Weekend Warrior Running

Injury Prevention Tips and Treatment for the Weekend Warrior

 By: Meg Irish
Posted: September 19, 2019

Not all of us are seasoned athletes, training consistently day in and day out because let’s face it, we have busy schedules to keep. For those of us who find other ways to sneak in exercise, we typically fall in the category of a weekend warrior, picking up a game of basketball with friends or participating in a weekend 5K. This category doesn’t necessarily mean you cram exercise in only on the weekend. It refers to a person who participates in physically strenuous activity only a few days of the week, rather than spreading it out evenly throughout the week.

According to the American College of Sports Medicine, the recommendations for physical activity for adults vary depending upon activity level. At least two and half hours per week is recommended for moderate activity such as walking, bicycling, or gardening. For more vigorous activity such as swimming, running, or aerobic dancing, at least an hour and half per week is recommended.

Weekend Warrior Running

The term “Weekend Warrior” refers to a person who participates in physically strenuous activity such as running, swimming, or cycling a few days of the week.

Common Injuries

Due to long periods of inactivity intermingled with bursts of high activity, the weekend warrior athlete tends to be more prone to injury. Predisposing injury factors include poor fitness base, older age, intermittent participation, increased weight, and medical comorbidities. Weekend warriors typically experience acute injuries such as an ankle sprain or muscle strain, tendinitis, and ACL or meniscus tears. These often occur because the athlete experiences greater stress over a shorter period of time compared to those who exercise regularly.

Dr. Lara Quinlan frequently sees patients with weekend warrior injuries. “The worst thing people do with ankle sprains is to not treat them. This leads to improper healing, inability to regain strength, proprioception, and reoccurrence injury,” said Lara Quinlan, MD, CAQSM. If left untreated, the patient loses their proprioceptive function, the sense of knowing the body’s relative position in space. The proprioceptive sensory receptors relay information to the brain about large and subtle shifts in movement. Without it, we would not be able to balance, dance, run, or walk on uneven surfaces. Read more

What you need to know about hypertension

What You Need to Know About Hypertension

By: Meg Irish

According to the American Heart Association, more than 100 million Americans have hypertension, also known as high blood pressure. Hypertension puts you at greater risk for various cardiovascular diseases including heart disease, stroke, and sometimes death. High blood pressure occurs when the force of blood flowing through your blood vessels is consistently high. This contributes to hardening of the arteries because the heart is continuously working harder to pump blood around the body. What you need to know about hypertension

According to TPMG Osteopathic Family Medicine Physician, Matthew D. Fenlason, DO, “Hypertension is the most common condition treated by primary care physicians and is responsible for the greatest number of chronic prescriptions.”

Blood Pressure Guidelines (American Heart Association)

  • Normal Blood Pressure: under 120/<80 mm Hg (millimeters of mercury)
  • Elevated Blood Pressure: 120-129/<80 mm Hg
  • Stage 1 Hypertension: 130-139/80-89
  • Stage 2 Hypertension: <140/90
  • Hypertensive Urgency: >180/>120
  • Hypertensive Emergency: >180/>120 with organ failure (kidney, heart, etc.)

Read more

McKenzie Method

Taking Treatment Into Your Own Hands – The McKenzie Method

By: Madison Bambini

If you’re suffering from an achy neck or back, leg or arm pain, numbness or tingling, you’re not alone. Have you been diagnosed with sciatica, sacroiliac joint pain, arthritis, or degenerative disc disease? Would you like to know how to alleviate your pain? There are several treatment options available, but a globally recognized approach known as the McKenzie Method not only treats your pain but helps you prevent future flare-ups.

What is the McKenzie Method?

Physical therapists who practice the McKenzie Method have to go through additional training and credentialing. A certified McKenzie practitioner is trained in the examination and evaluation for acute, subacute, and chronic conditions of the spine and the extremities. In order to become certified, a practitioner must complete four courses, 360 hours of clinical residency training, and pass the Institute’s written and practical credentialing examination.McKenzie Method

The method was developed by Robin McKenzie in the 1950s, a physical therapist in New Zealand. According to the McKenzie Institute of USA, “this well-researched, exercise-based approach of assessment, diagnosis and treatment uses a comprehensive and clinically reasoned evaluation of patients without the use of expensive diagnostic imaging (x-rays and MRIs).” In his practice he found that extending the spine could help “centralize” the patient’s pain by moving it away from the body’s extremities.

One difference between the McKenzie Method and traditional forms of physical therapy is the emphasis on having patients involved in self-management. “A main focus is teaching patients how to treat themselves to reduce dependency on medical intervention” said Megan L. Buckley, PT, DPT, MS, of TPMG Physical Therapy. “The McKenzie Method empowers patients to manage their pain as well as education to prevent future episodes.”

When Should You Get Help? What Are the Benefits?

At the first sign of back, leg, or arm pain, in the Commonwealth of Virginia, you can make an appointment with a physical therapist. Additionally, you can ask your primary care physician, who may refer you to a McKenzie Method certified physical therapist like TPMG Physical Therapist, Megan Buckley, PT, DPT, MS. The sooner you can receive treatment, the quicker the recovery process can be. There is a high recurrence rate for spinal conditions, and patients who receive this treatment method learn preventive measures to take to minimize future episodes. A few exercises a day that do not take a lot of time or special equipment can help to minimize or prevent conditions from reoccurring or worsening.


Most commonly the McKenzie Method addresses spinal conditions. More recently, the method has expanded to include treatment of common extremity issues related to the shoulder, elbow, hip, knee, and ankle.

McKenzie Method Goals

  • Eliminate symptoms
  • Restore full mobility
  • Give the patient self-treatment tools
  • Prevent and maintain future conditions

Williamsburg Physical Therapist

About Megan Buckley, PT, DPT, MS

Megan Buckley, PT, DPT, MS, is certified through the McKenzie Institute in the McKenzie Method. She has been practicing in outpatient orthopedics for 19 years with an emphasis on spinal treatment. Megan provides an individualized, comprehensive plan of care to her patients, as well as education and treatment in a warm and compassionate style.

Quick! Somebody Call a … Nurse Practitioner?

By: Meg Irish

With all the different technical titles that exist within the field of medicine, it can be confusing for patients when choosing a physician. In particular, there tends to be a misunderstanding around the title of Nurse Practitioner (NP).

What is a nurse practitioner?

A nurse practitioner is an advance practice Registered Nurse. This means they were once a registered nurse and went back to school to broaden their scope of practice. Nurse practitioners can diagnose and treat illnesses and prescribe medications. According to the American Association of Nurse Practitioners (AANP), NPs work “autonomously and in collaboration with healthcare professionals and other individuals, to provide a full range of primary, acute and specialty health care services.” These clinicians are becoming an integral part of healthcare facilities as their experience working as a nurse gives them a unique approach to patient care. Read more

TPMG Adds Physicians in Williamsburg and Newport News

Local medical group, Tidewater Physicians Multispecialty Group (TPMG), a network of over 220 physicians and advanced practice clinicians in over 75 offices across the Tidewater area, is adding a variety of physicians to Williamsburg and Newport News.

The Orthopedics division is expanding with the addition of Shane McGowan, MD, and Nicholas A. Smerlis, MD, FAAOS, CAQSH, practicing in both Williamsburg and Newport News. Certified hand therapist, Kerry Bate, OT, CHT, joins both Physical Therapy locations in Williamsburg and Newport News. Joining well-established gastroenterologist, Richard J. Hartle, MD at Digestive Disease Center of Virginia is board certified gastroenterologist, Frances J. Jones, MD, FACG. Also joining in Williamsburg, osteopathic family medicine physician, Matthew D. Fenlason, DO, who will practice at Williamsburg Family Medicine. Read more


Placing a High Priority on Mammogram Screenings for Women

Second only to skin cancer, breast cancer is the most common cancer found in women in the United States. One in eight women are diagnosed with breast cancer in their lifetime.

According to the American Cancer Society in 2019, an estimated 268,600 new cases of invasive breast cancer are expected to be diagnosed in women along with 62,930 new cases of non-invasive breast cancer. Most cases of breast cancer in women are found at 50 years of age or older; however, around 11 percent of new cases are found in women younger than 45 years of age.

There is currently no way to prevent breast cancer. The best option is to catch breast cancer early through screenings and exams. Furthermore, the earlier a patient is diagnosed, the more options they have available to them for minimally invasive treatment. Read more

Celiac Disease

What You Should Know About Celiac Disease

By: Meg Irish

Only a few years ago, if you requested “gluten-free” at a restaurant you received a blank stare. Today, one in five Americans choose a gluten-free lifestyle. Now you may ask yourself why eliminate foods like pastries, pasta, and bread out of your diet? Well, for some people this lifestyle is a choice, for those with celiac disease (CD), it is a necessity. Nearly one percent of the U.S. population is affected by CD, a severe condition that can lead to digestive problems and nutritional deficiencies.

What is Celiac Disease?

Celiac Disease

For someone with Celiac Disease, eating foods containing gluten produces an immune response that attacks the villi in the small intestine, which are used for the absorption of nutrients into the body.

CD is a serious autoimmune disorder where the ingestion of gluten (a protein found in wheat, rye, and barley) leads to damage of the small intestine. When an individual with this disease eats food containing gluten, their body produces an immune response that attacks the small intestine. These attacks lead to damage of the villi, small finger-like structures inside the small intestine used for the absorption of nutrients into the body.

“Like any organ, if the intestine is ‘sick,’ it cannot perform its job optimally, and many nutrients are not properly absorbed. The dysfunction is not a permanent issue; with a strict gluten-free diet the bowel will return to normal function,” said Jonathan D. Eisner, MD, FACG of TPMG Gastroenterology in Newport News. Read more

Shane McGowan

TPMG Orthopedics Division Expands with New Spine Surgeon


TPMG is proud to announce the expansion of the Orthopedics division with the addition of fellowship trained spine surgeon, Shane M. McGowan, MD, in September 2019. This marks an exciting growth period for the Orthopedics division, as service offerings recently expanded with the joining of fellowship trained hand surgeon, Nicholas Smerlis, MD, FAAOS, CAQSH, in June 2019.

Shane M. McGowan, MD

Dr. McGowan earned his medical degree from Stony Brook University in New York and completed residency training at St. Luke’s University Health Network in Bethlehem, Pennsylvania. He completed an orthopedic spine fellowship at the University of Maryland Medical Center/Shock Trauma Center in Baltimore; recognized as one of the top spine fellowship programs in the country.

Dr. McGowan utilizes various surgical techniques including open and minimally invasive surgery, robotic surgery, decompression, and spinal fusion. His special interests include the correction of spinal deformities and treatment of arm and leg pain/numbness resulting from compression of the spinal cord.

The TPMG Orthopedics division provides comprehensive orthopedic care with specialists in orthopedics surgery, adult joint reconstruction, joint replacement, foot and ankle surgery, sports medicine, musculoskeletal medicine, surgical and non-surgical spine care, and hand surgery.

As part of the spine team at TPMG Orthopedics, Dr. McGowan will work alongside board certified orthopedic surgeon, Dr. Jeffrey Moore, a former spine surgeon with more than 25 years of experience, who now devotes his practice to the evaluation and management of patients with non-surgical spinal related problems. Read more

TPMG’s Dr. John E. Brady is Named Board Chair of American Board of Family Medicine


Newport News, VA, August 02, 2019 –  Local medical group, Tidewater Physicians Multispecialty Group (TPMG), a network of over 220 physicians and advanced clinicians in over 75 offices across the Tidewater area, is proud to announce the naming of John E. Brady, MD as Board Chair of the American Board of Family Medicine (ABFM)

The ABFM is a not for profit organization governed by a Board of Directors whose mission is to improve the health of the public by assuring that any family physician who holds their certification has met rigorous standards. The ABFM is the third-largest board of the American Board of Medical Specialists (ABMS).

John E. Brady, MD

John E. Brady, MD

The ABFM Board of Directors is composed of physicians and public members who are passionate about both family medicine and quality patient care and have exemplified themselves as leaders in the field. The naming of Dr. Brady as Board Chair is a great accomplishment and TPMG values all the work he does for his patients and community. 

“When I was elected to be on the board of the ABFM, I hoped to be able to articulate both the voice and the frustrations of the front line physician. Being named Board Chair four years later means the board appreciates my perspective and the work I have tried to accomplish. I am deeply honored to be given this opportunity,” said Dr. Brady of TPMG The Village Doctor

“We are very proud of Dr. Brady’s achievements at ABFM and the impacts he makes for other physicians around the country. He continues to be an astounding physician for TPMG and we look forward to seeing his career flourish,” said Scott J. Banning, MD of TPMG Hidenwood Family Medicine.

Currently, there are over 92,000 family physicians who hold the ABFM certification across the country. As Board Chair, Dr. Brady ensures that the policies adopted by the Board of Directors get prioritized and implemented by the ABFM organization.

“It’s an honor to know someone for many years who has worked so hard on the national level to improve healthcare. He is standing up for patients and physicians and working alongside them to make these beneficial improvements,” said TPMG Chief Medical Officer, Steven S. Leblang, MD. 

Low testosterone

What Men Need to Know About Low Testosterone

By: Meg Irish

Constant fatigue, unexplained muscle or hair loss? Most men don’t realize they have low testosterone, but these are just a few signals that could indicate your levels have dropped below normal. A gradual decline in testosterone is typical with age, but age isn’t always the determining factor with testosterone deficiency syndrome (TDS).

Testosterone is produced in a circadian rhythm, meaning it ranges from 350 – 1100 ng/dL, typically being at its highest levels in the morning and lowest levels at night. Along with sperm production, testosterone regulates a number of functions, including muscle size and strength, sexual development, bone density, and fat distribution. Low testosterone levels mean the body does not produce enough of the male sex hormone, testosterone.

Symptoms and Risk Factors of Low Testosterone

There are numerous symptoms that men with low testosterone experience ranging from hot flashes and hair loss to reduced erectile function and depression.

Low testosterone

“I’ve had patients come in who’ve been on two, or even three, antidepressants and I check a testosterone level, and sure enough they come back with low testosterone levels, and we’re able to get them off antidepressants and they feel a million times better,” said Eric Darby, MD, FACS, urologist at TPMG Urology in Newport News, VA.

Having any one of these symptoms may not mean low testosterone, but if you have a combination of these symptoms, you may want to have your physician check your testosterone levels. Read more