Tuesday, May 12, 2015

How Can I Prevent Runner's Trots?

Michael Cordas, Jr., DO,
Runner’s trots, also known as runner’s diarrhea, is the urgent need to have a bowel movement mid or
immediately after a run and is common among long distance runners. The causes of runner's trots are still debated but changing your diet can help prevent it. Try these changes below to help prevent this from occurring to you during a run:
  • At least one day before running, limit or avoid high-fiber and gas-producing foods. If you run every day, eat those foods after you run.
  • At least one day before running, limit or avoid artificial sweeteners.
  • For three to six hours before running, limit or avoid caffeine and high-fat foods.
  • For at least two hours before running, don't eat anything at all.
  • Before, during and after running, drink plenty of fluids. Dehydration can lead to diarrhea. Avoid warm liquids, however, which can speed food through the digestive tract.
  • While running, use caution with energy gels and energy bars. In some people, these products can contribute to diarrhea.
  • Wear comfortable, loose fitting clothing when you run. 

Consider reducing the intensity or distance of your runs until the diarrhea improves. If these suggestions don't help, consult your doctor for additional suggestions

If you have an injury that is preventing you from doing your exercises, sport or any type of activity, please contact the PinnacleHealth Sports Medicine Center: www.pinnaclehealth.org/sportsmed

Monday, May 4, 2015

The Difference Between Overtraining and Overuse

Blog contributed by
Dr. Yurkewicz

Overuse injuries in runners happen in part due to poor mechanics, but overtraining also has a role in developing injuries. Most runners who are experiencing problems, are training inappropriately. Your body needs time to recover after a strenuous workout. If you continue to push without having a period of rest, it will lead to further breakdown of your body and eventually have problems with injuries.

Many of the overuse injuries that were described in the newsletter can be avoided with proper training practices. The goal of a training program is to allow for variation in intensity, frequency, and duration of the activity, while having periods of rest in between. When first starting out, slowly progress into more intense workouts.

Signs of overtraining can be decreased performance, easy fatigability, overuse injuries, mood disturbances and others.

If you develop any these symptoms, a full work-up ( including blood work) is often needed to make sure nothing metabolically is wrong. That combined with a decrease in  intensity of your workouts for 2-3 weeks, can help point to the cause.

The best prevention is to have varied workouts, and allow adequate rest periods in between workouts. Most “athletes” can exercise 4-5 days a week, giving them adequate rest periods. Exercising 7 days a week is not recommended. Treatment for overtraining is rest, which can be frustrating, thus take the proper steps to avoid it.


Proper stretching before and after exercise is very important, focusing on static stretches after a light warm-up. Most advise against dynamic stretching at this point.

Also when running long distance in high amounts, it’s important to make sure the shoes are well fitted, and that you are replacing them every 400 miles.

Another aspect that is often overlooked in runners is proper quadriceps and hamstring strength ratio. For example, if you can lift 100 lbs with your quadriceps during knee extensions, you should be able to lift 70 lbs with your hamstrings during knee flexion. Thus a ratio of 70% is a goal. This provides the best strength and stability around the knee joint itself.

As far as biomechanical aspects go in regards to proper running technique during the phases of heel/foot strike and push off, any abnormalities may present themselves as an overuse injury often involving the knee, hip or back in runners. A thorough evaluation, possibly including a dynamic gait analysis may need to be performed, as orthotics may be needed to correct the abnormality present. This in turn will lead to proper force distribution while running and prevent the overuse injuries.

If you have an injury that is preventing you from doing your exercises, sport or any type of activity, please contact the PinnacleHealth Sports Medicine Center: www.pinnaclehealth.org/sportsmed

Monday, March 9, 2015

Benefits of Excerising

Michael Yurkewicz, DO
If you aren’t in the right physical condition for the exercise you’re about to undertake, you could do your body more harm than good by jumping into a physical challenge. Whether you are a younger or older athlete, talk with your doctor before starting a new program. An evaluation may be in order to make sure you’re in the right shape to begin.

A sports medicine evaluation will look for subtle underlying cardiac and musculoskeletal disease that could be problematic for the athlete.

For the cardiac evaluation, the first step is to identify risk factors for cardiovascular disease. There are several factors including a family history of heart disease, smoking, hypertension, high cholesterol, impaired glucose tolerance, obesity, and a sedentary lifestyle. All of these can increase one’s risk for heart disease and thus increases risk of death during exercise. 

A cardiac evaluation helps to prevent those athletes with underlying cardiac disorders from participating in activities that could increase their risk for sudden cardiac death.

The American College of Sports Medicine stratifies adults into low, moderate and high-risk groups, and recommends testing based on which group they fall into.

Low Risk- Men <45years old and women <55 years old who are asymptomatic and have no more than 1 risk factor
Moderate Risk- Men >45 years old and women >55 years old who have 2 or more risk factors
High Risk- Any adult with any cardiac symptoms as above, including history of peripheral vascular disease or stroke, as well as underlying pulmonary
disease (COPD, asthma), or metabolic disease (diabetes, thyroid disorders)

If you have cardiac symptoms such as chest pain with exercise, shortness of breath with exercise, dizziness/syncope with exercise, or palpitations, your doctor may recommend a prompt EKG and echocardiogram; for the very young, a visit to a pediatric cardiologist may be in order.

The extent of the evaluation depends on the athlete’s age and underlying medical problems. Diagnostic testing may be used in certain older athletes prior to starting a regimen given your history and physical exam findings. For some, testing can include exercise stress testing.

Based on the findings of your evaluation, your physician will decide which type of exercise would be best and may recommend lower intensity exercise or moderate intensity exercise. Most doctors would advise against vigorous training as we age.

It is important to keep in mind that once started in a program, if any new symptoms develop, including unexplained decline in performance, stop the activity and seek prompt evaluation by your physician. 

Friday, January 23, 2015

Don’t let your family hibernate this winter!

Michael Cordas, Jr., DO,
The winter time can make it challenging to maintain an active lifestyle. But the cold weather shouldn't prevent you and your family from staying active. The Center for Disease Control (CDC) states that children and adolescents should do 60 minutes (1 hour) or more of physical activity daily. These guidelines are easy to meet even in the winter. There are many ways for you and your family to stay active.

Here are some ideas of how to keep you and your family active this winter:

  • Encourage kid to get moving inside. You don’t need a lot of space to exercise inside your home. Try push-ups, sit ups, jumping jacks and jumping rope for a good cardio work out.
  • If your kids are hooked on electronics especially during the winter, use technology to your advantage. Challenge your kids to find online exercise videos for their age and skill level.
  • Visit your local library and see the exercise videos they offer.
  • Check out your local gyms and fitness centers for kid-friendly classes and activities and even on-site child care.
  • Check out your local indoor facilities and YMCA’s for a list of pick-up and recreational sports leagues, camps and activities for all ages. Many offer pick-up games, rec leagues, lessons and camps for basketball, soccer, swimming, lacrosse, football, wrestling and even ice skating.

 Learn more about the PinnacleHealth Sports Medicine Center.

Wednesday, December 31, 2014


Michael Yurkewicz, DO
Adequate hydration prior, during and after exercise is of upmost importance to avoid potential complications of dehydration. As we exercise our body produces heat, in order for our body to dissipate the heat created, we begin to sweat, thus losing water. This loss of water can lead to serious complications if one is not properly hydrated, replacing what is lost. Such complications can include muscle breakdown, and kidney failure. Studies have been done in collegiate athletes, weighing football offensive lineman before and after practice. They found that during vigorous exercise they would lose 2-3 lbs. of water weight. Thus they found and began emphasizing replacing this water loss after practice to equal out the amount lost.

For every 1lb lost, one should consume 16oz of fluid, preferably water. Do not wait until you feel thirsty, as thirst is a late manifestation, and it could be too late. And remember to take frequent breaks to allow for hydration during exercise.

Adequate hydration is important regardless of the activity, but when combined with environmental factors such as high temperature, its importance is greater. When the temperature and humidity rise, our body’s natural ability to dissipate heat becomes impaired, this we are unable to get rid of the extra heat produced by our working muscles. This can lead to mild symptoms such as cramps, and heat exhaustion, to potentially devastating heat stroke. Symptoms can include but not limited to, muscle cramps, fatigue, dizziness, mental status changes, and elevated rectal temp.

If symptoms do arise, promptly remove from environment, orally rehydrate, apply ice to head, under arms and groin, and get to medical facility for prompt evaluation.

Michael Yurkewicz, DO
PinnacleHealth Sports Medicine Fellow

Friday, November 14, 2014

Sports Medicine Fellowship Program

Michael Yurkewicz, DO

Dr. Yurkewicz is board certified in Family Practice and is currently completing his one-year Primary Care Sports Medicine fellowship at the PinnacleHealth Sports Medicine Center.

Dr. Yurkewicz received his Medical Degree from Lake Erie College of Osteopathic Medicine.  He completed his Family Practice residency through PinnacleHealth and during his third year he was the chief resident.  Dr. Yurkewitzh received his undergraduate degree from Pennsylvania State University, The Behrend College, where he obtained a B.S. in Biology.

Over the past three and half years, Dr. Yurkewicz has covered many sporting events, including local high school football games, the Keystone State Games, Lebanon Valley College Ice Hockey team, Lacrosse and Injury Clinic, as well as conducting numerous pre-participation sports physicals. When not at the PinnacleHealth Sports Medicine Center, he is the team physician for Bishop McDevitt High School, under the direction of the Sports Medicine Program Director, Dr. Michael Cordas. 

Friday, October 17, 2014

2014 Football Season Support from Primary Care Physicians

The Pinnacle Health Sports Medicine team is excited to kick off the 2014 High School football season.  We would also like to extend a special thank you to all the orthopedic and family medicine residents who assist at the local high school football games.

Primary care sports medicine attending physicians include:

Michael Cordas, DO

Dr. Cordas is board certified in Family Practice and Sports Medicine and is the chairman of the Medical Advisory Committee of the Pennsylvania Interscholastic Athletic Association, a member of the Pennsylvania Athletic Commission and an advisory member of the National Athletic Trainers Association.

 Along with this background, he is medical director of the Primary Care Sports Medicine Fellowship program at PinnacleHealth and is a Fellow of the American Academy of Family Physicians and of the American Osteopathic Academy of Sports Medicine. Dr. Cordas was also the team physician for Penn State’s football and wrestling teams.

 Dr. Cordas adds extensive Sports Medicine experience to the PinnacleHealth orthopedic team that has been treating athletes from the weekend warrior to the professional level for many years.  PinnacleHealth surgeons perform more joint replacements than any other hospital in our expanded region and are in the top 1% of volumes for the state.

Amy  Zellers, DO
Dr. Zellers graduated magna cum laude from Lebanon Valley College in 2000 with a B.S. in Biology.  She attended medical school at the Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania and completed her residency training in Family Practice at Pinnacle Health systems in Harrisburg, Pa.  She also completed PinnacleHealth System’s primary care sports medicine fellowship and is board certified in both Family Medicine and Primary Care Sports Medicine.  She is a partner in Family Practice Center, PC and maintains an office practice in Steelton, Pa.  She is on staff at PinnacleHealth Systems and serves as the Assistant Program Director for PinnacleHealth System’s family medicine residency and primary care sports medicine fellowship.

Currently Dr. Zellers serves as the Chairman of the Department of family medicine for PinnacleHealth.  She also works with the PinnacleHealth Sports Medicine Institute and the PinnacleHealth System’s Spine Center of Excellence.

In addition Dr. Zellers is the physician for the Central Dauphin School district and the Harrisburg Area Community College as well as for Lebanon Valley College and the Harrisburg Stampede.   She provides medical coverage for the Keystone State Games and the annual Big 33 Football Classic.  She is a member of the American Osteopathic Association, the Pennsylvania Osteopathic Medical Association, the American College of Osteopathic Family Physicians and the American Osteopathic Association of Sports Medicine.

Dr. Zellers resides in Harrisburg with her husband Eric Shrader and their 6 year old twin boys Chase and Alex.

Matthew F. Wilson, DO
Dr. Wilson was born and educated in Pennsylvania. He received a Bachelor of Science from Juniata College and Doctoral of Osteopathic Medicine from Lake Erie College of Osteopathic Medicine. He completed his Family Medicine residency at Memorial Hospital in York, PA and went on to obtain a Sports Medicine Fellowship from PinnacleHealth.

Dr. Wilson is dual-board certified by the American Osteopathic Board of Family Physicians and the American Osteopathic Academy of Sports Medicine. He enjoys practicing osteopathic manipulative medicine, which he incorporates into his Sports Medicine practice.  As a part of his practice, as well, Dr. Wilson covers high school football on the sidelines during games and is happy to see sports injuries in his office.

Dr. Wilson has lived in South Central PA with his family for the past seven years. His hobbies include running marathons, skiing, watching football and gardening.