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Part II of II

April is National Stress and Anxiety Awareness Month! According to the National Institutes of Health, an estimated 19.1% of U.S. adults 18 and older had an anxiety disorder in the past year. Anxiety disorders were higher for females (23.4%) than for males (14.3%). An estimated 31.1% of U.S. adults experience an anxiety disorder at some time in their lives.

There are a wide variety of anxiety disorders and will vary by the objects or situations that induce them. However, the features of excessive anxiety and related behavioral disturbances are similar. Anxiety disorders can interfere with daily activities such as job performance, schoolwork, and relationships. Symptoms include: distress, nausea, shortness of breath, bowel pattern changes, excessive perspiration, frequent laughing or crying, restlessness, and is often associated with depression. While there are many types and degrees of anxiety and there is no substitute for medical and psychological care, there are some simple and basic tools to help manage the problem…daily exercise is one easy, affordable and accessible suggestion for most. Multiple studies have discussed the incidence of unhealthy self management of anxiety, including the use of alcohol and recreational drugs.

Last week, I presented coping tips for the management of anxiety. In this column, I will discuss one of the most understated benefits of exercise – mental health! 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.

Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing anxiety and depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that anxiety and depression scores were significantly reduced in 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 psychotherapy counseling group.

HOW EXERCISE REDUCES ANXIEY AND DEPRESSION:

According to research reported in sports medicine journals, exercise reduces anxiety and depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Anxiety and Depression:

Physiological or Physical Benefits of Exercise on Anxiety and Depression:

HOW TO BEGIN EXERCISE FOR ANXIETY AND DEPRESSION:

SOURCES: University of Pittsburgh Medical Center (UPMC); National Institutes of Health (NIH); The American Journal of Sports Medicine

Visit your doctor regularly and listen to your body.     

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

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

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

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

Part I of II

April is National Stress and Anxiety Awareness Month! According to the National Institutes of Health, an estimated 19.1% of U.S. adults 18 and older had an anxiety disorder in the past year. Anxiety disorders were higher for females (23.4%) than for males (14.3%). An estimated 31.1% of U.S. adults experience an anxiety disorder at some time in their lives.

There are a wide variety of anxiety disorders and will vary by the objects or situations that induce them. However, the features of excessive anxiety and related behavioral disturbances are similar. Anxiety disorders can interfere with daily activities such as job performance, schoolwork, and relationships. Symptoms include: distress, nausea, shortness of breath, bowel pattern changes, excessive perspiration, frequent laughing or crying, restlessness, and is often associated with depression. While there are many types and degrees of anxiety and there is no substitute for medical and psychological care, there are some simple and basic tools to help manage the problem…daily exercise is one easy, affordable and accessible suggestion for most. 

Multiple studies have discussed the incidence of unhealthy self management of anxiety, including the use of alcohol and recreational drugs. The University of Pittsburgh Medical Center (UPMC) recommends the following healthy tips for coping with anxiety:

Healthy Coping Tips:

  1. Get Enough Sleep 
    • Adequate sleep is critical for mental health. Unfortunately, anxiety can lead to sleeping problems and, according to the Anxiety and Depression Association of America (ADAA) inadequate sleep can worsen anxiety.
    • Seven to nine hours of sleep each night is recommended for most adults. The National Sleep Foundation recommends maintaining a regular schedule that includes going to bed at the same time each night and waking up at the same time each morning.
  2. Practice Mindfulness Meditation 
    • Incorporating meditation into your life can help you cope with anxiety, according to the National Center for Complementary and Integrative Health.
    • Research shows mindfulness meditation programs are effective in reducing anxiety and depression. UPMC offers a Mindfulness-Based Stress Reduction Course and a Beginners Guide to Meditation that have been proven to be very effective. Another option for reduction of anxiety and stress is Progressive Muscle Relaxation. This mind-body technique can be found in 5, 10, 15 or 20 minute videos.
  3. Spend Time in Nature 
    • How you deal with anxiety should include a walk in the forest or even a tree-lined park. In NEPA we are very fortunate to have access to beautiful walking and biking trails and state parks. Make time to enjoy them.
    • Research shows that “forest bathing,” long, slow walks in nature for health purposes, can lower blood pressure and relieve anxiety. A review of clinical trials published in the International Journal of Biometeorology found that salivary cortisol levels, biomarkers for stress, were significantly lower in groups who participated in forest bathing versus the control group.
  4. Take up Yoga or Tai Chi 
    • Yoga does more than increase your flexibility. It incorporates exercise, deep breathing, and meditation. Yoga is an all-in-one anti-anxiety activity, as shown in a review of body-centered interventions published in Frontiers in Psychology. Tai chi, a mix of meditation and martial arts, works much the same way.
  5. Dance Therapy 
    • That same research found that dance therapy, also known as movement therapy, reduces anxiety by engaging the body’s nervous system, which regulates how the body reacts to stress. In addition, dance/movement therapy increases production of serotonin, a chemical produced by the cells that’s responsible for mood.
  6. Breathe Through It 
    • When you begin to feel anxiety or a panic attack with symptoms such as: sweating, trembling, dizziness, rapid heartbeat and nausea, start to come on, “take a deep breath.” Research shows that slow deep breaths can calm you down and lower your heart rate while quick, shallow breaths can induce or worsen anxiety.
    • One breathing technique shown to reduce anxiety is diaphragmatic breathing. Using your diaphragm for deep breathing requires you to fill your lungs to capacity.
    • Breathe in slowly through your nose so that your stomach rises. Then, tighten the stomach muscles and exhale slowly through pursed lips. Repeat several times.
  7. Limit Caffeine and Alcohol 
    • Too much caffeine restricts blood vessels, which can increase blood pressure and contribute to anxiety. Coping with anxiety also doesn’t mean masking it with alcohol. Studies show that there is a complex relationship between alcohol and anxiety. While some may use alcohol and recreational drugs to mask the symptoms of anxiety (often leading to substance abuse disorder), some studies show that alcohol can interfere with the neurotransmitters that manage anxiety and prevent you from getting a good night’s sleep. Drinking alcohol to cope creates a sort of feedback loop, which makes anxiety worse and can lead to alcohol dependence.
  8. Check Your Medicine 
    • Certain medicines, such as corticosteroids, asthma drugs, and others, can cause anxiety. Ask your doctor if any medicines you take may be a contributing factor.
  9. Eat Healthy Foods 
    • Keeping the body nourished is essential for all functions of life. New research shows that a healthy diet may affect more than just weight and energy levels. One example is a Mediterranean Diet, with lots of vegetables, fruits, beans, lentils, nuts, whole grains, extra virgin olive oil and a moderate amount of fish (especially those rich in omega-3 fatty acids), with limited use of red meat.
  10. Keep a Journal 
    • Keeping a Journal can be a great way to keep track of your progress with anxiety and how your body responds to such situations. Tracing the triggers of anxiety can help you develop the skills to properly respond when put in anxious conditions.
  11. Exercise Regularly
    • Exercise promotes the release of endorphins. These brain chemicals reduce the body’s reaction to pain and stress. They also produce a feeling of euphoria, or happiness, that’s comparable to morphine. Just five minutes of aerobic exercise can kick start these anti-anxiety effects, according to some studies.  Next week in “Health & Exercise Forum” specific details about exercise for anxiety will be presented.

Talk to a Mental Health Professional

Chronic anxiety also can point to an underlying mental health issue. When your anxiety causes extreme distress or interrupts your ability to function on a daily basis, or when panic attacks are frequent and debilitating, it’s important to talk to your physician and ask for a referral to a mental health professional. They can provide a treatment plan, which may include specialized anti-anxiety medicine, psychotherapy, or both.

SOURCES: University of Pittsburgh Medical Center (UPMC); National Institutes of Health (NIH)

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!

Recently, a young woman came to my office with complaints of severe middle and lower back pain. On her first visit, I noticed her beautiful pink purse (big bag) and asked her permission to weigh the bag and discovered that it weighed 8 pounds. While 8 pounds does not seem excessive, the woman weighed 120 pounds and based on the research, would be advised to carry a 2.5-to-3.5-pound bag, (2-3% of her body weight).

A recent study shows that the average weight of a woman’s purse has increased by 38% and now exceeds 6 pounds. Despite technological advances, women have not found a way to simplify their lives, or at least what they think they need in their lives. High tech gadgets have only added weight to a purse already filled to the brim.

On a whim, I decided to ask permission to examine the contents of some of my patient’s purses. A typical purse includes the following: hairbrush, cosmetic bag, mirror, feminine products, keys, and sunglasses, reading glasses, checkbook, wallet, coupons, water bottle, and medications. Additionally, I discovered heavy high-tech products such as cellular phones, tablets, digital Bluetooth earpieces, and rechargers. Lastly, some women add the weight of a book or Kindle to the bag. Studies also show that the larger the bag and stronger the straps, the more items are stuffed in, resulting in a very heavy purse.

It is a pervasive attitude that a woman should never be stranded without her purse full of essentials. So, where is the problem? The problem is that carrying a heavy bag, usually on one side of the body, forces the body to tilt forward and to the opposite direction to compensate. Over time, this change in posture leads to neck, middle and lower back pain.

SIGNS THAT YOUR PURSE IS TOO HEAVY:

Consider the following suggestions to promote healthy use of a purse and prevent injury:

10 Suggestions:

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

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

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

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

Part II of II

Last week’s column was dedicated to Rosie Malloy as we discussed the importance of laughter for health and wellness. In this column, I will discuss one of the most understated benefits of exercise – mental health! 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 by helping reduce depression.

Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that depression scores were significantly reduced in 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 psychotherapy counseling group.

Depression is the most common mental disorder and is twice as common among women as in men. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician. Unfortunately, depression is on the increase in the United States. According to the National Ambulatory Medical Care Survey, in the 1990’s, 7 million visits to a primary care physician were for the treatment of depression. 10 years later the number doubled.

HOW EXERCISE REDUCES DEPRESSION:

According to copious amounts of scientific research, exercise improves health and wellness and reduces depression in two ways, psychologically (mentally) and physiological (physically). 

Psychological or Mental Benefits of Exercise on Depression:

Physiological or Physical Benefits of Exercise on Depression:

HOW TO BEGIN EXERCISE FOR DEPRESSION:

  1. First and most importantly, consult your primary care physician to confirm the diagnosis of depression. 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.
  2. Recognize and fight 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.
  3. 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.
  4. 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 more routine in 3-4 weeks so JUST DO IT !
  5. 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.
  6. Find a friendly, uplifting group of people to enjoy a good walk and talk. This may be more appropriate for people feeling isolated or withdrawn. Others may enjoy the peace and quiet of exercising and meditating alone.
  7. 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!
  8. Make it fun! Mix it up. Walk 3 days, swim or bike 1-2 days, some days alone, some days with a buddy.
  9. BE RELIGIOUS! Be religious about exercise BUT don’t get too compulsive!

SOURCES: British Journal of Medicine: Journal of Exercise and Sports Science

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.comPaul 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!

According to American Association of Retired Persons (AARP), those 50 years old and older are seniors! By this definition, as hard as it is to admit, I am well into senior status and as one, I offer holiday health tips for seniors.

Overindulgence during the holidays causes many seniors to make New Year's resolutions related to diet and exercise. But, this year, I propose that seniors incorporate healthy habits during the holiday season, and you may find that your resolutions are not as hard to keep.

  1. Exercise every day. - Every evening, get out of the house for a walk to view the Christmas lights. Dress for the weather, walk with a companion, and take along a flashlight to illuminate your path. Use caution to avoid falls on slippery sidewalks.
  2. Combine shopping and walking. - In inclement weather, combine holiday shopping with your daily dose of 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.
  3. Remember to take your medications. - 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.
  4. Eat your vegetables and salad first. - Beginning your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge in high-fat, high-calorie foods. Taste your holiday favorites in small amounts to satisfy your palate.
  5. Be aware of drug interactions. - 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. Also, be aware that alcohol should be avoided when taking many drugs.  
  6. Know your food ingredients. - 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.
  7. Practice allergy-free decorating. - 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 with an artificial tree.
  8. Get vaccinated for covid, flu and RSV. - The holiday season includes plenty of kissing and handshaking. Getting yearly vaccinations and frequent hand washing are your best defense for avoiding the covid, flu and RSV. If you are sick with a cold or flu, limit contact with others until you are symptom free, so you don’t infect others.
  9. Get a good night's sleep. - Holiday preparations and helping Santa means less sleep. Do your best to get to sleep 6-7 hours every night and avoid heavy foods and alcoholic beverages before bedtime. If you need to recharge, take a nap during the day.
  10. Spend Time With Loved One’s - The holiday season and throughout the year, be proactive and participate in outings with family and friends. Make a call and invite a loved one over for coffee and eagerly accept invitations. Studies show those who are social and interactive are mentally and physically healthier.

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

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

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

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

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

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

Snow Shoveling as a Form of Exercise:

People at High Risk of Illness Due to Snow Shoveling:

10 TIPS FOR SAFE SNOW SHOVELING:

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

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

Visit your doctor regularly and listen to your body.     

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

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

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

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

Osteochondritis dissecans, also called OCD, is the most common cause of a loose body or fragment in the knee and is usually found in young males between the ages of ten and twenty. While this word sounds like a mouth full, breaking down its Latin derivation to its simplest terms makes it understandable: “osteo” means bone, “chondro” means cartilage, “itis” means inflammation, and “dissecans” means dissect or separate. In OCD, a flap of cartilage with a thin layer of bone separates from the end of the bone. As the flap floats loosely in the joint, it becomes inflamed, painful and disrupts the normal function of the joint.  

Typically, OCD is found in the knee joint of active young men who participate in sports which involve jumping or full contact. Although less common, it is also found in other joints such as the elbow. 

Often, the exact cause of OCD is unknown. For a variety of reasons, blood flow to the small segment at the end of the bone lessens and the weak tissue breaks away and becomes a source of pain in the joint. Long term, OCD can increase the risk of osteoarthritis in the involved joint.

Common causes of OCD:

Some common signs and symptoms:

Diagnosis

To properly diagnose OCD a physician will consider onset, related activities, symptoms, medical history, and examine the joint involved for pain, tenderness, loss of strength and limited range of motion. Often, a referral to a specialist such as an orthopedic surgeon for further examination is necessary. Special tests specifically detect a defect in the bone or cartilage of the joint such as:

Radiograph (X-ray) may be performed to assess the bones.

Magnetic Resonance Imaging (MRI) may be performed to assess bones and other soft tissues such as cartilage, ligaments, muscles and tendons.

Treatment

The primary goal of treatment for OCD is to relieve pain, control swelling, and restore the complete function (strength and range of motion) of the joint. The age of the patient and severity of the injury determine the treatment methods. For example, medications assist with pain and inflammation reduction.

Conservative Treatment

Young patients who are still growing have a good chance of healing with conservative treatment. Rest and physical therapy are the conservative treatments of choice. Rest entails avoiding any activity that compresses the joint such as jumping, running, twisting, squatting, etc. In some cases, using a splint, brace and crutches to protect the joint and eliminate full weight bearing, may be necessary for a few weeks. Physical therapy, either as a conservative or post operative treatment, involves restoring the range of motion with stretching exercises and improving the strength and stability of the joint through strengthening exercises. Modalities for pain and swelling such as heat, cold, electrical stimulation, ultrasound, compression devices assist with treatment depending on the age of the patient and severity of the problem.

Surgical Treatment

Conservative treatment can often require 3 to 6 months to be effective. However, if it fails, arthroscopic surgery stimulates healing or reattaches the loose fragment of cartilage and bone. In some cases if the defect is small, surgery involves filling in the defect with small bundles of cartilage. In other cases, the fragment is reattached directly to the defect using a small screw or bioabsorbable device. More recently, surgeons are using the bone marrow of the patient to repair the deficit by stimulating the growth of new tissue (bone marrow stimulation).

In other cases, a plug of healthy tissue from the non-weight bearing surface of a patient's knee relocated to the defect to stimulate healing (osteochondral autograft transplantation OATS). While there are many surgical options for OCD, an orthopedic surgeon will help the patient decide the most appropriate procedure based on age, size of defect, and other factors.

Prevention

While prevention is not always possible, some measures can be taken to limit risk. For example, if a child playing sports has a father and older brother who had OCD, then it would be wise to consider the following: Avoid or make modifications for sports requiring constant jumping. Cross-train for a sport to avoid daily trauma (run one day and bike the next). Also, do not play the sport all year round (basketball in the fall/winter and baseball in the spring/summer). Seek the advice from an orthopedic or sports physical therapist to learn proper strength and conditioning techniques. Learn proper biomechanics of lifting, throwing, squatting, running, jumping and landing.

Sources: Mayo Clinic

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!

Age-related changes to your body are normal and expected. For example, loss of muscle tone, stiffness in joints, and loss of balance. With effort, some of these changes can be retarded and managed with stretching, strengthening and balance exercises. The brain is no different…it can slow down and lead to memory lapses. However, for most of us, it too can be managed and with a little effort, be kept sharp and clear.

Many experts feel that exercise is the best method to maintain not only physical health but mental health. Regular exercise can prevent the things that contribute to memory loss with age such as; diabetes, high blood pressure, high cholesterol, obesity and stroke.

Specifically, aerobic exercise may be most beneficial. Aerobic exercise is any type of sustained exercise that strengthens the heart and lungs to improve the body’s use of oxygen. This may include running/jogging, brisk walking, cycling, swimming, rowing, and the use of a treadmill, elliptical, stepper or similar device, at light to moderate intensity which requires the use of oxygen to adequately meet the oxygen demands of the body for an extended period of time. The generally accepted time and frequency is at least 30 minute sessions performed three or more times per week. Two 15 minute or three 10 minute sessions are also valuable. For those with back, hip, knee and other lower body pain, consider low-impact or partial weight-bearing activities such as a recumbent bike or stepper or upright bike instead of a treadmill.  

The benefits of a healthy diet are well-documented. Specifically, a Mediterranean-style diet comes highly recommended. It focuses on plenty of fruits and vegetables with fish instead of red meat and olive oil instead of butter.  Researchers found people who closely adhered to a Mediterranean diet were nearly 20% less likely to have thinking and memory problems.

Exercise your brain just as you do your body. Make time each day to challenge your brain. Learn something new to keep your mind sharp. Play cards, read a book, do crossword puzzles or other word games, take a class or learn play a musical instrument.

Human beings are social animals and in the right setting, we stimulate and challenge each other. Join a book club, fitness center, or a community center. Consider volunteering, taking an art or photography class. Social interaction can prevent isolation which can lead to depression and depression is associated with dementia.

Without adequate sleep, attention and concentration is compromised. Studies show that those who have normal restful sleep outperform those who are restless and sleep deprived. Some tips for better sleep are: avoid big meals before bed, keep a consistent sleep and wake up time, avoid nicotine, caffeine and alcohol close to bedtime. “

Consider an afternoon “power nap!” Recent studies show that an afternoon nap was rejuvenating to the mind and body. Participants improved on mental skills such as memory, calculation, orientation and attention.

Cortisol is the hormone associated with stress. Recent studies have found that elevated cortisol levels were associated with poorer overall cognitive functioning, including memory, language, and processing speed.

Try yoga, massage, breathing techniques to relax. Progressive muscle relaxation (PMR) techniques can be very effective…try it on YouTube!

Smoking is clearly one of the worst things you can do to your body AND MIND! Smoking can lead to early memory lose in part due to small strokes in the brain. Do whatever it takes to quit; nicotine replacement, medication, or counseling.

There are many medical conditions and medications associated with memory loss. Regular medical check-ups can prevent, diagnose and treat some of these conditions such as; depression, diabetes, thyroid disease, vitamin deficiencies, and drug interactions or side effects. For example, sleep aid and anxiety drugs associate with memory loss.

In addition to common tricks such as word association, sticky notes, use your smart phone for appointments and reminders. If you don’t know how to use a smart phone, it is time to learn something new…and that is a healthy brain activity!

SOURCES: WebMD; Harvard Health

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

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

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

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

Provisional Bag/First Aide Kit

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

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

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

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

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

Clothing:

Accessories:

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

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

MARATHON SUPPLY BAG – For those with support team

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

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

Don’t Forget:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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