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

• Osteoarthritis – is also known as degenerative arthritis. It is the most common form of arthritis in the ankle. It is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the ankle 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.
• Rheumatoid Arthritis (RA) – is a form of inflammatory arthritis in which many joints of the body can be affected. It is very destructive to the cartilage, joint and tissues surrounding the joint. It can occur at any age and usually affects multiple joints.
• Post-Traumatic Arthritis- is a form of arthritis that can occur following a trauma or injury to the ankle. It is a form of osteoarthritis that is triggered years after a fracture or ligament injury. Those of you who know Jim Gouldsbury, Jr., a local letter carrier for the United State Postal Service, may know the effects of prolonged weight-bearing on injured limp. Jim suffered from an ankle injury several years ago and worked in a job that requires constant weight-bearing. He is now suffering from traumatic arthritis at a relatively young age.

Symptoms of Arthritis

• Pain - usually occurs gradually. However, a sudden onset can occur, especially associated with a sudden twist or fall. Pain is often worse in the morning and improves with movement. Changes in the weather or barometric pressure can cause pain associated with arthritis.
• Swelling – can swell after increase activity at the end of the day.
• Stiffness – is more noticeable in the morning and improves with movement. However, overuse can create more pain and swelling and lead to stiffness also.
• Weakness – from disuse associated with pain and can lead to occasional buckling of the ankle when walking or climbing steps.                 
• Loss of Function- is associated with pain, swelling, weakness and stiffness which limits walking, stair climbing etc.

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.

• Anti-inflammatory Medications: such as aspirin, acetaminophen or ibuprofen to reduce pain and swelling in the joint. 
• Orthopedic Physical Therapy: such as heat, cold, ultrasound, electrical stimulation, joint mobilization, range of motion exercises, strengthening exercises, partial weight bearing aerobic exercises.
• Activity Modifications: such as eat well and lose weight, doubles tennis instead of singles, sitting or lying leg exercises instead of standing, walk instead of run, soft bed treadmill instead of hard surfaces, avoid squatting, kneeling, and bending.
• Supportive Devices: such as ankle sleeves, light bracing, orthothics (inserts), use good running shoes for exercise and walking, use good quality supportive shoes for work/dress.

Conservative But More Aggressive Treatment

• Corticosteroids: stronger anti-inflammatory medications than those above which are injected directly into the ankle joint.
• Viscosupplementation: a type of synthetic fluid, injected into the ankle joint and designed to imitate the joint fluid of the ankle to promoted healing and mobility.
• Glucosamine and Chondroitin: supplements taken orally to control the pain of osteoarthritis and promote healing.
• Rheumatoid Medications: specifically designed  for RA

Surgical Treatment

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

• Arthroscopic Surgery: uses a scope to clean and repair damaged tissues inside the ankle joint.
• Fusion Surgery: the ankle bones are surgically fused together to limit movement of painful joint.
• Total Ankle Replacement: replaces severely damage joint surfaces with metal and/or plastic.

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:

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:

• Get Help – Do not hesitate to get help from a mental health care provider if you need it. A professional can help you develop goals, techniques and strategies to deal with the stress or depression of chronic disease.
• Support Groups – Many people benefit from the conversation of others who share similar problems. Much can be learned from the experience and mistakes of others. Some people feel that they can gain satisfactory support from their family, while other immerse themselves in reading and writing poetry or listening to favorite music.
• Counseling – Some people with MS report a “fear factor” due to the unknown. Also, the dramatic change from being health and active to being the “other guy” is difficult. Psychological or spiritual counseling can be very productive. Return to your spiritual roots or find a new path toward peace.
• Healthy Lifestyle – eat healthy by consuming a well-balanced diet low in fat and sugar. Also, limit alcohol and caffeine consumption. The Cleveland Clinic recommends drinking eight 8-ounce glasses of water per day.
• Take Control – Try to control the things that you have control over. Get plenty of rest. When you get run down and stressed out, you are more vulnerable to a “flare-up” of symptoms. Modify your home and work environment to suite your physical and psychological needs.
• Exercise & Stay Active – Just because you have a chronic disease does not mean you have to avoid physical activity. It does mean you must be intelligent about the time, place, intensity, type and frequency of exercise and activity.

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:

• Never Overdo It -  With MS, less is more. If you overstress, overwork and become overtired, you will notice a decline in function. Once you find your comfort zone, stay in it.
• No Gain With Pain -  With MS, if you over stretch or over exert you WILL regress. Remember, the messages from your brain are not traveling through your nerves normally. STOP if you feel ill, weak or have pain.
• Warm Up/Cool Down – This is the safe way to perform any exercise program
• Safe Environment – Exercise in a safe area. Avoid wet floors, throw rugs, and poor lighting.
• Rail/Ramps – These simple devices are essential if you have a balance/coordination problem.
• Prosthetic/Orthotics – If you have foot drop or a weak leg when walking you may need a custom made brace to offer support and prevent injury.
• Variety – Keep you exercise program fun by having variety. Swim, walk, stretch, lift. Try yoga or tai chi. Use a stepper, recumbent bike or treadmill.
• Avoid Getting Overheated – MS symptoms can worsen in the heat. Avoid exercise and activity in the direct sun, between 10 am and 2 pm and drink plenty of fluids.
• Aerobic Exercise – 3 to 4 times per week for 30 minutes but not to fatigue or with pain. (swim, bike, walk)
• Weight Training – 2-3 times per week using light weights and 10-15 repetitions but not to fatigue or with pain. (use simple 2-3 pound dumbbells)
• Balance/Coordination Exercises – to complete your fitness program you may benefit from balance and coordination exercises. If you have poor balance these exercises will require assistance.

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!

• Structure House - a residential weight loss center in Durham, North Carolina. This all-inclusive health resort promotes physical, nutritional, and behavioral principles for helping guests achieve their wellness goals. Packages at Structure House can be purchased for weekly, monthly, or longer stays.
• Skyterra Wellness Retreat - an all-inclusive fitness resort and wellness retreat designed to help guests lose weight, gain muscle, and feel-better. Located in Pisgah Forest, North Carolina, Skyterra offers year-round packages in their lodge-style accommodations which include all meals, fitness classes, activities, and education.
•  Live In Fitness - Originally located in Long Beach, California, “Live In Fitness” has temporarily moved to a new location in Scottsdale, Arizona. It is an all-inclusive fat camp and promotes weight loss results rather than spa services.
• Weight Crafters - a popular weight loss camp located in the Tampa-St. Petersburg Florida area. The all-inclusive retreat program is focused on helping guests relieve stress, maximize wellness, lose weight, and improve their physical fitness
• Pocono Trails Adult Fitness Camps - offers fitness camps for young adults, moms, and families. Their young adult camp is designed for men and women ages 18 to 25. While the mom and family camps are open to those respective groups each summer. All camps take place at the Pocono Trails location in Reeders, Pennsylvania, along with their standard Camp Pocono Trails weight loss camp and Internet Habit Reversal Camp for kids and teens.
•  Biggest Loser Resort - a fitness resort in Java Center, NY. While the resort is named after the popular reality TV competition, the program itself is designed around healthy weight loss, rather than dramatic, short-term results.
• The Biggest Loser Resort places a major emphasis on exercise and calorie-controlled meals, with programs designed to accommodate multiple fitness levels.
• Hippocrates Health Institute - is located at the Hippocrates Health Institute in West Palm Beach, Florida. At this wellness resort, there is a heavy emphasis on diet and nutrition. Fitness may be a secondary focus, but you will still expect to exercise 4 hours every day, with a mix of strength and cardio classes.

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 I 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.

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 fitness retreats typically have an extensive workout plan as part of their standard program. Many resorts and retreats offer daily hiking, in addition to cardio and strength classes and assorted 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 will be 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, you 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.

Positive Results

Fitness resorts have been found to be effective for most attendees. 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.

While some people report losing 1-3 pounds-per-week at a fitness resort, others experience much more success. Exactly how much you will lose will be dependent on a wide variety of factors, including the duration and intensity of your exercise and activities and the calories you consume. Inherently, men tend to lose weight more easily than women, and younger people typically have an easier time shedding pounds than older people.

Ideally, for long term success, a fitness resort program should be a part of a healthy lifestyle, rather than an absolute weight loss goal. Be aware that many “spas and wellness centers” entice people with lavish facilities in a beautiful environment but mostly offer passive modalities such as massage, meditation, acupuncture, manicures, pedicures and facials. While these modalities have value, if your goal is jump start on weight loss and physical fitness, a fitness resort may be a better option.

Frequently Asked Questions…“Will they starve me?” “How intense is the exercise?” “Will I be intimidated?”

Most fitness resorts are not “diet retreats” or painful “boot camps.” With a little effort, you can easily find the right fit for you. You will not starve! While you need to limit caloric intake, you also need enough energy for the 3-6 hours of exercise and activities (swimming, biking, hiking, Zumba, Yoga) offered. There is no need to be intimidated as most attendees are like-minded people with the same goals and needs. A good resort will not only provide the right amount of calories and exercise for your goals but also educate you how to prepare meals and engage in proper exercise once you return home.

A Typical Day at a Fitness Resort

According to FitStays, most fitness resorts offer a set schedule and a camp-like experience for adults with three meals every day, usually prepared by expert nutrition staff and/or dietitians, designed around healthy foods. A typical morning begins with extended cardio exercises, such as a run, bike or hike. The afternoon may have more intense exercise classes such as strength training classes as well as more fun activities such as sports and games. Educational classes are offered throughout the day, so you can carryover the lessons from your fitness resort experience when you return home. Evenings are usually lighter to allow for leisure, rest, or spa services, which are also offered at many resorts.

NEXT WEEK: FITNESS RESORTS - PART II – A typical day at a fitness resort, recommended length stay, cost and top 20 recommended resorts.

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, please check out our exercise forum!

New Year’s Resolutions are very predictable. While most New Year Resolutions are health oriented, I purport that a healthy mind, body and spirit requires a healthy lifestyle. Interestingly, the ten most popular resolutions listed below, all have an impact on a healthy life.  

1. More Time With Family And Friends
   • Polls repeatedly show that one of the most consistent resolutions for the New Year is to make more time to spend with family and friends. Moreover, research shows that the comfort and camaraderie of these people whom we love is important to our health and well-being.
2. Begin or Improve a Fitness Program
   • The benefits of regular exercise is no longer anecdotal, it is factual. Daily exercise, even in small doses, has been associated with more health benefits than anything else known to man. Studies clearly demonstrate that it reduces cholesterol and coronary artery disease and the risk of some cancers. Also, it increases longevity, helps achieve and maintain weight loss, enhances mood, lowers blood pressure, and even improves arthritis. In short, exercise keeps you healthy and makes you look and feel better. If done properly, there is no down side. So, make this year the year to do it!
3. Adhere to a Weight Loss Plan
   • Recent studies report that more than 66 percent of adult Americans are considered overweight or obese. As a result, weight loss is one of the most popular New Year's resolutions. However, adhering to a weight loss program is not easy. It requires many things, including, setting reasonable goals and staying focused. Often, professional help is required. While this may be one of the most difficult goals to attain, the ultimate reward and value is well worth the effort.
4. Stop Smoking
   • Second only to losing weight, this resolution, while extremely difficult, is another life-saving goal that must be attempted. Studies report that smokers try and fail four times on average before they are successful. SO, KEEP TRYING! Get help. Talk to your physician about using over-the-counter or prescription nicotine replacement therapy and proven quit-smoking aids. Consider smoking cessation classes, support groups and hotlines in addition to the meds. This is one goal that is worth the effort.
5. Find Your Smile
   • Due in great part to our hectic and stressful work and family demands, the United States is home to millions of people requiring the use of mood elevators and antidepressants. As a result, it is important to learn what really makes you happy in order to FIND YOUR SMILE. It requires the balance of a healthy mind, body and spirit. It might be a walk in the snow, taking dance classes or a trip to the spa. One hint, it is often something simple and inexpensive.
6. Moderate Drinking
   • This is one tip for a healthier New Year that I expect to receive plenty of flack about! But, I would be remise if I did not mention this potentially harmful habit. While many people use the New Year as an incentive to finally stop drinking, most are unable to adhere to such a rigid goal. Studies show that moderate drinking can offer many health benefits such as lowering cholesterol and coronary artery disease but that is defined as one or two 8 ounce drinks per day and red wine is preferred. However, many heavy drinkers would do well to taper off to a moderate level. Consider participating in “Dry January!” For those with a problem and have decided that you want to stop drinking, there is a world of help and support available such as Alcoholics Anonymous. There are also a number of treatment-based programs, as well as support groups for families of alcoholics.
7. Get Finances in Order
   • This is one tip that few consider being health related. However, serious stress from financial problems affects millions of Americans every day. This cumulative stress can be very harmful to your health and can be lessened by initiating a plan. Get professional help and learn how to downsize and reevaluate your real needs…less toys with less stress for a longer life!  
8. Try Something New
   • There may be no one thing more important to gaining a new perspective on life that to have learned something new. It could be as drastic as returning to school to prepare for a career change or as simple as learning to play bridge. Have you vowed to make this year the year to learn something new? Take a course at local college or read a new book. Visit the Everhart Museum or take the free tour of the Scranton Cultural Center. It will enrich your life and make you a more interesting person. Most local colleges and universities offer distance and adult education programs.
9. Service To Others
   • Service to others is service to you! There may not be anything more gratifying than providing a service to others in need. Volunteerism makes you a better and healthier person. It fits into any schedule. Donate clothes, time or resources. Locally, we have many charitable causes in need of help: Be a “Friend of the Poor,” or serve lunch at St. Frances Soup Kitchen.
10. Get Organized
    • The goal of organization, like the goal of financial order, has similar health implications because it eliminates tremendous stress. There are many books and websites that offer suggestions on how to organize just about anything in your life. For this reason, I love my iPhone – there’s an App for that!

SOURCE: A. Powell, About.com Guide

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!

Holiday Spirit Requires a Healthy Mind, Body, Spirit!

Happy Holidays! It is at this time of year that we celebrate life with great hope and faith. People of many faiths take time to reflect, respect, and resolve. Christians celebrate Christmas, the miraculous birth of Christ, the Son of God, and the Messiah. Jews celebrate Chanukah, the miraculous festival of lights, when one night’s oil provided enough light and safety for 8 nights. Both major faiths promote healthy lifestyles for the mind, body and spirit. These faiths are grounded in hope, faith, love and peace. It is no surprise that studies repeatedly demonstrate that faithful and spiritual people live longer and healthier lives! At this turbulent time in the world, it is important to note that people of all faiths benefited equally!

With this in mind, I purport, that to be truly healthy, one must have faith because complete health is multidimensional. Socrates preached this message to his students thousands of years before Christ. One must have a healthy mind, which requires intellectual stimulation with attainable goals related to education and intellect. One must have a healthy body by eating well, engaging in physical activity and have attainable goals related to his/her body. Likewise, one must have a healthy spirit with faith, hope, prayer and meditation, comrades and counsel, and set attainable spiritual goals.

5 Health Benefits of Religion and Spirituality….(health.com)

How being religious or spiritual has been shown to benefit your mind, body and spirit.

1. Healthy Blood Pressure

High blood pressure (hypertension) can lead to heart disease and stroke, which are the leading causes of death in the United States, according to the Centers of Disease Control (CDC). It affects 1 in every 3 adults and only half of these people have their blood pressure under control. Well, religion and spiritually may help …

The health benefits of religion or spirituality are well documented.  One study conducted at Duke University Medical Center on 4,000 subjects, older adults who described themselves as religiously active were 40% less likely to have high blood pressure when compared to those less active. Moreover, they were surprised to find that those who described themselves as spiritual rather than religious also were less likely to develop high blood pressure.

2. Greater Sense of Satisfaction

Research also indicates that religious people are more satisfied with their lives than those without faith. A sociology study determined that high satisfaction among church goers may be due to the strong social bonds that are developed within a religious congregation. Regular church attendees see the same people weekly and often more often, when participating in rewarding and gratifying church-related volunteer work.

3. Greater Tolerance for Adversity

In an impressive study published in the Journal of the American Medical Association, researchers interviewed 345 late-stage cancer patients to assess their spirituality as it related to their illness. 88% stated that they were religious as it related to their coping mechanisms. It was determined that those using religion for coping demonstrated a 7.4% rate of resuscitation as compared to 1.8% for those not using religion as a coping mechanism.   

4. Stronger Immune System

According to a Duke University study of 1,718 older adult participants, those described as “highly spiritual” were 50% less likely to have high levels of anti-inflammatory proteins that weaken the immune system and have been linked to some cancers, viral infections and autoimmune diseases. The outcome was similar for those who attend religious services at least once a week.  

5. Greater Longevity

Those who attend religious services more than once per week are found to live and additional 7 years when compared to those who never attend services. Again, researchers feel that the social benefits of a belonging to a strong religious community may be a large part of the associated longevity. Additionally, the lifestyle of religious people is often healthier: members of these communities rarely engage in risky and unhealthy behaviors such as smoking, excessive drinking, indiscriminate, unprotected sex, etc. 

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 in Scranton and Clarks Summit and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!

Every December, as we finish the last of the leftover turkey, patients begin to talk about the holiday season and gift shopping. This conversation invariably leads to suggestions for gift ideas related to health, exercise and fitness. The suggestions below offer a wide variety of fitness related gifts, some expensive and frivolous and others reasonably priced and practical. I hope it makes your shopping a little easier. 

1. Dry Tech Exercise Clothing

Dry Tech is the best thing that has happened to exercise apparel since “jogging suit” was donned by all the “cool dudes” in the 70’s and 80’s . It is has great style and even better function. The specially made material is light weight and breathable and wicks moisture from the skin to the outer layers. Therefore, it will not get heavy with sweat which can weigh you down and cause friction with your skin which can lead to chaffing and blisters. The following exercise apparel is now available in Dry Tech:

• Short sleeve tee with a matching long sleeve shirt
• Shorts and compression under shorts
• Colorful socks

NOTE: Shoes are a very important aspect to safe and comfortable exercise but are unique for running and other specific sports (tennis, basketball). Sneakers may be too difficult to buy for someone else. A gift certificate to an athletic shoe store (Scranton Running or Dick’s) may be a better choice.

2. Trekking Poles

For walking and hiking enthusiasts, trekking poles can be the perfect gift, especially for those over 50 and when on uneven terrain or inclement weather. The research is compelling…less stress on the lower back, hip, knee and ankle, as well as improved balance and safety. Leki, Black Diamond, and Trekology are good name brands while LL Bean and REI are reputable companies.

3. Exercise Mat

An exercise mat is helpful if you decide to exercise at home. Also, a required equipment for participating in yoga or Pilates classes is a mat.

4. Hand-Held Dumbbells and Sandbag Leg Weights

These are essential for those interested in home exercise. For the average beginner, 3-5-8-10 pound (two of each) weights will be adequate.  Dumbbells are good for shrugs, biceps, and triceps, bent over rows and lats, and lunges. Incremented and stackable dumbbells are also available by Bowflex SelecTech 552 (5-52 pounds for $299). and NordicTrack $189. Sandbags, which can be purchased as graduated weights from 1 to 5 pounds, are good for leg extensions, hamstring curls, hip hikes and hip abduction.  

5. Resistance Bands

These cheap and versatile bands are also essential for a home program. The bands come in different colors to represent the amount of resistance with yellow being the easiest and black the most difficult. They are useful for upper and lower body. For specific band exercises visit a previous column in “Health & Exercise Forum” at The Times Tribune or www.mackareyphysicaltherapy.com

6. Aerobic Equipment

• Bike – Plus: upright or recumbent bikes are an effective and affordable method of aerobic exercise. It is very useful for those suffering from lower back, hip, knee or ankle/foot pain because it can be performed with partial weight bearing. Minus: must be able to bend your knees at least 110/115 degrees.  
• Treadmill – Plus: great for those who love to walk or run and need and indoor alternative in inclimate weather. Minus: large and expensive
• Elliptical – Plus: a good alternative to the pounding of running. Minus: expensive, large, and require full weight bearing. 

NOTE:  Peloton, NordicTrack, SoulCycle are some of the companies that offer interactive exercise programs (usually through an internet subscription) for aerobic exercise using bikes, treadmills, ellipticals or rowing machines.

7. Fitness Club Membership

• Location is important for convenience. The type of gym, such as, cross fit, exercise machines vs. traditional free weights, must be considered. Equipment and other services such as personal trainers, swimming pool, sauna, hot tubs, Pilates, and yoga classes are also important to some.
• If the person you want to gift already belongs to a gym, consider purchasing a gift certificate for massage, Pilates, yoga, spin class or aquatic exercises at their gym (which usually costs extra) or another studio.

8. Personal Trainer Gift Certificate or Home Virtual Trainers

This can be an opportunity for someone to either get the proper advice from a professional to begin a fitness program or to revamp and tune up an old stale program. Word of mouth is a good way to find a reputable certified trainer.

Peloton – ($2,495 bike, $3,495 treadmill); Mirror Exercise – ($1,495); Tonal ($3,995.) FightCamp – ($1,219.); Forme Studio ($2,495.)

9. Electronic Fitness Monitors or Wearable Tech Monitor

These devices use GPS technology to help the user track their activity to get more out of their exercise routines. They monitor activity, heart rate, distance, location, calories, and more. Some examples are:

• Pedometers – clips on a belt – best for tracking steps - tracks steps taken by walkers and runners and translates it to miles. Some also translate calories expended. Suggestions: “SteppyFit,” “ExeSteps” or Timex” $5-$25.
• Activity Trackers – worn as wrist band – best for tracking general fitness, calories and sleep patterns 24/7. It can be connected wireless to your cell phone. Suggestions: “Fitbit” $119 to $149. “Garmin” Vivoactive 3  $159. “Apple” Series 8.
• Running Watches – are worn as a wrist watch – best for timing workouts and counting laps - a rugged, waterproof watch to be worn while running to track laps, splits, countdown, intervals and training logs. However, it does not track distance, speed or heart rate. Suggestions: Timex Ironman $38.97. Garmin Forerunner 45S $129.
• Heart Rate Monitors – worn as a chest-strap or wrist strap – monitors your heart rate in real time.  Suggestions: Garmin Vivofit 4 $62.; Polar H10  $89.95, Apple Watch Series 8
• WHOOP – this next generation fitness and health monitoring is smaller and faster with new biometric tracking, including skin temperature, blood oxygen, and more. Whoop.com $30/month.
• Weight Loss – Suggestions: “Noom,” “Lose It”; “WeightWatchers,” “My Diet Coach” - helps you keep a journal, calculates calories for free. The App gives calorie credits if you exercise and provides ongoing feedback to help you stay on track to attain your optimal weight. Basic Apps are free and more advanced versions are under $10.
• Activity Monitor – Suggestions: “Fitbit” “Apple Watch,” “Garmin,” “Endomodo”; “Human” – uses GPS to track your every step when you go for a hike, run, fitness walk, touring walk at Disney, or bike ride on trails, ski cross country or downhill. It will calculate distance, speed, location, total time and total calories

10. Nutritional Counselor Gift Certificate

Sometimes you need professional help to get started and stay focused. Just as with a personal trainer, a qualified and licensed nutritional counselor will assist you in establishing a safe and effective program to meet your nutritional and dietary goals. Again, ask around to see who has a good reputation or who may be a good fit for the recipient of your gift.

These gifts can be purchased at most local sporting goods stores or on-line.

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, located in Scranton and Clarks Summit, and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, check out our exercise forum!

The “First Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate be grateful for the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. This year, I am also thankful for the dedicated scientists who developed the COVID 19 vaccination so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is, not only reflective and cleansing; it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful

1. Being Grateful is Contagious!
   • Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
2. Being Grateful Improves Physical Health
   • Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
3. Being Grateful Improves Psychological Health
   • Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
4. Being Grateful Fosters Empathy and Reduces Aggression
   • Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
5. Being Grateful Promotes Better Sleep
   • A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
6. Being Grateful Improves Self-Esteem
   • When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
7. Being Grateful Improves Mental Strength
   • Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion:

Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

Visit your doctor regularly and listen to your body.     

 Keep moving, eat healthy foods, exercise regularly, and live long and well!

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!