When a patient comes to our physical therapy clinic with lower back pain it is standard protocol to take a thorough history and complete a neurological exam. This is especially important if the patient has leg pain, tingling or numbness in one or both legs referred from their lower back. During the history, the patient will often report an increase in symptoms in their legs at night in bed. They report pain, tingling, a need to constantly move their legs. While some of these symptoms are associated with lower back pain and “sciatica” others, such as the urge to constantly move the legs, is not. This may be a symptom associated with another problem such as restless legs syndrome or RLS.
Recently, more information has become available on restless legs syndrome (RLS). According to the RLS Foundation, RLS is a neurological condition suffered by approximately 10% of the population in the United States. It is considered a central nervous system disorder. There are many manifestations of this disease. Some people suffer only mild symptoms creating urges to move their legs in bed at night. Others suffer severe symptoms of uncontrollable urges to move their legs sitting or lying. The problem may lead to insomnia, disrupted sleep, distress and fatigue.
Genetic among first-degree relatives: This type develops earlier in life and the symptoms are more severe. There is also an iron deficiency associated with genetic RLS.
Non-inherited or idiopathic. This type is more associated with aging. There are several criteria to diagnose RLS. Also, there are medications and other treatment options available for RLS. Exercise, including stretching, walking and weight-training can be very effective.
Read Dr. Mackarey’s Health & Exercise Forum – every Monday
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit MackareyPhysicalTherapy.com
The “first Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.
Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. This year, I am also thankful for the dedicated scientists who developed the COVID 19 vaccination so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is, not only reflective and cleansing; it is also good for your health!
Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:
There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.
Conclusion: Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!
Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
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November is National Chronic Obstructive Pulmonary Disease (COPD) month. COPD is the fourth leading cause of death in the United States, according to the Centers for Disease Control and Prevention. This problem refers to a group of lung diseases that causes damage to the airways and air sacs in the lungs. People with COPD suffer from diminished airflow and difficulty breathing. Emphysema and chronic bronchitis are two of the most common types of COPD. The damage can't be reversed, so treatment includes medications and lifestyle changes designed to control symptoms and minimize further damage, according to the Mayo Clinic.
Exercise is an important part of life for those with COPD because it improves the overall strength and endurance of respiratory muscles. When you exercise, muscles adapt and use oxygen more efficiently so your lungs don't have to work so hard. Also, in addition to improvement in breathing, exercise boosts mental health, helps maintain a healthy weight and blood pressure, and improves circulation. Most importantly, exercise will improve your quality of life with COPD. Before you begin an exercise program, see your family physician or pulmonologist for approval. Then, see a physical therapist to design a program specific to you needs. Always begin slowly and rest if you get short of breath, have chest pain, feel dizzy or sick to your stomach.
While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.
Walk Around the House – Start walking around the house for 1-2 minutes nonstop. Every 1-2 hours. Then, add 1-2 minutes every week.
Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds. Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.
Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day. Then, add 1-2 times per day.
Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.
Recumbent Bike – If balance is a problem, but you can tolerate more extensive. Endurance exercise, use a recumbent bike (a bike with a backrest)
Walking is free exercise and can be done in some form by almost everyone…even with an assistive device such as a cane or walker. For those with COPD who are active and fit – walk 4-5 days per week for 30 to 45 minutes. Less fit individuals can walk for 15 to 20 minutes. For those with COPD who are in poor condition and have significant SOB – walk for 2-3 minutes (to the bathroom or around the house) every 30 to 45 minutes. Try not to sit for 60 minutes without getting up and walking around.
Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck. More erect posture promotes better breathing. Perform 5 repetitions each 3 -5 times per day
Row-The-Boat - Pinch shoulder blades together as if you are rowing a boat.
I-Don’t-Know – Shrug shoulders up toward the ears as you do when you say “I don’t know.”
Chin Tucks – Bring your head back over your shoulders and tuck your chin in
Bicep Curls – sit in chair and bend your elbows up and down with a can of peas in your hands
Wrist Curls – as above but bend your wrists up and down
Chair Push-ups – Push up with your arms to get out of a chair
Saw Wood – pull a light resistance band (yellow) back from a door knob as if you were sawing wood.
Hip Hikes – Sit in chair and march by hiking your hip and lifting up your heel 4-6 inches off the floor
Leg Kicks – Sit in chair and kick your knee out straight – then bend it down to the floor
Hips Out and In – Sit in chair and bring your knees in and out against a resistance band
Toe Raise/Heel Raise – Sit in chair and raise your toes up – then raise your heels up
Diaphragmatic Breathing - The diaphragm muscle is essential for breathing. While sitting or lying down, put one hand on your abdomen and the other on your chest. Slowly inhale through your nose and try to separate the hand your stomach from the hand on your chest. Then, slowly exhale through pursed lips.
Pursed Lipped Breathing - breathe in through your nose slowly for 3- 5 seconds. Then, purse your lips as though you're going to whistle. Lastly, exhale slowing through the pursed lips over 5 to 10 seconds.
“Better Breathers Club,” in conjunction with the American Lung Association, offers a free local support group to help patients and their families suffering from COPD and chronic lung disease. For more information contact the American Lung Association at www.lung.org
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
World COPD Day 2022 is Wednesday November 16th! The purpose of this two part series on lung disease is to raise the level of awareness for the prevention and treatment of this disease.
Chronic obstructive pulmonary disease (COPD) has become the fourth leading cause of death and is one of the only major chronic diseases which has seen an increase in mortality rates. COPD includes emphysema, chronic bronchitis and asthma.
Patients with COPD suffer from progressive shortness of breath, cough, wheeze, and sputum production. Most patients with emphysema have been cigarette smokers.
Patients with emphysema develop obstruction to airflow as a result of narrowing of bronchial tubes due to excess mucous, smooth muscle constriction, and destruction of lung tissue. Eventually, the lungs become over distended, which leads to overexpansion of the chest itself. This process leads to the so-called ''barrel chest'' appearance of patients with advanced COPD.
The most common symptom of COPD is shortness of breath. Initially the patient complains of shortness of breath only with exertion, but symptoms progress over time to include difficulty breathing, even at rest. Eventually the disease worsens to the point that oxygen is required and the patient may become severely disabled.
Treatment of COPD starts with smoking cessation, and, when symptomatic, patients are started on inhaled bronchodilator medications. Some of these medications include albuterol, ipratropium, titotropium, and inhaled steroids. Long-acting bronchodilators such as formoterol or salmeterol and theophylline medications may be added. Oxygen is added when the patient's own oxygen level falls to a certain point. In fact, oxygen is the only therapy that has been shown to prolong the life of patients with COPD.
Over time, patients with COPD decrease their level of activity due to the sensation of shortness of breath. This downhill slide eventually leads to a very sedentary existence. Recent studies have shown that COPD not only affects the lungs, but is a condition which affects the diaphragm and the peripheral muscles. Patients with COPD have been shown to have abnormal limb muscles as a result of deconditioning and systemic inflammation.
Pulmonary rehabilitation has been shown in numerous studies to decrease the shortness of breath associated with COPD. Exercises to strengthen the arms are helpful to assist patients in performing activities of daily living such as combing hair, cooking, and reaching objects above their heads. Walking and riding a stationary bike are helpful to exercise the leg muscles, especially the large thigh muscles. Despite the fact that exercise programs may not improve lung function, the patients overall level of function are almost always improved.
Patients who participate in rehab programs have less shortness of breath, are less likely to be hospitalized, and have improved functional capacity. These patients have lower rates of healthcare utilization, and improved overall health status and quality of life scores. The ideal pulmonary rehabilitation program includes smoking cessation training, breathing and relaxation exercises, nutritional information, and training in proper use of medications. The most important feature of a pulmonary rehab program, however, is aerobic exercise involving the arms and legs.
Pulmonary rehabilitation is an integral part of the treatment of a patient with
COPD, and should be considered in any patient who can tolerate exercise. A cardiac stress test should be done to ensure that there are no occult coronary artery blockages or cardiac rhythm abnormalities.
In summary, COPD is a growing cause of disability, morbidity, and mortality. Medications, oxygen, and pulmonary rehabilitation can help to improve symptoms and quality of life. The combination of bronchodilator medications with pulmonary rehabilitation is the most effective approach when treating patients with COPD. Next week, in Lung Disease - Part II, learn more about pulmonary rehab for patients with COPD to improve their functional status.
Guest Columnist: Dr. Gregory Cali, DO – is a pulmonologist (lung doctor) in Dunmore, PA.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” COPD Part II – Exercise with COPD.
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. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
See all of Dr. Mackarey's articles at www.mackareyphysicaltherapy.com/forum
According to the World Health Organization about half of the world’s adult population has had a headache at least once in the past year. Prolonged use of electronic devices has greatly contributed to this problem. For many people, these headaches are infrequent and do not often affect daily life. But what about when your headache occurs frequently or is so severe it prevents you from going about your day to day activities? Some types of headaches are more easily treated and managed than others.
There are two types of headaches: primary and secondary. Primary headaches occur without an underlying disease and include migraines and tension-type headaches. Secondary headaches can be associated with serious disease, requiring emergency care, or can be referred from other structures of the body such as the cervical spine (neck).
Headaches symptoms that may constitute a medical emergency are: vomiting, seizures, fever, muscle pain, night sweat, weight loss, and neurologic symptoms such as blurred vision. If you are experiencing any of these symptoms, if your headache worsens, or your symptoms change it is recommended that you seek medical attention. Any headache that is unusual for you and does not resolve itself in a reasonable time should be brought to your primary care physician’s attention.
Migraines: Migraines are a primary form of headache that typically lasts from four to seventy two hours, can range from moderate to severe pain, and typically are located on only one side of the head. Often they can be accompanied by an aura, nausea or vomiting, sensitivity to sound, or light sensitivity. Migraines can be aggravated by routine physical activity such as going up stairs. This type of headache is thought to occur in the central nervous system and is related to blood vessels.
Tension-type: Tension-type headaches are the most common primary headache disorder and can last anywhere from thirty minutes to seven days. These can often have a pressing or tightening quality that occurs on both sides of the head. Here there is no nausea, vomiting, light sensitivity, or aggravation with physical activity. This type of headache is thought to occur in the central nervous system but can have a hereditary component and is usually associated with muscle tender points. Tension – type headaches can be treated with relaxation techniques such as Progressive Muscle Relaxation (PMR), medications, and physical therapy.
The most common secondary headache that is not related to a serious medical condition is a cervicogenic headache (originating from the neck).
Cervicogenic Headache: The length of time a cervicogenic headache can last varies. Here the pain is on one side and usually starts in the neck. This type of headache is aggravated or preceded by head postures or movements of the neck. Due to the nerves of the neck and face sharing common connections, pain signals sent from one region can lead to discomfort in the other. Physical therapy can be an effective treatment to help relieve symptoms. For example: posture, exercise, ergonomics, massage, manual techniques, traction, trigger point, and acupressure.
A cervicogenic headache can be caused by an accident or trauma or can stem from neck movement or sustained postures. Sustained postures could mean sitting in front of a computer at work or looking down at your phone. Changing these postures throughout the day could help reduce symptoms. Changing postures could mean bringing your phone closer to you using pillows or another supportive surface when reading or checking social media. If you are someone who works at a desk, it could involve taking breaks or getting a standing desk. However your life requires you to move, there are some simple and effective exercises you can perform throughout the day to help cervicogenic headache symptoms.
5 TIPS FOR TENSION HEADACHES
Progressive Muscle Relaxation: PMR is an effective method for reducing tension throughout the body. With this method you first tense a muscle group, such as at the neck or shoulder, and then relax the muscles noting the difference between the two. This helps reduce both stress and tension. For more information or to learn how to do PMR, refer to podcast at: https://www.psychologies.co.uk/try-progressive-muscle-relaxation
Manage your stress level: While stressors vary from person to person, one method for managing stress is with exercise. Any form of exercise can help reduce stress, but a cost free method is aerobic exercise such as walking or running. A less time consuming method could be to perform deep breathing exercises throughout the day.
Heat or cold: When feeling sore or stiff, applying a hot or cold pack or taking a hot shower can help ease a tension headache.
Posture: Some tips for posture are to make sure your head is over your shoulders rather than sitting forward and making sure you are sitting or standing up straight with your shoulders back.
Over the counter medications: Talk to your doctor or pharmacist for additional information.
5 TIPS FOR CERVICAL HEADACHES
Posture: See tips listed under tension headaches.
Ergonomics: If your job or hobbies require you to sit for extended periods it may be beneficial to change positions throughout the day or consider getting a standing desk. Also, limit time on electronic devices. When sitting make sure the monitor is at eye level, your legs are able to fit under your desk, and you are close to the keyboard and monitor. If you are working with a laptop or phone, avoid putting it on your lap. Instead, bring your laptop closer to you by putting pillows on your lap.
Exercise: Some exercises to help relieve symptoms are chin tucks, shoulder blade pinches, and back extension. These exercises can be performed multiple times throughout the day in sitting or standing.
Physical Therapy: Physical therapy may include massage, manual techniques, stretching, traction/ decompression and exercise. A physical therapist can assess your posture and provide strategies specific to you.
Over the counter medications: While medication may not cure cervicogenic headaches, they may help relieve pain. Talk to your doctor or pharmacist for additional information.
Contibutor: Alexa Rzucidlo, PT, DPT
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
As the days continue to get shorter and temperatures begin a slow steady decline, athletes and exercise enthusiasts will work harder to “fit in” a warm-up before running or other activities during the winter months. But, no matter how limited time is, skipping the warm-up is risky. This time of year, one can expect to feel a little cold and stiff, especially if you are over 40, and therefore a little caution and preparation are in order to avoid muscle/tendon strain, or worse yet, muscle/tendon tears. The Achilles tendon is one of the more common tendons torn. Prevention of muscle tears, including the Achilles tendon includes; gradual introduction to new activities, good overall conditioning, sport specific training, pre-stretch warm-up, stretch, strengthening, proper shoes, clothing, and equipment for the sport and conditions.
A muscle contracts to move bones and joints in the body. The tendon is the fibrous tissue that attaches muscle to bone. Great force is transmitted across a tendon which, in the lower body, can be more than 5 times your body weight. Often, a tendon can become inflamed, irritated, strained or partially torn from improper mechanics or overuse. Although infrequent, occasionally tendons can also snap or rupture. A tendon is more vulnerable to a rupture for several reasons such as a history of repeated injections of steroids into a tendon and use of medications such as corticosteroids and some antibiotics. Certain diseases such as gout, arthritis, diabetes or hyperparathyroidism can contribute to tendon tears. Also, age, obesity and gender are significant risk factors as middle-aged, overweight males are more susceptible to tendon tears. Poor conditioning, improper warm-up and cold temperatures may also contribute to the problem.
Tendon rupture is very painful and debilitating and must not be left untreated. While conservative management is preferred, surgical management is usually required for complete tears. The purpose of this column is to present the signs, symptoms and management of Achilles tendon ruptures.
The Achilles tendon (also called the calcaneal tendon), is a large, strong cordlike band of fibrous tissue in the back of the ankle. The tendon (also called the heel cord) connects the powerful calf muscle to the heel bone (also called the calcaneus). When the calf muscle contracts, (as when you walk on the ball of your foot), the Achilles tendon is tightened, tension is created at the heel and the foot points down like pushing a gas pedal or walking on tip of your toes. This motion is essential for activities such as walking, running, and jumping. A partial tear of the tendon would make these activities weak and painful, while a full tear through the tendon would render these activities impossible.
With age, the Achilles tendon (and other tendons) gets weak, thin, and dehydrated, thus making it prone to inflammation, degeneration, partial tear or rupture. The middle-aged weekend warrior is at greatest risk. A full or complete tear (Achilles tendon rupture) usually occurs about 2 inches above the heel bone and is associated with a sudden burst of activity followed by a quick stop or a quick start or change in direction, as in tennis, racquet ball, and basketball.
In some instances, the tendon can be injured by a violent contraction of calf when you push off forcefully at the same time the knee is locked straight as in a sudden sprint. Other times, the tendon is injured when a sudden and unexpected force occurs as in a trip off a curb or sudden step into a hole or a quick attempt to break a fall.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Achilles tendon 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. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit our Health and Exercise Forum!
Covid-19 has certainly redefined the workplace as many employees continue to work from home. Prolonged hours sitting at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.
Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.
Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy.com
It is two months away from the 25th Steamtown Marathon. This column is dedicated to those dedicated runners preparing for the big day, Sunday, October 9, 2022.
Congratulations and thank you to Bill King, founder and race director, and his band of brothers, for their tireless efforts organizing and sustaining a great race that instills pride for all people of NEPA. It has inspired many people, including me, to transfer the discipline and determination required to complete a marathon by overcoming challenges one mile at a time.
Now, a little marathon history: In 490 B.C. Phedippides, ran 25 miles from Marathon to Athens to deliver an important military message and died immediately. Ironically, the first marathon of the modern Olympic Games in 1896 in Athens was won by Spiridon Louis, a humble Greek peasant, who stopped along the way for a glass of wine and told the owner of the tavern that he would win the race. He was determined to pace himself properly, as he knew the dusty, hilly path better than anyone in the field. He was greeted with jubilation and become a hero and legend.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit: www.mackareyphysicaltherapy.com/forum
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
I have a vested interest in this column…I just had a big birthday! It is a BIG birthday because it is the one before I get health care insurance from Uncle Sam! Consequently, the “aging process” is very much on my mind!
In the book, “Being Mortal,” Atul Gawande discusses the role of medical care placing emphasis on “well-being” rather than survival, especially as it relates to end-of-life care. It is a “must read” for health care providers as well as the general public. The book also describes, in great detail, the process of aging; the physiology of bone and muscle mass loss, factors affecting balance and coordination, changes in mental acuity, memory, and mood. As depressing as it sounds (many of the changes begin as early as mid to late thirties), it is also a “call to arms!”
To prepare for the inevitable aging process one must be proactive, not reactive. From an early age, challenge yourself mentally by taking classes and learning things for which you may not have an interest. Try new physical activities and sports even if you feel unable to excel. Find balance in your diet by trying to eat fruits and vegetables that you don’t find appealing. Engage in daily exercise and physical activities even if you would rather be indoors playing video games. Lastly, get professional advice on matters beyond your scope. See your physician regularly for routine care and diagnostic tests, find a mental health professional if you are not at peace, consult with a physical therapist to help you design an exercise routine appropriate for your individual needs.
While it is never too late, remember, slowing down the aging process should not begin at 60, it begins at 30!
Minor word or memory loss is a normal part of aging as the brain changes and affects how you remember things. Don’t hesitate to use technology or other tricks to assist you. For example, consider using alerts, reminders and lists on your smart phone. Also, you may want to organize certain items in a set location, use post it notes or a white board. However, these reminders are not a substitute for keeping your mind sharp. Studies show that being social, exercising regularly, eating well and learning a new skill can go a long way to maintain a healthy brain.
According to several studies on aging, unfortunately, most people gain 1-2 pounds per year (10 to 20 pounds over 10 years). The aging body does not burn calories like you used to. But there are some simple steps you can implement to offset this pattern of weight gain. Obviously, eat less (less calories) and exercise more (stimulate your metabolism). Consider fruits, vegetables, and leaner protein instead of foods high in sugar/carbs and saturated fats and don’t forget portion control. Be active and take the stairs instead of the elevator.
Aging can also affect sexual performance. According to the Mayo Clinic, lower testosterone levels in men can lead to erectile dysfunction and hormonal changes in women can cause vaginal dryness. Stiff and painful joints add to the challenge. However, with a little effort, most healthy people can continue to be sexually active well into their 70’s and 80’s. Communication with your partner is important. Try new positions. Discuss hormone supplements and ED medications with your doctor. Try over-the-counter lubricants. Remember, exercise improves blood flow and stimulates sex hormones!
Like the other muscles in your body, pelvic and bladder muscles also weaken with age. This problem can be worsened for men by an enlarged prostate and for women following multiple births. However, the muscles can be strengthened by performing specific exercises that target the area called Kegel exercises. These exercises involve squeezing the muscles that control urine flow. For example, while urinating try to stop midstream and hold your urine flow for a few seconds. Repeat 10 times and do this 3-5 times a day. Other recommendations include eating foods high in fiber, avoiding carbonated drinks and limiting caffeine.
People often fall into a rigid routine with age. While this predictable pattern often provides comfort, it can also lead to boredom. Try changing your routine or schedule. Learn a new skill (baking, painting, golf) or visit a new place (museums, libraries, community centers). Getting a part-time job or volunteering can be rewarding and stimulating.
There are a number of reasons for one to feel lonely with age…children relocate, loss of a spouse, divorce. Experts say that it is important to take control by initiating contact with others. Call upon neighbors, friends, relatives, and former coworkers to chat or get together. Volunteer for a charity; join a book club or fitness group. Take classes at a local college and consider getting a pet.
Most health problems associated with aging can be treated. Regular checkups and routine diagnostic tests (blood work, colonoscopy, cardiac tests) will assure that health issues do not get out of control. Be sure to organize your medications and take them as directed. Keep a health journal or use and app on your phone to list meds, allergies and record tests and doctor visits.
SOURCES: National Institutes of Health; Mayo Clinic, WebMD
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit: www.mackareyphysicaltherapy.com/forum
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
I have a vested interest in this column…I just had a big birthday! It is a BIG birthday because it is the one before I get health care insurance from Uncle Sam! Consequently, the “aging process” is very much on my mind!
In the book, “Being Mortal,” Atul Gawande discusses the role of medical care placing emphasis on “well-being” rather than survival, especially as it relates to end-of-life care. It is a “must read” for health care providers as well as the general public. The book also describes, in great detail, the process of aging; the physiology of bone and muscle mass loss, factors affecting balance and coordination, changes in mental acuity, memory, and mood. As depressing as it sounds (many of the changes begin as early as mid to late thirties), it is also a “call to arms!”
To prepare for the inevitable aging process one must be proactive, not reactive. From an early age, challenge yourself mentally by taking classes and learning things for which you may not have an interest. Try new physical activities and sports even if you feel unable to excel. Find balance in your diet by trying to eat fruits and vegetables that you don’t find appealing. Engage in daily exercise and physical activities even if you would rather be indoors playing video games. Lastly, get professional advice on matters beyond your scope. See your physician regularly for routine care and diagnostic tests, find a mental health professional if you are not at peace, consult with a physical therapist to help you design an exercise routine appropriate for your individual needs.
While it is never too late, remember, slowing down the aging process should not begin at 60, it begins at 30!
While aching joints are expected with age, inactivity is not the cure. Controlled movement, exercise and sport modification, supportive devices, and non-prescription supplements and medicines can go a long way.
Controlled movement may include lifting lighter weights or doing squats at ½ or ¾ through your available range of motion. Sport modification includes playing pickle ball instead of tennis or brisk walking or biking instead of running. Supportive devices can be wrist or knee supports or enlarging your racket or golf club grips to lessen the impact on your hands. Over-the-counter treatments include; hot and cold packs, paraffin wax, topical ointments or medications, and nonsteroidal anti-inflammatory drugs (NSAIDs). When all else fails, see a physical therapist for professional advice and treatment and discuss other more aggressive options with your family physician.
Unfortunately, your skin also suffers from the aging process by getting thinner, drier, and less elastic. Avoid the things that can make them worse such as; smoking and ultraviolet rays from the sun or a tanning bed. Protect your skin from the sun, and if you smoke, quit. Consider skin products like moisturizers or prescription retinoids that might make wrinkles less noticeable over time. However, if it is really an issue for you, see a dermatologist.
Aging also makes your skin more vulnerable to drying but there are some things you can do. Use sun screen and wear sun resistant clothing and quitting smoking will go a long way. Drink alcohol in moderation because it can dehydrate you. Also, keep showers or baths to less than 10 minutes and use warm water instead of hot followed by applying oil-based moisturizer.
Loss of strength and endurance is common in seniors. The loss of bone density in women (and men) is also expected. The aging process is only partially responsible. Lack of exercise and activity can also contribute to the problem. Make time to exercise daily (or every other day). Weight training for your arms and legs can be easily performed using light to medium dumbbells or resistance bands. Aerobic exercise can include biking, walking, or swimming, gardening, or swimming for at least 30 minutes a day (or 15-minutes twice a day).
The loss of balance and coordination with age is a serious matter because it can lead to falls that impact long term health and independence. Studies show that those who continue to challenge themselves by riding a bike, dancing, or engage in traditional exercise are much less likely to suffer from early balance problems and are less likely to fall…so get to it! If you can’t do these activities safely, try holding onto your countertop and walk forwards, backwards and sideways, preferably when someone is home with you. See your doctor to be sure that you don’t have a medical condition or taking a medication that contributes to this problem.
Sleep problems are part of aging in many ways; difficulty falling asleep, staying asleep, lack of deep sleep, waking up and not being able to return to sleep, etc. Sleep deprivation can have a negative impact on physical and mental performance. There are some things you can do to improve your sleep such as avoiding coffee and alcohol. Also, try to avoid napping during the day. Talk to your doctor to keep problems that can impact sleeping like high blood pressure or GERD, under control and ask about melatonin supplements.
SOURCES: National Institutes of Health; Mayo Clinic, WebMD
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: Part 2 of 2 on Slowing the Aging Process. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.
For further inquires related to this topic email: drpmackarey@msn.com
For all of Dr. Mackarey's articles visit: http://www.mackareyphysicaltherapy.com/forum
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
