Andries Lodder biokineticist in Fourways
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Keeping Injury Free this Holiday Season

Posted on December 5th, 2018 by Andries Lodder

  By Jennifer Steele     It’s officially holiday season and so our routines are thrown out the window. The number of Christmas parties start to increase, the servings of pudding go up. While on the opposite side of the scale the exercise programs get put on the back burner. This is all normal. However, the problem comes in, in January when everyone heads out into their old programs a little to hard and a little to unfit and so injury strikes.   Therefore, below are some tips on how to stay fit, healthy and injury free this festive season:  

Plan but don’t over plan

  • Planning your workouts for the week ahead is a great idea. Not only can you prepare yourself for what is to come but you are far more likely to do the workout if it planned into your day. However, the problem around this time of year is people have more free time and so they over plan. There is no point planning a three-hour workout everyday and then only doing it once on December 1st.
  • Ensure that you are realistic in your plans and cover all your bases from cardio to strength and even make some time to do some stretches

Keep days off in mind

  • It’s the holidays and its supposed to be a time for you to relax. Therefore, it is not realistic to plan a workout every day. Keep in mind days that you won’t have time or won’t want to break into a sweat and put them into your schedule. Also make sure on these days you don’t sit around feeling guilty, enjoy your time off, spend it with family and friends doing something you love.


  • This is one of the most important factors to consider. If there are massive fluctuations in workload in November, December and January, then injury can occur. For example, going from running 60km a week in November to 30km in December and then back up to 60km in the first week of January then this is likely to lead to an over use injury. The solution is either to try and maintain a very similar workout schedule with only small fluctuation during the holidays or if you can’t to this ensure that in January when you start back up, start slowly.


  • While on holiday no one wants to spend hours and hours exercising. One of the solutions can be to do a High Intensity Interval Session. A typical HIIT session involves a period of high intensity exercise followed by a period of low intensity recovery exercise. This is then repeated between 5 and 10 times depending on the duration of the intervals.
  • HIIT has just as many benefits as other forms of lower intensity exercise for long periods. These include, subcutaneous fat loss, enhanced insulin sensitivity and cardiorespiratory health benefits.
  • A HIIT workout can be done in numerous ways with very little equipment and so is ideal for a holiday that has limited gym access. Here is a link to a quick and easy HIIT workout that requires no equipment and can be done anywhere.

Get a workout partner

  • A good way to be held accountable and to stick to a program is to get a workout buddy. If you are going away ask those that are going with if anyone has similar exercise habits as you. Exercising with someone who has similar goals makes the session more enjoyable and helps hold you accountable.

Cross training

  • It is almost impossible to stick to the exact same program during the festive season. Certain exercise classes will close, some people go on trips and equipment can be limited, time also needs to be spent with family and friends. Therefore, you need to adjust your program adequately. Cross training can be a great way to stay fit, reduce the chance of injury and keep your training enjoyable. This is also a great way to concentrate on strengthening any areas of weakness. Strengthening certain areas and stretching others can most often be done without access to a gym. Here is an example of some important cross training exercises that runners can include in their holiday programs.
  For more information on injury prevention and on improving your performance contact us to book your assessment. Most importantly have an amazing holiday season and keep training injury free.  

Exercise for the elderly

Posted on November 20th, 2018 by Andries Lodder

By Jennifer Steele
  The benefits of staying physically active throughout our lives are numerous. It prolongs physical independence, reduces aging, prevents the risk of diseases such as dementia and Alzheimer’s, it keeps bones and muscles strong, it also keeps your heart and pulmonary system healthy. As we age our bodies under go slow deterioration. Exercise can help slow this down, by strengthening both bones and muscles and assisting individuals in maintaining their physical capabilities. There are numerous forms of exercise that elderly individuals can do including weight bearing exercises, resistance training, cardio exercises and flexibility stretches.  

Weight Bearing Exercises:

One of the most effective forms of exercise for elderly individuals to do is weight bearing exercise. This means that throughout the exercise the individual has to hold up their own body weight against the downward pull of gravity. By incorporating weight bearing exercises seniors can improve their overall muscular strength, their bone strength, balance, coordination and overall quality of life. When performing weight bearing exercises the amount of stress placed upon the muscles and bones is increased due to gravity. The resistance that is placed on the body produces a force that stimulate bone and muscle cell growth. As the bones and muscles are both living tissue they then respond to the stress placed onto them by becoming stronger and increasing their number of cells. This means that they are adapting to that force so the next time they are placed under the stress it is easier to with stand.  



Sit to Stands:

  1. Seated at the edge of chair, place feet hip width apart, toes slightly pointed out, arms crossed across chest.
  2. Pushing into the heels and without using the arms to assist stand up
  3. Once fully upright, push bum backwards and sit back on the chair
  4. Repeat this motion 10 times (10 reps x 3)
  5. The lower down the chair the harder the exercise is to perform


Like with any individual including cardio exercise for the elderly is vitally important. Just like the other muscles of the body, the heart is also living tissue and so when it is stressed it gets stronger. When doing cardio exercises the heart rate increases and so the heart muscle is challenged. By including cardio exercises into their training, it will help keep their heart muscle healthy. The lunges also have to increase their work during cardio exercise and so they also get stronger.


  • Walking
  • Recumbent cycling
  • Swimming

Resistance Training:

Resistance training is very similar to weight bearing exercises as it challenges the muscles and help to improve their strength. However, the difference comes in that resistance training can be done on machines. Although performing exercises with machines is still beneficial and the muscles will get stronger it is still important to include body weight exercises in conjunction with these machines.  



Leg Press:

  1. Select an appropriate weight on the leg press
  2. Seated with the legs on the plate ensure that the knees are at 90 degrees and the feet just wider then hip width apart
  3. Push into the heels, straighten the legs
  4. Ensure you do not lock your knees as this is dangerous
  5. Perform 3 sets of 10 repetitions

Flexibility Training:

Getting into the habit of stretching every day will help improve you overall flexibility and range of motion. This will make everyday activities easier to perform as well as help prevent injury when doing other exercises. It is important to stretch specific muscles that are tight and this will vary for each individual.     It is vital for us all to remain physically active throughout our lives. With greater muscular strength, bone density, coordination and balance from training, individuals are more likely to stay independent and able to take care of themselves. However, it is also important to consult a doctor prior to starting a training program, especially if there are any chronic conditions and medications involved. It can also be a good idea to start training with a health care professional, such as a Biokineticist as they have medical knowledge that can help ensure you are exercising safely. For more information on what exercises are beneficial as well as safe to perform, don’t hesitate to contact us.   


Posted on November 13th, 2018 by Andries Lodder

By Jennifer Steele Osteoporosis is the term used to describe porous bones. It is a chronic medical condition that affects the bones of the body. The condition is such that the bones of the body become brittle as their micro-structure is altered. Our bones are living tissue and so from the moment we are born till the moment we die our bodies are replacing parts of our bones, developing the bones density and strength. When we are in our 20’s our bones are at their strongest. This time is known as our peak bone mass age. Within our bones we have different cells. There are certain cells that break down old bone tissue known as the Osteoclast cells. This process is known as resorption. Other cells known as the Osteoblasts then fill the spaces made by the Osteoclasts with new bone. This is known as the remodeling process. Related image These processes run continuously in our bones during all stages of our lives. Interestingly enough, it takes approximately 10 years for our entire skeleton to be replaced. Once we reach the age of 35 our Osteoblast cells slow down meaning the remodeling process becomes slower. For individuals with Osteoporosis the bone loss outpaces the bone growth and so the bones become brittle and porous. In simple terms the body either loses to much bone, doesn’t make enough bone or both. When we view the micro-structure of our bones under a microscope it looks like a honeycomb. However, when the individual has osteoporosis the holes and spaces in the honeycomb become much greater and so the bones density is far less. This makes the bone brittle and weak and in severe cases even minor bumps or falls can cause the affected bones to break. Image result for osteoporosis microscope The most common areas affected are the spine, hips and wrists. However, all areas of the body can be affected and can break if a force is applied. Osteoporosis is an extremely common disease and it is estimated that an osteoporotic fracture occurs once every three seconds. The disease affects one in three women and one in five men over the age of 50 years old.


To diagnose Osteoporosis a Bone Mineral Density (BMD) test is done. Unlike an X ray which can only identify if there is a fracture in a bone, a BMD test can measure the density of the bones. Based on the result of this test an individual will either be classified as normal, Osteopenic (low bone density) or Osteoporotic (extremely low bone density).

Prevention and Treatment:

Osteoporosis is a preventable disease and can be treated. Medication can be used to help treat osteoporosis where the primary aim is to slow down the bone loss and speed up the bone remodeling. There are usually two groups of medication and each are aimed at one of these aspects.


How can exercise help:
One of the most important aspects of treatment for individuals with Osteoporosis is to prevent falls. Therefore, this is the first area that exercise can be brought in to help. Exercises to improve balance, stability and reaction time should be included at least 2-3 times a week to help prevent the individual falling. Exercise can also be used to help prevent Osteoporosis. Doing weight bearing and muscle strengthening exercises will help maintain bone strength and growth. Weight bearing exercises can be both low and high impact and so it is important to chose suitable exercises for each individual.

Weight Bearing Exercises:

Examples of Low impact:
  • Elliptical trainers
  • Brisk walking
  • Stair machines
  • Recumbent Bicycles
Examples of High Impact:
  • Dancing
  • Jumping rope
  • Running

Strength Exercises:

Muscle strengthening exercises are also important as these also help maintain bone strength as well as help keep the individual independent, mobile and functional.
  • Sit to stands
  • Single leg balancing
  • Using light weight machines
For more information on how exercise can help treat and prevent Osteoporosis don’t hesitate to contact us.

Getting Started with Exercise

Posted on October 23rd, 2018 by Andries Lodder

Related image

By Jennifer Steele

How to Get Started:

Getting started

Getting started with a new gym program or trying to get healthy can be a very daunting task. Walking into the gym for the first time is something all newbies fear. This is why we are here to offer you some advice on how to start your exercise journey and how not to become overwhelmed with this new way of life. The first thing we going to talk about is that we don’t want you to see this as a temporary way of life and set yourself an end date. This is a lifestyle change that will lead to an overall healthier you. Previously we have spoken about the numerous benefits of exercise and living an active life and you need to keep all of those in mind as your progress. Setting yourself goals is going to be important. However, don’t only have goals around the numbers on the scale. We want you to have goals like improving your strength, running your first 5 km, lowering your blood pressure, gaining core stability, improving your resting heart rate and so on. .


For now, we want you keep these few simple things in mind as your start planning a new healthier you:
  • Choose a form of exercise that you enjoy
    • If you don’t enjoy what you are doing, then sticking to the program and adhering is going to be much harder. If you enjoy swimming instead of cycling, then do that.
  • Set SMART goals that are about more than just weight loss
    • Yes, losing weight can be one of your goals but we encourage you to have other goals relating to other aspects of your health and life so that once you reach your goal weight you are still able to see the benefits of all your hard work. Living a healthy active life will benefit you physically and mentally as well as improve your overall health so set goals in all these areas.
  • Fuel your body
    • One of the most important aspect of healthy living is the food you are eating. Not only to help you lose weight and become healthier but also to fuel your body and give you the necessary energy that you need for when you are exercising.
  • Set up a weekly schedule
    • Plan your training session into your week and book them out in your diary. By scheduling your gym sessions into your day you can no longer make the excuse that you don’t have time. Remember, when you make an excuse to not go to gym you are saying to yourself “My health is not a priority”. Also try to only schedule your sessions at a time that suits you. If you are not a morning person and keep missing that 5 am slot, then rather try and make it later in the afternoon to ensure that you get there. Be realistic with your plan.
  • Listen to your body and know when to push yourself and when to chill
    • Not every session you do has to leave you drenched in sweat, gasping for breath. Make sure you plan a few high intensity sessions, some strength, stability and flexibility into your training program. Cover all aspects of fitness in order to really see improvements, prevent injuries and get full enjoyment out of this way of life.
  • Ask for help
    • This is the most important tip! 
    • Whether you are unsure how to use a certain piece of equipment or how to do an exercise, ask for help. If you are confident enough to try the gym alone but still have a few questions then ask the staff for the small bit of guidance that you require. On the other hand if you really feel you have no idea what you are doing then seek out some one on one professional attention.
    • It is also important to ask for help to ensure you are performing the exercises correctly in order to prevent yourself getting injured.
If you are just starting out and require more information don’t hesitate to contact us. We can give you all the information you need and more importantly ensure you are exercising correctly.    

The Benefits of Exercise

Posted on October 23rd, 2018 by Andries Lodder

Image result for The benefits of exercise By Jennifer Steele We all have different motivators in life and the same can be said for the reasons behind why we exercise. According to data collected from Exercise Right Week 2016’s survey – out of over 8800 participants, 63.5% exercised with the main motivation being ‘to lose weight’ and ‘to get fitter’. Only 31% considered lengthening and improving their overall quality of life when exercising. The remainder of participants were training for athletic purposes. So how can we use this information to help improve people’s adherence to exercise and keep them active. Most people know the basic benefits; exercise helps you lose weight and it makes you stronger and fitter. A few people may know that there are other benefits but not many know the numerous benefits that including a few hours of exercise into your weekly schedule can do.

The Benefits:

Physical Benefits of Exercise:

  • It improves muscle strength and size
  • It improves joint functions and health
  • It improves fitness levels
  • It improves bone density levels
  • It prolongs independence and functional ability
  • It slows down the effect of aging
  • It reduces the risk of falling
  • It improves and elevates energy levels

Health Benefits:

  • It reduces risk of getting certain types of cancer
  • It reduces risk of heart disease, heart attacks and strokes
  • It reduces blood pressure
  • It lowers cholesterol levels
  • It prevents Osteoporosis
  • It assists with weight loss and preventing obesity
  • It reduces the severity of Asthma
  • It lowers blood sugar levels and improves the bodies insulin sensitivity
  • It reduces diabetes complications
  • It reduces inflammation levels
  • It triggers the growth of new brain cells and promotes good brain health
  • It helps manage Arthritis
  • It can help reduce chronic pain
  • It improves sleep quality

Emotional and Mental Benefits:

  • It improves self confidence
  • It releases good endorphins that make you feel happier
  • It treats and prevents depression
  • It reduces the risk of developing dementia and Alzheimer’s
  • It reduces stress levels


After reading these why wouldn’t you want to exercise. We are not saying you must live at the gym and spend your life sweating. All you need to start with is 3, 60-minute sessions or 6, 30-minute sessions. Therefore, in a week that has 168 hours in it, all we are asking for is 3 hours in total! That’s just 1.7% of your entire week that we are asking you to devote to yourself and improving your overall health. Image result for exercise and overall health For more information on the benefits of exercise don’t hesitate to contact us. We can give you all the information you need, as well as tailor make aprogram to suit your individual health and fitness goals.

Iliotibial Band Syndrome

Posted on October 1st, 2018 by Andries Lodder

By Jennifer Steele

  In our previous post we looked at what Fascia is and at one of the most common conditions associated with it, Plantar Fasciitis. Following on from that topic, another common and painful condition associated with fascia is Iliotibial band syndrome or ITB Syndrome. ITB syndrome or ITB friction syndrome is a chronic injury that causes pain on the outer aspect of the knee.

The Iliotbial Band:

The Iliotibial band is a thick fibrous layer of connective tissue that lies on the lateral aspect of the thigh. It attaches at the Iliac crest of the pelvis and runs down the lateral aspect of the thigh, crosses over the knee joint and attaches to the top of the Tibia in the lower leg. The ITB helps stabilize the outer part of the knee and it helps with both knee flexion and extension. Image result for iliotibial band syndrome

Iliotibial Band Syndrome:


When the knee joint is flexed, the ITB is located behind the femoral epicondyle. This is a bony protuberance of the femur or thighbone. When the knee gets extended the ITB moves forward and across the epicondyle. In order for this action to occur smoothly there is a sac of fluid known as a bursa between the ITB and the bone. The problem comes in when there is increase friction and stress placed on this area. With repeated stress and strain the ITB can become inflamed and rubs on the bursa and bone. This then cause pain on the lateral or outer aspect of the knee joint. In simple terms ITB syndrome is caused by repetitive bending and stretching of the knee during running, swimming, climbing and other activities.
Picture of the iliotibial band

Signs and Symptoms:

Symptoms typically start a short while into exercise and get progressively worse as exercise is continued.
  • Pain on the lateral or outer aspect of the knee when running or doing other aggravating activities
  • A clicking sensation when bending and straightening the knee
  • Pain after exercise that lingers
  • The ITB will be tender to the touch


Most people with plantar fasciitis recover with conservative treatment methods.
  • Rest:
    • Stopping the aggravating exercise is step one in the treatment process.
  • Ice:
    • Icing the inflamed area to relieve pain and swelling
  • Running biomechanics and road position:
    • Ensuring the correct biomechanics while running is essential. It is also important to check the camber of the road that you are running on as repetitively running on the same camber can lead to ITB pain. This is because more pressure is placed on the one leg.
  • Physical Therapy:
    • Specific stretching and strengthening exercises can be done to strengthen the surrounding muscles and take the pressure off the fascia and allow it to heal.

Here are simple exercises that you can do to help relieve the ITB pain:

Side Ways walking:

  1. Place Loop band/Thera Band around the ankles
  2. Stand with feet hip width apart, toes straight, knees bent, bum out backwards
  3. Now take a step with the right leg out to the side, keeping the knees out in line with the toes
  4. Then bring the left leg inwards so that the feet are back in the starting position, again focusing on keeping both knees out in line with the toes (perform this movement slow and controlled)
  5. Repeat steps 3 and 4 until you have completed 10-20 steps and then repeat on the left leg.
  6. Perform 4 sets of 10-20 repetitions on each leg

Foam Roller Stretch:

Image result for Foam roller ITB
  1. Place a foam roller on the floor or mat
  2. Lay on your side with the top of your ITB (hip) on top of the roller
  3. Support your upper body with your foam roller
  4. Move your body up and down so that the roller moves up and down the leg
  5. Go as far down as the knee joint
For more information about ITB Syndrome and how to treat this painful condition don’t hesitate to contact us for a full assessment.    

Plantar Fasciitis

Posted on September 27th, 2018 by Andries Lodder

By Jennifer Steele

  Fascia, or faciitis are not commonly occurring words and the majority of people don’t know what they mean. Unlike muscles, ligaments, tendons and bones the fascia in our body is far less talked about and known. So before we go any further and look at the problems it can cause let’s start by looking at exactly what fascia is, what it does and where it can be found.


To put it in simple terms, fascia is basically your bodies connective tissue. It is a band or sheet of connective tissue that is primarily made up of collagen fibers. It is responsible for supporting and connecting certain muscles, organs and the body as a unit. A good way to visualize exactly what your fascia is, is to picture an orange. Your skin is the outer orange layer while your fascia is the thick white layer just beneath it. Just as this fascia covers the whole orange so our fascia covers our whole body providing an additional protective layer between the skin and our other soft tissue structures. Basically, it surrounds each organ and muscle, offering protection from outside trauma. Fascia also envelopes and is penetrated by many nerves and blood vessels.


Like with other structures in our body, our fascia layers can become tight, distorted and develop adhesions. When this happens, it can lead to pain, alignment problems, poor and restricted blood flow and compression of certain nerves. This is where the problems come in. When the fascia becomes tight and inflammed due to the distortion or adhesions it leads to fasciitis. I am sure you have all heard of conditions such as Iliotibial band syndrome (ITB syndrome), and Plantar Fasciitis. These are both common conditions caused by tight, distorted fascia layers.

Plantar Fasciitis:

Image result for fasciitis Plantar Fasciitis is one of the most common causes of heel pain. It involves the inflammation of the thick fibrous band that runs along the underside of the foot. This band is the plantar fascia and it connects the heel bone to the toes.
Signs and symptoms
Plantar fasciitis commonly causes a sharp stabbing pain at the heel and it is usually far worse during the first few steps of the morning or following long periods of sitting or standing. The pain is usually worse after prolonged activity as opposed to during the activity. Under normal circumstances the plantar fascia under your foot acts as a shock absorber and supports the arch of your foot. However, if the pressure and impact on the fascia becomes too great, small tears can start to form in it. Repetitive tearing can cause the fascia to become irritated and inflamed which lead to the pain. In simple terms plantar fasciitis is the inflammation of the plantar fascia due to excessive stresses.
Risk Factors:
  • Age:
    • Plantar Fasciitis is most common in men and women aged 40-60 years of age.
  • Exercise:
    • It is most common in individuals who take part in high impact exercise such as; long distance running, ballet and high impact aerobic dancing can also lead to early an early onset of plantar fasciitis
  • Foot mechanics:
    • Flat footed or high arched individuals are at a higher risk of developing plantar fasciitis due to the distribution of weight across the foot.
    • An individuals running biomechanics, if poor, can also lead to plantar fasciitis.
  • Obesity:
    • Increased weight places more stress and strain on the feet and so can lead to plantar fasciitis.
  • Occupation that involve standing:
    • Factory workers, teachers and other individuals that spend the majority of their day standing are also at an increased risk of developing plantar fasciitis.
Most people with plantar fasciitis recover with conservative treatment methods.
  • Rest:
    • Stopping the aggravating exercise is step one in the treatment process.
  • Ice:
    • Icing the inflamed area to relieve pain and swelling
  • Physical Therapy:
    • Specific stretching and strengthening exercises can be done to strengthen the surrounding muscles and take the pressure off the fascia and allow it to heal.
Here are simple exercises that you can do to help relieve the plantar fasciitis pain:
  • Calf Stretch:
    • Place hands on wall and one foot in front of the other
    • bend the front knee and keeping the back heel on the floor push forward
    • Perform the stretch with both a straight knee at the back and then a bent knee
    • Hold for 20-30 seconds
Image result for calf stretches
  • Rolling out fascia
    • Using either a hard ball or frozen water bottle
    • Place it under the foot and applying light pressure roll the foot backwards and forward
    • Do not put all your weight onto the foot
    • Roll for a few minutes on both feet to release the plantar fascia
Related image
  • Towel scrunches
    • Seated on a chair with the knees 90 degrees
    • Place a towel under the feet
    • Using the toes scrunch the towel up pulling it towards the body
    • Release and then repeat
    • Perform 3 sets of 20 scrunches per foot
Image result for towel scrunches
  • Balancing on an unstable surface
    • Standing on an unstable surface such as a Airex mat, foam, pillow
    • Balance on on foot with the knees apart and slightly bent
    • Ensuring the toes and muscles of the arch of the foot are contracting and the arch is not collapsing inwards
    • Perform 3 sets of 60 seconds per leg
Image result for single leg balance on foam   For more information about what cause Plantar Fasciitis and how to treat this painful condition don’t hesitate to contact us for a full assessment.                    

The IMPORTANCE of Strong Glutes

Posted on August 28th, 2018 by Andries Lodder

Image result for the importance of strong glutes By Jennifer Steele

The role of our Gluteal Muscles

Did you know that the muscles of your derriere are so much more important then just making your favourite pair of jeans look good? Our bottoms or glutes are made up of three major muscles. The Gluteus Maximum, Gluteus Mininus and Gluteus Medius. These muscles are primarily responsible for extending the hips, abducting the legs and internally and externally rotating the hips. They are also extremely important in stabilizing the hips. The majority of people are concerned with the external appearance of this area of the body, but rather  its the ability of these muscles to perform their actions and jobs that is important. These days the vast majority of people’s jobs require them to sit all day, this position allows the glutes to actually switch off and so they stop firing efficiently. When this happens our hip flexor muscles tighten and so the position of the pelvis is pulled forward. This then leads to other kinds of problems such as; lower back pain, hip pain, knee pain and decreased athletic performance.

So, what are the benefits of strong glutes:

 Injury prevention:

  • Developing strong glutes is essential in preventing injury to the trunk and lower limb. Weak glutes can lead to an imbalance at the pelvis or hips which can cause excessive medial rotation of the femur and lateral tracking of the patellar. Meaning that the knee falls in when bent and that the patella tracks skew causing the bones to rub together. As you can see below an imbalance in the hips can lead to numerous problems of the lower limb and trunk.
Image result for knees falling inward patellar tracking
  • Weak glutes can also lead to lower back pain. When your glutes are strong, you have a stable pelvis and better support for your lower back. This means that a load can be more evenly distributed through the lower back and lower extremities. However, when the glutes are weak one side of the back takes greater strain then the other and so this can lead to pain. Weak glutes can also cause a Lordosis or excessive arch of the lower back which can also lead to pain.
Image result for lower back pain due to lordosis

Improved athletic performance:

  • Having strong glutes is essential in almost all sports not only because they can help prevent injury but because they can improve athletic performance. The glutes are responsible for acceleration, deceleration, explosive power and the change of direction. Therefore when athletes improve their gluteal strength they can increase their speed and power.

Fall prevention in the elderly:

  • Weak glutes also increase our risk of falling as we get older. The glutes and abdominals stabilise the pelvis and trunk and so help us maintain our balance. It is therefore important to ensure strong glutes as we age to prevent our risk of falling.

How to identify weak glutes

The Trendelenburg test:

This test is used to primarily test the strength of the glut Medius and minimums.
The test is performed by asking the individual to stand on one leg and lift the other leg off the ground. If the pelvis of the elevated leg cannot stay level with the other side this is an indication that stance leg has a weak glute.

Here are some exercises you can do to strengthen your glutes:

Side Ways walking:

  1. Place Loop band/Thera Band around the ankles
  2. Stand with feet hip width apart, toes straight, knees bent, bum out backwards
  3. Now take a step with the right leg out to the side, keeping the knees out in line with the toes
  4. Then bring the left leg inwards so that the feet are back in the starting position, again focusing on keeping both knees out in line with the toes (perform this movement slow and controlled)
  5. Repeat steps 3 and 4 until you have completed 10-20 steps and then repeat on the left leg.
  6. Perform 4 sets of 10-20 repetitions on each leg


  1. Stand with feet just wider then hip width apart, with toes pointing outwards
  2. Hands and arm out in front of you
  3. Keep head straight, do not look to the side or down
  4. In this position, squat as far down as possible without lifting the heels or falling backwards
  5. Return to starting position
  6. Perform 3 sets of 10 repetitions
These are just two examples of ways to strengthen your glutes. For more information and more exercises don’t hesitate to book an appointment with us.      

Degenerative Disc Disease

Posted on July 13th, 2018 by Andries Lodder


By Jennifer Steele

We all know how important our spine is. It is our back bone, it protects the spinal cord and allows us to bend, twist and bears the weight of the body. Back pain can affect many people, of many ages and for many reasons. This means identifying the exact cause of the pain can be hard.

One of the most common causes of lower back pain and neck pain is Degenerative Disc Disease (DDD). Before looking at exactly what Degenerative Disc Disease is it is important to understand the basic anatomy of the spine. Then the causes, symptoms and treatment for DDD will be more clear and easier to understand. 

Anatomy of the Spine

The spine is made up of 33 irregular bones called vertebrae. Between each vertebra there is an inter-vertebral disc (IVD).


These discs act as cushions and absorb the shock up the spine.

Each disc has a similar construction to a car tyre. An outer ring which is made up of fibrous bands is called the Annulus. The inside of this band is filled with a gel like substance called the Nucleus Pulposus. The discs act like coiled springs, with the Annulus pulling the vertebrae together against the elastic resistance of the nucleus on the inside.

Degenerative Disc Disease

Degenerative disc disease is one of the most common causes of back and neck pain. It is used to describes the breakdown of the vertebral discs in the back. Most commonly it occurs in the cervical spine and the lower back. This is because these areas of the spine undergo the most motion and stress in everyday movements and postures and so are most susceptible to degenerative disc disease.

Degenerative disc disease is often misunderstood. The word ‘degenerative’ seems to imply that the symptoms will get worse with age. However, this is not the case, rather it is referring to the actual process of the vertebral disc wearing away and degenerating. It is not considered an actual disease but rather it is the result of wear and tear on the spine that leads to pain, instability and other problems. A small amount of disc degeneration is a normal part of aging and most people will experience small changes in their spine health. However, not all individuals will experience symptoms of Degenerative Disc Disease.

The gel filled nucleus of the inter-vertebral discs is filled mainly with fluid. While you lie down and sleep at night this fluid is absorbed and then  when you stand and move around in the day the fluid is pushed out. As we age the discs ability to reabsorb fluid is lost and so the discs become brittle and flat. Interestingly, the  flattening out is why we get shorter with age. 

As the discs loose fluid they start to degenerate. If excess stress and strain is placed on these discs it can cause many problems. Disc herniation’s, spinal stenosis, spinal cord injuries, and pinched nerves can all result from DDD. 


The most prominent cause of DDD is the natural affects of aging and the wear and tear of life of the spine. However, there are a few other factors more within our control that can increase the risk of developing it:

  • Smoking
  • Lack of exercise
  • Obesity and carrying excess weight
  • Car accidents
  • Improper lifting techniques when carrying heavy loads
  • Poor posture during activities of daily living


  • Back or neck pain that can be a dull ache or sharp shooting. 
  • Limited movement of the back and neck during everyday activities
  • Referral pain into the arm or leg as a result of a pinched nerve
  • Increased pain when bending forward, twisting or sitting. 


There is no way to ‘cure’ Degenerative Disc Disease. However, living with the pain and symptoms does not have to be the only way forward. There are both conservative, as well as more radical treatment options that can help limit the symptoms associated with DDD, as well as slow down any progression. 

The best place to start with treatment is to get an accurate diagnosis of the exact aspects of the back that are being affected. Determining whether there are disc herniation’s, stenosis, joint problems are all important before starting treatment. 

Rehabilitation and exercise

It might be hard to believe but rehabilitation and exercise are one of the most important treatment options to explore when dealing with DDD. Strengthening the core and pelvic stabilizers, loosing any excess weight and improving flexibility can all help reduce the amount of stress the spine is placed under. High impact, explosive exercise should be avoided as this will only increase the pressure on the spine and can exacerbate symptoms. 


Pain relief medications, such as Non-steroidal anti-inflammatory drugs may be prescribed by your doctor to help reduce the inflammation and pain in the back. However, caution should be taken when dealing with chronic pain and the use of NSAID’s as they can put pressure on the kidneys and stomach lining causing other problems if used for prolonged periods of time. Cortisone injections can also help with pain relief. It should be noted that even though medication is not a solution to DDD, it can help relieve symptoms enough to allow the individual to begin rehabilitation exercises and other treatment options. 

Other Options

Other treatment methods can include going to see a Chiropractor or Physiotherapist as they can assist with any manipulations and pain relief that is required.

The use of heat, ice and ultrasound therapy is also very common, as these will help reduce the inflammation in the back and decrease some of the pain. 

Surgical Treatment 

Surgical treatment is very rare and is usually only recommended if there is; disc herniation, persistent pain and nerve compression. Surgery will only be recommend by a Neurologist or Neurosurgeon after assessing scans and x rays.  

Surgical procedures can include:
  • Spinal fusion:
    • Two vertebra are joined together with a bone graft
  • Artificial disc:
    • An artificial disc is inserted between two vertebra
  • Discectomy:
    • A portion of a disk is removed if it is compressing a nerve
  • Partial removal of the vertebra:
    • A small portion of a vertebra may be removed if it is pinching a nerve

For more information about Degenerative Disc Disease and how to include safe rehabilitative exercises into your treatment plan contact us here. 


Everything you need to know about ACL Injuries

Posted on July 2nd, 2018 by Andries Lodder

By Jennifer Steele

Basic Anatomy:

Your ACL or Anterior Cruciate Ligament is found in your knee joint.

It is one of the most important ligaments of the knee as it prevents the anterior translation or movement of the tibia against the femur. In other words, it stops your shin bone moving forward. It also assists in the general stability of the knee joint, especially during angular and rotational movements.

The ACL is assisted by other major ligaments in the knee these being:

  • The Posterior Cruciate Ligament (PCL)
  • The Medical Collateral Ligaments (MCL)
  • The Lateral Collateral Ligaments  (LCL)

Together these ligaments provide support to the knee and prevent it from dislocating.

Image result for ACL

Cause of Injury:

Injury to the ACL is usually traumatic and acute. It occurs suddenly and as a result of a a traumatic event . It can occur in sports that involve lots of stopping and starting, jumping and changes in direction. However, it  can also occur during everyday activities if there is a sudden twisting of the knee with the foot planted. When the bones of the leg twist in opposite directions under body weight it will result in the tearing of the ACL. 

Usually at the time of injury there is a popping sound, followed by swelling, instability and pain when weight bearing.

Severity of Injury:

ACL injuries, as well as all injuries to ligaments of the body are classified based on severity. Any ligament injury is know as a strain and they are classified into three groups:

Grade 1:

The ligament is slightly stretched but there is no tearing. There is minor pain and swelling but minimal laxity.

Grade 2:

The ligament is stretched and there is a minor tear. There is moderate pain and swelling and there may be bruising. There is noticeable laxity.

Grade 3:

The ligament has undergone a complete tear. There is severe pain, swelling and bruising and complete laxity. Surgery is usually required to reattach the ligament.

Image result for ACL



Depending on the severity of the tear treatment will vary. In order to determine the severity various tests can be done;

  • Special tests to test the laxity of the joint
  • Scans such as X-rays and MRI’s.

Grade 1 and 2

For a grade 1 and 2 tear surgery is generally not required. Physiotherapy will be helpful in the initial stages to assist in pain management and to minimize the swelling. Once the pain and swelling is under control specific rehabilitation exercises will be required to regain full function at the joint and to strengthen the muscles around the knee joint that will stabilize the joint and prevent re-injury. 

Grade 3

A fully torn ACL will not heal without surgery. However, for more elderly, less active individual’s surgery is not always required. Bracing and physical therapy can be used and effective for these individuals. Specific exercises can be done to restore function and provide stability to the joint.

For individual that are very active or involved in sports surgery is recommended. Usually the ACL is not sutured back together it is rather fully reconstructed using a tissue graft. This tissue graft acts as a scaffolding around which the new ligament can grow. The graft is usually taken from either the patellar, hamstring or quadricep tendon or in certain cases a cadaver tendon can used. The surgery is usually arthroscopic, as this is less invasive and means less pain and recovery time.

Interesting facts: 

  • Sports such as soccer, basketball, hockey and football all have higher prevalence’s of ACL injuries then other sports.
  • Interesting, women are at higher risk of ACL injuries due to their wider pelvis and greater pelvic angles which places bigger stress on the knee.
  • Contact sports are only responsible for 30% of ACL injuries, while the remaining 70% come from noncontact sports.
  • Up to 50% of ACL injuries also have damage to the Collateral ligaments and cartilage of the knee
  • Preventative strength training can reduce ACL injuries by 50%


Regardless of the severity of the tear and the treatment required rehabilitation is a vital part of recovering from an ACL injury.

A specific rehabilitation program will help you regain full function of the knee as well as strengthen the muscles that surround and support the knee. Not only will doing adequate rehab allow you to return to sport and activities of everyday life, it can also prevent re-injury.  Ensuring correct form and technique while performing these exercises is essential to prevent re-injury and correct strengthening.

It is therefore advisable to begin your rehabilitation program with a trained health care professional. For more information about ACL injuries, or for a rehabilitation program don’t hesitate to contact us.