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Diabetes Mellitus

Posted on September 28th, 2017 by Andries Lodder


By Jennifer Steele

Diabetes Mellitus is a chronic lifelong condition that affects the bodies ability to use and produce insulin, thus affecting its ability to use and process the sugars we eat. There are 3 types of diabetes, Type 1, Type 2,  and Gestational Diabetes. Even though there are these different types all of them have one major thing in common.

In people without diabetes the body breaks down the sugars and carbohydrates that we eat into a substance called glucose. All the cells of the body then are able to use this glucose as their fuel. However, in order for the glucose to enter the cells and be used as fuel a hormone called insulin is required.

This is where diabetes comes in. In a diabetic, the body either does not produce insulin, it can’t use the insulin it does produce or combination of both. Since the body’s cells are unable to take up the glucose, it starts to build up in the blood stream. This can be dangerous as high blood glucose levels can damage the small blood vessels of the kidneys, the eyes, heart and nervous system.

Here is a short overview of each type of diabetes:

Type 1 Diabetes:

Type 1 diabetes is an autoimmune disease caused by the body attacking its own pancreas with antibodies. Due to this the insulin producing cells of the pancreas are unable to produce insulin at all. Individuals with type 1 diabetes have to take insulin in the form of an injection, a pen or an insulin pump.

Type 2 Diabetes:

Type 2 diabetes is the most common form of diabetes and can sometimes be considered a milder form of diabetes. Even with that being said it can still have major health implications and can be life threatening if not treated properly. In type 2 diabetics the body still produces insulin. However, it either produces too little or the body’s cells have become resistant to it and they no longer respond to it and so they no longer are able to absorb or take up the insulin that is available. Type 2 obesity predominantly affects obese individuals and is usually due to insulin resistance. There is no cure for type 2 diabetes but it can be managed with nutrition, exercise and weight management interventions. In some severe cases diabetes medication is also necessary to manage the condition.

Gestational Diabetes:

Gestational diabetes is triggered during pregnancy and often leads to the mother becoming insulin resistance. It is often diagnosed during the second and third trimester and can be dangerous as the high blood sugar levels of the mother travel through the placenta to the baby and can affect the baby’s growth and development.

So how does exercise come into play?

Exercise is an essential component of treating and caring for diabetes. When exercise is included in the treatment of diabetes numerous benefits will occur:

  • Improvement in blood glucose control, predominantly in individuals with type 2 diabetes.
  • Improved insulin sensitivity and lower medication requirements.
  • Reduction in body fat and weight loss, which helps increase insulin sensitivity.
  • Cardiovascular benefits and reduced risk of cardiovascular disease.

Recommendations for exercise programming

All exercise programs for individuals with diabetes should be individualized based on the individual’s medication schedule, presence of any diabetes complications, their own goals and their personal preferences. Both cardio and strength exercises should be included in the program to develop and maintain the individual’s cardio respiratory fitness, body composition and muscular strength and endurance.

Individuals with diabetes should follow the following precautions when exercising:
  • During their exercise sessions, a carbohydrate food source should be readily available.
  • They should consume adequate fluids before, during and after exercise.
  • They should practice good foot care by wearing proper shoes, cotton socks and inspecting their feet on a regular basis especially after exercise.
  • They should always carry medical identification.

If you suffer from Diabetes or any other chronic disease we recommend you seek medical advise before beginning an exercise program. 


The Power is in the Plate

Posted on September 4th, 2017 by Andries Lodder

There’s been a craze in the fitness world in the last decade- Power Plate. This is exercise equipment in the form of a vibrating platform. There is a vibrating base which may vibrate upwards and downwards, close to 1 to 2 millimetres, 25 to 50 times per second.

Although Power Plate is already being used by many women to lose weight and to firm up, it is also very efficient for seniors wanting to stay fit. It’s principle of acceleration, giving fast muscular contractions, allows active seniors to keep fit and has health benefits as people advance in age.

Power Plate is a very good way of training efficiently but softly, and this because of the 2 main advantages:

  • Firstly, the absence of weight:
    • The fact that you work out without weight on the Power Plate reduces the risk of getting hurt.
  • Secondly, The Power Plate gives you the latitude to work on a static, semi static or sitting manner, thus easily adapting to the level of stress
    • For example, the more you bend in a squat the more you work.

Training on Power Plate enables the seniors to continue maintaining their bodies and reinforcing their muscular toning, all these at their own pace. Power Plate also allows for short and soft sessions such as only doing stretches, resulting in the improvement of flexibility and the moves’ amplitude.

Say Goodbye to age related health problems:

Osteoporosis is a disease where the bones are at risk of breaking easily due to increased bone weakness. Bone fragility affects 30% of the women 65 years old and more. It is also responsible for 145 000 fractures per year. High impact sports such as jogging or tennis help to fight against the loss of bone density. However, there is a snag. These activities are sometimes difficult to practice, particularly for the elderly. Enter the Power Plate. Several studies (particularly the one Steven Boonen of the University of Leuven, Belgium) proved that the vibrations of the Power Plate subsequently lead to a noticeable increase in bone mineral density. Regular physical activity on the Power Plate can be useful for the prevention of Osteoporosis.

Prevent Falls:

A number of physiotherapists, led by Doctor Michel Cabrol, an occupational therapist and sport doctor, drafted an experimental project, proposing to the residents of a retirement home in Cannes, these exercise programmes on the Power Plate. Revelations according the Doctor Cabrol were such that, the plate was particularly useful inn “putting back at work’, the muscular work, in a static manner, but with the patient not exerting themselves.

The Power Plate enables seniors to recuperate some muscular strength in the lower limbs. The proprioceptive centres located in the soles of the feet also get stimulated in the process. These centres, work as receptors, transmitting the information to the brain, which progressively, will reprogram on its ‘hard drive’, the balance notion.  By doing so, the Power Plate can contribute to freeing the elderly from the infernal ring imprisoning them: prolonged confinement to bed, melting of the muscular mass, decrease in bone density, not to mention fall fear of standing again and all these finally leading to sedentariness and immobility.

Pain Relief:

A static session on the Power Plate can benefit seniors who are suffering from backache. The sit on the Power Plate on low intensity programming sessions of thirty seconds alternating with rest times of the same length. The sessions can also be done while one is standing but immobile. The vibrations force a reaction out of the muscles, leading to relaxation of the body and a feeling of well-being. At the end of the sessions the feeling is always a positive. Doctor Michel observed in his patients, a real well-being and a relief following the sessions on the Power Plate.

Training programmes adapted to seniors:

Following observations of the beneficial effects on the seniors, the Power Plate teams have developed adapted programmes. They have an umbrella theme know as FEEL BETTER. These programmes are able to yield the following interesting results:

  • Flexibility:
    • A training session aiming to improve the body’s flexibility.
  • Stability 1 and 2:
    • Training sessions aiming to improve stability in the bottom of the body as well as body coordination.
  • Rejuvenation:
    • A session specifically geared towards destressing body and mind.
  • Solid Bones:
    • A programme focused on strength and coordination to reinforce the bone structure.
  • Active Ageing:
    • A functional preparation for the 65 years old and more with the objectives of improving mobility, balance and facilitating the smooth running in the journey of their daily lives.

Last but definitely not least:

Although moderate physical activity such as brisk walking is safe for most people, the importance of talking to your doctor first cannot be emphasised enough. Whatever you do, talk to your doctor before you start an exercise programme.

Original Article by:

Caroline Malokotsa, The Power is in the Plate, Senior Planet August 2017/Issue 3, Page 18-20

Exercising during pregnancy

Posted on August 25th, 2017 by Andries Lodder

By Jennifer Steele

Pregnancy is a very unique time in any women’s life and during this time a woman experiences many changes. Physiological, anatomical and, emotional changes all present themselves and most of the time normal behaviours and routines end up changing. However, even with all these changes occurring, it is important to remember that habits adopted during pregnancy can affect a woman for the rest of her life. Along with all these changes, during this time women also have thousands of questions running through their heads. Is it normal to feel like this, can I still eat this, should I lie like this, and one of the most frequent questions; can I still exercise?

The short answer to this question is, yes. Yes, you can still exercise and in fact exercise is as important during pregnancy as it is when you are not pregnant.

Here is how you can go about incorporating exercise into your pregnancy.

The first thing to do is check with your health care provider:

If you exercised regularly before getting pregnant and you have no complications with your pregnancy you should be able to carry on working out as you had done before with very few modifications. If you did not work out before then you should start with beginner’s exercises and possibly seek the assistance of a health and fitness professional who can help guide you on where to start and what exercises you should and shouldn’t do. It is important to check with a health care provider before exercising because if there are any complications with your pregnancy exercise could both you and your baby at risk.   

Once you have been cleared to exercise you can then use these guidelines to help you plan your exercise sessions:

Type of exercise:

Focus should be placed on exercises that improve and maintain your cardiovascular and musculoskeletal fitness levels. Therefore, both aerobic exercises such as walking, jogging, swimming and cycling as well as resistance exercises with light weights or bands should be included in the exercise program.

When pregnant you should avoid doing exercises that involve you lying for any prolonged period of time on your back. 


This is one of the harder variables of exercise prescription to advise pregnant women on. To prescribe intensity to non-pregnant women a percentage of their maximum heart rate is usually used. However, during pregnancy a women’s heart rate response to exercise is often erratic and unreliable. For this reason, rate of perceived exertion is used when describing the desired level of intensity. For moderate intensity exercise during pregnancy your rate of perceived exertion should be between 12-14, which is considered somewhat hard. As the pregnancy progresses most women tend to voluntarily decrease the intensity of their workouts.


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Duration of Exercise:

It is advised that pregnant women exercise from anywhere between 30-60 minutes.

It is just important to be aware of the temperature that you are exercising in, as your body’s ability to thermoregulate is jeopardize by the pregnancy. You should avoid exercising for prolonged periods in hot environments. You should also make sure you have adequate hydration as well as wear cool loose clothing.


It is recommended that you do an accumulation of at least 30 minutes of light to moderate intensity exercise every day.

Even though pregnancy is associated with numerous anatomical and physiological changes, there are very few instances that will prevent otherwise healthy, pregnant women from following the same recommendations.

For more information on how to exercise during pregnancy you can speak to your doctor or a health care professional such as a Biokineticist who will be able to guide you through appropriate exercises that are safe and that will best prepare you body for your pregnancy, labour and post partum recovery. 

In our next post we will look at the benefits of exercising during pregnancy. 

The Benefits of Strength Training for Children and Adolescence

Posted on August 10th, 2017 by Andries Lodder

By Jennifer Steele

In today’s society like many adults, kids and teenagers are becoming more and more inactive. The urge to sit and watch hours of television, play computer or tv games, sit on their phones or tablets is becoming increasingly high and so more and more kids are starting to experience the same problems associated with inactivity that adults do. This being said, it is not the case for all kids. One the other end of the scale there are kids and teens that are taking part in every sport offered to them. They are trying to balance all the physical demands that are placed on them by all the sports and quiet often their bodies cannot handle it and they end up injured. More often than not the pain or injury is because their body doesn’t have the necessary strength to cope with all the demands.

The question is then what can be done to help kids on both ends of the scale?

Strength training:

The topic of strength and weight training for kids and adolescence has been one of controversy for many years. Many have said that by lifting weights at a young age children’s growth will be stunted due to damage to their growth plates or they will get injured. This in fact could not be further from the truth. When done correctly, using the correct technique and following the correct program guidelines, a strength and conditioning program for kids and teens can end up assisting in their overall growth and physical development rather than hindering it. A child participating in a strength and conditioning program that is well structured and has the necessary supervision is at not greater risk of injury then a child playing supervised rugby.

What are the Benefits of strength training for children and teens:


There are numerous benefits of strength training in kids and teens such as:

  • Improved overall body strength
  • Improved coordination, balance, agility and athletic performance
  • Decreased risk of obesity and other chronic diseases associated with inactivity
  • Decrease risk of sporting injuries due to over use or lack of strength
  • Improved self confidence
  • Decreased risk of taking part in risky behaviours such as drinking alcohol, taking drugs or smoking
  • Decreased risk of developing osteoporosis

These benefits definitely are a great reason for kids to include strength training into their daily activity. However, a child’s strength and conditioning program should not resemble an adults. Firstly, it should be tailored to the individual age of the child, and most importantly focus should be placed on performing exercises correctly rather than on adding weight and increasing resistance. The few rare cases of stunted growth and damage to growth plates have occurred when equipment was misused, to heavy weights were lifted with incorrect form and technique or there was no supervision during the strength training session.


Here are some guidelines based as to what should be focused on with each age group:

  • Ages 6-10
    • Focus on overall fitness and development of all motor and sports related skills.
    • Emphasize placed on fun
    • Avoid highly structured and high intensity training
  • Ages 11-14
    • Still focus on overall fitness and development of all motor and sports related skills
    • Some resistance training and sport-specific training may be added. When conducting strengthening exercises, make sure you show the athletes how it will help them in their sport.
    • For all strength exercises emphasis should be placed on doing the exercise with the correct technique and form
    • Begin all exercises using body weight before adding resistance
  • Ages 15-18
    • Now is the time to begin sport-specific training.
    • A period of warming-up, stretching, and cooling-down are a must in any type of training, including strength training.
    • For all strength exercises emphasis should still be placed on doing the exercise with the correct technique and form
    • As individuals get stronger resistance and weights can be increased slowly

Before a child begins a strength and conditioning program they need to learn the correct technique for all exercises they are going to be performing. Parents should also check that there is adequate supervision and that the program their child will be taking part in is suitable for their age and physical development level.

So let’s encourage kids to get out the house, off their phones and to start moving their bodies as much as possible.

Exercising with Correct Form

Posted on July 31st, 2017 by Andries Lodder

By Jennifer Steele

You exercise regularly and are keeping fit and healthy, and yet you are still getting injured. So often this is the case, not only with elite athletes but also with individuals who are just exercising because they enjoy it. Most of the time the reason behind all these injuries are incorrect form.

Performing an exercise with correct form means that the joints, muscles and tendons within the body during an exercise are correctly aligned and not put under excessive amounts of pressure. Ensuring proper form not only helps prevent injury to the body but it also ensures that the correct muscles are targeted during each exercise. If for instance you are doing a bicep curl, which is intended to work the biceps in the upper arm, and you are swaying and moving the upper body to help you lift the weight then chances are you are working far more than just the biceps. In doing this you are not getting the full benefit of the intended exercise and you could be straining other muscles and joints.

One of the primary reason for incorrect form or technique is due to lifting weights that are too heavy. When the weight is to heavy the first thing to go is form and you start using other parts of the body to compensate for the heavy weight. In doing this the joints of the body move out of alignment, pressure is places on ligaments and tendons, other muscles start contracting and taking strain. Another factor effected by lifting weights that are too heavy is the range of motion. There is little point in performing an exercise—such as a Squat—if you are not able to successfully go through the full range of motion, or if you need to compensate for a weakness. Rather you should work with less weight, fully developing your muscles through the prescribed range of motion and using proper technique to produce the necessary movements. Not only will this help prevent injuries but it will also greatly improve your strength.

Below let’s look at the correct form for a fundamental functional exercises:

The squat:

  • Look straight ahead (During the squat you should not drop the head and look down or lift the head and look up)
  • Chest out
  • Shoulders level
  • Hand can be placed behind the head or straight up above the head, or out in front of you parallel to the floor
  • Back slightly arched or neutral (at no time during a squat should your lower back round)
  • Feet should be slightly wider then hip width apart
  • Toes pointed slightly outwards
  • Weight should be on the heels or the feet
  • As you begin to bend your knees push your hips and bum back
  • Your knees should stay in line with your toes and not fall in at any time when doing the squat.

  • The knees should also not push forward and go over the toes.
  • Go through a full range of motion with bum and thighs going below parallel to the floor.

Tips to help correct squat form:

  • One of the best ways to correct squatting form is to do wall facing squats. With the toes touching the wall and hand above the head. Keep the knees out and squat down as low as possible. By doing the squat this way the wall prevents your knees going over your toes and it helps you to engage and activate the glutes correctly.

  • If you find you can’t keep your knees out and over your toes it can be useful to add a thera-band around the knees to assist in activating the necessary muscles.

So are you squatting correctly?

Take a look at how you are performing all exercises during your workouts as incorrect form could lead to injury and if you are unsure about what the correct form is, ask a fitness professional to assist you.

Achilles Tendinopathy

Posted on July 26th, 2017 by Andries Lodder

By Jennifer Steele

The Achilles tendon attaches the calf muscles to the heel bone and is responsible for raising the heel off the floor, or calf raising. The tendon is used both in our everyday lives when walking, running, or climbing stairs, as well as during most of sports and exercise activities.

We have all heard of people’s weaknesses or vulnerabilities being deemed their ‘Achilles heel’. This reference was brought about because in so many athletes and individuals it is their Achilles that is their weak link. When this tendon is overused and inflamed it can cause such severe pain and disability that it can bring even the strongest people to a standstill.  

When the tendon is over worked and intense repetitive loads are placed on it, it can become damaged which leads to the pain associated with Achilles Tendinopathy. After each loading or training session, the tendon suffers from tiny microtrauma injuries. In a normal tendon, these microtraumas will heal and the next time it is exposed to loading it will be stronger and able to withstand greater loads. However, in the case of Achilles Tendinopathy the tendon does not heal completely between sessions and so over time the damage builds up and this leads to a degenerative tendon and tendinopathy.

Individuals that are at a higher risk of developing Achilles Tendinopathy are:

  • exercising without warming up
  • suddenly increase their physical activity intensity without proper progression
  • taking part in sporting activities that require rapid changes in direction
  • wearing old or ill-fitting shoes
  • older individuals individuals with bony heel spurs.

Incorrect running or jumping technique can also predisposed athletes to the condition, as can certain chronic diseases such as hypertension and diabetes. There have also been reports of certain antibiotics leading to tendon inflammation and predisposing individuals to tendon ruptures, therefore it is best to check the side effects of all medications before exercising while taking them.

The main symptom of Achilles Tendinopathy is pain at the back of the heel area during walking, running or other physical loading of the tendon. The area may become swollen, red and warm to the tough. The pain is often worse first thing in the morning with the tendon feeling stiff and tight, it is also always worse during activity, exercise or sports that place increased loads on the tendon.

The immediate treatment for Achilles Tendinopathy is treatment of the symptoms using rest and ice. Non-steroidal anti-inflammatory drugs can also be taken to help relieve the pain. Most importantly the individual will need to modify their physical activity and the exercise routine in order to give the tendon sufficient rest, as well as include specific rehabilitation exercises for the tendon.

Before beginning rehabilitation exercises a health care professional such as a Biokineticist or Physiotherapist should be consulted. Generally, the program they will prescribe should include light stretching of the muscles of the lower limb as well as eccentric heel drops that will strengthen and improve the tendons ability to absorb loads placed on it.

Achilles Tendinopathy is not the same as an Achilles Tendon rupture. A rupture is rather an actual tear of the tendon and can be a far more severe injury depending on the severity of the tear. A rupture can either be complete or incomplete and often require surgery as treatment. Achilles Tendinopathy does not necessarily predispose an individual to an Achilles Tendon rupture. However, it can increase the chances of a rupture occurring. It is therefore necessary to follow the correct treatment and rehabilitation protocols to minimize risks of further injury and re occurrence.

Everything you need to know about Lower Back Pain

Posted on July 3rd, 2017 by Andries Lodder


Lower back pain is experienced by almost everybody at some point in their lives. The pain in the lower half of the back or lumbar region can be intense and is one of the top reasons for missed work amoung adults. As bad as all this sounds there is some good news- more often than not lower back pain can get better on its own and if it doesn’t there are many effective forms of treatment that can help.

Before we look at treatments lets discuss the symptoms and some of the most common causes of lower back pain. The symptoms of lower back pain all vary, it can be a dull aching pain, a sharp shooting or stabbing pain. The pain can be acute, which is a very sudden pain as a result of injury, pain that persists and last for weeks to months at a time is considered chronic lower back pain.

The main culprits and causes of lower back pain:

Muscle and ligament strains and sprains:

Lower back pain caused by sudden injuries can be due to ligament and muscle injuries. If treated correctly at the onset of the injury then the back pain can be resolved in roughly 6- 12 weeks depending on the extent of the injury.

Poor posture and lifting techniques:

Jobs that involve substantial amounts of physical activity such as, heavy lifting, pulling or any twisting movements can lead to lower back pain especially if done with poor technique. However sitting at a desk all day also comes with risks of its own. Sitting for hours on end at a desk with poor posture, hunched shoulders, and in a chair with bad back support places excess pressure on the spine and is one of the largest contributors to lower back pain.

Herniated disks:

The fluid filled disks that absorb pressure between the vertebras of the spine can degenerate and often the fluid inside can bulge or herniate out. If this herniation touches and puts pressure on the spinal nerves, this can lead to sharp shooting pains, numbness and intense pain.

Other chronic conditions such as spinal stenosis, spondylolysis and fibromyalgia can also cause lower back pain.

Basic treatments for lower back pain:

Once the cause of the lower back pain has been identified and diagnosed by a health care practitioner then the appropriate treatment can be implemented. 

Short periods of rest and activity modification:

Initially short periods of rest can be helpful to relieve lower back pain. However, it is not recommended that a person rests for more than 2 days as this can make healing even more difficult. If the initial rest isn’t effective then activity modification can be helpful. Avoiding the aggravating activity can help reduce muscle spasms and pain and create a more healing environment.

Heat/ice therapy:

Heat from a hot bath or heating pad can help relax muscles in spasm; it will also increase blood flow to the area which will help increase the body’s natural healing processes. If the lower back pain isn’t due to muscle spasm or tension, but rather due to inflammation then applying ice instead of heat onto the affected area can help reduce the swelling and pain.

In conjunction with the above forms of treatment it is advised that individuals start a supervised exercise program that will strengthen and stretch the appropriate muscles to help reduce and prevent further back pain.

General exercises to treat lower back pain:

  • Individuals should focus on stretching the muscles of the lower back, core, hips and legs. It is important to remember that stretching exercises shouldn’t never be bounced or pushed to a point of intense pain.
  • Stabilization exercises are essential to help stabilise the spinal column during all movements to ensure that excess stresses and pressures are not places on the muscles, ligaments and joints of the spine.
  • Core strengthening exercises are also as important as stabilisation exercises. The core acts as a corset and encloses and stabilises the spine. Core stabilisation exercises require more than just doing sit ups and crunches. Below are examples of 2 basic stabilisation exercises the can be performed to help reduce back pain.

Bird Dog:

  • Begin on your hands and knees, with your spine in a straight line from head to toe and core engaged.
  • Now, lift your left arm and right leg off the ground simultaneously, extending your right leg behind you and left arm in front of you.
  • Hold for five seconds, return to your starting position and repeat for 10 to 15 reps, alternating sides.

Dead bug:

  • Lie on your back with your knees bent to 90 degrees.
  • Lower your right arm behind your head while simultaneously lowering your left leg to just above the ground.
  • Return to your starting position and repeat on the other side, alternating for 10 to 15 reps.

If you experience any pain while performing these exercises then you should stop immediately. It is also advised that before beginning an exercise program you should consult a health care professional who can assess your own individual strengths and weaknesses and prescribe appropriate exercises to address these specific areas.




Posted on June 21st, 2017 by Andries Lodder


Your Menisci

The knee is a common site of injury as it is located at the end of two long lever arms, the tibia and femur. The knee compromises of ligaments and muscles on which it is dependent on for its strength and stability.

Among the most common knee disorders encountered by orthopedic surgeons are meniscal lesions. Meniscal injuries occur in any age group and are associated with sudden rotation of the leg while the foot is planted or while the knee is bent.

Medial meniscus injuries occur more often as a result of the lateral meniscus not being attached as firmly to the tibia. Function of the menisci includes load transmission, joint lubrication, joint nutrition, shock absorption and stability.

Do you think you have a meniscal tear? Well, a severe meniscal tear will result in a large amount of pain down the edge of the knee where the injured meniscus is located. The pain however has also been known to be more vague and dull and the whole knee feels in pain. Irrespective of the severity of the tear the knee will feel stiff, swell up and feel tight, such as water on the knee. A restriction in range of motion is also a good indicator of meniscal damage.

Initial treatment is always RICE: Rest, Ice, Compression and Elevation of the injured site. You can also wear a knee brace and get some anti-inflammatories.

Secondary treatment is to make an appointment with a Physiotherapist or Biokineticist to determine the severity of the injury as well as to guide you along the route of recovery with a specified rehabilitation pain management (physiotherapists) and strengthening program (biokineticists).