Beach Abs

Posted on December 5th, 2011 by Andries Lodder

When it comes to making changes in your physique, you must get clear on what you want, and be honest with yourself from the beginning. Perfection is not required, but there is a great balance between work done in the kitchen, and in the gym. Lets make your goal a reality.

When it comes to diet, there is no perfect meal, however, it comes down to calories in vs. calories out. It’s as easy as that!

A Couple of Steps to follow

Eat throughout the day – The body is pre-disposed to hold on to every ounce of energy you feed it. Fat is stored as energy reserves. When you starve yourself, the body holds on to the fat. Supplying your body with food on a consistent basis will get your metabolism going, and allow you to use more fat as a source of energy.
Drink more water – Make it a habit by keeping a bottle of water with you where ever you go. With proper hydration levels, it will be easier for the body to utilize fat for energy.
Limit alcohol consumption – Excessive alcohol will have negative effects on your progress. A glass of wine with dinner won’t hinder your progress.
Have the right personal approach to abdominal training – Having a strong core is so crucial to maintaining correct form in the gym, which can lead to fewer injuries in the future when doing other exercises.

The abdominals are composed of four main muscles: The Rectus Abdominis, External Oblique, Internal Oblique, and Transversus Abdominis. Each muscle has a role in the stabilization of a strong core, and the approval of all on the beach. Implement a routine that hits each one of these muscle groups to an equal degree for a intense workout:

The ab workout

Warm-up: 50 trunk twists – 2 sets, 25 full-sit ups.

Superset 1) balance ball sit-ups with side bend/ balance ball leg raises- 2 sets

Superset 2) bicycle crunches – 2 sets

Superset 3) leg raises – 1 set

Superset 4) 30 second planks and 30 second side-bridges – 1 set

Cool-down: 50 trunk twists – 2 sets, 25 full sit-ups

Other exercises to add variety: Balance ball knee crunch, Roman chair raises.

This is a fairly advanced routine, and beginners should use caution and start out using one set of each exercise. Use a stopwatch and see how long it takes you to complete the workout and try improve on it every time.

This is a very manageable strategy to get that body we all die to show off at the beach. Now stop reading and start planning.

http://pure-nt.co.za/blog/beach-abs/

Pedal Power

Posted on November 10th, 2011 by Andries Lodder

By Andrew Savvides, Qualified Physiotherapist

With summer on our doorstep and days getting longer and warmer, many people are taking to the outdoors to find their fitness fix. And, what better way to enjoy this country’s spectacular natural areas and climate than through mountain biking or cycling. Many have set the annual 94.7 Cycle Challenge as their goal, and with the event around the corner beginners and experienced cyclists alike have been taking to streets and off-road trails in preparation.

Aside from knowing where the best spots are to enjoy a post-cycle breakfast, what else do cycling enthusiasts really need to know? Fitness and preparation for any sporting activity include understanding the associated risks – making this an opportune time to delve into common cycling injuries.

There will always be traumatic injuries that result from falls and other unplanned adverse events, the effect of which a physiotherapist will do their best to mitigate, to encourage healing. However what many physiotherapists deal with is the effect on the body of the repetitive motion and rhythm of cycling, which can cause what is called a repetitive strain injury due to incorrect biomechanics.

Common biomechanical faults:

Forward head posture with craniovertebral extension (causing many cyclists to suffer neck pain)
Thoracic kyphosis (the spinal curve being exaggerated due to the cycling position)
Posterior pelvic tilt (the pelvis tilted backwards)
Hip adduction and internal rotation (the hip turned inwards and across the body also due to the cycling position)

These postural problems can be minimized far in advance of commencing cycling by spending a little extra money on ensuring that a bicycle is set up correctly for an individual’s unique physiology – by a professional.

Something as simple as making sure your saddle is at the correct height and that your cleats are in the right position – and not rotated – can go a long way towards preventing much future discomfort and injury.

That said, the cycling position is not a natural one and following training in this position for extended periods of time many cyclists develop weakness of their hip extensors (which move hips backwards), their abductors (which move hips outward), lateral rotators (which turn the hips out to the side) and over activity of the hip flexors (which move hips forward), the adductors (which move hips inwards) and the medial rotators (which turn hips inward).

It is also very common for cyclists to have very tight calf muscles, which affects range of movement at the ankle making cyclists more prone to injury in that area. Remember to always stretch hip flexors, adductors, medial rotators as well as the calf muscles adequately before and after training.

It’s very important for cyclists to strengthen their hip extensors, abductors and lateral rotators. A very good way to do that is to start cross training i.e. exercising off the bike to target these muscle groups through other forms of exercise. It has also been shown that cyclists have a lower bone density -especially in the lumbar spine and hips – due to excessive calcium loss through sweating and all the hours spent on the bike. As cycling is a non-weight bearing activity it doesn’t promote an increase in bone density, but cross training – particularly doing weight-bearing exercises – will ensure bone density remains optimal.

Physiopro – Pedal Power

Why Chiropractic?

Posted on September 23rd, 2011 by Andries Lodder

By Bradley Waterer

Chiropractors are Health Care Professionals who are trained to diagnose and conservatively manage neuromusculoskeletal pain and dysfunction. Chiropractors treat conditions that affect muscles, nerves and joints in the spine, hips, knees, ankles, feet, shoulders, elbows, wrists, hands, head and ribs. These conditions may result from every day wear and tear or injuries sustained through sports or accidents. Treatment is covered by medical aid and workman’s compensation.

How would Chiropractic help you?

Everyday actions such as a fall, lifting objects, stress, bad postures etc. can cause the spines moveable segments to become dysfunctional and fixated. Joint fixations lead to many short and especially long term problems if left untreated. The reasons for this are as follows:

Joint Dysfunction irritates many structures (such as muscles, joints, ligaments) which have a large nerve supply and are capable of detecting pain.
Joints need movement for their health. Lack of movement reduces the nutrient supply within a joint and degeneration will start to occur.
If a joint is fixated, then the muscles around it are not used, causing them to become small, weak, stiff and painful.

A combination of the above, leads to abnormal forces within the body which leads to i) pain cycle development and ii) degenerative processes

i. Pain Cycle

ii. Degenerative Processes

Phase 1: decreased range of joint motion, thickening of soft tissues.

Phase 2: further decrease in joint motion, joint degeneration begins, joint inflammation and pain, start of bony changes and overgrowth which can compress many important structures and cause pain.

Phase 3: uncorrected joint dysfunction allows further degeneration, bony and soft tissue changes, which will eventually progress to disc or facet joint fusion.

Phase 4: disc or facet joint fusion and massive bony overgrowth which compresses important pain generating structures.

By correcting joint dysfunction Chiropractic prevents or slows down the degenerative process by enhancing joint health. After careful clinical examination Chiropractic breaks the pain cycle by targeting and correcting each of its contributors. Scientific research provides evidence that Chiropractic reduces joint dysfunction, pain and muscle spasm, through various neurophysiological mechanisms.

The Chiropractic Profession concerns itself with the premise that prevention is better than a cure. Clinical techniques utilized by chiropractors help to identify joint dysfunction before pain develops and it is for this reason that regular screenings and maintenance treatment should be done.

Any further information needed please don’t hesitate to contact Bradley

b_waterer@yahoo.com or www.sandtonchiropractic.com

5 Tests That Could Save Your Life

Posted on September 9th, 2011 by Andries Lodder

Outlive the double dip recession by spending your medical aid money where it counts

by Justin Park

There are health tests we need, and those we don’t. Pelvic ultrasound? Sounds ultra suspicious. Occult blood test? Only if it comes with an exorcism. Urinalysis? Great, now I’ll be kicked off the tour…

Cardiac CT Angiography

These colourful 3D images allow radiologists to calculate one of your most important heart numbers: your coronary artery calcium score, a measure of how much plaque is piling up in your arteries. A 2007 study of over 10 000 people published in the journal Atherosclerosis reported that calcium scores alone can predict heart attacks, while a 2003 study found that a high calcium score is associated with a tenfold increase in heart-disease risk. This is compared with a less-than-twofold increase in risk from traditional risk factors such as diabetes and smoking. The test has one significant downside: the radiation exposure from your average cardiac CT is equal to 600 chest X-rays, according to a study in the Journal of the American Medical Association. This produces a one-in-5 000 risk of cancer, another study reveals.

Who needs it

Men with some of the risk factors for heart disease whose physicians may be on the fence about starting treatment. “In these medium-risk cases, cardiac CT scans and calcium scoring can provide the extra level of information that we feel we need,” says Dr Gerald Fletcher, a professor of cardiology at the Mayo Clinic. The lower the calcium score, the lower the risk. If you reach 112, your physician might recommend statins.

Cost

Approximately R8 500. This is an expensive one so make sure you have a letter of motivation from your doctor and get your medical aid to agree to it before you have it done. Most medical aids will reimburse you if you’ve previously had an abnormal stress test or chest pain.

Bone density scan

Think osteoporosis affects only old ladies? Fact is, men begin losing bone mass at age 30. That’s why it’s important to assess the state of your skeleton now with a dual energy X-ray absorptiometry (DXA) scan, which uses low-radiation X-rays to measure bone mineral density (it can also measure body fat percentage). “DXA scans allow us to identify people at high risk for fracture so they can start treatment to strengthen their bones before a fracture occurs,” says Dr Lisa Mickelsfield, senior researcher at the UCT/MRC Research Unit for Exercise Science and Sports Medicine. Your doctor might suggest adding weight-bearing exercise and strengthening workouts to your exercise programme, and supplementing your daily diet with up to 1000mg of calcium and up to 400 IU of vitamin D.

Who needs it

Anyone with any osteoporosis risk factors: inactivity, smoking, a family history of the disease.

Cost

Approximately R1 000. You will need to be referred to the radiologist by your doctor. To increase the odds of your medical aid covering the scan, make sure your doctor notes any risk factors.

VO2 max test

With the VO2 max test, you hop on a treadmill or stationary bike and give your maximum effort while wearing a mask that captures your every breath. By analysing the amount of oxygen you consume, the test determines how efficiently your body extracts and uses oxygen from the air. This makes it the gold standard of fitness markers, as well as a strong indicator of your overall health. “Blood pressure and cholesterol are used as predictors of potential disease, whereas fitness is a predictor of health. VO2 max tests are done to attain a valuable physiological marker for your current state of fitness. Utilising the information from the VO2 max test you can identify the most appropriate training intensity and type of training for you specifically,” says Johannesburg-based biokineticist Andries Lodder.

Who needs it

Anyone who wants their blood to pump. If your score is under 18ml/kg/min, talk to your doctor about increasing the intensity of your workouts.

Cost

From R1 000 to R1 400. The test is available at physical therapy, rehab or cardiopulmonary centres. Insurance providers won’t cover it.

Virtual colonoscopy

By definition, something “virtual” usually can’t compare to the real thing. But with a virtual colonoscopy, you avoid the two downsides of a traditional colonoscopy – sedation and the risk of a perforated colon–while still benefitting from the one big upside: test results you can stake your life on. “Virtual colonoscopies have the same sensitivity for detecting large polyps, which are the precursor lesions of colon cancer,” says Morningside-based radiologist Dr Ralph Posner. Though the CT scanning technology of a virtual colonoscopy can miss some smaller polyps, a University of Wisconsin study found that these are usually benign anyway. And don’t sweat the radiation; you’ll receive up to eight millisieverts, an amount that isn’t considered dangerous. Look around for the new upgraded machines that deliver an even lower dose of radiation (five millisieverts), says Posner.

Who needs it

People aged 50 and older, especially those on blood thinners, because an “oops” with a regular scope could cause dangerous internal bleeding. The exception: if your family has a history of colon cancer, you should be screened at least 10 years before the age your relative was when he or she was first diagnosed, Posner says. People who are overweight or inactive, drink or smoke heavily, or have an inflammatory bowel disease should also consider early screening.

Cost

Up to R4 000. Many medical aid plans now recognise the effectiveness of virtual colonoscopies and increasingly cover them.

Nutritional evaluation

While it’s not a test per se, putting your diet under the microscope could result in a leaner body and longer life. “The benefits of meeting with a dietician are accountability, moral support and troubleshooting if your progress stalls,” says registered dietician and Men’s Health’s expert Megan Pentz-Kluyts. In a 2008 Kaiser Permanente study, diabetic patients who received nutritional counselling were nearly twice as likely to lose weight as those who had no guidance. To find a registered dietician who can see beyond the food pyramid, Pentz-Kluyts recommends going to the Association for Dietetics in South Africa’s website (www.adsa.org.za) and clicking on “Find a dietician in your area”. Then call the RD and ask how he or she stays up to date on the latest research, which should include reading journals such as the South African Journal of Clinical Nutrition.

Who needs it

Anyone who should lose weight or simply wants to know how they can eat to beat disease.

Cost

R350 to R500, depending on the length of your session. Your medical aid may reimburse you if you have a condition that can be improved with diet changes. Ask your doctor for a referral.

http://www.mh.co.za/health/top-10-health-issues/must-have-medical-tests

Anatomical & Mechanical Analysis of Cycling

Posted on August 28th, 2011 by Andries Lodder

by Andries Lodder

My major objectives are to analyze the movements of cycling and the major muscles involved, and the contribution towards achieving the most successful and effective results during exercise.

Simple Classification

The Primary Purpose for this movement is speed and distance. Speed is a major factor, for the purpose is to complete the route or course in the shortest amount of time. Distance is just as important for cycling, for the longer the route, the better the endurance of the athlete has to be.⁵

The Movement of Phases can be classified as a Cyclical skill, due to the fact that it is continuous in nature, or done in an repetitive manner. One movement flows immediately into the next. Therefore classified in two phases: Propulsion phase and Recovery phase. When looking at the two phases simultaneously (pp. 2-3), there can be seen that no. 1 and no. 6 are almost identical, just the opposite. Where in no. 1 the left leg is in the propulsion phase and the right leg is in recovery phase, so in no. 6 the right leg is in the propulsion phase and the left leg is in recovery phase. Therefore the rest can be associated in the same manner. The Propulsion phase is initiated from photo 1 through to photo 5, therefore from Top Dead Centre to Bottom Dead Centre. The Recovery phase then commences from photo 6 through to photo 10, from Bottom Dead Centre to Top Dead Centre, completing 1 full rotation of a pedal stroke. ^{2, 5}

During the Classification of the Skill an erect posture is not maintained, more in a crouched position. This is also a means of movement for exercise and fitness. Motion is given to one’s own body through locomotion on wheels (supported by the ground). Impact is received from one’s own body, in this case the lower extremities.^{5, 8}

In the Simultaneous-Sequential Nature of Motion one could detect that it is more of a combination of the two. In the Sequential continuum maximum speed is extremely vital over long periods of time. In the Simultaneous continuum it is more of a push-pull movement, movement is directed along a straight line.⁵

Propulsion Phase

Recovery Phase

Anatomical Analysis

Propulsion Phase

Ankle – Dorsiflexed Knee – Extended Hip – Extended

Joint Joint Action Segment Moved Force for Movement Concentric Contraction Eccentric Contraction Ankle Dorsiflexion accompanied byslight Abduction & Eversion(3 motions together = Pronation) Foot & Shank Muscle & gravity (As well as momentum when in motion) Tibialis Anterior Gastrocnemius & Soleus Knee Extension with slight ExternalRotation Shank & Thigh Muscle & gravity (As well as momentum when in motion) Rectus Femoris
Vastus Mediali
Vastus Lateralis Hamstrings (Most prominent Semimembranosis) Hip Extension, Adduction & External Rotation Thigh Muscle & gravity (As well as momentum when in motion) Gluteus Maximus Hamstrings (Biceps Femoris) Iliacus & Psoas
Rectus Femoris
Gluteus Medius

Table adapted from 1,2 & 5 | Photographs from 9

Recovery Phase

Ankle – Plantar Knee – Flexed Hip – Flexed

Joint Joint Action Segment Moved Force for Movement Concentric Contraction Eccentric Contraction Ankle Plantar Flexion accompanied by slight adduction & inversion (3 motions together = supination) Foot & Shank Muscle (as well as momentum when in motion) Gastrocnemius & Soleus Tibialis Anterior Knee Flexion with slight internal rotation Shank & Thigh Muscle (as well as momentum when in motion) Hamstrings (Semimembranosis), and assisted by Gastrocnemius Rectus FemorisVastus MedialisVastus Lateralis Hip Flexion, Abduction & internal rotation Thigh Muscle (as well as momentum when in motion) Iliacus & Psoas, assisted by Rectus Femoris & Gluteus Medius Gluteus Maximus Hamstrings (Biceps Femoris)

Table adapted from 1,2 & 5 | Photographs from 9

Mechanical Analysis

Introduction to Mechanical Analysis

The mechanical Analysis of human performance involves the identification of laws and principles that help explain the most appropriate form for the execution of the activity and identify the mechanical reasoning for success or failure.⁵To explain the mechanical factors that contribute most to performance, it is necessary to look at the underlying objectives of cycling in motion:⁵

Balance, to attain mobility
Locomotion, to travel a prescribed distance
Projection, for optimum speed and accuracy
Manipulation, to reproduce a pattern
Maximum effort, for maximum speed, power and force

Each of these underlying mechanical objectives requires consideration of different but overlapping sets of mechanical factors.Forces involved in mechanical analysis are always as follows:⁵

Weight – interactions between the mass of body and the position of the center of gravity.
Momentum – the ability to stay in motion.· Normal reaction – interactions between the body and the object (bicycle).
Friction – force that opposes efforts to slide or role one body over another.
Drag – resistance to forward motion experienced by objects moving through, in this case, air.
Lift – result of changes in air pressure as the result of differences in airflow velocities. Lift is perpendicular to drag flow.
Buoyancy – the upward force counter balancing the weight of the body, acting vertically downward at the center of gravity, in water.

Forces Involved During Cycling

Weight: During cycling, force is proportional to the slope and total weight of the bicycle and the rider. Therefore, the greater the slope and the larger the combined weight, the larger the force of gravity will be.¹

Momentum:During momentum, inertia forces are present. The retarding of acceleration and deceleration is proportional to the total mass and the rate of acceleration. Therefore, retarding acceleration and increasing rolling resistance. In other words, for a rapid increase in speed, mass in a whole has to be decreased.Also occurring, is energy loss during braking, wasting kinetic energy of motion. Unfortunately, this energy can’t be recovered in any simple fashion.²

Normal reaction: For improvement, resulting in conservation of energy due to less body movement on the bicycle, can be the result of correct posture on the bicycle, improving pelvic stability, balance and co-ordination. Together with stability is drafting during cycling, the closer the rider sits on the leaders wheel, the more energy he saves. Up to 35% conservation of energy as when cycling alone.¹

Friction: Can be devided into correct pedaling motion and rolling resistance.Rolling resistance – To do with the tires on an particular surface. For a decrease in rolling resistance, inclusion of smoother and harder road surfaces, high tire pressure, narrow tires and less weight on tires. Energy lost when wheel, tire, surface do not spring back elastically and fails to return all of the energy to the bicycle. Therefore energy lost due to transfer of energy into heat energy. On rough roads, energy is lost to bouncing.¹ Pedaling Motion – Linear reciprocating motion. Pedal in an ‘oval’ shape fashion. Push forward as far as possible by leading of the heel without tensing it, at the bottom of the stroke, the ankle is pointing slightly downwards, now make a scraping motion backwards. The shape of a stroke should feel basically oval. Therefore being efficient with your stroke and creating as much force possible, with the least amount of force and tension.⁸

Photographs from 7

Drag: This depends on a number of factors:³

Cross-sectional area of the body perpendicular to the flow of air.
Shape of the body.
Smoothnes of the surface.

Aerodynamic drag also consists of 2 types of drag, skin friction drag and pressure drag. Skin Friction Drag – The friction force of the wind, the clothing that flutters (visual demonstrations). Pressure Drag – Contributes to the movement of the body and the shape of the bicycle. Air flows smoothly around a streamlined shape. Therefore Power is proportional to the product of drag force and velocity. Therefore an increase in speed asks for an increase power needed. Therefore a rider in an crouched position, decreases wind resistance. To change from riding with a rounded back to a flat back, rotate the pelvis forward on the saddle and lower your chin to fill the gap between your shoulders and arms. By improving the riders position on the bicycle, is the most efficient way to increase potential speed.⁴

Lift: It is the result of changes in air pressure as the result of differences in airflow velocities. Lift is perpendicular to drag flow.⁵

Buoyancy: Only applicable to activities taking place in aquatic environments. Therefore not applicable to cycling.⁵

Reference List:

Edmund R. Burke. (1986). Science of Cycling. Copyright © 1986 by Edmund Burke.
Edmund R. Burke, Mary M. Newsom. (1988). Medical and Scientific Aspects of Cycling Copyright © 1988 by Edmund R. Burke and Mary M. Newsom.
James G. Hay. (1993).The Biomechanics of Sport Techniques (4^th ed.) Copyright © 1993, 1985, 1978, 1973 by Prentice-Hall, Inc.
Edmund R. Burke. (2002). Serious Cycling (2^nd ed.). Copyright © 1995, 2002 by Edmund R. Burke.
Nancy Hamilton, Kathryn Luttgens. (2002). Kinesiology: Scientific Basis of Human Motion(10^th ed.). Copyright © 2002, 1997, 1992, 1982 by the McGraw-Hill Companies, Inc.
Carla Z. Hinkle. (1997). Fundamentals of Anatomy and Movement: A Workbook and Guide Copyright © 1997 by Mosby-Year Book, Inc.
Gerry Carr. (1997). Mechanics of Sport: A Practitioner’s Guide. Copyright © 1997 by Gerald A. Carr.
Cycle Lab Academy. (1999). Lab Cycling ® Instructors Course Manual. Copyright © 1999 by Cycle Lab Academy.
Photographic Evidence of Skill provided by own Digital Camera for the distinguishing between skill phases.

60 Minutes: Maximise Your Training Hour

Posted on August 11th, 2011 by Andries Lodder

By Andries Lodder for Modern Athlete Magazine Oct 2011

Session: Russian Steps Spinning Class

Spinning classes are one of the best ways to maintain anaerobic fitness levels. Anaerobic training improves muscle speed, strength and power.

Benefits of spinning:

Spinning offers enormous control over variables that you can’t control outside, such as wind, temperature and road surfaces
Spinning bikes has a fixed wheel unlike normal bikes where you can free-wheel, therefore no cheating
Spinning offers you potentially very high leg speed (cadence in excess of 200rpm) which is just about impossible on normal bikes

Take advantage of this by using spinning to develop great leg speed, therefore improving your fast twitch muscle fibers. These are fibers that contract more quickly and with greater amount of force, leading to greater performance in short duration, high intensities, lasting from mere seconds to about 2 minutes.

Therefore next time you start a race with a frenetic pace, you’ll be able to stay with the pro’s and not get dropped.

A cool and fun workout is ‘Russian Steps’, which involves increasing intensities/duration of working intervals, and decreasing duration of recovery periods.

Warm-up: 5 min, with light resistance and comfortable cadence, peaking at 70% MHR, 30 sec acceleration and then recovery till back to 70%.

Main Set:

10 sec flat out sprint, 50 sec recovery
20 sec flat out sprint, 40 sec recovery
30 sec flat out sprint, 30 sec recovery
40 sec flat out sprint, 20 sec recovery
50 sec flat out sprint, 10 sec recovery
1 min flat out sprint
5 min recovery
Repeat 3 times

Cool Down: 5min recovery followed by static stretches

Tip: All sprints done with light resistance and very high cadence (hence, if no resistance, your muscles don’t have any resistance to contract against and therefore increasing your chances of getting injured)

Modern Athlete Magazine – 60 Minutes: Maximise Your Training Hour

Ask An Expert: Pain In The Leg

Posted on August 11th, 2011 by Andries Lodder

By Andries Lodder for Modern Athlete Magazine Oct 2011

Question

When I start running I get a bad pain in my lower calf on my left leg and after a while the pain moves up into my calf, my knee, my thigh and into my bum. The pain is worst when running up hills. I was told it could be an irritated sciatic nerve and that I should do a lot of stretching exercises.

This has been going on for about 2 years and prevents me from training for Comrades. Your advice would be greatly appreciated.

Answer

It sounds like this problem has been going on for quite some time now. To be frankly honest, there are so many variables that need to be taken into account here, as in: What type of pain it is? Does the pain go away as soon as you stop, or does it stay for a period of time afterwards? Do you always run on the same camber of the road? Have you had any previous injuries involving your left side?

Just by telling me what type of pain it is will guide me in a much better direction.

If it’s a sharp shooting or burning pain, sciatic nerve compression is most likely, most commonly sciatic nerve compression. In this case the pain starts normally from your bum area down towards your calves and not vice versa as you described. For pain relief here gluteal (piriformis muscle specifically) and hamstring stretching is the best thing to do.

If it’s a dull ache, it’s more a muscular problem, especially the piriformis muscle being too tight and too weak, not providing enough stability to the pelvis.

Deep gnawing pain tells me it’s osteogenic, meaning bone related. This could be due to a leg length discrepancy (one leg being shorter than the other) and cause pain due to overcompensation of the one side of the body.

Stinging pain suggests joints/ ligaments/ tendons, suggesting muscular imbalances, such as calves, hamstrings and quadriceps not strong enough and not providing your joints with enough stability during running.

You mentioned that the pain gets worse during hill running. This is also a great indicator of the muscles being too weak. Strengthening of the posterior muscles is very important for runners, especially the calves and hamstring muscles. One thing you can try during a run is to walk up the hills; this will strengthen your calves, whereas trying to run it will work more your quadriceps and put more strain on your weaker calves.

My suggestion is to see a professional, especially because you’ve been sitting with the problem for 2 years now. A Chiropractor would be able to assist with all areas discussed here, as well as a Biokineticist would do a full biomechanical analysis, to pinpoint the problem area and fix it once and for all.

Remember, all problems are fixable, as long as you seek the professional help you need. Your body is your temple, treat it as such.

Modern Athlete Magazine – Ask An Expert: Pain In The Leg

Boost Energy With Low GI Eating

Posted on August 5th, 2011 by Andries Lodder

by Tabitha Hume, Clinical Dietician

Why is it that people dieting on starvation rations so often just cannot shift the extra fat, while some people who eat like horses, stay thin?

The answer hit clinical dietician, Tabitha Hume, like a bolt from the blue: sugar is not the enemy…fat is. Sugar doesn’t make you fat…fat does.

The way to banish fat, and it’s many associated health problems, Tabitha realised, was to kickstart a sluggish metabolism by radically increasing one’s intake of carbohydrates…even including those sugary foods traditionally frowned upon by health experts!

The X-Diet shows you how rev up your metabolism by feasting on delicious energy giving foods, and how to eliminate fats from the diet without ever feeling deprived. Not only does this revolutionary lifestyle eating plan rapidly melt away and unsightly fat , it also:

Lowers blood pressure and cholesterol levels.
Reduces the risk of heart disease and stroke.
Provides relief from gout, headaches, chronic spastic colon and indigestion
Provides boundless energy and banishes mid-afternoon fatigue
Prevents low blood sugar

Backed up by cutting edge international medical research, Tabitha’s X Diet explains fat loss and carbohydrate metabolism in the simple and entertaining way, reflecting her passion for food, flavour and the delight of the varied and sensuous diet.

It has many fat free recipes, tips for cooking and eating fat free and informative question-and-answer sections and real-life patient histories

Tabitha Hume – Blog

Shoulder Rehabilitation

Posted on July 29th, 2011 by Andries Lodder

Rehabilitation of the Shoulder Using Exercise

There are many types of injuries and surgeries that involve the shoulder. The exercise phase of shoulder rehabilitation may begin very early. It is important to understand some basic concepts in order to achieve the best functional return of your arm. Your Biokineticist will provide details specific to your particular injury. Following are some general guidelines for initial shoulder exercises.

Begin by performing exercises slowly and with control. Concentrate on the quality of motion.

Exercise in a pain-free range. When baseline pain or discomfort arises, exercise in a range that does not increase pain.
Try to relax while doing your exercises.
Avoid exercising in a range that causes “popping” in the shoulder.
Try to keep the shoulder blade down and back while exercising. The motion should come from the true shoulder joint and not from the shoulder blade (unless it is a specific exercise for the shoulder blade).
Before increasing exercise resistance or speed/rate, consult your Biokineticist.

Shoulder Problems

The shoulder is a ball-and-socket joint that allows for an abundance of varied types of movements. Unlike the hip joint, which is a very stable joint, the shoulder is more closely similar to a bowling ball on a dinner plate. This means that while shoulder has excellent movement, it also can become unstable and susceptible to injury.

Dislocations

The shoulder joint is surrounded by a capsule of tough fibers. If the shoulder is pushed too far in any direction, it can dislocate, which means that the upper arm bone has stretched or torn through the capsule. In addition to tearing the capsule, dislocations can cause fractures to the shoulder socket or tears to the labrum or ligaments. The labrum is a fibrous ring of cartilage (similar to rubber) that helps make the socket deeper. Ligaments are strong fibers that help to hold the shoulder together.

Bursitis

The bursa is a fluid-filled sac in the shoulder that helps reduce friction and protect the muscles from rubbing against the bones. Excessive overuse or improper conditioning can cause irritation the bursa.

Tendonitis/Impingement Syndrome

Tendons attach muscle to the bone. Overuse or improper conditioning can irritate the tendons, causing tendonitis. If the situation becomes chronic, the body begins to deposit calcium in the tendon. Eventually the tendon becomes pasty and will break. This is called calcific tendonitis.

Rotator Cuff Tears

There are four major muscles that attach to the shoulder joint. They are referred to together as the rotator cuff. Injury or excessive overuse can cause a tear in one or several of these muscles.

Arthritis

Another result of wear and tear is arthritis, which is the breakdown or softening of the bone in the shoulder. This generally occurs on the ball and socket and sometimes at the AC joint, which is the “tip” or “point” of the shoulder.

Adhesive Capsulitis

Adhesive capsulitis or “frozen shoulder” is a condition that comes on slowly. The exact cause is not known at this time. The shoulder becomes painful, leading to reduced motion. The joint capsule becomes adhered to other tissues in the shoulder joint, which leads to less range, and the cycle continues until there is no motion left in the shoulder.

Fractures

Fractures usually occur with trauma or a fall, but as noted earlier, can happen with dislocations as well.

Treatment

First phase rehabilitation always done by a Physiotherapist and Final phase rehabilitation by a Biokineticist.

Modalities such as ultrasound, electrical stimulation, heat and cold can enhance healing and provide pain relief for conditions of bursitis, tendonitis, and minor rotator-cuff tears. Biokinetic therapeutic exercise is initiated for range-of-motion recovery, strengthening, conditioning and endurance. Exercise is also helpful for regaining stability in the dislocated shoulder. Manual therapy or hands-on treatment may be necessary for frozen shoulder or situations in which range is limited. With proper care and perseverance with therapy, many shoulder dysfunctions can be resolved.

If a rotator cuff tear, fractures, labral tear or arthritic damage is severe enough, the shoulder may require surgery. If you have any question or concerns, consult your Biokineticist.

The head work behind Your headache!

Posted on July 11th, 2011 by Andries Lodder

Most people have at some time or another suffered from headaches or know of someone close to them that has. For a lot of us though it’s not a regular thing, maybe we partied a bit too hard the night before or are just having a really stressful day, and we take some pain killers and carry on with our day to day lives. But for some it is a devastating condition that impacts every part of their life, as well as the lives of those close to them. How many of you husbands out there have come home after a long days work and all you want to do is get ‘close and comfortable’ with your wife, only to hear “Not tonight honey… I have a headache!” Classic example.

The effects of headaches go a lot deeper than just the pain in the head. People suffer from a large amount of psychosocial factors, such as functional disability and loss of concentration, making work and studies a nightmare. They have a decreased productivity and emotional handicap which has a negative impact on close relationships and can lead to anxiety, anger and eventually depression. I mean when you are in pain you become miserable, and nobody wants to be around miserable people or even worse…..be that miserable person.

But there is hope, through a multi-disciplinary approach a lot of headache sufferers can be helped to lead normal, productive, happy lives.

Ok let’s talk a little bit about headaches. Firstly you get Primary headaches, which are not associated with other diseases and are the most common kind and then you get Secondary headaches, which are a symptom of an underlying ominous disease. Obviously these types of headaches are a lot more serious and here is the “Red Flag” list of things to look out for:

Red Flags

Sudden onset of a new severe headache
Progressively worsening headache
Onset after exertion, straining, coughing or sexual activity
Onset of first headache after 50 yrs old

If you have any of these symptoms please go and see your doctor immediately as your headache could be a warning sign of something a lot more serious!

Primary Headaches

Why do we get headaches? How does it all work?

Well there are a lot of different triggers, both internally as well as externally that can lead to a headache. i.e. Muscular, Vascular , Temporomandibular joint (TMJ) or cervical dysfunction, stress, posture, certain foods, dehydration, sinuses, bright light, alcohol, hormonal changes, sleep disturbances and the list goes on.

These triggers are not necessarily what are causing the pain they just set it off, like a landmine. I was at a headache lecture the other night and the doctor explained it like this.

In your brain you have the trigeminocervical nucleus ,and what that big fancy name does is that it’s the principle centre of the head and neck involved in the transmission of nociceptive information .i.e “the headache generator”

So basically what all these different triggers do is sensitize the “headache generator” more and more until eventually it explodes like a landmine and sets of a headache. They have also found that in chronic headache sufferers the “headache generator” part of the brain is more sensitive to the incoming messages from the different triggers than non sufferers. So what we need to do to prevent these headaches from developing is to try and desensitize the “headache generator” by cutting down the amount of stimuli it is receiving from the triggers. But in order to do that you firstly have to identify your own individual triggers.

A good way of doing this yourself (and I highly recommend this), is to keep a headache diary, in order to discover your own individual headache pattern.

Date
Time
Duration
Rate Intensity (1 to 10)
Possible triggers
What relieved headache
Ability to function

This will help you start picking up trends and understanding your headache better.

Two of the major internal triggers are firstly Muscular .i.e. trigger points (a hyperirritable spot in a taut band of muscle) mainly in the head and neck muscle groups, causing the Tension type headaches. Secondly the Vascular system, where the arteries in the scalp and skull vasodilate causing Migraines. Some migraine suffers experience either a visual disturbance, vertigo, numbness, weakness etc, prior to the onset of a headache. We call this an aura, which is caused by the blood vessels in the brain vaso-constricting. It is still unclear why this happens prior to the onset of these migraines.

Stress, Ergonomics and Posture are very big external triggers that need to be looked at and corrected.

Physiotherapy plays a major role in treating both the internal as well as external triggers along with a multi-disciplinary team of course. Helping to correct the muscular system and looking at correct ergonomics and posture as well as core stabilising exercises and manipulation therapy have been proven to give lasting relief to headache sufferers.

A lot of people turn to the medicine cabinet when a headache is knocking on the door to try and mask the pain. The medications used are either Preventative or Rescue medication. Rescue medication you take once you already have the headache e.g Simple analgesics (Asprin, Paracetomol), Triptans (Imigran, Maxalt) etc

Preventative medication on the other hand you take before the headache starts and is only prescribed for severe, regular headaches when nothing else is helping. Some examples are Trepiline(Anti-depressant), Epilum, Atenolol(beta-blocker) .

The problem with all these drugs is that some people don’t respond to them and many of them have really bad side effects. If patients get depend on the medication and are using them regularly they can also develop Medication Overuse Headaches which a lot of the times are worse than their original headache that they started with.

Myself being a physiotherapist, I believe that medication has a role in headache treatment but there are many other ways than just “popping a pill'(which just masks the pain and doesn’t deal with the true cause of the problem) to cure your headaches.

For instance I was at another course where the lecturer explained just by advising his patients to drink more water [(30ml/kg body weight /day) so if you weigh 60kg you should drink 1.8L of pure water a day] and keeping their blood glucose levels constant (by eating more low GI foods and smaller, regular meals during the day), almost all of their headaches had improved. Something small to think about…

Thank you for taking the time to read through this article. I hope it has benefited you in better understanding your headache and how to treat it.

Andrew Savvides
Physiotherapist
physiopro.co.za/