The Spine

The spine is made up of 5 regions – cervical, thoracic, lumbar, sacral and coccygeal.  Each region is made up of vertebrae, which support the weight of our body, and aid in transferring loads between the upper and lower parts of our bodies. The cervical spine is made up of 7 vertebrae; the thoracic spine has 12 vertebrae; the lumbar spine has 5 vertebrae; the sacral region is made up of 5 fused vertebrae; and finally the coccygeal region has 4 fused vertebrae.  All this makes up a very important structural system which we use every day and rely on to function. 

The spine has 4 normal curves to it as well, which constitute posture and can be changed due to a number of factors; disease, heredity, and other forces acting on the spine.  A change in these curves is what gives everybody their different postures.  The picture shows the curves we have in the spine.

In between each vertebra is an intervertebral disk, which provides a cushioning between each vertebra.  These disks have a function of absorbing shock and they allow the spine to bend.  These disks receive no blood supply, and it is important that they keep moving to remain healthy; i.e. sitting for a long time is not healthy for a disk, constantly changing posture or body position is vital for the health of our disks. 

Any changes in the curve of the spine, or injury to a vertebral disk, could cause back pain.  As these curves change, the way muscles work changes as well.  A variety of muscles are attached to the spine, and in a perfect posture, these muscles would function at their best.  As those curves change, and as your posture changes, the muscles start working differently; for example some muscles become tight and some muscles become weak.  All these changes can be responsible to back pain.  Changes in muscles can also affect other structures like nerves and the intervertebral disks.

As a biokineticist, we assess these spinal curvatures (i.e. your posture), and we can prescribe exercises for you to help correct these changes, and try get the muscles working to their optimal function.  As well as strengthening the “core”, these are the baby steps to a stronger body.  If the basics are not there, and spine is not at its best, then everything else is going to struggle to work efficiently and the body won’t be able to do what you want it to do!!!!

The Back

For the next few weeks we will start talking about the back and all the problems that go with it.  Unfortunately, this is an injury that affects the majority of the population at some point in their lives, and it affects any age group, active people and non-active people. In most cases there is an actual diagnosis for back pain, but in some cases it becomes difficult to make a diagnosis which makes treatment challenging.  A number of factors can contribute to why a person’s back becomes painful; it doesn’t necessarily have to be a traumatic injury to the area. 

Some of these factors can include:

·         Poor posture

·         Muscle weakness

·         Muscle tightness

·         Incorrect exercising technique

·         Sitting at a desk all day

In many cases, a large proportion of what we see in patients is poor “core stability”.  Many of you may have heard of this concept and it is associated with Pilates.  Basically, what this means is, the deep stomach muscle called transverse abdominis, which runs as a band across our middle, is responsible for this “core stability”.  The misconception is that by doing 100 stomach crunches a day is enough stomach strengthening. 

As you can see in this picture, we have 4 different stomach muscles.

Rectus abdominis, the green muscle, is your 6-pack, and crunches and sit-ups strengthen that muscle group.

The obliques, both internal and external, are strengthened with side crunches for example.

It’s the yellow muscle, transverse abdominis that we need to focus on.  Largely, what happens is this muscle is weak, forcing the back to take-over the role of supporting you.  This places a strain on the back, in particular the lower back, and all the muscles in that area, therefore causing you pain.  If we get this transverse abdominis stronger, the correct muscles will then be supporting you, not your back, therefore decreasing the strain on that area and the muscles. 

It sounds easy, but it’s easier said than done to strengthen this muscle correctly.  It takes time and dedication to certain exercises to build this strength.  It is also something to become aware of on a daily basis, something you should eventually be doing 24/7!!  If the “core” is not strong enough, then the rest of your body will not function at its best...a six-pack means nothing without a strong “core”!

So over the next few weeks, we will introduce you to how the spine works; some of the common complaints and injuries we see; and how everything is connected to the spine and how it functions. 

Functional Movement Screening

Functional Movement Screening

Another assessment tool that we use is called Functional Movement Screening or FMS.  We assess the motor control, kinematic and biomechanical limitations through the identification of basic movement patterns. Kinematic means we look at the motion of the body, and biomechanical means we look at the movements and forces acting on the musculoskeletal system.

The movement patterns that we look at consist of the following:

·         Overhead squat

·         In line lunge

·         Hurdle step

·         Active straight leg raise

·         Trunk stability push up

·         Rotary stability

We can record these movements for video analysis or normal observation, and from the results we can again determine muscle imbalances, muscle weaknesses and any compensation that the body makes as a result of the imbalances and weaknesses.  The results then give us the information we need to create an exercise program for you to correct any problems so that your body start moving and working in more functional and correct manner.  This is all important because any imbalance or weakness puts your body at risk for pain or injury.

This is the website we refer to specifically for this method of assessment. It will provide you with much more information about this form of assessment so that you have a better understanding.

http://www.movementbook.com/

Massage Prices

Specific massage (i.e. only calf or neck or lower back etc) - R150

Back and neck massage - R200

Leg massage - R250

Full body massage - R300

Sports Massage

Morning everyone

Just a note on the sports massage, if you book we accept cash only! Unfortunately we do not accept EFT. Please keep this in mind when you book!
Thanks

Sports Massage

Sports Massage

As I mentioned in a previous blog, we offer sports massage at both the Rosebank and Medifocus practices.  Sports massage is a type of Swedish massage that stimulates circulation of the blood and lymph fluids.  It can include trigger point therapy to help break down any knots in the muscles and increase range of motion.  Sports massage was originally designed for athletes, but is useful for anyone with chronic pain, injury or range-of-motion issues.

You can contact Lorene (lorenem1@gmail.com) or call either the Rosebank or Medifocus practices for more information on sports massage or to book an appointment.

EMG Analysis

EMG Analysis

Another assessment tool that we use is called EMG analysis. We use mainly in shoulder evaluations, along with the Isokinetic testing we mentioned before. 

EMG stands for electromyography.  It is the study of muscle electrical signals.  EMG is measured using similar techniques to that used for measuring EKG, EEG or other electrophysiological signals.  Electrodes are placed on the skin overlying the muscle.  Once these electrodes are placed, we ask you to perform several movements and the EMG will record the muscle activity during the movements and during the rest periods.

This form of assessment gives us information about which muscles are inactive or overactive, and gives us the information we need to correct these imbalances.  Imbalances cause incorrect movement and the body then moves in such a way that may put at risk for injury, or may already have caused pain and injury.  So, this is a vital instrument in our assessment.

Here are some links again to sites about EMG testing if you would like extra information.

http://www.medicinenet.com/electromyogram/article.htm

http://www.noraxon.lunarpages.net/semg/faq.php3

Isokinetics

Isokinetics

A lot of our assessments and rehabilitation includes what we call isokinetics.  This testing is done on an Isokinetics machine or dynamometer, and this machine can determine muscle strength and imbalances.  It can give us a good idea if one leg is stronger than the other, for example, and what exactly we need to work on to improve on those results. We can also use the isokinetic machine to do exercises on, as you would do a leg press, for example.  So the machine can provide us with lots of information.

We can assess the shoulder, elbow, hip, knee and ankle on the machine, and from those results, provide you with an exercise program to help correct whatever we find.  It’s also easy to reassess you in a couple of weeks and see that your improvement is like; we can give you an actual percentage!  So we use the machine in all our assessments and in some of our rehabilitation sessions to give us detailed information to work with; and to give you a comprehensive rehabilitation program and to aid in your recovery.

Things to remember when it comes to the isokinetic machine:

·         We cannot test you or exercise you on the machine if the joint is painful, swollen or inflamed.

·         Post-surgery, we can only test you on the machine between 10 and 12 weeks after the operation.

If you would like more information on the Isokinetic machine, here are some website links that you can take a look at:

http://www.isokinetics.net/basics/first.htm

http://www.wisegeek.com/what-is-isokinetics.htm

Our work and our practices

Our Biokinetics practice focuses around orthopaedic injuries and post-surgery rehabilitation, meaning that any muscle or joint injury is our area of specialisation.  We deal with back, shoulder, elbow, hip, knee and ankle injuries predominately.  We also include children and the elderly, as well as sports people in the patients we see.

We have 3 practices that you can contact if you require a Biokineticist.  There is a practice at the Centre for Sports Medicine in Rosebank, a practice at Wilgeheuwel Hospital in Radiokop, and we recently opened a practice at Medifocus in Sundowner, Randburg.

Rosebank is a sports centre where we work closely with physiotherapists, a podiatrist, sports physicians and orthopaedic surgeons.  Wilgeheuwel Hospital has a swimming pool facility, as well as working with physiotherapists and the orthopaedic surgeons.  Medifocus is a smaller practice that works closely with podiatrists, and hopefully a physiotherapist in the near future.  Sports massage is offered at both Rosebank and Medifocus. 

If you would like to contact one of the three practices, here are the contact details.

Rosebank: 011 442 8233

Wilgeheuwel: 011 794 1226

Medifocus: 011 794 6383

Good Morning

Good morning everybody!

For some more information about Biokinetics you can visit the website of Biokinetics Association of South Africa www.biokinetics.org.za.

Have a good day :)

2011

Welcome back to everybody after what we hope was a good holiday, and if you didn’t go away, at least lovely time spent with family and friends.  We hope that it’s going to be a very successful and prosperous year for you!

As this is the official start of our blog, we would like to invite you again to send us comments and feedback about you would like to read about and get information on, so that we can provide you with the most beneficial posts.  We would also appreciate it if you would invite family and friends to follow us.

With that said, we wish you all the best for 2011 and we look forward to hearing from you!