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:

Cause

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.

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

Treatment

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:

Place Loop band/Thera Band around the ankles
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 (perform this movement slow and controlled)
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

Foam Roller Stretch:

Place a foam roller on the floor or mat
Lay on your side with the top of your ITB (hip) on top of the roller
Support your upper body with your foam roller
Move your body up and down so that the roller moves up and down the leg
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.

Fascia

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.

Fasciitis

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:

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.

Treatment

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

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

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

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

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:

Place Loop band/Thera Band around the ankles
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 (perform this movement slow and controlled)
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

Squats:

Stand with feet just wider then hip width apart, with toes pointing outwards
Hands and arm out in front of you
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

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.

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.