sun Block, Sun Glasses and bug spray – to protect your skin and eyes from the sun and ward off ticks and other bugs.
• Plan ahead.  Use a container with wheels to carry supplies to the garden.  When necessary it should be carried/pulled with hands, distributing the workload equally and decreasing stress in the joints of your body.
• Eat Well and Stay Hydrated – When working outdoors eat and drink properly for the climate and temperature.
• Use Adaptive Devices -  Special gardening carts, wheel barrels, motorized carts, and a garden tractor with a cart can make a job easier, especially for those with disabilities.
  • “Easy-Grip” tools are available for those unable to grip strongly. For example, hand shovels and weed cultivators that attach to the wrist/forearm with Velcro straps and tools with telescoping extensions are available. (www.wrightstuff.biz)
  • Mobile Adjustable Stools – with arm rests and 2-3 steps that allow you to go from sitting upright to a position closer to the ground.
  • Elevated and Raised Beds – allows gardening from a standing, sitting or wheelchair height for improved safety and enjoyment.
  • Pipe Planter or Seeder – a PVC pipe 5-6 feet long allows planting and seeding without bending or kneeling. For example, a 6 or 8 inch pipe allows plants to slide down and be tampered into a hole and a 1-2 inch pip allows seeds to slide down to the ground for cover or planting.
  • Kneeling Pads, Mats, Carts – are healthier for your knees and back.

Source: Karen Funkenbusch, MA; Willard Downs, PhD.: U. S. Department of Agriculture - Agricultural Engineering Extension

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

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

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

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

Part I of II

Farmers and gardeners in NEPA always say that Memorial Day, the “kick off” day for planting without the fear of frost, however, this year we have had an unusually cold and wet spring… but it is not too late to start…not only for the beds but your body! While gardeners are anxious to work in their gardens and enjoy the fruits of their labor, a relaxing and enjoyable activity can turn dangerous quickly. Precautions are necessary as repetitive stress injuries such as shoulder and elbow tendonitis and carpal tunnel syndrome can stem from raking, weeding, digging and pruning. Additionally, simple scrapes, blisters, and bites can turn into serious problems if not treated appropriately.  Since prevention is the best approach, the American Society of Hand Therapists (ASHT) promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.

ASHT recommends following these upper extremity warm-up exercises prior to gardening:

Note:  These exercises should never be painful when completing them.  You should only feel a gentle stretch. Hold 10 seconds and repeat 5 times. Should you experience pain, please consult a physician or hand therapist.

1. Forward Arm Stretch: Fold your hands together and turn your palms away from your body as you extend your arms forward.  You should feel a stretch all the way from your shoulders to your fingers.
2. Overhead Arm Stretch: Fold your hands together and turn your palms away from your body, but this time extend your arms overhead.  You should feel the stretch in your upper torso and shoulders to hand. 
3. Crossover Arm Stretch: Place your hand just above the back of the elbow and gently push your elbow across your chest toward the opposite shoulder.  This stretch for the upper back and shoulder and should be performed on both sides.

ASHT recommends the following guidelines to prevent injury and foster healthy gardening practices:

• Wear gloves at all times.   Bacteria and fungus live in the soil and a small irritation or cut can develop into a major hand infection.  Glove choice should be specific to the specific task.  Thick, leather or suede gloves may protect your hands from thorns, cuts and scrapes while pruning roses.  Rubber or latex coated gloves may be appropriate to aid in grip when working in the soil.
• Keep your hands and arms covered.  Be especially careful if you live in an area where you may disturb a snake, spider or rodent living in your garden.  You will be better protected from poison ivy, insect bites, ticks and other common skin irritants that may inhabit a garden.
• Take a break every hour or switch to another activity.  Overuse of repetitive motions, such as digging, and sustained/constant gripping can cause tendonitis of the wrist, elbow or lead to carpal tunnel syndrome.  Break up large tasks into short sessions, with a rest and stretch break between gardening sessions to reduce muscle fatigue.
• Use a tool when digging into unfamiliar or new areas.  Buried sharp objects can cause tendon lacerations or punctures.  Use the correct tool for the task at hand in order to avoid accidental injury. 
• Store your tools to prevent accidents.  Learn how to use and store your tools correctly to prevent accidents, and keep sharp tools out of the reach of children at all times.  Also make sure to put all tools away after use to prevent future injuries.
• Regular/periodic tool maintenance.  Keep garden tools in top working order to reduce the physical effort required for yard and garden work.
• Use well designed tools.  Use tools with non-slip rubber or padded hands to protect the smaller joints in your hands.  Make a circle with your index finger and thumb—that is how the grip of the tools should be.  The shape of the handle should provide equal pressure along the palm. 
• Avoid awkward motions.  Using better body positioning minimizes muscle pain.  Work with the wrists in a neutral position by avoiding the extremes of motion (up, down and sideways).  Hold objects with a light grasps or pinch. To avoid a tight sustained grip.  Use both hands for heavy activities like lifting a bag of potting soil and alternate hands on more repetitive tasks like scooping dirt out of the bag into a pot.
• Plan ahead.  Use a basket or large handled container to carry supplies to the garden.  The basket should be carried with both hands, distributing the workload equally and decreasing stress in the joints of your upper body.

Professional Contributor: Nancy Naughton, OTD, CHT, is an occupational therapist and certified hand therapist practicing in NEPA.

Next Week: “Prevention of Gardening Injuries” Part II of II.  

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!

Allergies affect 30 % of adults and 40% of children in the United States. Avoiding the outdoors is often not an option…especially if you enjoy outdoor activities and sports. Not long ago, it was unthinkable that an athlete with serious allergies could compete at a high level, such as the Olympics. Now, in great part due to advanced research, medications and proper management, an Olympic gold medal for those suffering from allergies is a reality. Recently, the National Institute of Allergy and Infectious Disease at the National Institutes of Health have published research on this topic to provide a better understanding and make recommendations.

The most common allergic reactions which athletes suffer from are sneezing, itchy and watery eyes, runny nose and coughing. Moreover, 67% of those with these symptoms also suffer from asthma. The athlete in NEPA is particularly vulnerable when the pollen count is high during spring and fall for several reasons. One, after being indoors all winter, one might develop a heightened sensitivity to allergens. Also, increased rapid and deep breathing during exercise makes athletes more susceptible to significant symptoms when exposed to allergens such as tree, grass and weed pollens.

Treatment:

Allergy Shots/Drops:

As mentioned last week, allergy skin testing can be performed to determine the allergens to which you are susceptible. Once determined, allergy shots are effective in building up tolerance to these allergens. If appropriate, you may be able to use allergy drops, administered under the tongue and conveniently used at home.  

Pre-Treat:

Asthma suffers should use their inhaler BEFORE symptoms occur. A recent study found that pretreatment using a short-acting bronchodilator inhaler within 15 minutes before exercise is very effective in preventing asthma symptoms for more than four hours. It is important to keep a bronchodilator available. If you fail to benefit from this, see your physician for other methods to control your exercise-induced symptoms.

Warm-up/Cool Down:

Whether you have allergic respiratory problems from rhinitis or asthma, you many benefit from conditioning your airways with a 10 to 15 minute warm-up before and cool-down after the activity. This may serve to gradually prepare your lungs for an increased demand.

Hydrate:

In addition to preventing dehydration on hot and humid days, constant hydration is very important for the athlete with allergies to prevent dry airways in athletes.

Educate Staff:

Know the signs and symptoms of asthma (coughing, wheezing, tightness in chest, shortness of breath).

Plan for the Problem:

Some schools have a file on each student athlete with a allergic or asthmatic problem which requires medication. The file includes information such as medical doctor release and instruction, emergency contacts and medications. Students must have their medications on hand before they can enter the field. The National Athletic Trainers Association recommends using a peak flow meter to monitor at risk players and can determine when a player can return to the field.

Practice in Climate Control:

If possible, find an alternate practice facility with climate control for athletes at risk. Plan practices for these athletes when the pollen count is low. Check the newspaper or internet for pollen counts in your area. Training by the water, (ocean) where there is a breeze and less pollen is helpful.

Additional Suggestions:

Shower and change clothing immediately after being outdoors

During a flare up, do less aerobic exercise to limit stress on respiratory system. Try strength training indoors instead. 

When pollen count is high, keep windows shut at home and in your car….use air-conditioning.

Keep pets out of your bedroom…especially when sleeping

Dry clothing in dryer…do not hang on clothesline outdoors

Sources: American College of Allergy, Asthma, and Immunology. National Athletic Trainers Association.

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

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

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

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

Part II of II

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

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

SHOES AND EQUIPMENT for WINTER:

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

• Salomon – SpeedCross or SpikeCross - $ 200.
• Topo MTN Racer 3 - $150.
• Brooks – Ghost 16 GTX - $170

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

Winter CLOTHING AND TRAINING:

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

• WARM-UP - Spend more time warming up followed by slow gentle stretching in cold temps.
• THE BRAIN - Can anticipate changes in body temperature, with feedback from the skin, and will adjust the intensity automatically. Subconsciously, the brain calculates the outside temperature and the duration of the activity and will automatically slow down the performance even before fatigue occurs. If the performer attempts to override the brain, the cerebrum responds by creating severe symptoms and sensations of exhaustion such as those associated with heat strain or hypothermia. Therefore, the temperature in which you intensely perform will overpower even the fittest athletes.
• STRATEGIES FOR OPTMIMAL PERFORMANCE IN COLD TEMPERATURE -
• Researchers developed various strategies for athletes to stabilize their core temperatures in extreme hot or extreme cold conditions.
  • BELOW 45 DEGREES FAHRENHEIT – CAUTION/COLD: Humans possess limited physiological defenses against the cold.
    • Clothing – it is important to layer clothing. Use performance apparel such as UnderArmor (headgear, gloves, shirts and pants) to allow sweat to breath away from the skin to the next layer of clothing. Use a facemask to cover your mouth and nose to prevent frost bite and warm air before it enters the lungs. Chemical hand and toe warmers are great. Wear running shoes designed for winter conditions when surfaces are slippery.
      • Warm-Up – gently warm up inside but don’t break a sweat. Wait for your running partner in the warm car or house until they arrive. The best warm up in very cold weather is to begin your activity SLOWLY! Runner’s, for example, should run a ¼ the normal pace for 3-5 minutes, then ½ pace for 3-5 minutes, then ¾ pace for 3-5 minutes to prevent injuries. After 10 to 15 minutes, you may open up the throttle.
      • Safety – is important. Be alert for icy patches and poor visibility for cars. Wear fluorescent and reflective colors running in fog, dusk or dawn. Run in daylight with the warmth of the sun when possible.
      • Cross-Train- if it is very snowy, skip the run and try cross-country skiing or snowshoe walking or jogging for a change. It is a great running substitute and vigorous workout!
      • Food & Drink – is different for activities in the cold. For short-term exposure (1-4 hours) make sure you fill your muscles with lots of glycogen by getting 4 grams of carbohydrates for every pound of body weight. During exercise consume extra carbs by drinking 5 to 6 ounces of sports drink every 15-20 minutes. Hikers and campers performing vigorous activity in the cold for days at a time will require extra fat in their diet and on their bodies to store for energy. This is no time to count calories or fat intake, as anyone who has climbed the high peak knows!
  • 45 TO 50 DEGREES FAHRENHEIT – OPTIMAL Many physiologists and outdoor enthusiasts consider this temperature range to be optimal. It still requires 10 minutes of slow warm-up by ½ to ¾ pace running or cycling. Also, layers are advisable to start off warm, keep warm and shed before you become overheated. Food and drink requirements are still important as with all long duration activities but may be ¼ to ½ the above requirements.

Visit your doctor regularly and listen to your body.     

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

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

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

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

Part I of II

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

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

The advantages are many:

• There is NO learning curve - if you can walk, you can shoe
• There is little to no risk of injury - it requires more endurance than coordination
• The equipment is inexpensive - as compared to skis
• The walking and hiking trails are free - Lackawanna State Park, Rails to Trails or the snow covered streets of your neighborhood
• The aerobic exercise is great and caloric expenditure tremendous. According to Weightwatchers, a person weighing 150 pounds will burn approximately 650 to 700 calories per hour of snowshoeing

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

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

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

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

Equipment - Choosing the right snowshoe

3 Types:

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

Cost of Snowshoeing:

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

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

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

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

Visit your doctor regularly and listen to your body.     

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

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

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

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

While I normally do not address the topic of shoveling snow until January, considering recent weather events, I thought it might be valuable to present it sooner. Much has been written about the dangers of snow shoveling for your heart. However, while not fatal, low back pain is the most common injury sustained while shoveling snow. Heart attacks are also more common following wet and heavy snow.

Snow shoveling can place excessive stress on the structures of the spine. When overloaded and overstressed, these structures fail to support the spine properly. The lower back is at great risk of injury when bending forward, twisting, lifting a load, and lifting a load with a long lever. When all these factors are combined simultaneously, as in snow shoveling, the lower back is destined to fail. Low back pain from muscle strain or a herniated disc is very common following excessive snow shoveling.

Snow Shoveling as a Form of Exercise:

• GOOD - For the Young and Healthy – studies show that snow shoveling for 15 minutes is considered moderate physical activity and extreme and vigorous physical activity when performed more than 15 minutes even for young healthy college students.
• BAD – For the Older and Unfit – research clearly shows that there is a significant increase in heart attacks among snow shovelers. If you have any risk factors or medical condition and do not exercise regularly consult your physician.
• Cold Weather – makes this activity even more difficult and physically stressful. Cold air makes breathing more labored and difficult and cold temps create added strain on the body.

People at High Risk of Illness Due to Snow Shoveling:

• History of Heart Attack
• History of Heart Disease
• History of High Blood Pressure or High Cholesterol
• Smokers
• Inactive & Sedentary Lifestyle
• Overweight
• Elderly

10 TIPS FOR SAFE SNOW SHOVELING:

1. MEDICAL CLEARANCE: If you have any medical condition or risk factors consult your physician.
2. PAIN: Stop immediately if you experience any pain. Especially in the chest, left arm, jaw, face, neck, or lower back.
3. ERGONOMICS: Choose a snow shovel that is right for you:
   1. An ergonomic shovel with a curved handle allows you to keep your back straighter or arched when shoveling
   1. An ergonomic shovel with a shorter or adjustable handle length allows you to keep your back straighter and knees bent when shoveling. The right handle length allows you to arch your back 10 degrees with your knees slightly bent when the shovel is on the ground.
   1. A plastic shovel blade is lighter than a metal one and will be better for your spine.
   1. A smaller blade is better than a larger blade. It may take longer but will stress your back less.
4. PUSH: When possible, push the snow. Do not lift it. Lifting is much more stressful on the spine. You can find shovels that are ergonomically designed just for pushing snow.
5. WARM – UP: Be sure your muscles are warm before you start to shovel. Cold and tight muscles are more likely to strain than warm, relaxed muscles. Layer and consider compression shirts or tights can help prevent cold and tight muscles.
6. LEVERAGE: When you grip your shovel, spread your hands at least 12 inches apart. This will improve your leverage and reduce strain on your lower back.
7. TECHNIQUE: Shoveling technique is very important. The American Academy of Orthopaedic Surgeons recommends:
   • Squat with your legs apart, knees bent and back straight.
   • Lift with your legs. Do not bend at the waist.
   • Scoop small amounts of snow into the shovel and walk when you want to dump it.
   • Do not hold the filled shovel with outstretched arms.
   • If snow is deep, remove in piecemeal, a few inches at a time.
   • Rest and repeat as necessary.
   • Move your feet and do not twist your back as you shovel or dump. Never throw snow over your shoulder
8. CAUTION: Be cautious shoveling wet snow. One full shovel can weigh 25 pounds.
   • Shovel wet snow slowly in piecemeal.
9. PACE YOURSELF: Take frequent breaks and stretch your back in the opposite direction of shoveling. For example: 1. Lean backwards and extend your lower back. 2. Pinch your shoulder blades together.
10. TECHNOLOGY:
    • Snow Blower - Use a self-propelled snow blower. It will put much less stress on your lower back than shoveling snow if used correctly. For example, push the blower with your legs and keep your back straight or arched and knees bent.
    • Ergonomic Shovels:
    • 2 Handle Shovels: ErgieShovel or Snow Joe Shovelution
      • Push Shovels: Garant Yukon or Garant Sleigh Shovel
    • Snow Melting Alternatives:
    • www.warmlyyours.com - WarmlyYours - HeatTrak® portable snowmelting system for roofs, gutters, driveways, sidewalks, stairs and handicapped ramps uses electric mats or runners for home or office which can be customized.

Sources: The Colorado Comprehensive Spine Institute; American Academy of Orthopaedic Surgeons 

Visit your doctor regularly and listen to your body.     

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

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

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

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

Provisional Bag/First Aide Kit

It is one week away from the 27^th Steamtown Marathon. This column is dedicated to all the runners preparing for the big day. One small piece of advice; start slowly, avoid the first mile adrenaline sprint downhill, and enjoy the journey! Remember, only one Olympic marathon winner (Juan Zabala, Argentina, 1932) was in the lead at the 5 mile mark. Lesson: The last miles matter more than the first!

Today, I hope to address some common questions for the novice marathon runner or for those coming from other locations to run in the race. What should you pack? How should I dress? What supplies will I need?

Elite runners are so experienced that they know exactly what to pack in preparation for the big marathon day. However, those, running in marathon for the first or second time usually have lots of questions. First, what you need and what you can bring will depend on your support team. If you are running alone and will not have family or friends meeting you along the way, then you are limited to a fanny pack and a few supplies. If you have a support team, then they can carry a bag with supplies, meet you along the course and you can have a sense of security.

Remember; do not do anything different on race day. Try out special clothing, water with supplements and snacks on a practice run. Also, experiment with your best pre-race meal. You will be getting up at 5-6:00am to catch the bus from Scranton to Forest City. You may want to pack breakfast to eat in the high school gym such as; bagel, peanut butter, jelly, banana and coffee or Gatorade. Moving your bowels before the race is a must.

Dress: Columbus Day Weekend in NEPA could bring 30 to 40 degree temperatures when you catch the bus in Scranton and at the 8:00 am race starting time in Forest City.

Clothing:

• Hat and Gloves: Wearing a hat, light gloves can be a good idea. DryTech materials are best to prevent retention of sweat.
• Long Sleeve Shirt and Light Jacket may be necessary. Wearing old items are best so they can be discarded along the way once you are warmed up.
• Remember, any extra items can be placed in a labeled bag at the starting line and will be transported to the finish line for your convenience. So, if it’s a cold morning, wear a jacket and warm up pants on the bus to the starting line and “bag it!”

Accessories:

• Sunglasses and Sunscreen: If sun and warm temps are forecasted, sunglasses are best placed on top of your hat until needed and sunscreen applied before the race.
• Skin Lubrication: Lubricate your skin with petroleum jelly in areas of potential friction such as arm pits, nipples, thighs and feet.
• Dry Tech Clothing: Wear dry tech protects, including shirt, underwear and socks, to prevent excessive moisture and friction.
• Favorite Water Source and Snack: Water and light snacks will be provided every 2 miles but sometimes it is good to have your own favorites, especially in the high school gym before the race.

MARATHON FANNY PACK – Especially for those running without a support team

If you don’t mind the little pack on your butt, a fanny pack can be valuable. In it, you will want supplies such as: small bandages, small roll of medical tape, ibuprofen, antacid tablets, small tube of lubricant, favorite running snack, and extra shoe laces. One might also consider packing a little money, credit card, ID, emergency contact numbers and medical insurance cards. A cell phone is optional.

MARATHON SUPPLY BAG – For those with support team

your supply bag. In the bag, you might consider all of the above fanny pack items and: A change of clothes such as: extra running shoes, socks, shorts, shirt, water proof wind breaker, according to the weather, especially if rain is predicted.  Towels, ace bandages, gauze pads and wrap, antibiotic cream, mole skin, sunscreen, petroleum jelly, safety pins, extra water and favorite sport drink, favorite sport snacks, extra ibuprofen, antacid, anti diarrhea medicine, chemical ice pack, mobile phone, money, credit cards, ID, medical insurance cards.

For those with allergic reactions, remember to pack: epinephrine, antihistamine, and other important medications.

Don’t Forget:

Map and directions to the bus or starting line, course map, race number, and get your timing chip.

Enjoy! Enjoy! Smell the roses, take in the fall foliage and chat with a fellow racer. Savor the moment enjoy the day…you are doing something very special!

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!

Like many of you, I have always enjoyed the outdoors...walking, running, biking, hiking etc. However, recently, I have been more concerned about being safe, (getting older and more cautious, distracted drivers) when doing these activities on the side of the road.

Almost 15 percent of all motor vehicle injuries to people happened to those not in cars but while walking, running or hiking, so one needs to be safe. In fact, over 4,000 walkers or runners were fatally hit by a motor vehicle according to the Centers for Disease Control (CDC). These statistics continue to increase as the number of distractions to drivers increases (phone calls, texts, etc). Consequently, walkers, runners and cyclists must be more aware than ever to prevent injury from motor vehicles and stay safe.

Five high risk factors for walkers, runners and cyclists:

• After dark
• At rush hour in high traffic
• Walk or run “with” instead of “into” traffic flow
• More than one other person with you
• Headphones

 “Runner’s World” offers the following recommendations to stay safe:

• Leave word. Tell somebody or leave a note at home about where you plan to go and how long you plan to be out. That way your loved ones will know to come look for you if needed.
• Protect yourself: If your route is in a high crime area, avoid dawn and dusk, carry self-defense spray, exercise with a partner, leave jewelry at home and vary your route and routine.
• Identify yourself. Run with proper ID, and carry a cell phone with emergency contacts taped to its back.
• Pretend you're invisible. Don’t assume a driver sees you. In fact, imagine that a driver can’t see you, and behave accordingly.
• Face traffic. Except for cyclists, walking and running “into” oncoming traffic is best. It’s easier to see, and react to, oncoming cars. And cars will see you more clearly too.
• Make room. If traffic gets heavy, or the road narrows, be prepared to move onto the sidewalk or shoulder of the road. When walking or running into traffic, stay as far left as possible. When biking, favor the far right side of the road.
• Be seen. Wear high-visibility, brightly colored clothing. When out near or after sunset, reflective materials are a must. (If you don't own reflective clothing, a lightweight reflective vest is a great option.) And use a headlamp or handheld light so you can see where you're going, and drivers can see you. The light should have a bright LED (drivers see blinking red as a hazard).
• Unplug your ears. Avoid using iPods or wearing headphones—you need to be able to hear approaching vehicles. If you do use headphones, do so with the volume low and just one earbud in.
• Watch the hills. When they crest hills, drivers' vision can suddenly be impaired by factors like sun glare or backdrops.
• Beware of high-risk drivers. Steer clear of potential problem areas like entrances to parking lots, bars, and restaurants, where there may be heavy traffic.
• Watch for early birds and night owls. At odd hours be extra careful. Early in the morning and very late at night, people may be overtired and not as attentive.
• Mind your manners. At a stop sign or light, wait for the driver to wave you through—then acknowledge with your own polite wave. That acknowledgement will make the driver feel more inclined to do it again for the next walker or runner. Use hand signals (as you would on a bicycle) to show which way you plan to turn.

CYCLISTS -

• Stay on the right and obey traffic rules.
• Wear a helmet
• Use hand signals when turning
• Wear visible clothing and have reflectors on your bike
• Carry a tire patch and first aid kit
• Maintain your bike
• Watch for pedestrians, parked cars, loose gravel and cracks and potholes.

Source: http://www.runnersworld.com

Visit your doctor regularly and listen to your body.     

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

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

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

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

There is plenty of summer remaining … so make time to get to the water! Research shows that spending time outdoors has many positive effects on your health. Moreover, new research has found that being near a body of water makes us calmer and healthier. You know that special feeling you get when you drive to the lake or the beach and jump out of the car and smell the fresh air and hear the sound of splashing in the lake or the waves of the ocean? Well, it is not just because you’re on vacation…the water makes your muscles relax and breath deeper. Your brainwaves slow down to simulate the gentle roll of the water…lake or ocean! These “blue environments,” not to be confused with “blue zones” are the subject of extensive research at the University of Exeter Medical School in the UK.

Time spent near water promotes physical activity, general fitness and well-being. In addition, noted for reducing the incidence of diabetes and other diseases associated with obesity. Additionally, time near the water slows down our heart rate, reduces stress hormones and improves mental health. In fact, the study also found that subconsciously, people consistently preferred pictures of natural environments (rivers, lakes, oceans) even when compared to attractive urban landscapes. In fact, urban landscapes with water (rivers, fountains etc) were far more popular than those without. Also, health disparities between coastal and inland communities are more noticeable for low-income individuals who do not have the means to venture to the coast. This may be one of the reasons that four out of the five “Blue Zones” discovered by Dan Buettner are islands.

WHY BEING IN, ON, OR AROUND THE WATER IS HEALTHY

• WATER STIMULATES ALL 5 SENSES -Water provides a totally immersive experience.  We feel the coolness trickling on our skin, we taste the salt, smell the seaweed, hear the waves and splash of the water, and see the sun glistening on the water.
• WATER STIMULATES OUR NERVOUS SYSTEM -Water impacts our physiology in that it triggers our parasympathetic nervous system to lower heart rate and blood pressure which promotes relaxation. Even the act of drinking a glass of water can promote relaxation and wellness.
• WATER IS BLUE…BLUE IS THERAPEUTIC -If the rolling blue waves in the lake and ocean aren’t enough, the blue light waves will work to promote further relaxation. Additionally, the beautiful backdrop of a blue sky is the icing on the cake to make you chill out! Similar to “white noise” used by millions of parents to promote sleep for infants and toddlers, “pink noise” (the noise associated with natural sounds) is more smooth, soothing, ongoing and natural as it reduces brain wave activity…have you ever experienced a “beach nap?”
• WATER STIMULATES OUR INNATE BIOPHILIA - The biologist and naturalist Edward Wilson coined the term “biophilia” to describe the theory that humans have an instinctive bond with nature. As a species, our origins have begun on open savannahs and endless shorelines. These natural environments instinctively return us to a simpler time and place.
• WATER IMMERSION BALANCES OUR HORMONES -Did you ever notice the inner harmony of swimming underwater or total floating? When you are doing these activities, your body sends signals to balance stress hormones similar to the bodies response to meditation or relaxing.
• WATER ACTIVITIES STIMULATE ENDORPHINS -Whether you are swimming, surfing, kayaking, paddle boarding, fishing, clamming, walking the shoreline, digging a water hole or making a sand castle, these activities will stimulate endorphins. These natural chemicals associate with increased levels of with happiness, pain management and overall well-being.

In addition to the benefits of being by a body of water, just being outdoors promotes better health and wellness:

• 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.
• 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
• Improved Mental Health – Documentation reveals that light affects mood. So, unless you live in a glass house or a light box, getting outdoors is important to your mental health.
• Improved Concentration – Richard Louv, author of the book, “Last Child in the Woods,” coined the term, nature-deficit disorder.” This term, supported by research, found children with ADHD focus better when 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.
• 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.

Sources: NIH, Global News, Plume, L, University of Exeter Medical School in the UK.

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!