Degenerative Disc Disease

Posted on July 13th, 2018 by Andries Lodder

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.

Causes

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

Symptoms

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.

Treatment

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.

Medication

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

Treatment:

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%

Rehabilitation:

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.

To Train or Not To Train??

Posted on June 19th, 2018 by Andries Lodder

By Jennifer Steele

Its that time of year, cold and flu season is officially upon us. If you are an athlete or even just training for a specific event getting the dreaded flu can really put a spanner in your training program. One of the biggest frustrations that comes along with the flu, is deciding when to train through illness and when to take time off. Below are a few guidelines that can help you make a decision on whether to train or not.

When to train and when not to train:

A Cold

The common cold is inflammation of the upper respiratory tract. Symptoms include a runny nose and sore throat. There is no cough, body aches, fever or chills.

When suffering from a cold it is advisable to take it easy. Doing light exercise such as a brisk walk or slow jog appears to have no adverse reactions on the body. However, high intensity exercise should still be avoided.

The Flu:

The flu on the other hand is a viral infection. Symptoms include, muscles aches, fever and chills, a cough, extreme tiredness and swollen glands.

The best advice is to stop entirely when you have the flu. The only way to get back into training quickly when you have the flu is to fully rest and allow the body to recover. When the symptoms have fully subsided and you are better you can go back to training.

There are a few rare but highly dangerous conditions that can occur when the body is put under strain when ill with the flu. Most notably, Viral Cardiomyopathy and Viral Polymyositis. Simply put when the body is attacked by a virus it can lead to temporary weakening of the muscles cells of the body. This can extend to the muscle cells of the heart. The problem comes in when you exercise and the heart muscle is placed under strain. This can lead to inflammation and even paralysis of the heart if it is already inflected with a virus.

Simple Guides:

A simple way to determine if you are sick enough to take the day off is using the neck test. If the symptoms are only present above your neck, then you are clear to do light activity. However, if they are below and in your chest you should rather take the day and next few days off to rest.

Returning to Training:

It is also important to remember that going back to pre-illness training immediately can result in a relapse and further illness. After a high intensity session, the body’s immune system is temporarily compromised and so immediately jumping into a HIIT session after illness can lead to a relapse.

It can be frustrating taking time off from training to recover, especially when training for a specific event but rather take the extra few days off. Starting up again to soon means you risk having to take another week or two off due to relapse. It is also important to remember that you will not lose much fitness. Taking just the time off that a common cold take to subside is short and so your fitness will almost be what it was pre-illness. However, this time taken off should not be seen as a taper in training.

Guidelines for coming back:

After a cold or flu there will be lingering fatigue that lasts for a week or two. The first few sessions back should be done at what you would consider 50-75% of your max.
The first workout session back should be very light to allow the body to avoid the body being placed under too much stress. Start with a recovery session such as a brisk walk, yoga or Pilates, stretch or even an easy swimming session.
Avoid a high intensity session for at least a week after illness especially the flu.
Allow more rest days in your training program for the first two to three weeks back after the flu in order to allow your body to adjust and avoid relapse.

Please take note that the above are just guidelines about when to train and when not to. Always make sure to get approval from your GP or doctor before continuing your training when feeling ill. Make sure to listen to your body and use common sense instead of trying to push yourself. This is very dangerous and can make your condition far worse.

For more advice about training don’t hesitate to contact us .

Cross Training for Runners

Posted on June 4th, 2018 by Andries Lodder

By Jennifer Steele

What is Cross Training?

Cross training refers to the inclusion of different and varied exercises, that supplement and differ from the exercise or event for which you are specifically training for.

When speaking specifically in term of running, cross training then refers to cycling, swimming or strength training. When these varied exercises are included it not only builds strength and flexibility in the muscles that running does not target, but it also takes the impact and pressure off the muscles that do take impact during running.

When doing strength training the same muscles groups required for running are generally targeted, but they are loaded in such a way as to help increase the power and strength of the muscles. In doing this it helps build the speed and strength of the runner, as well as helps protect them from injury. Cross training also helps prevent boredom and burnout.

Reasons to cross train:

The exact type of cross training done will vary from person to person, dependent on the reason for doing the cross training. Some individuals cross train because they are injured and need rehabilitation, others want to add extra training without increasing their mileage, while others simply want a bit of variety in their program.

Injury Rehabilitation and Recovery:

For those that are injured to is important to stay fit and active while allowing their injury to heal. Doing exercises that are pain free and that will assist in recovery are important.

Adding Intensity:

Many people want to increase the amount of training that they are doing. However, if they increase their mileage the likelihood of developing an injury goes up. Cross training therefore allows them to add to their running without increasing the risk of injury.

Variety:

One of the most common reasons for incorporating cross training into their programs are that

Tips for cross training:

Similar muscles and energy systems should be worked to that which are needed in running.
Focus initially on stability as this will help prevent injury both in running as well as when doing other forms of exercise.
Include core strengthening exercises as a strong core will help prevent injury and improve overall efficiency in all movements.
Make sure training is sport specific
Once a strong, stable base has been built more explosive, plyometric exercises can be included.

Important Exercises to Include:

Here are just 4 exercises that runners can include their training programs that will help with their stability, mobility and strength.

Sideways walking:

Place Loop band/Thera Band around the thighs, just above the knees
Stand with feet hip width apart, toes straight, knees bent, bum out backwards
Now take a step with the right leg out to the side, keeping the knees out in line with the toes
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
Repeat steps 3 and 4 until you have completed 10-20 steps and then repeat on the left leg.
Perform 4 sets of 10-20 repetitions on each leg

Wall Squats:

Stand with toes as close to wall as possible
Feet just wider then hip width apart, with toes pointing outwards
Hands above the head in a V position
Keep head straight, do not look to the side or down
In this position, squat as far down as possible without lifting the heels or falling backwards
Return to starting position
Perform 3 sets of 10 repetitions

Step Throughs:

Start in a push up position
Step through with the right leg, placing the right foot next to or as close as possible to the right hand
Keep the left leg as straight as possible
In this position bounce the hips lightly up and down
Return right leg to starting position
Repeat on the left side
Perform 3 sets of 5 repetitions per leg

Scorpion Stretch:

Start lying on your stomach, with arms out at your sides, head down straight
Now lift the right leg and foot off the ground
Bend the knee and aim the right foot towards the left hand
Keeping the right shoulder flat on the floor
Return the leg to starting position
Repeat on the left side
Perform 3 sets of 5 repetitions per leg

There are many exercises that can be used by runners to cross train. In particular focus should be placed on stability, strength of the core, gluts, hamstrings and quadriceps, and ensuring that all exercises are done with the correct form and bio-mechanics.

For an individualize and specific program that is tailored to your specific needs contact us here. We can help you increase your speed, endurance and overall performance, while preventing injuries and over-training.

The Multiply Fitness Assessment

Posted on June 4th, 2018 by Andries Lodder

What is the Fitness Assessment:

A Multiply fitness assessment is an alternative to getting Active Dayz™ for members who live an active lifestyle but are unable to track it. You will earn points towards your Multiply status for completing a Multiply fitness assessment through the Biokinetics Association of South Africa (BASA).

Multiply members pay only R192 for a fitness assessment. Your fitness assessment is valid for six months.

Momemtum rewards

If you are a Momentum Health member or have Momentum Myriad life insurance, you will get cash back and discounts based on your Multiply status, Healthy Heart Score and number of Active Dayz™ or fitness level. Get up to 60% off Myriad premiums and up to R2 500 per month back in HealthReturns⁺.

Points

Provider

You pay only R192 for your Multiply fitness assessment. After your assessment, you’ll earn the following points, depending on the fitness level achieved:

Fitness Level	Points
Level 1	5
Level 2	10
Level 3	15
Level 4	20
Level 5	25

Premier

You pay only R192 for your Multiply fitness assessment. After your assessment, you’ll earn the following points, depending on the fitness level achieved:

Fitness Level	Points
Level 1	5
Level 2	10
Level 3	20
Level 4	30
Level 5	40

What to expect when you go for a fitness assessment?

It involves:

A fitness test to determine cardiovascular fitness
Upper and lower body flexibility
Peak flow test
Body fat percentage
The assessment takes 20 mins with your biokineticist.

What to bring:

Wear comfortable clothing, like track pants, tights or shorts and running or walking shoes.
Take your gym towel.

You will receive comprehensive feedback, and an overall fitness level (between 1 – 5) which can be printed and/or emailed to you.

For more information visit https://www.multiply.co.za/engaged/get-well/get-active/fitness-assessment/

Chronic and Overuse injuries

Posted on May 22nd, 2018 by Andries Lodder

By Jennifer Steele

Types of Injuires

The majority of injuries sustained through exercise and sports can be categorized into two groups, acute injuries and chronic overuse injuries. In simple terms acute injuries occur suddenly and usually because of a traumatic or specific incident, while chronic overuse injuries occur over time, there is no sudden onset and they get worse as time goes on. Chronic injuries usually occur as a result of repetitive movements with continuous impact on the same soft tissue structures occurring time and time again.

Preventing injuries is every athlete’s goals. However, chronic injuries are far easier to prevent then acute injuries. Due to the sudden, unplanned traumatic event, athletes can rarely prepare themselves against an acute injury. However, with stability training and proper muscular balance the severity of acute injuries can be lowered. Chronic injuries on the other hand can more often then not be prevent with the correct training to a far greater degree.

So how do chronic injuries occur?

Doing too much to quickly:

When we exercise we apply stress to our bodies, our bodies then adapt to this stress by strengthening the various tissues under stress. Muscles get bigger and stronger, tendons get stronger and bones get denser. However, if exercise is done to quickly and the body isn’t given enough time to adapt then the body is overloaded and the trauma it undergoes can lead to microscopic injuries and inflammation. If this is continued it come lead to a chronic injury.

When starting out an exercise program make sure to start slowly, perform exercises at an intensity that you can handle, focusing on form and schedule in adequate rest and recovery days. Only progress when your body is ready to.

Not giving the body enough time to rest and recover:

In a similar way to doing too much too quickly, not giving your body adequate rest also leads to injury as a result of inadequate adaptation. The microscopic injuries that occur build up and eventually lead to a big injury

Returning to play to soon after a previous injury:

After an injury the body goes through a specific healing process, there is usually a period of rest, healing and rehabilitation. If an athlete does not give the body the right amount of time to undergo its full healing process the likelihood re-injury is high. Likewise, after a serious injury an athlete will need to undergo rehabilitation. Specific exercises will need to be done to ensure they have proper muscle balance, correct biomechanics and adequate skills to return to sport. If this stage is skipped once again the likelihood re-injury is high.

Not Cross Training:

When training for a specific event or sport it means repeatedly doing the same activity. However, it is important to vary your training and do cross training. For example, cyclists should not only train on the bike, instead they should also include leg strength exercises as well as core stability into their programs. This strengthens the necessary muscles to help improve performance and prevent injury. It also protects the same muscles and joints from repeatedly taking impact.

Incorrect form or technique:

When training with incorrect form or technique extra stress is placed on certain joints and muscles. For example, when doing squats, the Glutes should be active, and the knees should not fall in. If they do, instead of the exercise working the Glutes strain will be placed on the inside of the knees and if the exercise is repeatedly done wrong this could damage the knee joint, ligaments and cause an injury.

Muscle Imbalances:

All muscles in the body act in pairs. There is an agonist and an antagonist. There should be balance between both these muscle groups. For example, the hamstrings and the quadriceps are a pair. If the one muscle group is significantly stronger than its counterpart, it can lead to injury as the joint that they act on will have limited movement in certain directions or to much movement in others. Thus placing increased tension and strain on both the joint and the muscles.

Using the wrong equipment:

This could be everything from the shoes worn to the surface train upon. Equipment used in sport should enhance performance and not hinder it. If a neutral foot runner wears pronator shoes it will put stress on their joints and muscles and lead to injury. If the floor being trained upon is concrete and repeated jumping or explosive movements are done it can lead to injury. The grip of a tennis racket, the length of a hockey stick, the grip on a running shoe, all equipment should be the right fit, type and not change the natural biomechanics of the athlete’s body.

The Four Stages of a Chronic Injury:

The pain and discomfort disappear during the warm up
The discomfort disappears during the warm up but reappears again after the activity.
The discomfort gets worse during the activity
There is pain and discomfort all the time

Treating the injury during stages 1 and 2 will mean with the appropriate measures will ensure it does not get worse and the athlete will be able to continue with their training with only a few alterations. However, if it gets to stages 3 and 4 then the aggravating activity needs to be stopped immediately, only returning after treatment and when completely symptom free.

Injuries can affect anyone not just athletes. With the correct training the severity of acute injuries and chronic injuries can be lowered to a significant degree. If you are experiencing pain and discomfort and think you are on the way to an injury seek professional help before it gets bad. Contact us here for more information on how to treat and prevent injuries from getting in the way of your training.

Overtraining

Posted on May 2nd, 2018 by Andries Lodder

By Jennifer Steele

So many athletes suffer from overtraining syndrome, especially when training for big events and competitions. Previously we have spoken about the importance of including rest and recovery sessions in their training programs. However, there are still those that fail to do so and train longer and harder without increasing their recovery time. For an individual to see improvements in their performance the body needs to be overloaded to a certain extent. When the body is overloaded and exposed to a high level of demands it is forced to adapt to these demands and that is when performance gains are seen. The problem comes in when the overload exceeds the bodies recovery capacity. When there is inadequate time for recovery an athlete is at risk of overtraining and developing overtraining syndrome, which can have a detrimental effect on both the physical and mental state of the athlete.

So how can you tell if you are at risk of overtraining?

Feeling washed out, tired, drained, and lethargic
Elevated resting heart rate
General aches and pains and an increase in the incidence of injuries
Decreased levels in performance
Insomnia
Headaches and decreased immunity with the development of colds, flu and other illnesses
Irritability or depression
A loss of enthusiasm or drive for their sport
Decreased appetite and weight loss

The solution:

If you are experiencing these symptoms and are at risk of overtraining or are currently in an over trained state, you can try the following:

Ensure you are getting an adequate amount of sleep. 8-12 hours of sleep is necessary when training at intensities. Including a short nap in the day can also help reduce the stress on your body and increase your recovery levels.
Take 3-5 days off from training completely. After adequate rest you will feel rejuvenated and want to return to training.
Reduce your training volume and intensity for a few days.
Get a deep tissue or sports massage. This will assist in your muscle recovery as well as allow your mind to relax.
Ensure you are eating an adequate amount of food each day and getting the nutrients your body requires such as proteins, carbohydrates, fats, vitamins and mineral.

It is important to remember to listen to your body and give it the rest and time off that it requires. Take at least one full rest day a week and give your body time to rest between workouts in the week. It is great to work towards a goal but it important to remember that in order to achieve that goal you need your body to be at it peak.

For more information and training advise contact us here.

The Importance of Rest and Recovery

Posted on April 20th, 2018 by Andries Lodder

By Jennifer Steele

In today’s world of competitive sports all athletes are searching for a competitive edge. Some spend an extra few hours in the gym or practicing their techniques. Others ensure their training is as sports specific as possible. However, how many are optimizing their recovery sessions and rest time?

Rest and recovery are seen as the ‘forgotten training component’.

This is because most athletes understand the importance actual training plays in their performance. However, few understand the important role that recovery, rest and sleep play. When it comes to strength, conditioning and practice sessions athletes and many other individuals plan their training weeks and days meticulously, understanding exactly what they need to put their bodies through in order to excel on game day.

On the other side of the training they are doing is recovery. However, many athletes fail to schedule into their programs; massages, short power naps, ice baths, rest days, and post season time off. Deep down they know their body needs to recover but when it comes to taking a day off or resting they feel guilty and so they continue training.

What athletes need to understand is that adaptation and gains in strength, power and technique don’t occur during a heavy training session. Rather it is during the recovery after the session and rest when the adaptations occur. Rest is physically necessary so that muscles can repair themselves, rebuild and strengthen. It is during this time that energy stores are replenished and repairs take place. Without adequate rest the body is in a constant state of overtraining. If in this state for too long there is risk of the person developing overtraining syndrome.

Rest and Recovery can also be split into two categories:

Short term recovery:

This occurs immediately after an exercise session. It can consist of the short low intensity exercise, known as Active Recovery, replenishing the bodies energy and fluid stores by eating and drinking a post exercise meal and drink. The use of recovery techniques involving the removal of chemicals and fluids that build up during exercise are also used here. Sleep and sleep quality are also an important factor that needs to be considered for short term recovery. After all training sessions, especially hard/intense sessions the quality of sleep that an athlete gets has a massive effect of their recovery.

Long term recovery:

This is more the recovery that is built into a full training season. It includes rest/recovery days in each week, taper weeks, rest blocks and post season time off. All these factors play a role in an athlete’s overall recovery.

If not managed correctly both short and long-term recovery can have detrimental effects on an athlete’s competitive career, performance levels and overall health and wellbeing.

So how can rest and recovery be incorporated?

Sleep

Athletes should include short power naps between 10-20 minutes into their day following or between training sessions to help and encourage their bodies natural recovery processes. They should also aim to get between 8 and 12 hours sleep every night to allow their bodies to fully recover from the days training and prepare then for the next.

Nutrition and Hydration

Athletes should follow an individualized diet that takes into account their specific caloric needs. They should also ensure that they eat at the right times in the day taking into account the goals of each training session and ensure that they replenish and remain hydrated throughout the day by drinking adequate water and when necessary sports drinks.

Stretching and Mobility

Athletes should ensure they include adequate stretching and mobilizing exercises into their training sessions. During their warm up including dynamic stretches and mobility exercises can help prepare the body for exercise and prevent injury. While including stretches after a session can assist in flexibility, as well as reducing tight and stiff joints, improving mobility, reduce muscle soreness and assist in short term recovery.

Recovery Techniques

Heat, ice, compression, massage, and other specific techniques have been shown to help speed up and improve athlete’s recovery from strenuous training sessions. By reducing inflammation, improving circulation and assisting in muscles repair techniques such as sports massage, compression boots and ice baths can be used by athletes to help assist their bodies in dealing with the demands of training and improving their recovery times.

Athletes need to understand that with greater levels of training comes a greater need for planned rest and recovery sessions and periods within their training schedules. Remembering that fitness and strength isn’t acquired in the gym, rather it is when the body is allowed to recover that results and adaptation take place and present themselves. Dedicating specific time to recovery can help give all athletes the competitive edge they are looking for, increase their performance, lengthen their careers and keep them injury free.

For more information and to make use of our recovery techniques don’t hesitate to contact us.

Thoracic Outlet Syndrome (TOS), here’s what you need to know!

Posted on March 28th, 2018 by Andries Lodder

Thoracic Outlet Syndrome?

By Xavier Mc Creanor

Thoracic Outlet Syndrome is a term used for several different conditions that can occur when nerves and blood vessels in the thoracic outlet are compressed or irritated. The thoracic outlet is the narrow space between your collarbone and first rib. Blood vessels, nerves, and muscles that extend from the back to the arms pass through this area. If the space in the thoracic outlet is too narrow, these structures can become compressed. The increased pressure on the blood vessels and nerves may cause pain in your shoulders, neck, and arms. It can also cause numbness or tingling in your hands.

Types of Thoracic Outlet Syndrome

Vascular – Compression of the artery and/or vein. This type of thoracic outlet syndrome occurs when one or more of the veins or arteries under the collarbone (clavicle) are compressed. Vascular thoracic outlet syndrome symptoms include: discoloration of your hand, arm pain and swelling, blood clot in veins or arteries in the upper area of your body, lack of colour in one or more of your fingers or your entire hand, weak or no pulse in the affected arm, cold fingers, hands or arms, arm fatigue with activity, numbness or tingling in your fingers, weakness of arm or neck or a throbbing lump near your collarbone.

Neurogenic – The nerves become compromised from an extra cervical rib (see Figure 1 below), present at birth. This form of thoracic outlet syndrome is characterised by compression of the brachial plexus. The brachial plexus is a network of nerves that come from your spinal cord and control muscle movements and sensation in your shoulder, arm and hand. In the majority of thoracic outlet syndrome cases, the symptoms are neurogenic. These neurogenic symptoms include; muscle wasting in the fleshy base of your thumb, tingling sensation in your arm or fingers, pain or aches in your neck, shoulder or hand and lastly weakening grip.

Nonspecific-type (Disputed or painful form) – No neurological deficit but patients experience neurological symptoms and pain. Typically, these patients’ clinical tests are negative, but they complain of pain. This type is also called disputed TOS. Doctors find the reality of nonspecific TOS debatable. People with nonspecific-type thoracic outlet syndrome have chronic pain in the thoracic outlet that worsens with activity, but a specific cause of the pain can’t be determined.

How is Thoracic Outlet Syndrome Diagnosed?

Your doctor will perform a physical exam and review your symptoms. The doctor might perform a few tests to reproduce the symptoms to make a more accurate diagnosis. The doctor might also send you to do an X-ray, MRI, Electromyography (EMG), or a nerve conduction study to confirm your diagnosis.

How can a Biokineticist help you?

Biokinetic treatment is recommended to help strengthen and stretch the shoulder muscles. Your Biokineticist can help you to strengthen these muscles to improve your range of motion and your posture. Exercises can provide support for the collarbone and the muscles surrounding the thoracic outlet. Regular exercises may take the pressure of the blood vessels and nerves affected in the thoracic outlet area.

If you are overweight your Biokineticist can assist you with a weight-loss training program focusing on exercises that will help relieve symptoms over time. A healthy weight is important for reducing pressure on the joints affected.

Prevention is better than cure therefore your Biokineticist will educate you on the following;

How to maintain a proper posture while sitting or standing
How to perform the correct stretches
Guidance on maintaining a healthy weight and lifestyle
Performing strengthening exercises
How to avoid activities that make your symptoms worse
How to avoid repetitive movements
The correct way to lift heavy objects

Our team of Biokineticist are ready to assist you, please feel free to contact us today.

Article resources:

What is Thoracic Outlet Syndrome?

https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve_surgery/conditions/thoracic_outlet_syndrome.html

More on Thoracic Outlet Syndrome

https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos

Mayo Clinic’s take on Thoracic Outlet Syndrome

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

Thoracic Outlet Syndrome from Orthopaedic Surgeons perspective

https://orthoinfo.aaos.org/en/diseases–conditions/thoracic-outlet-syndrome

The Importance of Core Stability

Posted on March 26th, 2018 by Andries Lodder

By Jennifer Steele

When speaking in terms of the human body, stability refers to a person’s ability to control the movement and position of their muscles, joints and limbs. With greater stability comes greater control. So, with this in mind, core stability refers to the individual’s ability to control and move their core with or without movement of the other limbs of the body. The greatest misconception is that in order to have a strong core and to have a stable core you need to have a 6 pack, or that if you have a 6 pack you have good core stability.

However, this is not the case. Having a visible 6 pack or a well-defined core requires an individual to have a certain level of body fat. The lower the level of body fat the more visible the core muscles will be. However, this has nothing to do with the individuals ability to control and stabilise their trunk, lumbar and abdominal regions.

So how do we go about developing good core stability?

First let’s look at the muscles involved in the core, then how we can go about strengthening them and finally the benefits of having good core stability.

Muscles Involved:

The core muscles are like a corset and wrap around the trunk. They are like a powerhouse and when they have adequate strength and work together they provide a solid base for which all other muscles of the body can act against. The Transverse Abdominus, Multifidus, Diaphragm and Pelvic Floor muscles all form part of the cylinder that are the core stabilisers. These muscles all keep the spine in its most neutral position and help to aid in preventing injury. Prior to any movement of the limbs of the body the corset of core muscles should contract to keep the body ridged and stable and provide a solid foundation against which the limbs can move.

Benefits of Core Stability:

Injury prevention:

Improving core stability is essential in preventing injury to all areas of the body. It is especially important in preventing lower back injuries as it is the primary stabilizer of the lower back and when the core works effectively it helps to relieve the pressure off of the lower back. It is also important to prevent other injuries such as hamstring strains or hip impingement. When the core is activated prior to other movements the other muscles of the body can work more efficiently together and movements are better controlled and performed with better technique which reduces the risk of injury.

Rehabilitation from injury:

Strengthening the core stabiliser when recovering from all injuries is important as it will help improved the quality of all movements. It will also help in preventing the injury from reoccurring as well as improve overall control within the body.

Improved Sporting Performance:

With improved core stability comes improved sporting performance. No matter who the athlete, core stability and strengthening should be included in everyone’s training regime. Not only does it prevent injury like we said before but it will help improve balance, coordination, reaction time, efficiency and quality of movement, as well as overall strength and power.

How to Improve Core Stability:

Phase 1: Back Flat on the Floor

A good place to start training your core is by doing core stability exercises where the lower back is flat on the floor. By starting here is ensures that while the muscles strengthen the back is still supported and is protected from injury. When doing any of these exercises it is important to push the lower back into the ground and not let it arch up.

An example of this exercise is the dead bug

Dead Bug:

Lie on your back with both your arms and legs up in the air
Push the lower back into the ground and activate the core
Slowly lower alternate arm and leg towards the floor (To the point where you feel the lower back coming off the floor)
Return the arm and leg to the starting position and repeat with the other side.
Perform 3 sets of 10 reps per arm/leg

Phase 2: Back unsupported, stable base

Once you have mastered control of this type of exercise you can progress your training to exercises where the back is no longer supported and instead the core has to do be in control and strong.

First start by doing a basic 4 base plank.

Plank:

Lie on your stomach on an exercise mat
Push up onto your elbows and toes
Engage your core and ensure you have a flat back
Start by holding this position for 15 seconds and then progress up to a minute as you get stringer

Phase 3: Back unsupported, unstable base

Once you have mastered a basic plank, you can start lifting each limb off the ground making the core work harder to stabilize the body.

Reduced base of support plank:

Lie on your stomach on an exercise mat
Push up onto your elbows or onto straight arms and toes
Engage your core and ensure you have a flat back
Now lift each limb up from the floor and hold for 10-20 seconds (Alternating limbs for the duration of 1-2 minutes)
Once you can lift one limb progress to lifting alternating arm and leg at the same time like the picture below
Start by holding this position for 15 seconds and then progress up to a minute as you get stringer

Phase 4: Back unsupported, additional instability

The final stage is when the back is unsupported and you add elements of instability to the exercise. Placing the hands on a bosu, or the feel on a swiss ball while performing a plank is a good place to start.

Plank on a Bosu:

Place hands on the edge of a bosu ball
Push up onto toes and hands
Engage your core and ensure you have a flat back
Start by holding this position for 15 seconds and then progress up to a minute as you get stringer
Once you can hold this position you can make the exercise harder you can add leg movements such as knee tucks into the exercise

Plank on a swiss ball with leg lifts:

Place feet on a swissball
Push up onto straight arms onto your hands
Engage your core and ensure you have a flat back
Start by holding this position for 15 seconds and then progress
Once you can hold this position you can make the exercise harder you can add leg movements such as leg lifts into the exercise
Note: The further away the swiss ball is from your body the harder the exercise

For more information on how to improve your core stability and on exercises to include in your program contact us and book your assessment today.