Peroneal Tendonopathy

Posted on July 11th, 2019 by Andries Lodder

Are you suffering from pain on the outside of your foot while running, walking or jumping? If the pain is directly behind the little bone that sicks out on the outside of your ankle, then you could have Peroneal Tendonopathy.

Peroneal Tendonopathy occurs when the Peroneal Tendons become inflamed. This can be due to an increase in load or overuse of the tendons which leads them to rubbing on the bones of the ankle and becoming inflamed. Overtime the tendons will thicken to try and compensate for the increased load, leading to further inflammation.

Anatomy:

There are two Peroneal tendons in each leg. They run down the outside of the lower leg and behind the lateral malleolus of the ankle (bony bump on the outside of the ankle).

One tendon attaches on the outside of the foot at the base of the baby toe, while the other goes underneath the foot and attached underneath the arch. These tendons provide stability to the ankle and protect the joint from sprains. They also assist in turning the foot outwards and in stabilizing the arch of the foot.

Causes:

Any activity that involves excessive ankle movement can lead to Peroneal tendonopathy. However, it is especially common in runners who supinate and roll their feet outwards leading to pressure being placed on these tendons and causing it to rub on the malleolous in the ankle.

Risk factors:

Overuse
A sudden increase in training
Poor footwear
Poor biomechanics of the lower leg
Muscle imbalances
Individuals with a high arch in their foot

Signs and Symptoms:

Peroneal tendonopathy can be either acute, meaning it develops very suddenly usually following a specific traumatic event or more commonly, it can be chronic and develop over time.

Symptoms:

Pain behind the lateral malleolus
Pain at the back of the ankle
Pain when turning the foot out
Pain during and after weight bearing activities, such as running
Ankle instability
The skin at the back of the ankle will be warm to the touch due to the inflammation

Diagnosis:

A medical professional will use an individual’s history to determine if they have the risk factors and symptoms of Peroneal Tendonopathy. A variety of movement and biomechanic tests can also be done by a physiotherapist or Biokineticist to determine if the tendons are inflamed.

A CT scan or MRI might be necessary to rule out any tendon ruptures or other abnormalities in certain cases.

Treatment:

Since the tendons are inflamed due to overuse, rest will be essential in helping reduce the inflammation, swelling and pain. Therefore, only non-weight bearing activities should be done for the first few days and weeks depending on severity. Anti-inflammatory drugs can be taken to help with any pain if prescribed by a medical professional.

Initially the best treatment is rest, ice, compression and elevation in order to allow the tendons time to recover.

After which a exercise program should be started in order to correct any biomechanical abnormalities or muscles imbalances. Exercises to strengthen the peroneal muscles and tendons should be performed, as well as ankle stability exercises. If the individual is a runner then their running style and technique should be checked and corrected if necessary. Their footwear should also then be checked to see if it is appropriate.

Exercises:

Single leg balancing:

Stand on one leg with the supporting knee a little bit bent
Ensure your hips stay in line and that the arch of your foot does not collapse
Balance for as long as possible
To make this exercise more effective it can also be done on an airex mat or balance pad
Balance for 30 – 60 seconds per leg for three to four rounds
Arm, head and eye movements can also be added to make this exercise more challenging

Ankle Eversion exercises:

Place a Thera band or loop around your foot
Pulling from the ankle only turn your foot outwards
Ensure your leg and knee do not move and that only your ankle turns
Do 3 sets of 10- 20 repetitions per leg

Calf stretches:

Standing with one leg forward and bent and the other straight out behind you
Keep the feet straight forward and the both heels pushed into the ground
Bent forward to stretch the Gastrocnemius muscle of the calf of the back leg
Hold this stretch for 30 seconds
Then bend the back knee and sit back into the back leg to stretch the Soleus muscle of the calf
Hold this for 30 seconds
Repeat this twice per leg

For more information or to book an assessment if you think you could be suffering from Peroneal Tendonopathy do not hesitate to contact us.

Whiplash Associated Disorder

Posted on June 26th, 2019 by Andries Lodder

By Fathima Jeewa

Trauma to the neck is common during motor vehicle collisions and injury during sport. A common neck injury is whiplash which is a sprain to the upper cervical region. Neck sprains typically occur at the extremes of motion, a violent muscle contraction or an external force.

The cervical region forms one of the five regions in the spine, i.e. cervical, thoracic, lumbar, sacral and coccygeal. Each region is structurally and functionally different and plays an important role in spinal movement and strength.

The cervical vertebrae is made up of 7 vertebrae with each vertebrae increasing in size. The cervical region contains spinal nerves which innervate muscles of the neck, shoulder and diaphragm. These nerves also provide sensation for the skin of the ear, neck and upper chest. Impingement of these nerves can result in headaches, neck pain and breathing difficulties.

What is Whiplash?

During a whiplash the neck is violently forced forward and then backward resulting in overstretching of the anterior and posterior muscles as well as ligaments in the neck muscles.

Symptoms of a whiplash include:

Pain in the surrounding neck and shoulder muscles
Stiffness
Restricted range of motion of the neck
Ongoing symptoms for several days and more
Loss of balance
Headaches
Muscle spasms
Sensation of pins and needles

Management of whiplash injury

Treatment includes rest, ice and non-steroidal anti-inflammatory drugs prescribed by a medical practitioner.
A collar may be used for additional cervical support continuous ice and heat therapy can then be used.
Progression to gentle stretching and exercises supervised by a physiotherapist or Biokineticist.
Return to competitive sport should not occur until there is no pain and all neck tests have been proved negative.
Symptoms should be monitored closely and discussed with the physician, physiotherapist and Biokineticist.

For more information or treatment on whiplash associated disorder, feel free to contact us and let us help you.

Important facts about Asthma

Posted on June 18th, 2019 by Andries Lodder

By Nicole Harran

Asthma is a condition in which a person’s airways become inflamed, narrow and swell, producing extra mucus, making it difficult to breathe. It can be a minor attack or severe which can interfere with daily activities. In some cases, it can lead to a life-threatening attack.

The exact cause of asthma is not entirely understood, however, each individual has different triggers.

Asthma signs and symptoms include:

Shortness of breath
Chest tightness or pain
Trouble sleeping caused by shortness of breath, coughing or wheezing
A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Treatment

Prevention and long-term control are paramount in stopping asthma attacks before they start. It usually involves identifying your triggers, avoiding them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control.

In case of an asthma flare-up, you may need to use a quick-relief inhaler.

Medication

The right medications for you depends on several things:

Age
Symptoms
Asthma triggers
What works best to keep your asthma under control.

Commonly there are two categories of medication:

Preventive, long-term control medications – reduce the inflammation in your airways that leads to symptoms.
Quick-relief inhalers (bronchodilators) – quickly open swollen airways that are limiting breathing.

How to avoid triggers:

Use your air conditioner. Air conditioning reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors.
Decontaminate your decor. Minimize dust that may worsen symptoms by replacing certain items in your bedroom.
Maintain optimal humidity. If you live in a damp climate, talk to your doctor about using a dehumidifier.
Prevent mold spores. Clean damp areas in the bath, kitchen and around the house to keep mold spores from developing.
Reduce pet dander. If you’re allergic to dander, avoid pets with fur or feathers.
Clean regularly. Clean your home at least once a week.
Cover your nose and mouth if it’s cold out. If your asthma is worsened by cold or dry air, wearing a face mask can help.

For more information on asthma and how to train around it contact us

Obesity and Exercise

Posted on June 6th, 2019 by Andries Lodder

By Jennifer Steele

Obesity is a complex disorder that involves an excess of body fat. This is not just a cosmetic concern as it can result in numerous health problems, such as heart disease, diabetes and high blood pressure.

Classification

An individual can be classified as obese in several ways.

BMI
- When an individuals Body Mass Index (BMI) is greater than 30 they are classified as obese.
- BMI can be calculated by dividing an individual’s weight (kg) by their height (m) squared. A BMI between 25 and 29.9 places an individual in the overweight category.
- The problem with this method of classification is that BMI does not take an individual’s muscle mass into account. Therefore, a very muscular person such as a body builder and an obese person could have the same BMI even though their body composition is drastically different.
Body Fat Percentage
- Individuals with body fat percentages of greater than 32% for women and 25% for men are considered obese.
- Body fat can be measured using calipers, a body fat scale that uses bioelectrical impedance analysis, air displacement plethysmography, MRI scans or CT scans.
- This can be a better way to establish an individuals body composition. However, the accuracy of the results can be hugely affected by the method used to calculate an individuals body fat percentage and so the results are not always reliable.
Waist Circumference
- A waist circumference greater then 80 cm in women and 92 cm in men.
- When measured in the correct place this can be a helpful measurement as it is a good indication of where an individual is storing their fat. When excess fat is mainly stored around the abdomen it increases an individuals risk of co-morbid diseases such as high cholesterol, heart problems and diabetes.

Obesity is a result of an energy imbalance, an excess of calories taken in and to few calories burned.

There are numerous factors that influence how many calories an individual burns each day, such as genes, gender, age, and body size. However, with all people the amount of physical activity performed each day has the biggest influence.

Keeping physical active and consuming a healthy diet can help people stay at a healthy weight, as well as help people lose weight. The amount of exercise each individual needs to do is dependent on their own personal goals. However the World Health Organisation does recommend a minimum of 30 minutes of moderate exercise each day or 2.5 hours a week. Moderate intensity exercise is any activity that increases your heart and breathing rate, but you are still able to maintain a conversation.

Examples of moderate intensity exercise:

Fast walking
Jogging
Cycling
Swimming
Circuit training

Along with this moderate intensity exercise, including 2-3 resistance or strength training exercises sessions a week can also help to increase muscle mass which helps with fat loss.

When it comes to exercise it should be noted that doing any physical activity is better then doing none. If you are currently not exercising you should start gradually, and it can be beneficial to receive the help of a trained professional. If you have any health issues or co-morbid diseases, such as high blood pressure, diabetes, or heart conditions then seeking the help of a health care professional such as a Biokineticist is advisable as they can tailor make an exercise program appropriate for your health conditions.

Even just including a small amount of exercise into your lifestyle can drastically help improve your health. Just always remember that the weight won’t come off in a week and that a total lifestyle change, diet, exercise and mindset will get you the best results.

For more information or help on on improving your health don’t hesitate to contact us to set up an assessment.

Lung Function Testing

Posted on June 3rd, 2019 by Andries Lodder

By Nicole Harran

Lung function testing consists of a variety of tests that check how efficiently the lungs work. The most commonly practiced test is spirometry.

Spirometry is used to detect the amount of air the lungs can hold and how forcefully one can empty air from the lungs. It is commonly used to screen for breathing problems. These include; diseases that affect lung volumes and airways, such as chronic obstructive pulmonary disease (COPD) or asthma.

There are 2 types of disorders that cause problems with air moving in and out of the lungs:

Obstructive – This is when air has trouble flowing out of the lungs due to airway resistance. This causes a decreased flow of air.
Restrictive – This is when the lung tissue and/or chest muscles can’t expand enough to accommodate the air. This creates problems with air flow, mostly due to lower lung volumes.

About Spirometry:

These tests are not painful. They are performed by a pulmonary function technician (or biokineticist), who will require you to use maximal effort to blow out and breathe in air into a device. The tests are repeated a minimum of 3 and maximum of 8 times to make sure the results are accurate.

There are certain pre-test instructions that should be made aware to the patient before the test:

Do not smoke 6 hours prior to testing.
Avoid consuming alcohol 4 hour prior to testing.
No heavy exercise 30 minutes prior to testing.
If they use a short acting inhaler, it should not be consume 6 hours prior to testing.
Wear lose fitting clothing.
Do not eat a heavy meal before the test.

When to perform a pulmonary function test?

If suspected or screening for:

Allergies
Respiratory infections
Trouble breathing from injury or surgery
Chronic lung conditions
Restrictive airway problems
Exercise induced asthma

Once the test has been completed your results will be presented to the technician. The results will be interpreted by a medical practitioner and the appropriate responses will be taken to ensure your optimal health.

Graphs depicting a normal, obstructive and restrictive flow volume loop which the medical practitioner will interpret.

For more information on lung function testing and to know whether you should perform a test or not, contact us and let us guide you.

Fitness Testing; VO2Max and More

Posted on May 14th, 2019 by Andries Lodder

By Jennifer Steele

Fitness Tests:

Fitness tests can be used to measure certain abilities of the human body. Every fitness test has a specific outcome or value that it aims to measure. This outcome then becomes an athletes baseline value. Future tests and results can then be compared with this baseline and it can be determined if progress has been made.

Fitness tests do not only provide a baseline or starting point for an individual, but they can also be used to determine which areas need to be focused and improved upon. These areas can then become the primary focus of an athletes training program for that season. Fitness testing and its results are primarily used to help coaches and trainers in designing the most appropriate athletic training program.

Benefits of fitness testing:

Strengths and weakness can be identified
- Strengths and weaknesses can be identified by comparing the athletes results with those of other athletes in the same training group, other athletes in the same sport or in a similar population group.
- Once areas of weakness have been established, training programs can be developed and adapted to focus on these areas and improve them.
Progress can be monitored
- Preseason testing allows athletes to establish where their fitness levels are.
- Future fitness test results can also be compared to the preseason baseline results and any changes or improvements can be noted.
These tests provide incentives
- For athletes one of their goals could be to improve their fitness test results. Therefore, during training, they will work harder to get fitter and achieve this goal.
- Meeting certain fitness levels can be one of the criteria required to make a certain level or team and so this can provide an athlete with motivation to keep working harder if they see they are nearing their goal.

Common fitness tests:

Beep / Bleep Shuttle Run Test.
- 20 minute test
- Maximal running aerobic fitness test
Sit and Reach Test.
- Measure of flexibility
- Primarily lower back and hamstring flexibility
Handgrip Strength Test.
- Maximum isometric strength of the hand and forearm muscles
- The general rule is that people with strong hands tend to be strong elsewhere and so it can be used as a general test of strength
Skinfold Body Fat Test.
- This is a common method for determining body fat
- For certain athletes and sports people keeping body fat at certain level is advantageous
Vertical Height Jump Test.
- Used to determine the maximum leg muscle power an athlete can produce.
- The higher they can jump the more power they have are considered to have in their body.
Illinois Agility Test.
- Used to test an athlete’s ability to slow down, change direction and speed up again.

These tests do not require large amounts of equipment or laboratories and can be done on athletes of almost any level.

‘Laboratory’ Tests

There are also more complicated fitness tests that require qualified professionals and specialized testing. These tests are usually only needed by professional athletes who require a much deeper insight into their bodies and how they are functioning.

VO2Max Test:

A VO2Max test, also known as a maximal oxygen uptake test, is a test usually performed in a high performance center, laboratory, or specialized exercise facility. It is a measurement of the maximum amount of oxygen a person can utilize during intense exercise. It is a very common measure and fitness test done to determine an athlete’s aerobic endurance. It is one of several tests that can be done when determining an athlete’s cardiovascular fitness levels and performance capacity.

VO2Max is measure in milliliters of oxygen used in one minute per kilogram of body weight, ml/kg/min. The test is based on the premise that the more oxygen an athlete consumes during high intensity exercise, the more the body will generate adenosine triphosphate (ATP) or in simple terms, energy within its cells.

How is a VO2Max test performed:

A VO2Max test is a graded exercise test meaning that the intensity of the test is gradually increased over specific periods of time. The test is either performed on a stationary bicycle or a treadmill. The athlete will have to wear a face mask that is connected to a machine that can analyse their respiratory rate, the volume and concentration of both oxygen and carbon dioxide inhaled and exhaled. A heart rate belt will also be worn around the chest to measure the athletes heart rate throughout the test.

The test usually takes between 10-20 minutes to complete the test.

VO2Max is reached when your oxygen consumption reaches a steady state despite an increase in the workload.

Factors that influence VO2Max:

Age:
- VO2Max usually peaks in an individual around age 20 and then slowly declines by roughly 30% by age 65.
Gender:
- It has been shown that elite females’ athletes typically have a VO2Max value then their male counter parts. However, when the value is adjusted based on their body size, blood volume and hemoglobin content then men’s VO2Max values generally are about 20% higher then women’s.
Altitude:
- This is a simple factor as there is simply less oxygen to consume at a higher altitude. Therefore, an athlete generally experiences a 5% decrease in VO2Max values for every 5000 feet gained.

As with everything else, technology has also started to influence the fitness testing industry. More and more people are focusing on their health and getting into cycling, running, triathlons, CrossFit and so much more. In all these disciplines tracking your progress and training is becoming more popular and more important then ever. Companies such as Garmin and other fitness tracking companies have seen the need for this and have created products to help individuals of all levels track their heart rates, their speed, their distance and even their VO2Max.

The predicted value of an individual’s VO2Max by the Garmin is accurate to within 5%. This is a far cheaper, more accessible method of fitness tracking that people are starting to use instead of paying the high price attached to a VO2Max test performed in a fitness lab.

So, whether you are a weekend warrior, a professional athlete or a casual gym goer, why not start testing your fitness in various ways. Keep record of your results and then rest the same test in few weeks’ time and note the improvements.

For more information on testing, how to do it, and how to improve your results do not hesitate to contact us!

https://www.verywellfit.com/what-is-vo2-max-3120097

Cardiovascular Endurance with Injuries

Posted on April 24th, 2019 by Andries Lodder

By Fathima Jeewa

One of the most common phrases we often hear is “you need to improve your fitness levels” …But what does that mean?!

Cardiovascular endurance is also known as aerobic capacity. This is the body’s ability to sustain submaximal exercise over an extended period of time. This ability depends on the competence of the pulmonary and cardiovascular systems.

Factors that affect the efficiency of the cardiovascular and pulmonary systems:

Sedentary lifestyle
Injury
Pulmonary disease
- Asthma
- COPD
Heart disease
- Chronic heart failure
- Ischemia
Lifestyle and metabolic disease
- Diabetes (type 1 and 2)
- Hypertension
Neuromuscular disease
- Stroke
- Brain injury
Orthopaedic diseases and disabilities
- Arthritis
- Osteoporosis
Immunological and hematological disorders
- HIV/AIDS
- Cancer

All of the above-mentioned factors have an effect on aerobic capacity due to direct impact on the heart and lungs or an indirect impact by continuous disuse of the cardiovascular system. These factors need specific types and amounts to combat the decline in aerobic system. This is where a Biokineticist can help! We are able to design a structured and specific aerobic exercise program taking into consideration the specific needs of the individual.

How do you continue training your cardiovascular system if you are injured?

Injured – rest is advise. This could lead to detraining of the cardiovascular system within 1-2 weeks.

What is detraining?

Due to their aerobic capacity declining, when they return to sport they have a high chance of injury reoccurring due to fatigue setting in. This can be combated by doing non-weight bearing exercises during the rehabilitation phase of the injured side such as swimming, rowing or biking or use of the upper body such as arm ergometry when the lower body has been injured. As the individuals pain scale and condition improves, they can progress to walking, cross – country, running or jumping rope.

What is the ideal amount of aerobic exercise one should do?

Moderate intensity aerobic activity: 5 or more days per week, for a minimum of 30 minutes
Vigorous-intensity aerobic activity: 3 or more days per week, for a minimum of 20 minutes

How can you work out what your target heart rate is?

By using a simple formula, one can calculate what heart rate to work at.

THRmax = 220 – age. x %

Example we want to work at 65% for a 75 year old.
220-75 (age)
= 145 x 65%
=94.25 Bpm

This means we will be training at 65% of his heart rate max.

For untrained and injured individuals we always train at a lower intensity and then build up endurance until the individual is able to cope at a higher intensity for a longer period of time.

It takes approximately 6 – 8 weeks for an individual to show improvement in his aerobic capacity thus continuous aerobic training will improve one’s fitness levels which will ultimately benefit in longer training sessions, reduced fatigue and reinjury.

Let’s keep active and stay injury free! For assistance with staying fit and injury free contact us.

Common Golfing Injuries

Posted on April 16th, 2019 by Andries Lodder

Golf is an extremely complicated sport when it comes to analyzing the biomechanics of one’s swing. Due to the swing being such an asymmetrical repetitive motion, it places the body under huge amounts of stress from multiple directions. The body is not designed to withstand these unnatural forces and without enough strength and mobility, this could lead to various injuries throughout the body.

Golf techniques prone to injuries:

Casting – when a golfer uses excessive wrist action in their back swing, hoping to achieve a greater range of motion and increased distance, it can become problematic. This action leads to a large eccentric contraction (lengthening of the muscles) of the leading arm and concentric contraction (shortening of the muscle) of the forearm flexors of the following arm. Repeatedly doing this in a swing can lead to lateral and medial epicondylitis.
Sway – When a golfer attempts to gain momentum by shifting the weight backwards with the backswing and then pushing it forwards with the actual swing, it predisposes one to hip and back injuries due to the excessive movement.
Weight shift – a weight shift within a golf swing is extremely important when it comes to the biomechanics of the rest of the body. Golfers who don’t shift their weight during their swing often compensate by using other parts of the body. The shoulders and the thoracic spine are usually the sections which take the strain, leading to injury.

Common injury areas:

Lower back – For all the avid golfers who spend many hours hunched over their clubs to inevitably improve their game, may be doing more damage than good.
When standing hinged over your clubs for hours on end and then adding rotational forces to that already loaded lower back, it places large amounts of stress to that area. Without some core training, back strengthening and derotating your spine, lower back pain is inevitable.
Rotator cuffs – The rotator cuffs, are four stabilizing muscles within the shoulder. If the incorrect biomechanics are repetitively used during a golf swing, this could very easily lead to impingement’s and even tears of the muscles. This makes shoulder stability and strength training a vital component for golfers.
Elbow – Two commonly know injuries with regards to the elbow are know as “golfers elbow” and “tennis elbow”. Golfers elbow: refers to the irritation and inflammation of the tendon on the inner side of the elbow. Surprisingly tennis elbow is more common in golfers. Tennis elbow: refers to the irritation and inflammation of the tendon on the outer surface of the elbow. Treating tendinitis can be a tedious task, however, it involves strengthening of the forearm muscles and tendons, reducing inflammation and correcting your technique to avoid the unwanted repetitive stresses.
Knee – Knee injuries vary in type and severity when it comes to golf. During the golf swing, your knees serve as the point of stabilization while the hips are rotating. This becomes problematic with weak knees as the knees move out of alignment and this places large amounts of stress on them. Strengthening and stretching the muscles surrounding the knees is of utmost importance to prevent any knee pain.
Wrist – The wrists take a large proportion of the impact when striking a golf ball. If the wrists are not strong enough to withstand these forces, they can become irritated and inflamed, leading to possible tendinitis. For this reason it is paramount to strengthen the wrists and forearm muscles.

Preventing these injuries:

Lower back pain:

Two common causes of lower back pain involve; a weak core and tight muscles (very often tight hamstrings which cause a malalignment of the pelvis).

Core strengthening is an essential component that should be incorporated into all training programs as the core serves as the bodies center of balance and stability. Working the core and ensuring the correct engagement allows for the muscles of the lower back, hips, pelvis and abdomen to work in harmony. When the muscles work in harmony it creates an ideal environment for the body to work in and prevents any unwanted movements.

Core exercises: Dead bug

How to do it:

Lie face up with your arms extended toward the ceiling and your legs in a tabletop position (knees bent 90 degrees and stacked over your hips). This is starting position.
Slowly extend your right leg out straight, while simultaneously dropping your left arm overhead. Keep both a few inches from the ground. Squeeze your butt and keep your core engaged the entire time, lower back pressed into the floor.
Bring your arm and leg back to the starting position.
Repeat on the other side, extending your left leg and your right arm.

Rotator cuff injuries:

Your rotator cuff muscles are made up of a group of four muscles within the shoulder/scapular area: teres minor, infraspinatus, supraspinatus and subscapularis. These muscles serve a very important role in shoulder movement and stability. Rotator cuff injuries often occur due to overuse and improper functioning of these muscles. This makes strengthening these muscles very important, especially in golf, due to the biomechanics associated with the golf swing and stance.

Rotator cuff exercises: Isometric internal and external rotation

How to do it:

External rotation:

Bend your elbow 90 degrees, make a fist, and press the back of your hand into the wall as if you were rotating your arm outwards.
Use a small towel for a little padding, if needed.
Gently press into the wall for about five seconds. Slowly release pressure on the wall. Stop the exercise if you feel any increased pain.
Repeat the exercise 10 to 15 repetitions, and then start the next rotator cuff isometric exercise.

Internal rotation:

Bend your elbow 90 degrees, make a fist, and gently press into the corner wall or door jamb as if you were trying to rotate your hand inwards towards your belly button.
Remember, no motion should occur in your shoulder during the exercise.

Elbow: Tennis elbow (Lateral epicondylitis)

Treating lateral epicondylitis can be a tricky and frustrating process. Tendons have a poor vascular supply and this makes their healing process take much longer than many other parts of the body. Rehab and injury prevention of tennis elbow involves resting the arm and allowing the muscles and tendons to recover as well as strengthening the forearm muscles.

Tennis elbow exercises: finger web exercises

How to do it:

Placing the hands and fingers in different positions in/around the web and squeezing, extending, pulling or pushing apart the web.
These exercises can be done for the wrist.

Knees injuries:

Knee stability and leg strength is paramount in more than just a golf setting. The legs are essential components in allowing us to move around independently and complete many activities of daily living. They are our base of support for the rest of the body and need enough strength and stability to allow us to complete desired tasks.

Leg strengthening exercises: Quad and Hamstring setting

How to do it:

Quadriceps setting:

Lie flat or sit with your leg straight.
Tighten the muscle in the front of your thigh as much as you can, pushing the back of your knee flat against the floor. This will pull your kneecap up your thigh, toward your hip.
Hold the muscle tight for around 10 seconds.
Repeat this exercise .

Hamstring setting:

Lie on your back on the floor or a bed.
Pull your heel into the floor or bed as much as you can.
Hold this position for around 10 seconds.

To prevent any unwanted golf injuries or to maintain the strength and mobility needed to carry on playing a pain free golf game, contact us and let us help you.

Common Cycling Injuries

Posted on April 10th, 2019 by Andries Lodder

By Jennifer Steele

Humans have been riding bicycles since the early 1800s and it is now one of the most popular weekend sporting activities to take part in. Whether it be road racing, mountain biking, completing a few laps at your local bike park or just popping out for a coffee, there are always people out riding.

Cycling is also now seen as one of the best ways to boost one’s overall health. It can assist with weight loss, help fight chronic disease, improve overall fitness and strength levels as well as help decrease stress levels. With this in mind its no wonder the number of cyclists continues to rise every year. However, even with all its health benefits, like other sports, cycling also has its problems.

Injuries

No one wants to be forced off their bike due to an injury. Like with any sport one minute you are in the best form of your life and the next you can’t even get out of bed without pain.

These are some of the most common injuries cyclist face, how to deal with them and prevent them keeping you out the saddle.

Common Injuries:

Impact injuries:

The biggest problem with cycling is the fact that unlike many other sports you can fall off your bike. You can fall off your bike, and you can fall hard!! Impact injuries due to falls are very common in cycling and most often can’t be prevented. However, ensuring that you ride within your limits, take safe lines, and wear the appropriate protective equipment such as a helmet can help prevent injuries.

Lower back pain:

Due to the nature of a cyclist’s posture. Leaning forward curled over the handle bars, means that lower back pain is one of the most common injuries experienced by cyclists. Three of the most important factors to consider when dealing with lower back pain caused by cycling are:

Position and bike set up
- If you are experiencing lower back pain the first thing you can get checked is your bike set up and your posture/position on the bike. For example; if your handle bars are to lower it can cause back pain so simply raising them up could help alleviate some of the pain.
Core strength
- If a cyclist’s core is weak then their lower back will be put under constant strain while on the bike. Improving overall core stability and strength can help reduce back pain in cyclists, as well as improve their power output; as their legs are pushing off a stronger base.
Posture off the bike
- It is not only your posture off the bike that can lead to problems. If you sit at a desk all day it could be your posture, there that is causing the problems. Ensure your desk at work is set up correctly and that you are aware of how you are sitting and when the pain is at its worst.

Knee pain:

The knee joint is involved every time a cyclist turns over the pedals. The problem comes in when the knee gets pulled out of alignment. Most knee problems on the bike come from an incorrect bike set up. For example, if the saddle is to low it can lead to pain in the front of the knee due to strain being placed on the quadriceps, while pain behind the knee can come from a saddle that is to high which stretches the hamstrings out at their attachment. Most cyclists fasten their feet to the pedals of their bike with cleats. However, if the cleat is not set up correctly it can also cause problems. Pain on the medical or lateral aspect of the knee is a common sign of incorrect cleat set up as the knee does not track correctly in these circumstances.

Wrist arm hand or neck pain:

Ideally when cycling about 60% of your body weight should be positioned over the rear of the bike and 40% at the front. If to much goes over the front and through the handle bars it can lead to pain in the wrists and neck. Therefore, your seat should not be to far away from the handle bars and the handle bars should not be to low.

It is also important to not grip the handle bars to tightly and to make a concerted effort to relax the shoulders as this can help prevent the Trapezius muscles from tightening up causing neck pain.

Saddle Sores

A saddle sore is considered any sore, raised area of skin or irritation around the buttocks or undercarriage area. As the name would suggest they are caused by contact with the saddle. Friction between the saddle, skin and cycling shorts fabric can lead to horrible skin reactions and sores.

The most common cause of a saddle sore is old cycling shorts and a too high saddle. It is also important to find a saddle that suits you, as well as your gender as specific men’s and women’s saddles can help reduce rubbing and irritation from occurring.

The best thing to do once a saddle sore has formed is to keep the area clean and dry. If it is painful to sit on the saddle the best thing to do is to take a few days off the bike to allow the skin time to heal and calm down.

Hot foot

This is a burning sensation, numbness or pain felt on the underside of the foot. It is usually as a result of pressure being placed on the nerves that travel through the ball of the foot, towards the toes. In order to prevent and treat it the pressure within the foot needs to be redistributed. The pressure in the foot can be due to:

The foot swelling due to heat
Tight socks
Cleat placement
Poor insole support

Achilles Tendonitis:

This is an overuse injury cause by inflammation of the Achilles. Like with knee problems the main cause of Achilles problems in cyclists is the cleat and foot position on the pedal. If the cleat is pushed all the way forward, then the calf muscles will be overused during the pedaling action causing the Achilles to become inflamed. The same is true if the seat is to high as the toes will be continually plantar flexed engaging the calf muscle continuously.

When it comes to cycling injuries, bike set up is one of the most important factors to consider. It is important that if you are experiencing pain to get a professional to check your set up and posture on the bike. It is also important to ensure your core stability is good and that you are doing adequate strength training to prevent any muscles imbalances or injuries.

For more information regarding cycling injuries and how to prevent them do not hesitate to contact us to set up a consultation.

Neck Pain

Posted on March 19th, 2019 by Andries Lodder

By Nicole Harran

Neck pain is becoming an increasing problem amongst the population. Various factors are contributing towards neck pain which will be discussed and some tips will be provided on how to prevent and deal with it.

The Neck:

The neck is made up of a series of vertebrae which extend down from the skull to the upper torso. Between the vertebrae are intervertebral discs which serve as a shock absorber, allowing for motion within the spine. Within the vertebrae is the spinal column – a cord of nerves that send signals from the brain to the rest of the body, creating movement.

Causes of neck pain:

Muscle tension and strains – Overuse of the neck muscles may cause pain and tension. Activities such as working at a desk for too long, sleeping in a bad position, gritting your teeth and bad posture may all contribute towards neck pain.
Posture – one of the biggest contributing factors towards neck pain. It often places excessive stress on the cervical spine, straining the muscles and causing deviations of other regions of the spine and body. The misalignment often leads to injuries and pain.
Injury – The neck is particularly vulnerable to injury during, accidents, falls and sports where the neck is forced to move outside of its normal ranges. Injuries can vary in seriousness; from acute whiplash to varying degrees of paralysis if the spinal cord is damaged.
Illnesses – Meningitis, cancer, infections and various other illnesses can contribute towards neck pain.
Bone diseases – Osteoporosis, rheumatoid arthritis and spondylosis are just some bone diseases which may predispose an individual to neck pain.
Nerve compression – Herniated discs or bony spurs in the vertebrae of your neck can press on nerves branching out from the neck, causing pain in the neck or referred pain.

Prevention:

Good posture
Take frequent breaks from work and strenuous activities
Establish good ergonomics
Avoid carrying heavy bags over one shoulder
Sleep in a good position
Wear protective gear when necessary
Keep active
Stretch your neck slowly and correctly

How to train your postural muscles:

When doing any exercise, especially with the upper body, learn to set the shoulders and exercise in this position.

– Lift the shoulders up and back (squeezing the upper back muscles) and slowly lower the shoulders in this pulled back position.

Seated rows.

– In a seated, upright position, wrap a theraband around the feet (alternative to using a machine). After setting the shoulders, keeping the back upright, pull the elbows backwards.

– Keeping the elbows tucked in towards the body, palms facing up and squeezing the upper back.

Internal and external rotation of the shoulders.

Internal and external rotation with band

Standing/seated, shoulders set, using a resistive device. With external rotation, keeping the elbows squeezing the side of the body, rotate the arm outwards, against the resistance (resistance will travel across the body).

For the internal rotation, keeping the elbows squeezing the side of the body, rotate the arm towards the body (the resistance will travel towards the body).

Arm wall slides.

Standing with your back against the wall, feet slightly away from the wall. Bend the knees slightly and press the lower back into the wall. Keeping this position, raise the arms to 90 degrees and bend the elbows to 90 degrees. Slowly slide the arms up and down the wall, keeping the assumed position.

Thoracic mobilization stretch.

– Lying supine on the floor or hard surface, place a rolled up towel under the back at chest level. Keeping the legs straight and pressing the lower back into the floor raise the arms and elbows to 90 degrees. Slowly try press the forearms back towards the floor, preventing the back from arching.

– Lie in each position for 1 – 2 minutes thereafter moving the towel slightly higher towards the neck.

What to do?

If you are experiencing neck pain, have experienced neck pain or want to prevent neck pain, contact us and let us help you. We can assist in stretching and strengthening of the neck muscles, help with posture and provide guidance for day to day activities to prevent pain.