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Patients often tell me that they would like to exercise but hesitate due to their knee or hip pain. They want to know what type of exercise is best for those suffering from osteoarthritis (OA). Osteoarthritis is also known as degenerative arthritis. It is the most common form of arthritis in the knee. It is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the joint which eventually wears down to the bony joint surface. It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. It causes gradual onset of pain, swelling and stiffness in the involved joint, especially after increased activity and weakness with loss of function due to disuse.

However, OA is not an excuse to avoid exercise but it is important to be smart about it. Regular exercise is essential to maintain a normal lifestyle for those with OA. However, if you do the wrong exercise, use poor technique, or are too aggressive, you could flare-up your joints and do more harm than good.

Benefits of Exercise for Those with OA:

When performed correctly, exercise for those with OA has many benefits:

Pain Control

Exercise controls OA pain by releasing natural pain control chemicals in the body called endorphins. It also controls pain by assisting in weight loss and improving range of motion.

Weight Control

We all know how well exercise burns calories and that increased body weight creates increase stress on the joints.

Prevention of Joint Stiffness

Exercise will help maintain joint range of motion. A stiff joint is a painful joint.

Prevention of Muscle Weakness

Exercise will help maintain muscle strength. Weak muscles will allow or increase in joint wear and tear.

Maintain Lifestyle

If a joint is stiff and weak, then they become painful which negatively impacts your lifestyle. Exercise can prevent this problem.  

Tips How To Exercise With Osteoarthritis:

Start Slowly

Wean into exercise because if you advance too quickly, you will flare up the joint and have increased pain. For example, walk for 5-10 minutes the first session. If you do not have pain, add 1-2 minutes each session.

Lose Weight

Every pound lost equates to less stress on your joints. For example, a loss of 5 pounds of body weight translates to 20-30 pounds of stress through the knee, according to David Borenstein, MD, President of the American College of Rheumatology. Also, body weight has a direct impact on daily activities. For example, walking upstairs creates stress through the knee equal to 4 times body weight and seven times body weight going downstairs. Therefore, less body weight equals less stress.

Low Impact Workouts

Low impact exercise creates less stress on the joints while strengthening leg muscles and those who those who maintain leg muscle strength have less stress on their joints. It is even important not to load your arms with heavy objects when walking or using stairs to limit joint stress.

Some examples of low-impact exercises are: walking, swimming, elliptical trainer, and biking. Strength training is also low-impact and should be performed with low weight and high repetitions. Water therapy is great for those with OA, especially in a heated pool. It is a great low-impact exercise with less gravity and stress on the joints. Walk, swim and do mild resistance exercises in the water. Use a snorkel and mask for swimming to limit excessive neck turning and back extension.

Walking is a great form of exercise; however, walking softly is important for those with OA. Wear good running shoes and orthotics if necessary. Discuss this with your physical therapist or podiatrist. When possible, use soft surfaces like cinder, mulch or rubber. Avoid grass and soft stand due to instability and torsion that may irritate your joints.  

Warm-Up

Warming up your body is critical to prevent injury to the muscles and tendons. This can be done by marching in place or using aerobic equipment such as a bike for 5 to 10 minutes before exercise. Always perform the warm-up activity at ½ your normal pace.

Balance & Relaxation Techniques

Tai Chi and ballroom dancing are two good examples of activities which promote balance and relaxation. Studies showed that those with OA who participated in Tia Chi two times a week for eight weeks reported less pain, increased range of motion and improved daily activities and function. They also noted less low back pain and better sleeping.

Proper Clothing

Stay warm in winter and consider wearing compression shorts. Be cool in the summer months with DrytechR type material.

Pre/Post Exercise First Aid

If you are sore for longer than 12 to 24 hours after exercise, then you overdid it and must make adjustments next time. Otherwise, use hot packs, bath or shower before you exercise to loosen up and apply ice to your joints after exercise, especially if they are sore.

Post Exercise Stretch

Gentle, active range of motion stretches after exercise is important to maintain mobility. Do not bounce or cause pain. For example: Low Back – knees to chest; Arms – row –the – boat, arms behind head, arms behind back; Legs – wall lean calf stretch, bend and extend knees, open and close hips.

SOURCES: Rothman Institute, Philadelphia, PA and American Academy of Orthopaedic Surgeons; www.lifescript.com

Visit your doctor regularly and listen to your body.     

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

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

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

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

Gardeners and Computer Mouse Users Be Aware!

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

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

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

Common characteristics of persons who develop tennis elbow:

Symptoms:

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

Treatment Options:

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

Passive Stretch in Wrist Flexion with Elbow Extension

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

Isometric/Eccentric Wrist Extension with Elbow Extension

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

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

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

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

Visit your doctor regularly and listen to your body.     

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

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

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

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

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.

American College of Sports Medicine Hydration Recommendations:

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

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

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

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

There are Many Positives About Aging!

Ageism is prejudice or discrimination on the grounds of a person’s age…

While I hesitate to discuss politics, as an aging physical therapist, I feel that it is incumbent upon me to speak out against ageism, especially with so much attention being paid to the age of the candidates in the upcoming US presidential election. Interestingly enough, age seems to be of more concern for President Biden (age 81), than his opponent, former President Trump (age 78), even though there is only 4 years between them. By the way, “Corporate Sages,” Warren Buffett, CEO of Berkshire Hathaway is 93 years old and Rupert Murdock, CEO of News Corp is 86 years old and their stock holders seem very satisfied! Two local examples of aging with an “A Game” are my 92 year old mentor, Dr. Gino Mori, founder of Delta Medix, who took college classes for enrichment until the age of 90 and Fr. Bernard Mcllhenny, SJ, retired dean of admissions at the University of Scranton, who plays golf (competitively) at least once a week at the age of 98.

It is low hanging fruit to list all the problems associated with age; muscle and bone loss, balance deficits, delayed mental processing, and memory loss to name a few. However, the purpose of this column is to present the positive qualities of the “golden years!”

Wisdom, Wisdom, Wisdom

There are no shortcuts for the assimilation and accumulation of knowledge and wisdom that one acquires over a lifetime and it cannot be taught…only experienced! Not only do older adults know what they know, more importantly, they know what they DON’T know! Moreover, they know how to use this knowledge efficiently and effectively. This is referred to as “crystallized intelligence” and it keeps improving with age…even at 65-75 and more.

Steady Eddie

While the term “Grumpy Old Men/Women” makes for good TV, the reality is that most of us get more agreeable, likable and consistent with age. Older people are less volatile, control their emotions and tend to focus more on the important things in life.

Collegiality

With age, people tend to be less egocentric and more in tune with the feelings and emotions of others. Using this acquired insight, one can foster a more cooperative and productive solution to problems with friends, family and coworkers.

Improved Sex Life

Quality over quantity with age! Studies show that women over 40 and much older have improved sexual satisfaction when compared to their youth. Moreover, women over 80 were more satisfied with sex than those between 55 and 75! Go figure!

Enjoy the Sunrise

Whether you like it or not, there is a good chance that you will become a “morning person” with age. As sleeping patterns change, including sleep interruptions, we tend to go to bed earlier and rise and shine with the sun. The good news is that you can start your day early to “suck the marrow” out of the day.

Headaches Are Over

Most migraine sufferers report little to no headaches after age 70. And, for older adults who experience headaches, they tend to be less painful and debilitating.

Have a Purpose

Studies show that early retirement may not be good for your health. The Longevity Project that people who continue to be productive, have purpose, and enjoy their work, live the longest. So maybe, Biden and Trump want the POTUS job in order to stay healthy!

Fear Not

While older adults may fear falling and breaking a bone, they don’t have the same fears and concerns that distract many younger people. With age, self-esteem and confidence improves and with wealth, education, good health and a sense of purpose, these qualities increase exponentially. According to the American Psychological Association, while more young people report high stress levels, older Americans report less. And, even when encountering a stressful situation, older people have learned coping methods to manage it better than younger people. 

Productivity

We can waste our time debating the potential problems with an aging POTUS, however, we must decide between two candidates that will be octogenarians while in office. With that in mind, we must focus on the potential for solid, honest, dedicated, effective and productive leadership to guide us through the next four years. Research has shown that the workforce is aging worldwide and older workers are a critical component to overall productivity in an age of worker shortages. A thorough assessment of the literature related to the productivity of an aging workforce shows that older workers are at least as productive and in some cases (that does not require heavy labor), are more productive than their younger coworkers. In great part, this is attributed to the aforementioned positive aspects of aging such as “crystallized intelligence”. In view of this, ageism has no place in the workplace because older workers can and do keep up.

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

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

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

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

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

JUNE IS GREAT OUTDOORS MONTH! AS WE KICK OFF SUMMER AND CELEBRATE THE FOUR OF JULY, MAKE TIME TO GET THE HECK OUTSIDE! Research shows that spending time outdoors has many positive effects on your health. While there are many year-round activity options, in Northeastern Pennsylvania our short-lived summer is the inspiration to “suck the marrow out of a sunny day!”  Summer in NEPA is enjoyed in many ways such as walking, running, hiking, biking, horseback riding, boating, kayaking, and swimming. Studies show that even less vigorous activities such as fishing, picnicking camping, barbequing, or reading a good book on the porch are healthier than being indoors.

It is reported that Americans spend 90% of their lives indoors and that number increases with age. Worse yet, for some, venturing outdoors is considered risky behavior with fear of the sun, ticks, wind, mosquitoes, and other creatures of God. Well, the truth of the matter is the risk of being one with nature is far less than the ill effects of a life stuck indoors. Please consider the following benefits of spending time outdoors.

Benefits of being Outdoors:

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

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

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

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

I have been advising my patients to exercise, keep active, and walk as long as they can in order to stay mobile and healthy. However, seniors often tell me activities that require prolonged walking is limited by ankle pain from arthritis. They often ask, “What is arthritis of the ankle?” How does it happen? What can I do about it?

Three Most Common Forms of Arthritis of the Ankle

Symptoms of Arthritis

Diagnosis

Your family physician will examine your ankle to determine if you have arthritis. In more advanced cases you may be referred to a specialist such as a podiatrist,  orthopaedic surgeon or rheumatologist for further examination and treatment. X-rays will show if the joint space between the bones in the ankle is getting narrow from wear and tear arthritis. If rheumatoid arthritis is suspected, blood tests and an MRI may be ordered. The diagnosis will determine if you problem if minor, moderate or severe.

Treatment

Conservative Treatment

In the early stages your treatment will be a conservative, nonsurgical approach, which may include; anti-inflammatory medication, orthopedic physical therapy, exercise, activity modifications, supplements, bracing, etc. You and your family physician, podiatrist, orthopedic surgeon or rheumatologist will decide which choices are best.

Conservative But More Aggressive Treatment

Surgical Treatment

When conservative measures no longer succeed in controlling pain and deformity, improving strength and function then more aggressive treatment may be necessary.

SOURCES: Rothman Institute, Philadelphia, PA and American Academy of Orthopaedic Surgeons

Visit your doctor regularly and listen to your body.     

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

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

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

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

Human beings were designed to move…walk, run, climb, lift, hunt, and gather. Contemporary man has suffered greatly from a technologically driven inactive and sedentary lifestyle. Inactivity is associated with many health problems; obesity, adult-onset diabetes, high blood pressure to name a few. The problems associated with lack of movement are many:

Constipation

The more you move your body, the more you colon moves!  A regular and consistent exercise and activity regime, results in a more consistent bowel schedule, especially with age. Healthy muscle tone in your abdominal muscles and diaphragm is also the key to moving waste through your digestive tract.

Stiff Joints

Osteoarthritis, rheumatoid arthritis and many inflammatory or auto-immune diseases can cause achy and stiff joints. However, even healthy joints can also stiffen when you don’t use them enough. Put them to work so they don't get tight and cause pain.

Shortness of Breath

All muscles get weak from lack of use, including the muscles that help your lungs expand and contract as you breathe if you don’t work them out regularly. The less exercise or activity you do, the more you experience shortness of breath, even during easy daily tasks.

Depression or Moody

Physical problems are not the only complication of inactivity. A lack of movement can also increase feelings of anxiety and depression. Aerobic exercises like walking, biking, swimming, or running, have been proven to stimulate endorphins to boost and steady your mood, and even improve your self-esteem.

Lack of Energy

Many studies have found that regular movement improves energy. Exercise helps deliver oxygen and nutrients to your tissues. When you sit or are inactive, tissues are not getting the same amount of fuel they need to keep you going.

Slow Metabolism

Movement stimulates your metabolism. Hyperactive people burn more calories…just by fidgeting! Even if you are not hyperactive, the more active you are, the more calories you burn each time you move.

Difficulty Sleeping

One of the first recommendations sleep doctors make to their patients suffering from insomnia is exercise. When you keep a regular exercise routine, you fall asleep faster, and you sleep deeper once you drift off.

Brain Fog

Regular exercise tells your body to make more chemicals called growth factors. They boost blood vessel production in your brain. The more blood that gets to your brain, the better you can think, remember, and make decisions.

High Blood Pressure

Spending most of your time sitting raises your risk of heart disease, in great part due to the fact that partly you’re more likely to have high blood pressure. This is a big risk factor for heart issues like coronary artery disease and heart attack.

High Blood Glucose

When physical activity is a regular part of your life, your body has an easier time keeping your blood glucose under control. Exercise can stabilize blood sugar levels and keep you out of the type 2 diabetes danger zone.

Lower Back Pain

When your core muscles are weak from lack of use, they can’t support your back the way they should. This makes it much easier to tweak your back muscles during everyday movements like standing or reaching. Pilates, yoga, and other exercises that use stretching are good for building a stronger back. Schedule an appointment with a good orthopedic and sports PT.

Hunger Pains … “Hangry”

Logically, one might think that you’d be hungry more often if you exercised more, but the opposite is usually true. Aerobic exercise like biking, swimming, walking, and running can actually decrease your appetite because it changes the levels of certain “hunger hormones” in your body.

Sick Often

Studies show the more moderate activity you get, the lower your chance of catching a cold or other germs. When you make exercise a habit, your immune system gets stronger.

Dull and Pasty Skin

If your skin looks duller than usual, a lack of movement may be to blame. Some studies show that moderate exercise boosts your circulation and your immune system, which helps your skin keep that youthful glow.

SOURCE: WebMD

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

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

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

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

In addition to lowering blood pressure, this gentle form of exercise can help maintain strength, balance, flexibility and mental health and is an ideal activity for all ages!

This research was brought to my attention by my friend and mentor from Dalton, Peter Frieder, Chairman,Gentex Corporation and current Board Chair at WVIA. Peter is celebrating his birthday today with a number of years that clearly does not represent his physiological age, in great part due to his dedication to health and wellness. Happy Birthday and thank you!

According to a new study by the China Academy of Chinese Medical Sciences (CACMS), the ancient martial art practice of Tai Chi is effective in lowering blood pressure as much, if not more, than traditional aerobic exercise. For those with prehypertension or hypertension and are unable to tolerate the repetitive and prolonged weight bearing stresses of running, walking or cycling, these results have tremendous implications. The slow, gentle and controlled movements and positions of Tai Chi coupled with controlled breathing and meditation may be a valuable alternative, especially for those with aging muscles and joints. Improved strength, flexibility balance, posture and mental health are additional bonuses.

WHAT IS TAI CHI?

Tai Chi is multifaceted in that it combines martial arts, slow gentle and controlled movements, sustained postures, a focused and meditative mind, and controlled breathing. It is considered by many to be “meditation or medication in motion.”

Tai Chi involves slow-motion movements transitioning with control from one position to another. The positions have historically been named for the actions of animals, for example:

“White Crane Spreads its Wings”

Deep and purposeful breathing, mental focus, body awareness and meditation are integral components of the exercise. The beauty of Tai Chi is not only in the physical form, but also in its safety for all levels of fitness. It is helpful for individuals from high level athletes to those with physical disabilities. The movements are natural and gentle without forcing the muscles and joints to extreme or uncomfortable positions. It is often used as an adjunct therapy in the wellness as well as rehabilitation of a variety of athletic (ACL surgery, joint replacements) and neurological conditions (Parkinson’s, MS, head trauma), to name a few. Based on the aforementioned Chinese study, Tia Chi can be applied as a technique to control or lower blood pressure, especially for those who cannot utilize traditional aerobic exercise.

HEALTH BENEFITS OF TAI CHI

Tai Chi has been found to offer many physical and mental benefits. Some of these include:

Muscle Strength – upper and lower body, trunk and core strength

Flexibility – participants report improved range of motion and flexibility of the spine and extremities

Balance and Proprioception – some studies report a reduction of falls due to a variety of sustained positionsand improved awareness of one’s body in space

Aerobic Conditioning  -  recent studies have found that participants have lower heart rate and blood pressure

Mental Health – through improved balance, strength, and flexibility, studies show participants have gained confidence and control as well as lower blood pressure and stress reduction.

HOW TO BEGIN TAI CHI

All Tai Chi classes begin with four basic principles: warm-up, instruction, practice and breathing.

Warm-up- gentle easy motions to warm-up and loosen the joints and muscles to prevent injury.

Tai Chi Forms – “Short Forms” are beginner movements which are gentle, slow, and short in duration while “Long Forms” are more advanced.

Breath Work – gentle breathing combined with movement to relax the mind and focus energy

GETTING STARTED (HarvardHealth):

Don’t be intimidated by the language or history – Yang, Wu, Cheng are only brands of movements with a history of martial arts but this in no way impacts participation.

Get medical clearance – check with your physician to see if Tai Chi is safe for you. Some orthopedic or vestibular problems might require special attention.

Observe or take a beginner class – often available at local fitness clubs or senior centers. Research options in your area and find a friend to join you. Consider an introductory instructional video to get a feel for Tai Chi. (See local Tia Chi classes below)

Meet with an instructor – if it makes you more comfortable, make time to talk to an instructor before enrolling in a class.

Dress for success – wear loose-fitting clothes that allow for range of motion and comfortable shoes for balance and support.

Track your progress – use an app or keep a journal of your progress. Heart rate, blood pressure and endurance (the time you can hold a pose or tolerate a class) are easy to monitor.

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

Sources: HarvardHealthPublishing; New Atlas; China Academy of Chinese Medical Sciences (CACMS); National Institutes of Health

Local Tai Chi Classes: Steamtown Yoga, Scranton, PA; Mission Yoga, Scranton, PA;Dragon’s Heart Tai Chi & Kung Fu, Clarks Summit, PA; Rothrocks Kung Fu & Tai Chi, Duryea, PA

For more information: HarvardHealth; www.taichihealth.com; www.treeoflifetaichi.com

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

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

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

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

This column is dedicated to the memory of John R. O’Brien, Esq., who recently passed due to medical complications associated with multiple sclerosis (MS). John was a source of joy and inspiration for those fortunate to have known him. Twenty years ago, John hesitantly agreed to contribute to my column on MS with two requirements: one, if the column would be valuable to those affected by MS and two, he would remain anonymous. When speaking with his dedicated wife, Sally, it became very apparent that any discussion of John’s life would be diminished if it was defined by the disease because he was committed to turning his “DISABILITY INTO AN ABILITY!”

With the help of his loving wife, family, friends, and devices such as an electric scooter and adaptive car, John not only lived but thrived! He was a skilled lawyer, a respected member of the Bar, and an active member of the community. John served on the executive committee of the Lackawanna Bar Association. In addition, the Lackawanna Pro Bono honored him recently. He also taught business law and healthcare law and coached Prep’s mock trial team.

John shared his thoughts with me about the challenges of redefining life… from Golf Club Champion to living with a physically disabling disease. Anyone who knew him would agree that he succeeded in doing so through his keen intellect and sharp wit and humor…his heart and brain overcompensated for his body! In addition to reading books in Latin and Greek, he had his crossword puzzles published in The New York Times and Los Angeles Times. In September 2023, John conducted an interview with presidential historian Doris Kearns Goodwin before a full house at the Scranton Cultural Center. Ms. Goodwin later reported that John was the most knowledgeable, effective and enjoyable interviewer she’s encountered.

John’s absence will be deeply felt and his legacy will continue to shape our community for years to come!

Multiple Sclerosis:

Multiple Sclerosis is a chronic disease. While it may lay dormant and stable for a period of time, living a healthy lifestyle will make a positive contribution toward how you and your family live with Multiple Sclerosis. Studies show that a life of family, love, and support are essential to maintain a positive attitude with a chronic illness. This combined with a healthy diet and proper exercise can contribute greatly toward taking control and living a relatively normal life with MS.

PSYCHOLOGICAL & SPIRITUAL WELLNESS:

As I have mentioned in many other columns, studies show that people with good attitudes and great faith live longer than others. This is especially helpful when living with chronic disease like Multiple Sclerosis. The Cleveland Clinic offers some suggestions how to maintain a positive attitude:

EXERCISE & PHYSICAL WELLNESS:

Many sources, including the Cleveland Clinic suggest that exercise, when performed properly, can have a positive impact on Multiple Sclerosis symptoms both physically and psychologically. However, because you have a chronic illness, you should consult with you family physician and physical therapist before beginning an exercise program. They will advise you on the proper type and amount of exercise.

TIPS FOR EXERCISE WITH MS:

Visit your doctor regularly and listen to your body.     

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

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

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

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

Kick Start Your Wellness New Year’s Resolutions: PART II OF II

January is the time of year that many people set goals and resolve to be their very best. Not surprisingly, weight loss and fitness are the most common resolutions. It is also a time when many residents of NEPA will plan vacations and travel to warmer climates. Well, it may be that you can do both… This year consider visiting a “Fitness Resort.” According to “FitStays,” fitness resorts are rapidly gaining popularity for people of all sizes and shapes. Last week in Part I of “Fitness Resorts” we discussed value of fitness resorts. This week we will present “a typical day, how long you should stay, expected costs, and some recommended resorts.

What is a Fitness Resort? (fitstays.com)

A fitness resort is a vacation destination where travelers go to exercise and lose weight. Sometimes called a “weight loss resort”, “fitness retreat”, “wellness resort”, “weight loss boot camp”, or “adult fat camp”, fitness resorts around the United States cater to people of all shapes and sizes.

Most fitness resorts consist of pre-determined, calorie-limited menus to help travelers in their weight loss journey. Some resorts promote menus of 1,000 to 1,500 calories-per-day, which is fewer than most people burn naturally via their resting metabolic rate (RMR).

In addition to net-negative calories through nutrition, fitness resorts and retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to strength classes, cardio, sports, and other physical activities.

The combination of healthy nutrition and active exercise means that most visitors can expect to lose weight at a fitness resort. Specific weight loss goals are determined by which fitness resort you pick, how long you stay, and how strenuously you want to stick to the program.

Fitness Resort – What’s it all about?

Fitness resorts (fitness retreats) are not your average “Reality TV Fat Camp.” In fact, your do not have to be excessively overweight to attend as people of all shapes and sizes benefit and enjoy the experience. Thousands of people chose to visit fitness resorts and fitness retreats every year because they are looking for a healthy alternative to a typical vacation. Instead, many want to “kick-start” a healthy lifestyle in a controlled environment. The basic concept of combining a limited-calorie diet with daily exercise, most people will have net-negative calories every day, lose weight, and gain strength and endurance at a fitness resort—provided they stick to the program.

Length of Time/Cost

Typically, fitness resorts offer one week programs but multiple weeks with a variety of options are available. However, for the best outcomes and carryover, experts recommend 2-3 weeks for your first visit to a fitness resort.

Fitness resorts, like everything else, vary in cost. According to FitStay, programs cost as little as $1,500 per week (all-inclusive), while some are more than $7,000 per week.

To choose the best fit for you, your budget, and goals, visit fitstay.com. Remember, most fitness resorts are all-inclusive, meaning that you won’t need to budget any extra for food. The program includes meals. Also, when choosing a fitness resort consider: location (where would you like to travel?); cost (how much can you afford to spend?); how long can you stay (one, two or three weeks?)

FitStays – Top 20 Fitness Retreats (7 of these discussed below):

NOTE: One of these includes a fitness retreat in our very own Pocono Mountains!

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

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

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

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