Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what they should avoid, how to prevent and what is recommended to prevent or limit the progression of arthritis. Osteoarthritis (OA) is also known as degenerative arthritis. It is the most common form of arthritis in the knee. OA is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface.
It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the joint involved, especially after increased activity. While diet and exercise help, some people are more likely to develop OA based on previous trauma or injury, labor intensive occupations and genetics. Either way, we all get OA to some degree but there are a few things you can do to limit wear and tear to your joints.
However, OA is not an excuse to avoid exercise, but it is important to be smart about it. Regular exercise is essential to maintain a normal lifestyle for those with OA. However, if you make poor lifestyle choices, do the wrong exercise, use poor technique, or are too aggressive, you could flare-up your joints and do more harm than good.
Don’t Burn the Candle at Both Ends
Poor sleep can affect your joints. One study found that people with arthritis felt more pain after restless nights. One theory is that when you don’t sleep well, it triggers inflammation in your body, which may lead toOA over time.
Don’t Slouch and Slump
Posture matters. Sit up straight. When you slump in your chair, it puts more stress on your muscles and joints and tires them out. Two good posture stretches are making a double chin by bringing your head over your shoulders and the second is pinching your shoulder blades together.
Don’t Ignore Pain
The exercise mantra “no pain, no gain” may be appropriate for a young healthy athlete, however, it may prove counterproductive for most of us. It’s true that some muscle soreness is OK, but not if it lasts for days or if your muscles are swollen or too sore to move or to touch. Joint pain isn’t normal, so pay attention to it. If you think you overdid it, ease up on your exercises. If the pain won’t go away, check with your doctor.
Don’t Overdo Computer Time
It can literally be a pain in your neck -- and your elbows, wrists, back, and shoulders. The problem isn’t just bad posture, but that you hold it for too long. That overworks your muscles. It also puts pressure on the discs in your back. Set up an ergonomic workstation. If you’re in a soft chair, prop up your arms with cushions to take the load off your shoulders and your neck. Be sure to get up and move every hour.
Don’t Get Rigid and Repetitive in Your Exercise Routine
If you perform the same exercise, sport or activity every day, you use the same muscles and joints repeatedly. Remember, overtraining problems commonly occur in single sport athletes. Mix in fun sports and activities to break the monotony by adding fun activities such as golf, swimming, biking, skiing, hiking or playing tennis. Avoid weight bearing exercises two days in a row. Run one day, walk, swim or bike the next. Use the elliptical instead of the treadmill on various days. Limit intensity – only work out intensely 2-3 times out of 5 days per week.
Don’t Squat
Avoid squatting…deep squatting is bad for your hips and knees. Even when gardening, use a kneeling pad instead of bending down and squatting.
Don’t Smoke and Chew Tobacco
Nicotine from cigarettes and chewing tobacco cuts down on blood flow to your bones and to the cushioning discs in your back. It limits how much bone-building calcium your body can take in. It also breaks down estrogen, a hormone you need for bone health. And it slows new growth that thickens bones…which can lead to OA and osteoporosis.
SOURCES: WebMD, University of Pennsylvania
Visit your family doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: 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
Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what they should avoid, how to prevent and what is recommended to prevent or limit the progression of arthritis. Osteoarthritis (OA) is also known as degenerative arthritis. It is the most common form of arthritis in the knee. OA is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface.
It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the involved joint, especially after increased activity. While diet and exercise help, some people are more likely to develop OA based on previous trauma or injury, labor intensive occupations and genetics. Either way, we all get OA to some degree but there are a few things you can do to limit wear and tear to your joints.
Your joints, which link your bones together, are sensitive to heavy loads. Every pound on your frame puts 4 pounds of stress on your knees. It also strains your back, hips, and feet.
That causes wear and tear that can lead to damage, aches, and pain. A poor diet, which can lead to being overweight, can also be the source of inflammation. That can make all your joints, including in your hands, stiff, painful, and swollen.
Don’t Text Too Much
“Texting thumb” is a real thing. Your tendons can get irritated and lock your thumb in a curled position. All that looking down at your phone is just as bad for your neck and shoulders, too. Every inch your head drops forward raises the load on your muscles.
Don’t Wear High Heels Too Often
While they might look styl”n, the higher the heel, the more your weight tips forward. Your leg muscles have to work harder to keep your balance and alignment, which can cause pain. When heels go up, so does the twisting force in your knees. If you wear them every day, you increase your odds of developing OA.
Don’t Wear the Wrong Shoes
Old, worn-out shoes will not adequately support your feet and ankles. That’ll throw your knees, hips, and back out of whack. Also, make sure your sneakers are right for your sport. High tops for basketball, for example, can protect your ankles from sprains and flip flops or summer beach shoes are not meant for long distances…especially if you are over 50.
Don’t Crack Your Knuckles
That satisfying pop comes from tiny bubbles bursting in the fluid around your joints, or from the ligaments snapping against the bone. While it might not cause OA directly, one study showed that this habit may cause your hands to swell and weaken your grip.
Don’t Carry a Heavy Bag
Whether it’s a purse, backpack, or messenger bag, packing too much can cause neck, back and shoulder pain. Heavy weight on one shoulder throws off your balance and your walk. If you tend to carry things only on one side, the constant pull overstretches your muscles and tires out your joints.
Don’t Use Wrong Muscles for the Job
When you put too much load on little muscles, your joints pay the price. If you need to open a heavy door, for example, push with your shoulder instead of your fingers. When you lift something off the floor, bend at your knees and push up with your strong leg muscles, instead of your arms.
Don’t Sleep on Your Stomach
While it might help with snoring, it may not be best for the rest of your body. Lying on your belly pushes your head back, which compresses your spine. Your head also will face in one direction for longer stretches than if you sleep on your back.
Don’t Skip Stretching
Gentle, comfortable, active stretching on a regular basis can help strengthen your muscles and tendons. It also can make them more flexible. That allows your joints to move more easily and helps the muscles around them work better.
Don’t Skip Strength Training
Once you turn 40, your bones start to get a little thinner and more likely to break. If you build muscle with strength training, it slows bone loss and triggers new growth. So, you not only get stronger muscles, but denser bones, too. Together, they stabilize your joints so you’re less likely to get hurt. In fact, studies show that the stronger your leg muscles, the less stress on your knees.
SOURCES: WebMD, University of Pennsylvania,
Visit your family doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
Next Week: Part II of II “Save Your Joints”
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!
NEW YEAR’S RESOLUTION: GET A “RUNNER’S HIGH” ON LIFE!
The number one New Year’s Resolution in the United States is to lose weight. A close second is to gain control over one’s life. One of the best ways to lose weight is thought diet and exercise. It can also be a very effective method to begin taking control of one’s life. This is especially true for those suffering from stress, anxiety and depression. This year make your New Year’s Resolution to “Get a Runner’s High on Life!”
Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness – not to mention burn calories.
Physical activity, specifically aerobic exercise, while well known for its importance to one’s physical well-being has also been scientifically proven valuable for preventing and easing stress, anxiety and depression. Studies have found improvement in mental health for groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks when compared to a control group and a group in counseling.
EXERCISE FOR PHYSICAL HEALTH:
Loss or Maintained Body Weight
Reduces LDL /Raises HDL Cholesterol
Improves Circulation and Blood Pressure
Reduces Risk of Heart Disease
Prevents Bone Loss
Reduces Stress/Muscle Tension
Lowers Risk of Depression
Improves Sleep Pattern
Improves Strength and Flexibility
Improves Balance/Reduces Risk of Falls
Improves Immune System
Improves Pain Threshold
EXERCISE FOR MENTAL HEALTH:
Helps a person gain control over their lives
Increases self-esteem
Diverts attention away from worry, concern or guilt
Improves mood – with visible signs of improvement in physique & body weight
Increases sense of pleasure and satisfaction
Anger management – release pent-up frustration, anger and hostility
Increase in brain serotonin (natural mood elevator chemical in brain)
Increase in beta-endorphins (natural mood, stress & pain control chemical in brain)
Improvement in natural sleep patterns
HOW TO BEGIN EXERCISE TO GET THE “RUNNER’S HIGH” ON LIFE:
Consult your primary care physician. Be sure that your symptoms are not related to other health problems. Also, if you are using antidepressants or other medications discuss the impact it may have on your exercise program with your physician.
Recognize and fight stress, anxiety and depression symptoms that are contrary to or prohibit physical activity such as: fatigue, lack of energy, slow motor skills. Work hard to recognize and overcome these symptoms to begin an exercise program. An aerobic exercise routine should eventually lessen these symptoms.
Be realistic. Expect that aerobic exercise will take time to have a noticeable benefit. Do not get overly ambitious and set yourself up for failure.
Begin with an aerobic exercise program that is practical and destined to succeed. For example: inactive and deconditioned people should begin walking 5 minutes per day, 3-5 days per week for 1 week. Then, add 3-5 minutes each week until you attain 30-45 minutes per walk 3-5 times per week. Younger and fitter people can begin to walk for 15 minutes and continue until they attain 45-60 minutes per walk, 3-5 times per week. Remember, what seems impossible today will be easier and become routine in 3-4 weeks so JUST DO IT!
Find a pleasurable environment: a beautiful park (Nay Aug), a scenic lake (Lake Scranton), quiet countryside (rural farmlands of Dalton). Use a mall in inclement weather.
Find a friendly, uplifting group or individual to walk, talk and exercise with. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
Be specific and compliant! Make a serious commitment. Keep a journal or exercise log. Mark a calendar. 30-45 minutes, 3-5 days per week – NO EXCUSES! Get and exercise buddy you can count on and help keep you compliant!
Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!
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!
Happy Holidays Seniors! My gift to readers this holiday season is to offer some health tips for seniors. However, before I get accused of being a “Scrooge” about enjoying the food and drink associated with the season, please know that I was raised in an Italian kitchen. As such, it is fair to say that I have and will eat my fair share of the Italian Christmas Eve food celebration consisting of, but not limited to: Chianti wine, seafood antipasti, calamari, baccala, smelts, pasta with anchovies, seafood ravioli, cannoli, Italian cheesecake and Baci Perugina Dark Chocolate Hazelnut candy, cappuccino, espresso, sambuca and limoncello.
Overindulgence during the holidays causes many, including seniors, to make New Year's resolutions related to diet and exercise. But, this year, I propose that you incorporate healthy habits during the holiday season, and you may find that your resolutions are not as hard to keep. According to American Association of Retired Persons (AARP), seniors are considered those 50 years old and older. I will never forget how humbled I felt when I received my application to join AARP a few years ago. With this in mind, this year I offer healthy holiday tips for seniors, who are especially vulnerable to unhealthy holiday habits.
Every day, get out of the house for a walk to view the outdoor Christmas lights and decorations. Dress for the weather, walk with a companion, and take along a flashlight if necessary to illuminate your path and use caution to avoid falls on slippery sidewalks.
Combine shopping and walking.
In inclement weather, combine holiday shopping with your exercise. Indoor malls are great places to walk. Inquire with the mall management about walking clubs. Plan to shop early or late to avoid crowds. If you are planning on shopping in a particular store, park at the opposite end of the mall -- even if time is short, you will still get some exercise.
Routines are disrupted during the holidays and you may forget important medications. Make a special reminder to take your medications or order re-fills. If you are traveling, be sure to take enough medications with you in case of delays and have a copy of your prescriptions in case of loss. Be sure to bring a phone number for your doctor along with your health insurance cards, in case of emergency. Carry your medications in your carry-on luggage if you are flying.
Beginning your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge on high-fat, high-calorie foods. Taste your holiday favorites in small amounts to satisfy your palate.
According to Dr. Amy Anderson, internal medicine physician on the medical staff at Baylor University Medical Center," says holiday spices like cloves, thyme and sage can interfere by as much as 50 percent with the body's natural ability to utilize common drugs." Talk with your doctor or pharmacist about your medications and find out if there are any foods you should avoid while taking them.
If you have food allergies, ask about ingredients before you indulge. Be especially careful of home-baked goods if you have an allergy to tree nuts or peanuts. Those ingredients can be deadly if you are affected by these types of allergies.
If you suffer from allergic rhinitis, holiday decorations stored in the attic and basement can build up a coating of dust and mold that can trigger allergies. Some people may also need to rethink Christmas tradition and substitute an artificial tree.
The holiday season includes plenty of kissing and hand shaking. Getting a yearly flu shot and frequent hand washing are your best defense for avoiding the flu. If you are sick with a cold or flu, limit contact with others until you are well so you don’t infect others.
Holiday preparations and helping Santa means less sleep. Do your best to get to get at least 6-7 hours of sleep every night and avoid heavy foods, chocolate, caffeine and alcoholic beverages before bedtime. If you need to recharge, take a nap during the day.
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!
Pediatricians and the American Academy of Pediatrics Recommend Parents Use Good Judgment
The American Academy of Pediatrics (AAP) cited studies suggesting that heavy use of electronic media may interfere with children’s speech and language development replace important playtime with parents and lead to obesity. Studies also have found that more than 90 percent of U.S. kids have used mobile devices and most started using them before age 1. The pediatricians’ group recommends no screen time for children up to age 2. Moreover, they recommend total screen time, including TV and computer; use should be less than one hour daily for ages 2 and older. Pediatricians don’t want parents to overreact. They understand that a little screen time on occasion is not likely to harm a child, especially if they are typically active and creative most of the day.
Dramatic increases in virtual education and toys powered by artificial intelligence (AI) make purchasing toys even more challenging. This may be the year to consider safe and appropriate gifts that promote physical activity. The academy’s website offers suggestions on ideal toys for young children, including balls, puzzles, coloring books and card games. Visit: AAP.org or HealthyChildren.org, the official parenting website of the AAP.
American Academy of Pediatricians Toy Recommendations:
Giving gifts to children is a favorite part of the holidays, whether they're wrapped under a tree or exchanged with the lighting of a candle. When choosing a toy for a child, the American Academy of Pediatrics recommends the toy be appropriate for the child's age and stage of development. This makes it more likely the toy will engage the child – and reduces the risk it could cause injury. Below are some additional tips from the AAP on toy selection and safety:
Appropriate: Select toys to suit the age, abilities, skills and interest level of the intended child. Toys that are too advanced will frustrate your child and may pose safety hazards for younger children.
Developmental: When choosing gifts for babies and toddlers, consider toys that will build developmental skills. Toys that can be manipulated, such as shape sorters, stacking blocks, and baby-safe puzzles, are great for developing fine motor, cognitive, and perceptual skills. For more tips on choosing toys for babies, visit HealthyChildren.org “toy selection.”
Purpose: If you are considering a digital device for a child or teen, such as a tablet, smart phone or game system, think about the purpose of the device and the rules you want to set around its use. For more information, see these tips on HealthyChildren.org “mindful technology use” and “digital media use for young children.”
Batteries/Magnets: Be cautious about toys containing button batteries or magnets. Children can have serious stomach, throat and intestinal problems – including death – after swallowing button batteries or magnets. In addition to toys, button batteries may be in musical greeting cards, remote controls, hearing aids, and other small electronics. Small, powerful magnets may be part of building toy sets. Keep button batteries and magnets away from young children and call your health care provider immediately if your child swallows one.
Electrical: To prevent burns and electrical shocks, do not give children under age 10 a toy that must be plugged into an electrical outlet. Instead, buy toys that are battery-operated.
Small Pieces: If you are buying a gift for a young child, look for toys without small pieces. Young children can choke on small parts contained in toys or games. Government regulations specify that toys for children under three cannot have parts less than 1 1/4 inches in diameter and 2 1/4 inches long. For more: HealthyChildren.org “how to buy safe toys.”
Balloons: Children can choke or suffocate on broken or uninflated balloons. Do not allow children under age 8 to play with them.
Ribbons/Strings: Remove tags, strings, and ribbons from toys before giving them to young children. Watch for pull toys with strings that are more than 12 inches long, because they could be a strangulation hazard for babies.
Read the Label: When your child receives a gift, be sure to read the label and instructions. Warning labels give important information about how to use a toy and what is the appropriate age. Be sure to show your child how to use the toy.
Storage: Parents should store toys in a designated location, such as on an open shelf or in a bin, and keep older kids' toys away from young children. If you use a toy box, choose one with no lid or a lightweight, non-locking lid and ventilation holes. Visit: HealthyChildren.org “toy box safety.”
Artificial Intelligence: Toys powered by AI chatbots which interact with children are often inappropriate. For example, these chatbots can talk in depth about sexually explicit topics and inform listeners where to find knives and matches.
SOURCE: American Academy of Pediatrics (AAP); healthychildren.org
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!
More than 65 million people, almost 30% of the population in the United States, are actively involved in providing 20 or more hours of care for a chronically ill, disabled, or aged family member or friend each week. As our population continues to age, this number is expected to grow rapidly.
The role of a caregiver is multifaceted and often involves tasks and skills beyond the education or comfort level of most providers. Some examples include; managing money, paying bills, shopping, cleaning, maintaining and repairing a home, dispensing and injecting medications, cleaning wounds, changing dressings, catheter management, bed baths, assisting in position changes, transferring from the bed to the chair, ambulation, stair climbing, bathroom assistance for toileting and showering and many other responsibilities. Consequently, a caregiver is often at risk for mental, spiritual and physical fatigue or breakdown. It is no surprise that depression, illness and injury often plague a caregiver and eventually, the caregiver is in need of a caregiver. One of the most common injuries suffered by a caregiver is back pain.
Lower back pain (LBP) is one of the most common problems in our society. Over 90% of all Americans will suffer from it at least once in their lives. It is generally agreed that prevention is the best treatment for LBP.
TIPS FOR THE PREVENTION OF BACK PAIN FOR THE CAREGIVER:
Maintain Health & Fitness Level
As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well and exercise regularly.
Aerobic Exercise
Aerobic exercise will help prevent weight gain and stiffness for a healthier lower back. It will also help with the stress and depression associated with providing care for a loved one. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. You can also use an elliptical or bike at home while your loved one is resting. Get outdoors and take multiple short walks …go around the block a few times per day.
Core Exercises
Core stabilization exercises designed to strengthen the abdominal and lower back muscles will help prevent injury. Some examples of core exercises are:
Pelvic Tilt - lying on your back and performing a pelvic tilt as you flatten you lower back into the floor.
Pelvic Tilt and Heel Slide - lying on your back, hold a pelvic tilt as you slide your one heel up and down and repeat with the other heel.
Core on Ball - Perform arm exercises such as biceps and triceps with light weight while sitting on a therapeutic ball while simultaneously trying to hold an isometric contraction of your abdominal and lower back muscles.
Do Not Smoke
Smoking effects natural healing because it constricts the small blood vessels. Smokers have a much higher incidence of LBP and failure from lower back surgery.
Practice Good Posture & Body Mechanics
Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.
Caregivers spend much of the day with their spine bent over a bed or chair feeding, bathing, and lifting a loved one. Postural exercises are designed to stretch your back in the opposite direction of this forward flexed position. Examples include:
Chin Tucks - tuck your chin back to bring head over shoulders.
Shoulder Blade Pinch - pinch your shoulder blades together.
Standing Arch - while standing put your hands behind back, extend lower back 10-20 degrees.
Perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.
Ergonomics
Sitting - When sitting, use an ergonomic work station and chair with a lumbar support and adjustable heights. Get close to your desk, keyboard and monitor.
Driving - If you drive long distances, use a lumbar support to keep an arch, sit close to your steering wheel to prevent bending forward.
Bending – Get an adjustable bed and raise it to a comfortable height when feeding, dressing or bathing your loved one.
Lifting - Think twice. First bend your knees and arch your back. Then, brace your abdominal muscles. Bend your spine forward as little as possible to lift the patient.
From Lying to Sitting in Bed - Bend your knees, maintain an arch in the back with head up, and bend over as little as possible. Bend the knees of your loved one; roll their trunk toward you to get their legs over the edge of the bed as you pivot their weight on their butt to get them sitting upright.
From Sitting in Bed to Sitting in Chair - Bend your knees, maintain an arch in the back with head up, and bend over as little as possible. Place your hands around the waist or on a transfer belt. Use your legs, turn with feet, and do not twist spine. Block the feet and knees of your loved-one with your feet and knees and use them to pivot and transfer from the bed to the chair. Be sure the chair is along side of the bed and arm of chair removed if possible before the lift.
Transfer Belt - Use a transfer belt around the waist of the patient. Grip the transfer belt, instead of the patient or clothing, during the lift or when ambulating.
Lower Back Lifting Belt - Also, if you have a back problem, consider using a lifting belt or back brace to protect your back when lifting the patient. Immediately following the lift, stand up straight and stretch lower back into extension.
Transfer belts and lower back lifting belts can be found online or at your local pharmacy.
Lift Chair – For patients that require maximum or moderate assistance and only one caregiver is available to lift or transfer, an electric lift chair should be considered.
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!
November is National Alzheimer’s Disease Awareness Month. It is appropriate that it is also National Family Caregivers Month, since many people afflicted with Alzheimer’s are physically well and often rely on caregivers. It would be very unusual to find a person whose life has not been affected by someone with Alzheimer’s disease (AD). AD is a form of dementia. It is sometimes referred to as Senile dementia/Alzheimer’s type (SDAT). Currently, more than 4 million people in the USA have AD. Approximately 10% of all people over 70 have significant memory deficits. The number doubles each decade after 70. The risk increases with age and family history for the disease.
AD is a progressive degenerative disease of the brain that affects memory and thought process. Memory impairment is the hallmark of this disease. Also, those suffering from AD present changes with the following: language, decision-making, judgment, attention, and other personality or aspects of mental function. AD progresses differently in each case.
Two types of AD have been identified, early onset and late onset. In early onset, symptoms appear before the age of 60 and progress very rapidly. It accounts for 5-10% of all cases. Autosomal dominant inherited mutations have been found in early onset AD.
The cause of AD is not completely understood; however, most experts agree that both genetic and environmental factors are involved. It is important to rule out other medical causes before a final diagnosis of AD can be made. Only a post-mortem microscopic examination of brain tissue can confirm the diagnosis. Structural and chemical parts of the brain disconnect as the brain tissue shows twisted fragments of protein that clogs up the nerve. Clusters of dead and dying nerve cells block the transmission of information and communication from one nerve cell to the next. AD causes a disconnection of areas of the brain that normally work together.
RISK FACTORS:
Family History; Age
High Blood Pressure – over a long period of time
History of Head Trauma
High Levels of Homocysteine (a chemical in the body related to heart disease and depression)
Female Gender – as women live longer
The Greater Boston Physicians for Social Responsibility and the Science and Environmental Health Network offer the following guidelines to reduce the Risk of Developing AD:
Practice Good Nutrition All of Your Life
Provide and teach youngsters good eating habits. High calorie foods and drinks should be discouraged to prevent obesity and diabetes.
Eat Lots of Fresh Fruit and Vegetables
Fruits and vegetables, especially those that are deep green, provide essential antioxidants, vitamins, and other important micronutrients. Many contain healthy omega-3 fatty acids.
Avoid Saturated and Trans Fat. Use Vegetable Oils Instead
A low-fat, plant-based diet with small amounts of dairy, lean meat and chicken is preferred. Avoid frequent use of oils high in omega-6 such as corn, safflower, sunflower, and peanut oils.
Eat Foods High in Omega-3s
Eat fish at least once a week. For those who do not like fish, try fish oil. Limit use of fish that are high in mercury and PCB’s such as: swordfish, king mackerel, albacore and fresh tuna. Less contaminated fish are: haddock, Pollock and wild Alaskan salmon.
Avoid Routine Consumption of Sugar
Table sugar, corn syrup, maple syrup, honey high in fructose cause rapid blood sugar elevation which is linked to obesity, type II diabetes, and heart disease.
Consume Low-Glycemic Carbohydrates
Whole grains and legumes (chick peas and lentils) can help prevent sudden increases in blood sugar. Other examples are: brown rice, barley, oats, rye, buckwheat, fruits, non-starchy vegetables, pasta, winter squashes and tubers (yams, sweet potatoes).
Get Food From Local and Organic Sources
Local growers and Co-ops tend to offer fresher foods with higher levels of nutrient and less pesticide use. NEPA has some great seasonal local farmer markets.
Modest Consumption of Alcohol
Evidence supports the use of one-half to two drinks per day for adults. Red wine and green tea are recommended. Some studies show that caffeine may reduce the risk of Parkinson’s and AD.
Avoid Food Additives, Such as Aluminum
While the evidence of the danger of cooking in aluminum pots may not be valid, recent evidence suggests that dietary aluminum may increase the risk of AD. For example, some baking powders, pancake and waffle mixes contain high levels of aluminum.
Reduce Exposure to Toxicants
Toxic chemicals in the home, workplace and community can increase the risk of AD. Lead, solvents used in building and remodeling, and lawn and garden chemicals may be harmful.
Increase Physical Activity
30 minutes of moderate aerobic exercise each day is very beneficial for physical and emotional wellness. It improves blood flow, releases endorphins and prevents obesity.
Increase Social Activity
Social activity on a regular basis has been found to reduce the risk of AD. Volunteer, join a club, play a sport or game with a group, take classes and keep in touch with friends and family.
Reduce Stress
Technology has put us on sensory overload. We must learn a new technological skill every week to keep up. Demand for immediate communication increases daily. We cannot escape for a moment. Make time every day to relax, breathe deeply, listen to relaxing music, exercise or sit quietly.
Exercise Your Brain
Some studies show that maintaining a healthy mind requires some work. Do crossword puzzles, word games, board games, and read books. Current wisdom suggests that learning something new is the most important thing to keep your mind healthy…time to learn to play the piano!
Source: The HealthCentralNetwork, Inc
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!
PREVENT STRESS FRACTURES
It is two weeks away from the 28th Steamtown Marathon. After training all spring and summer for the first seven Steamtown Marathons, not a Columbus Day Weekend goes by without my thoughts of this great event.
I would like to introduce this topic with some marathon history. In 490 B.C. Athens was under attack by the Persians and was outnumbered more than two to one. The Athenians fought bravely and defeated the enemy in the town of Marathon. The victory kept the intruders 26 miles away from Athens. To keep the anxious citizens of Athens calm, leaders immediately ordered a foot soldier, Phedippides, to run to the capital city to share the news. Phedippides ran, in full armor, for 26 miles from Marathon to Athens, delivered the message and died immediately. Now, people do the same thing of their own free will!
Each year at this time, dozens of runners preparing for the Steamtown Marathon come to my office with severe shin pain known as shin splints. Unfortunately, in many of these athletes, this problem can lead to a much more severe and advanced problem with shin splints called a stress fracture.
What is a stress fracture?
A stress fracture is fatigue damage to bone with partial or complete disruption of the cortex of the bone from repetitive loading. While standard x-rays may not reveal the problem, a bone scan, and MRI will. It usually occurs in the long bones of the leg, mostly the tibia but also the femur (thigh) and foot. Occasionally, it occurs in the arm.
Who is at risk?
10-21% of all competitive athletes are at risk for stress fractures. Track, cross country and military recruits are at greatest risk. Females are twice as likely as males to have a stress fracture. Other athletes at risk are: sprinters, soccer and basketball players, jumpers, ballet dancers are at risk in the leg and foot. Gymnasts are also vulnerable in the spine while rowers, baseball pitchers, golfers and tennis players can experience the fracture with much less frequency in the ribs & arm.
The problem is much more prevalent in weight bearing repetitive, loading sports in which leanness is emphasized (ballet, cheerleading) or provides an advantage (distance running, gymnastics).
Stress fractures usually begin with a manageable, poorly localized pain with or immediately after activity such as a shin splint. Over time, pain becomes more localized and tender during activity and then progresses to pain with daily activity and at rest.
Causes of Stress Fractures:
Overuse, Overload, Over training – is the number one cause. Running too many miles with too much intensity with too much frequency is the perfect formula.
Inadequate Fitness Level – or activity level prior to the stress fracture. For example, the high school runner takes the summer off and then quickly accelerates his/her program to quickly for cross-country in August/September.
Poor Biomechanics – when your feet hit the ground the forces are absorbed and transferred to the rest of the body. If the biomechanics of feet are not perfect, then the forces are not absorbed, and another body part bears too much force. For example, flat or pronated feet poorly absorb the shock and pull the tendons of the foot and shin.
Recent Change in Training Schedule – sudden increased intensity or speed
Recent Change in Running Surface – sudden change to a hard or soft surface
Recent Change in Footwear – shoes too hard or too soft, too much control or too little control, too much pronation or too much supination
Overweight – running with an extra 10 pounds and attempting to return to running as a method of weight loss
Underweight – the underweight female athlete is at high risk for stress fractures. If underweight and have a history of menstral irregularities or and eating disorder, the risk of stress fracture increases significantly
History of Stress Fractures – makes the athlete two times as likely to have another
Treatment & Management:
Alternate Training – cross train with non-weight bearing activities: bike, swim, elliptical
Gradually Build Up Fitness Level – wean into activity 1-2 miles, then add ½ mile at a time
Correct Biomechanics - Orthotics, Running shoes, see a Podiatrist
Gradual Change in Training Schedule
Gradual Change in Surfaces – ½ run on soft surface, ½ run on hard surface
Gradual Change in Footwear – walk in new shoes first, then run 1-2 miles
If Overweight – gradual exercise with diet, not too much too quickly
Mix run & walk every 10 minutes
If Underweight – improve diet maintain healthy body fat%
Consult Family Physician – early management often involves immobilization, rest, pain medicine 4-6 weeks for healing.
non weight bearing cross training such as the recumbent bike, swimming, elliptical
physical therapy modalities such as ultrasound, cold with electrical stimulation, biomechanical taping or orthotic supports, and exercises for foot, ankle muscles.
Visit your doctor regularly and listen to your body.
Read Health & Fitness Forum Next Monday/Sunday: Preparing Your First Aid Kit For the Steamtown Marathon
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!
Here are 10 most common exercise myths!
No Pain, No Gain.
FALSE – Why pain is different than discomfort…
Muscle soreness and “feeling the burn” can occur during a normal healthy exercise routine. However, you should never experience sharp, deep, intense, or lingering pain during or after exercise. In fact, if the soreness lasts more than 24-48 hours, then you did more damage than benefit to your muscles and other tissues and it is time to scale back and take time off. If necessary, use RICE (rest, ice compression and elevation). It is important to get in tune with your body and learn the difference between muscle strain and fatigue, discomfort and pain from soft tissue damage from overuse and overload. Find the proper amount of weight and repetitions and gradually increase over time.
Always Stretch Before You Exercise.
FALSE – This is not always the best advice
There is no solid evidence that stretching alone before a sport or activity prevents injury. In fact, over stretching may be counterproductive before a sport as it may weaken the muscle. The current wisdom on the matter is; never stretch a cold muscle. Instead, warm up for 5-10 minutes by actively moving the extremities and light jogging or biking and THEN lightly stretch the arms, legs, back etc. More vigorous stretching should be performed to improve the flexibility of tight muscles (ie calf and hamstring muscles) and best done after your workout but not before a sporting activity (tennis, basketball, etc.).
Lifting Weights Will Make You Bulky.
FALSE – Depends on your hormones
It is very unlikely that women and prepubescent males will bulk up from lifting weights…especially light weights (blame or thank hormones). It will, however, increase metabolism and fat burning efficiency which can lead to weight loss and good muscle tone. Stick with low resistance and high repetitions for best results.
With the Correct Program, Spot Reduction Can be Achieved
FALSE – It is not possible to target an area of the body to burn more fat
It is very common for women to ask for a specific exercise to reduce the fat in their buttocks, thighs, and abdomen. Regretfully, it is not possible to target weight loss in these areas or other body parts. In fact, when you lose weight through diet and exercise, the caloric expenditure will be evenly distributed throughout the body. However, once the adipose tissue in a specific part of the body such as the abdomen is reduced from general weight loss, targeting the area with exercises specific to that muscle group will improve the tone and definition for a leaner look in that region.
If you don’t have 45-60 Minutes to Exercise, Don’t Bother.
FALSE – The research on this topic does not support it
Sure, it would be great to dedicate 60 minutes 5 -6 days a week for exercise. But for most of us who work and raise a family it is not practical. The good news is that the research supports 30 minutes of exercise 3-5 days a week. Moreover, evidence shows that 10 minutes, three times a day, 5 days per week will help you attain the 150 minutes a week supported in most exercise studies.
If you have Arthritis, Exercise will make it worse.
FALSE – There is no evidence to support this…but it supports the opposite.
Most people with the most common form of arthritis, osteoarthritis, feel better when they are moving. That is not to say that they don’t have increased symptoms when they OVERDO it. An exercise program specifically designed for a person’s problems and limitations will improve their symptoms and function. For example, if an individual has arthritis in their knees, they should use an exercise bike (partial weight bearing) or swim (buoyancy effect of water) instead of walking or running (full weight bearing) for aerobic exercise. Furthermore, they would do far better with light cuff weights in a sitting or lying position to strengthen their legs than performing squats or lunges. It is important to remember, the weight gain and joint weakness and stiffness associated with a sedentary lifestyle will do more harm to an arthritic joint than a proper exercise program.
You Need a Sports Drink When you Exercise
FALSE – Not unless you are planning a killer workout
The number one reason most of us exercise is to lose or control body weight. High calorie sports drinks are counterproductive and unnecessary. If you do not plan on exercising for more than 60 minutes, good old fashion H2O is more than adequate. However, if you plan to do a “killer” workout for more than 60 minutes and may incorporate a high intensity interval training (HIIT) program, than a sports drink with electrolytes and other nutrients, may be of value.
Exercise Machines are Better than Free Weights
FALSE – For most of us, effective resistance training is not about the equipment
It is safe to say, caveman was pretty fit and strong despite the fact that he never went to a gym and lifted weights. He did however, lift, push, pull, and carry heavy stones, timber, and animals for day-to-day survival. So too, it is for modern man, the body does not distinguish between the resistance provided by a elastic band, dumbbell, or cable with pulleys and weight stacks. As long as the basic principles of strength training are applied, (isolating a muscle or muscle group, loading the muscle with enough force to bring it to fatigue without causing tissue damage, and allowing for adequate rest and recovery) than the muscle will gain strength regardless of the type of resistance.
Running is Better Than any other Form of Aerobic Exercise
FALSE – Don’t tell that to competitive swimmers
First, let me confess that I love to run and up until recently, I ran almost daily. However, now that I am over 60, I had to find new forms of aerobic exercise which would be kinder and gentler to my joints. So, I mix it up between biking (indoors and outdoors, recumbent and upright), brisk walking or hiking, elliptical and stepper and swimming laps. Again, like the caveman weightlifting example, the body (heart and lungs) does not know what is causing an increase in heart rate for 30, 45 or 60 minutes, it only knows that it must respond to allow the body to function under this stress. And, in the process it becomes conditioned to the point that it will work much more efficiently when not under stress with a lower heart and respiratory rate and blood pressure at rest.
Those over 50 would be well-advised to engage in low-impact aerobics on a regular basis. For example, if you want to run two to three days per week, do not run two days in a row and consider performing low impact exercise in between. Some examples of low impact aerobics are walking, treadmill walking, swimming, elliptical trainer, and an exercise or road bike.
If You Never Stop Exercising than you won’t have to adjust your exercise program as you age.
FALSE - Why Change is Necessary with Age…
For many years, I have repeatedly preached about the value of engaging in an active lifestyle throughout life. It is especially important to be active as one gets older to maintain mobility and independence. However, many take this advice to an extreme and refuse to accept the inevitable changes that occur in the body with age. They run, jump, lift and throw like a teenager and often fail to modify their activity or exercise regimen appropriately for their age.
Consequently, they suffer from multiple injuries, including muscle tears, tendonitis, bursitis, impingement, and advanced osteoarthritis. Keep in mind, everyone ages differently. One person at 60 years of age may be the equivalent of another at 50. However, change with age is inevitable, so be kind to your body…it’s the only one you have! It is always prudent to consult your physician and physical therapist for a program designed specifically for your needs.
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!
Happy Labor Day! There is little doubt that the workplace has been redefined since the pandemic as many employees continue to work from home. Sitting for many hours at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.
Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways.
For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.
Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics.
Prevention of Lower Back Pain:
Maintain Fitness Level:
As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well, exercise regularly and don’t smoke. Smokers have a much higher incidence of LBP and failure from lower back surgery.
Practice Good Posture & Body Mechanics:
Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back. Also, consider sitting on a physio ball, which promotes proper posture for part of the day.
Perform postural exercises throughout the day. Most of the day we sit, stand, and reaching forward and bend our spine. These exercises are designed to stretch your back in the opposite direction of flexion. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.
Chin Tuck: Tuck your chin back to bring your head over shoulders.
Shoulder Blade Pinch: Pinch your shoulder blades together.
Standing Extension: While standing, put your hands behind back and extend lower back 10-20 degrees.
Good Body Mechanicsand ergonomics are also important in the prevention of LBP. When lifting, think twice. Think about the weight, shape and size of the object. Think about where the object is going and the surface resistance of the floor. Does it require two people to lift? Can I safely lift that high or bend that low?
When bending to lift an object think about safety:
Proper Lifting Technique:
Spread Legs Apart Shoulder Width
Bend at the Knees and Limit Forward Bending the Spine
Arch Lower Back Slightly
Get and Maintain a Firm Grip
Contract and Hold Abdominal (stomach) Muscles
Lift With Legs (not back)
Do Not Pivot or Rotate Spine With Load (use feet and step turn)
Lift Slowly and Carefully (don’t hurry)
Take Time to Perform Back Extension Stretches After the Lift
Remember, Pushing is Better Than Pulling a Heavy Load
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!
