“When is it safe for my child to start weight training?” This is a very common question asked by parents of young athletes who are looking for advice regarding their children’s participation in weight training. This month, for example, I received three such inquiries. While some who are eager to get a “competitive edge” may not be satisfied with the answer, these recommendations are grounded in the scientific literature and medical specialist with the hope to prevent injury and dispel fear and fallacy.
Weight training, weight lifting or resistive training all describes the use of a resistive force on a muscle to improve strength. While much attention has been given to the benefits of weight training in adults, much less has been written about its application in children.
According to the Journal of Pediatric Orthopedics, children less than 12 years old are considered prepubescent or before puberty. Teenagers who are between 12 and 19 are considered to be adolescents. Studies consistently demonstrate that strength gains are much more significant in adolescents than in preadolescents. It is important to note that these strength gains are not only from the enlargement of muscle fibers (hypertrophy), but also from the improvement in the coordination and efficiency in muscle contraction and the recruitment of motor units and fibers within the muscle.
Preadolescents lack the hormones necessary to develop masculine characteristics. Adolescents begin to produce the hormones of testosterone and androsterone to develop secondary sexual characteristics such as pubic hair and enlarged genitalia. In view of this, age 13-14 is the optimal age to safely begin and benefit from a well-designed weight training program.
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
While many people celebrate the Labor Day holiday by firing up the grill, others will be shopping to get their students ready for the school year. One item on the shopping list should be a good quality and well-fitted backpack…to prevent lower back pain!
In 2018, the government of India announced a ban on homework and recently in Poland; the government ministers did the same. Can you imagine…a ban on homework? In an effort to promote student health and address recent surges in the incidence of back pain in the young, there will be no homework for students in grades one and two.
It was estimated that the majority of students ages 7 – 13 in India were carrying almost half their body weight. Not surprisingly, medical practitioners noticed a dramatic increase in reported cases of back pain among this group and decided to take action. In addition to the homework ban for grades one and two, Indian authorities have also implemented a limit of 10% of the student’s body weight.
Back pain in students seems to be universal. Each year, as students in the United States prepare to return to school from summer vacation, the subject of backpacks arises. The good news: when compared to purses, messenger bags, or shoulder bags, backpacks are the best option to prevent lower back pain. The bad news is, most of the 40 million students in the USA using backpacks, are doing so incorrectly.
Studies have found more than 33% of children had LBP that caused them to miss school, visit a doctor, or abstain from activity. Also, 55% of children surveyed carried backpacks heavier than the 10-15% of their body weight, which is the maximum weight recommended by experts. Additionally, the study noted that early onset of LBP leads to greater likelihood of recurrent or chronic problems. Backpacks that are too heavy are particularly harmful to the development of the musculoskeletal system of growing youngsters. It can lead to poor posture that may lead to chronic problems.
The following information on backpack safely is based, in part, by guidelines from The American Physical Therapy Association. Parents and teachers would be wise to observe the following warning signs of an overloaded and unsafe backpack:
Consider the following suggestions to promote backpack safely and prevent back injury:
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Tennis elbow, also called lateral epicondylitis, is an inflammation of the lateral (outside) bony protuberance at the elbow. It is at this protuberance that the tendon of the long muscles of the hand, wrist and forearm attach to the bone. As the muscles repeatedly and forcefully contract, they pull on the bone, causing inflammation. The trauma is irritating when working the muscles in an awkward position with poor leverage like hitting a backhand in tennis.
It is not unusual for a patient to come to my office with severe pain on the outside of their elbow. Especially, after intensifying their tennis workouts or changing the racquet string tension. Others come to me with pain on the inside of the elbow (“golfer’s elbow”) from wrist action that advanced golfer’s use at impact. However, this problem is not only for tennis players and golfers. Laborers working with wrenches or screwdrivers with an awkward or extended arm can also develop tennis elbow. Others who are vulnerable are: those working for hours at a computer using a mouse as well as those working hard maintaining their lawns and gardens.
In a more chronic problem, lateral elbow pain may arise by a degenerative condition of the tendon fibers on the bony prominence at the lateral elbow. Sporadic scar tissue forms from a poor attempt by the body to overcompensate and heal without eliminating the cause.
While symptoms may vary, pain on the outside of the elbow is almost universal. Patients also report severe burning pain that begins slowly and worsens over time when lifting, gripping or using fingers repetitively. In more severe cases, pain can radiate down the forearm.
Conservative treatment is almost always the first option and is successful in 85-90 percent of patients with tennis elbow. Your physician may prescribe anti-inflammatory medication (over the counter or prescribed). Physical/Occupational therapy, rest, ice, and a tennis elbow brace to protect and rest may be advised. Ergonomic changes in equipment, tools, technique and work-station may be necessary. Improvement should occur in 4-6 weeks. If not, a corticosteroid injection may be needed to apply the medication directly to the inflamed area. Physical therapy, range of motion, and stretching exercises may be necessary prior to a gradual return to activity. Deep friction massage can assist healing.
Exercises performed in a particular manner to isometrically hold and eccentrically lengthen the muscle with contraction.
New Conservative Treatment: Platelet-Rich-Plasma (PRP) is a new treatment for the conservative management of degenerated soft tissues that has recently received great media attention. In great part, due to its success in several high profile athletes. According to the Journal of the American Academy of Orthopaedic Surgeons,(JAAOS), platelet-rich plasma (PRP) is autologous (self-donated) blood with an above normal concentration of platelets. Normal blood contains both red and white blood cells, platelets and plasma. Platelets promote the production and revitalization of connective tissue by way of various growth factors on both a chemical and cellular level.
The actual PRP injection requires the patient to donate a small amount of their own blood. The blood is placed into a centrifuge (a machine that spins the blood at a high velocity to separate the different components of blood such as plasma, white and red blood cells), for approximately 15 minutes. Once separated, the physician draws the platelet-rich plasma to be injected directly into the damaged tissue. In theory, the high concentration of platelets, with its inherent ability to stimulate growth and regeneration of connective tissue, will promote and expedite healing.
Surgery for tennis elbow is only considered in patients with severe pain for longer than 6 months without improvement from conservative treatment. One surgical technique involves removing the degenerated portion of the tendon and reattaching the healthy tendon to bone. Recently, arthroscopic surgery developed to perform this technique. However, research does not support the value of one over the other at this point. Physical/occupational therapy is used after surgery. Return to work or athletics may require 4-6 months. More recently, a surgical technique using ultrasound to guide a needle to debride (clean) the area of scar tissue has been developed. If eligible for this procedure, the time required for healing, rehabilitation and return to activity is much shorter.
If you feel you suffer from tennis elbow, ask your family physician which of these treatment options are best for you.
Visit your doctor regularly and listen to your body.
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
This column is repeated every year at this time with the intent of raising the level of awareness to prevent death or serious illness from heat stroke in athletes and other active people in hot, humid weather.
It is the end of July and we have managed to survive two “heat waves” in NEPA. While it is important to have fun in the sun, please be mindful of how your body reacts to high humidity and heat and take appropriate precautions. Athletes are particularly vulnerable this time of year due to daytime practice sessions. (August 5 & 6, 2024, first day of acclimatization and August 12, 2024, first day of practice for fall sports according to PIAA). Visit www.piaa.org for more information. Keep in mind, you don’t have to be running a marathon or playing football in full uniform to suffer from heat stroke.
Heat stroke, one of the most serious heat-related illnesses, is the result of long term exposure to the sun to the point which a person cannot sweat enough to lower the body temperature. The elderly and infants are most susceptible and it can be fatal if not managed properly and immediately. Believe it or not, the exact cause of heatstroke is unclear. Prevention is the best treatment because it can strike suddenly and without warning. It can also occur in non athletes at outdoor concerts, outdoor carnivals, or backyard activities.
Some “old school” folks think that wearing extra clothing and “breaking a good sweat” is an optimal goal for exercise. However, it may be potentially very dangerous in hot and humid conditions. When exercising in hot weather, the body is under additional stress. As the activity and the hot air increases your core temperature your body will to deliver more blood to your skin to cool it down. In doing so, your heart rate is increased and less blood is available for your muscles, which leads to cramping and other more serious problems. In humid conditions, problems are magnified as sweat cannot be evaporated from the skin to assist in cooling the body.
The American Academy of Pediatrics and The American College of Sports Medicine has the following recommendations which are appropriate for both the competitive athlete and weekend warrior:
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
The 27th Steamtown Marathon is three months away and, despite the warm weather, many local runners are deep into training. With serious heat waves of summer, any prolonged endurance activity in minimal to moderate heat can be dangerous if not prepared. Adequate hydration is critically important, not only to those training for a marathon but also for other outdoor endurance activities such as cycling, hiking, long distance power walking, etc
Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.
In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.
The risk of dehydration is not limited to endurance athletes and outdoor enthusiasts. Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years.
Is water adequate to prevent dehydration? Will a sports drink improve my performance? While some answers to these questions apply generally to all, others vary according to the temperature, humidity, length of time and intensity of the activity and condition of the athlete.
Proper hydration is essential for the comfort and safety of the recreational and serious athlete. Hydration is critical to maintain cardiovascular function, body temperature and muscle performance. As temperature, humidity, intensity, and duration of exercise increase, so too does the importance of proper hydration. Excessive sweating can lead to a loss of blood volume which requires the heart to work much harder to circulate you blood through your body.
Dehydration is a major cause of fatigue, loss of coordination, and muscle cramping leading to poor performance. Prehydration, (drinking before exercise) is the first step in preventing dehydration. Marathon runners, other long-distance runners, and cyclists often prehydrate1-2 days before a big event. Rehydration, (drinking during or after exercise) is the second step in preventing dehydration. While athletes may be more vulnerable to dehydration, all persons engaging in exercise would benefit from increased performance, delayed muscle fatigue and pain by maintaining adequate hydration. Proper prehydration would include drinking 12-16 ounces of water 1-2 hours before exercise. Athletes with other health issues should consult their family physician before engaging in long distance endurance sports.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
June is migraine and headache awareness month! 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.
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. Typically, there is no nausea, vomiting, or aggravation with physical activity, however, light or sound sensitivity can occur. 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.
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.
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 or using an ergonomic desktop. See photo below.
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.
Visit your doctor regularly and listen to your body.
Dr. Chua is a neurologist and headache specialist at Geisinger Health System in Northeast Pennsylvania. In addition to caring for people with headache and facial pain disorders, Dr. Chua also serves as: Director of Headache Medicine at Geisinger, Clinical Director of Neurology at Geisinger Wyoming Valley, faculty at Thomas Jefferson University’s Advanced Headache Diagnosis and Management Post-Graduate Certificate Program, and Treasurer and Executive Board Member of the Association of Migraine Disorders. In her spare time, she enjoys going on adventures with her husband and toddler, learning new skills (she is now certified in battlefield acupuncture), and buying great books she will never have time to read!
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
One of the greatest frustrations in modern medicine occurs when a safe, tried, and proven treatment exists to prevent deadly disease, but it is not possible to administer it to the potentially vulnerable victims. Over time, the disease unnecessarily spreads exponentially. Malaria in sub-Saharan Africa where one million die from the disease each year and tuberculosis in Haiti where the highest rate in the Western Hemisphere exists, are two examples. Another such disease that can be prevented with vaccination is the Human Papillomavirus, (HPV). While some strains of HPV lead to cancer an almost 100 percent disease prevention rate is associated with those vaccinated before the age of first potential exposure.
Despite validated scientific evidence of safety for more than 15 years, HPV vaccination skepticism not only persists, but is on the increase. Surveys show that the “anti-vaccine” culture fueled by COVID 19 has carried over to other vaccinations, including HPV. For example, provider orders for HPV vaccines decreased 24% in 2020, 9% in 2021 and 12% in 2022 when compared to 2019.
Many parents belonging to the “anti-vaccine movement” justify their actions with completely unfounded and unsupported fears of autism and other illnesses from the vaccine. However, their decisions affect the health of not only their children, but others as well.
According to Paul Offit, MD, professor of pediatrics, division of infectious diseases director of the Vaccine Education Center at the Children’s Hospital of Philadelphia (CHOP), every year in the United States, thousands of men and women die of cancers that can be prevented with a simple vaccine administered during adolescence to prevent HPV. He states, “It is critical that doctors and parents keep in mind; the disease is NOT ABOUT SEX…IT IS ABOUT CANCER!”
The Centers for Disease Control (CDC) has listed the prevention of HPV as a one of its “Top 5 Health Initiatives.” The pressure will be on health care providers to take the time to educate and dispel myths in order for parents to make informed decisions for the health of their children. In fact, local pediatrician Anders Nelson, who spends significant time educating parents and children about the importance of vaccination, requires parents to sign a “Refused HPV Vaccine” form and boasts a 99% compliance rate.
2013 the CDC reported 13.9% of males and 37.6% of females’ ages 13-19 are completing vaccination for Human Papillomavirus (HPV). Despite such low vaccination rates, a 50% reduction in HPV among 14 -19-year-old females was noted. Moreover, studies demonstrate a near 100% success rate to eradicate HPV in children vaccinated between the ages of 9 and 11 years old, leading health professionals to ask a frustrating and burning question: “Why do parents hesitate to vaccinate their children from a potentially deadly virus when a safe and effective cure exists?”
Reasons cited by parents for not vaccinating are challenging to health providers. Some of the most common responses include misunderstanding of HPV and its impact, unfamiliarity with vaccine recommendations, distrust of vaccine safety, religious and moral issues with mode of disease transmission, and social pressures. It will be the purpose of this column to dispel myths and address these concerns among parents.
HPV is the most common sexually transmitted disease (STD) in the United States. It is estimated that nearly all sexually active Americans will at some point become infected with the virus. HPV is spread by direct skin to skin contact. Although the infection maybe asymptomatic, it is still possible to spread the virus. Condoms are not 100% effective to prevent HPV because infected skin may be present outside of the barrier.
Studies have demonstrated that 90 percent of sexually active males and 80 percent of sexually active females will be infected with HPV in their lifetime. Moreover, 50 percent of HPV infections are high-risk, which can lead to cancer if the body does not clear these infections.
HPV is a family of viruses that primarily produce warts, but a limited number are responsible for cancers. There are a total 120 different subtypes of the virus capable of producing warts on skin or mucus membranes. Specific strains of the virus show preference for sites of infection, and different disease progressions. For example, most types are responsible for common warts on the hands and feet, however, there are strains with a preference for producing genital/anal disease. Moreover, the HPV causing the most of significant concern are those strains responsible for certain cancers. Some HPV strains will directly interrupt a cells repair cycle, resulting in vulnerability to be transformed into a cancerous cell. HPV types 16 and 18 are high risk for cancer and account for 70% of all 490,000 cases cervical cancer with 3,900 deaths. In addition, these two types cause penile, anal and head/neck cancers.
Prevention is paramount because once infected there is no treatment for HPV infections. Only the associated lesions, including genital warts, recurrent respiratory papillomatosis (RRP), pre-cancers, and cancers are treated. Treatment options professionals utilize are biopsy, cauterization, cryotherapy, and can be mildly to severely disfiguring. Biopsy results are used to determine the HPV strain and treatment. High risk subtypes lead to increased medical observation and have the potential for more invasive treatments which can impair fertility and cause facial disfigurement.
The most popular HPV vaccine available for use is Gardasil. It has been proven to safely protect against HPV 16 and 18, which account for 70% of all cervical cancers. Gardasil additionally protects against other high and low risk virus types.
The Gardasil vaccine was initially developed in the mid 1980’s at various institutions in the US and abroad. HPV proteins were added to a previous vaccine base that was proved safe and effective. After almost 30 years of testing and scrutiny by the FDA, Gardasil was deemed safe and released to the public in 2006.
Since distribution of the Gardasil vaccine, 270 million were administered worldwide with less than .032% serious adverse events. The reported vaccine reactions are injection site discomfort, dizziness, and fainting. Furthermore, research has concluded that there is no association with neurological conditions such as Guillain-Barre’ and Autism.
Gardasil is licensed for use for males and females ages 9 through 26 years. The vaccines are administered in a series of three on a 0, 2, and 6-month schedule. Studies have shown vaccination earlier in the recommended age spectrum has more advantageous results. For example, vaccinated children between the ages of 9-11 display an almost 100% prevention of disease. Sexually activity is not a contraindication to receiving the vaccine, but the vaccine is not recommended to those currently pregnant.
Despite the safety and efficacy of the vaccines, one reason reported by parents for not vaccinating their children is the concern that vaccination will increase sexual activity in adolescents. Although disconcerting for parents, a study conducted two years before the introduction of Gardasil by the U.S. Department of Health and Human Services reported that the number of sexually active teens has increased to 30% in ages 15 to 17 and more than 63% in ages 18 to 19. Furthermore, these numbers continued to increase regardless of public programs in sexual education and abstinence.
Since released in 2006, Gardasil has made a direct impact on HPV prevalence in adolescents. Even with less than desirable vaccination rates, HPV prevalence among adolescent females age 14-19 is declining. The decline in affected teens is predicted to lead to decreased future HPV related cancers. These vaccinations are safe, effective, powerful tools at our disposal to protect our children from the detrimental effects of a preventable disease. If you would like more information on Gardasil, consult your local Family Physician, Pediatrician, or Obstetrician-gynecologists (OB/GYN). Remember the advice of CHOP pediatrician, Dr. Paul Offit regarding the HPV vaccination for adolescents, “it is critical that doctors and parents keep in mind; the disease is NOT ABOUT SEX…IT IS ABOUT CANCER!”
Sources: CDC, Journal of Pediatrics, JAMA, International Journal of Cancer, Journal of Infectious Disease; www.MerckVaccines.com (GardasilR)
Medical Reviewer & Contributor: Anders Nelson, MD., F.A.A.P. is a pediatrician with offices in Scranton, PA.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Seasonal allergies affect 30 % of adults and 40% of children in the United States. Avoiding the outdoors is often not an option…especially if you enjoy outdoor activities and sports. Not long ago, it was unthinkable that an athlete with serious seasonal allergies could compete at a high level, such as the Olympics. Now, in great part due to advanced research, medications and proper management, an Olympic gold medal for those suffering from seasonal allergies is a reality. Recently, the National Institute of Allergy and Infectious Disease at the National Institutes of Health have published research on this topic to provide a better understanding and make recommendations.
The most common allergic reactions which athletes suffer from are sneezing, itchy and watery eyes, runny nose and coughing. Moreover, 67% of those with these symptoms also suffer from asthma. The athlete in NEPA is particularly vulnerable when the pollen count is high during spring and fall for several reasons. One, after being indoors all winter, one might develop a heightened sensitivity to allergens. Also, increased rapid and deep breathing during exercise makes athletes more susceptible to significant symptoms when exposed to allergens such as tree, grass and weed pollens.
Allergy skin testing can be performed to determine the allergens to which you are susceptible. Once determined, allergy shots are effective in building up tolerance to these allergens. If appropriate, you may be able to use allergy drops, administered under the tongue and conveniently used at home.
Asthma suffers should use their inhaler BEFORE symptoms occur. A recent study found that pretreatment using a short-acting bronchodilator inhaler within 15 minutes before exercise is very effective in preventing asthma symptoms for more than four hours. It is important to keep a bronchodilator available. If you fail to benefit from this, see your physician for other methods to control your exercise-induced symptoms.
Whether you have allergic respiratory problems from rhinitis or asthma, you many benefit from conditioning your airways with a 10 to 15 minute warm-up before and cool-down after the activity. This may serve to gradually prepare your lungs for an increased demand.
In addition to preventing dehydration on hot and humid days, constant hydration is very important for the athlete with allergies to prevent dry airways in athletes.
Know the signs and symptoms of asthma (coughing, wheezing, tightness in chest, shortness of breath).
Some schools have a file on each student athlete with a allergic or asthmatic problem which requires medication. The file includes information such as medical doctor release and instruction, emergency contacts and medications. Students must have their medications on hand before they can enter the field. The National Athletic Trainers Association recommends using a peak flow meter to monitor at risk players and can determine when a player can return to the field.
If possible, find an alternate practice facility with climate control for athletes at risk. Plan practices for these athletes when the pollen count is low. Check the newspaper or internet for pollen counts in your area. Training by the water, (ocean) where there is a breeze and less pollen is helpful.
Shower and change clothing immediately after being outdoors
During a flare up, do less aerobic exercise to limit stress on respiratory system. Try strength training indoors instead.
When pollen count is high, keep windows shut at home and in your car….use air-conditioning.
Keep pets out of your bedroom…especially when sleeping
Dry clothing in dryer…do not hang on clothesline outdoors
Sources: American College of Allergy, Asthma, and Immunology. National Athletic Trainers Association.
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
According to the American Diabetes Association (ADA) and the Centers for Disease Control (CDC), 11.3% of the population in the United States or almost 37.3 million adults and children has diabetes. Unfortunately, the number keeps rising and one-third of these people are not aware that they have the disease. It will be the purpose of this column to raise the level of consciousness through education and offer recommendations for lowering blood sugar levels naturally.
Perhaps no goal is more important to a person with diabetes than maintaining a healthy blood sugar level. When managed over time, healthy blood sugar levels can slow the onset of complications associated with the disease. According to the ADA, pre-diabetes, or impaired glucose tolerance, occurs when blood glucose levels are higher than normal (110 to 125mg/dl) but below type 2 diabetes levels (126mg/dl). 54 million Americans have pre-diabetes in addition to the 20.8 million with diabetes.
While medications are effective in maintaining blood sugar levels, for those who are borderline, there are effective ways to lower your blood sugar naturally. Your physician will determine which treatment is most appropriate for your problem. Also, maintaining your ideal body weight is always important.
SOURCES: The American Diabetes Association (ADA), CDC, NIH, and Lifescript
Visit your doctor reguLlarly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. 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 exercise forum!
November is National Diabetes Awareness Month. This column will present information regarding type 1 and type 2 diabetes and the diagnosis and symptoms of the disease. Next week, Part II will present the role of exercise in the management of the disease.
What is it?
Diabetes is a disease where the hormone insulin is not adequately produced or used by the body. Insulin is needed for cells to take up glucose after it is broken down from sugars, starches and other food that we eat. When working properly, this provides the fuel necessary for activities of daily living. While the exact cause is not completely understood, genetics is known to play a big role. However, environmental factors such as obesity and inactivity have also been found to play a large role.
According to the American Diabetes Association (ADA) and the Centers for Disease Control (CDC), 11.3% of the population in the United States or almost 37.3 million adults and children has diabetes. Unfortunately, the number keeps rising and one-third of these people are not aware that they have the disease.
A Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT) can be used to screen a person for diabetes or pre-diabetes. Due to the fact that it is easier, quicker and cheaper, the FPG is the recommended test by the ADA. A FPG test results between 110 and 125 mg/dl indicates pre-diabetes. A FPG of 126 mg/dl or higher indicates diabetes.
Type 1 diabetes occurs when the islet cells of the pancreas are destroyed and unable to produce insulin. Without insulin, the cells of the body are unable to allow glucose (sugar) to enter the cells of the body and fuel them. Without the hormone insulin, the body is unable to convert glucose into energy needed for activities of daily living. According to the ADA, 5-10% of Americans diagnosed with diabetes has type 1. It is usually diagnosed in children and young adults.
While type 1 diabetes is serious, each year more and more people are living long, healthy and happy lives. Some conditions associated with type 1 diabetes are: hyperglycemia, ketoacidosis and celiac disease. Some things you will have to know: information about different types of insulin, different types of blood glucose meters, different types of diagnostic tests, managing your blood glucose, regular eye examinations, and tests to monitor your kidney function, regular vascular and foot exams.
While symptoms may vary for each patient, people with type 1diabetes often have increased thirst and urination, constant hunger, weight loss and extreme tiredness.
Type 1 diabetes increases your risk for other serious problems. Some examples are: heart disease, blindness, nerve damage, amputations and kidney damage. The best way to minimize your risk of complications from type 1diabetes is to take good care of your body. Get regular checkups from your eye doctor for early vision problems, dentist, for early dental problems, podiatrist to prevent foot wounds and ulcers. Exercise regularly, keep your weight down. Do not smoke or drink excessively.
Type 2 is the most common type of diabetes as most Americans are diagnosed with type 2 diabetes. It occurs when the body fails to use insulin properly and eventually it fails to produce an adequate amount of insulin. When sugar, the primary source of energy in the body, is not able to be broken down and transported in the cells for energy, it builds up in the blood. There it can immediately starve cells of energy and cause weakness.
Also, over time it can damage eyes, kidneys, nerves or heart from abnormalities in cholesterol, blood pressure and an increase in clotting of blood vessels. Like type 1, even though the problems with type 2 are scary, most people with type 2 diabetes live long, healthy, and happy lives. While people of all ages and races can get diabetes, some groups are at higher risk for type 2. For example, African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders and the aged are at greater risk. Conditions and complications are the same as those for type 1 diabetes.
People with type 2 diabetes experience symptoms that are more vague and gradual in onset than with type 1 diabetes. Type 2 symptoms include feeling tired or ill, increased thirst and urination, weight loss, poor vision, frequent infections and slow wound healing.
Sources: NIH; American Diabetes Association; Harvard Health Publications
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. 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 exercise forum!