Never Miss Breakfast! by Lindsey Leatherbarrow ( Dietitian )

Breakfast literally means “break the fast”. It is a vital meal that replaces fuel used by the body and brain overnight. During the night, the body builds and repairs itself and the nutrients required for this need to be replenished. Breakfast gives you the energy to start the day. It allows you to deal with the mental and physical demands of the morning whether at school, work, or just out and about. Eating breakfast improves mental alertness and physical performance. Being hungry is a distraction to learning, and so if your children are to grow well and perform at their peak, they need a good start to the day. Having a good breakfast is more likely to improve concentration as well as improve their moods.

Breakfast should ideally provide about a quarter of our daily nutritional requirements. Research shows that those who eat breakfast are more likely to meet nutritional requirements for nutrients such as vitamins, minerals and fibre.

A wholesome breakfast should include:

A starch or carbohydrate rich food, to provide energy, B vitamins, some iron and fibre: breakfast cereal (ideally not sugar coated), porridge or bread. A calcium rich food – milk, cheese or yoghurt. This will provide protein, calcium and B vitamins. The calcium keeps bones strong. Always choose low fat or skimmed (fat free) dairy products.

A fruit – fresh, frozen, dried or stew fruit will all do. This will provide vitamins and fibre to the breakfast. Breakfast is a perfect time to include at least one of the 5 recommended portions of fruit and vegetables for the day.

It is also good to include a drink at breakfast – whether this is water, milk, tea or coffee.

BREAKFAST IDEAS

Oat with low fat or fat free milk served with raisins or cranberries. All-Bran with low fat fruit yoghurt with some fresh juicy strawberries. Peanut butter on two slices of whole wheat bread with a glass of milk and a banana. Cheese on two slices of low GI or rye bread plus a half a grapefruit on the side.

Adults and children should be encouraged to eat breakfast every day. It is estimated that in South Africa, 1 in 10 children skips breakfast but by routinely eating breakfast, you and your family will be developing a healthy habit that will last a lifetime. People who eat breakfast have more balanced diets than those who skip this meal, and be eating this vital meal, you are far less likely to be overweight. Missing breakfast often leads to snacking on less healthy food later in the morning.

Breakfast has to be quick to prepare, nutritious and tasty. By the time you have boiled a kettle for a cup of tea or coffee, you could already have had a bowl of cereal! From TODAY start with a good breakfast!

How to treat and beat your plantar fasciitis- By Melissa Biffi, Biokineticists

The plantar fascia is a thick band of ligaments connecting the heel bone to the toes. It works with the Achilles tendon to store and return energy during specific movements and supports the arch of your foot. For most of you runners suffering from this acute, sometimes chronic heel pain, you’d wonder what the need for your plantar fascia is, if it just causes pain! It does in fact have an important function, to stabilize the forefoot as the force during push off increases.

So if it’s there to help you, why would it cause pain? Often pain results due to strain of the plantar fascia thus causing inflammation, weakness and swelling, making it hard to get around. Why would this happen? Many plantar fasciitis cases are the cause from factors such as tight calves and repetitive hill workouts, however the largest factor is owing to fallen or collapsed arches. Flat footed individuals are more likely to develop and suffer from this condition as collapsed arches places more tension on the fascial ligament thus overloading the attachment at the heel bone.

The most common sort after treatment is to mash your foot out with a ball or an iced bottle. Yes this may help relieve the tension and loosen up the ligament; however this is only temporary, providing an invitation for the pain to return at a later stage. So why deal with the chronic pain when Biokinetics and exercise therapy can completely stomp out that plantar fasciitis. Biokinetics aims to find the cause and deal with it using an individualized and specific exercise intervention. Often enough, the flexor digitorum brevis muscle, or more simply put, the muscle in the sole of your foot is weak, allowing for collapsing in the arch. This may also be combined with overall weakness in the lower limbs and general tightness that needs to be dealt with appropriately and conservatively to prevent further aggravation and even possible heel spurs (bony outgrowths on the heel).

As for you runners looking for a quick fix, it is important not to rush the process and seek proper medical advice and initial supervision when it comes to rehabilitative exercise, whilst trying your best to avoid those corticosteroid injections and surgery to relieve the pain. As biokineticist’s it is our job to treat conservatively and to determine faults in your running technique that may be contributing to your pain. Since foot strike patterns significantly increase tension in the plantar fascia, it is important to avoid mid or forefoot strike. While recovering from the condition, it is recommended that you decrease your stride length and increase your cadence and to wear appropriate shoes with enough support for shock absorption.

With correction in form and general activity and the combination of a rehabilitative exercise program, you may just be able to stomp out your plantar fasciitis and enjoy the open roads and trail runs pain-free. 

Things you didn't know about your back pain? - Natasha Eekhout (Paladin Biokineticists)

If you haven’t yet experienced the nagging pain in your lower back, well then heck that’s pretty impressive and you can consider yourself to be one of the lucky ones! It seems like a prevalent condition but how much do we really know about it?

1.      Back pain is one of the most prevalent ailments and surprisingly costs the country more than cancer and diabetic treatments combined, bet you didn’t know that! At least 80 out of 100 people will experience back pain, usually caused by everyday strains and sprains, during their life time and often it’s recoverable, if not, then you may have yourself a problem.

2.      Stop being a hypochondriac, scans aren’t necessarily required when you’re experiencing back pain. A short visit to your healthcare provider such as a physiotherapist will be able to identify if a scan is really needed depending on your symptoms and past medical history. A Biokineticist may also be of use to you, prescribing specific rehabilitative exercises to prevent further pain and injury.

3.      Interpretation of your scans can be skewed and misinterpreted. Research has shown that back scans of people who have bulging or herniated discs don’t even experience pain. Often people who do have back pain are told that all of these indicators are definitely the cause of the pain, when sometimes it may be referred from elsewhere or simply just muscle weakness. The results of your scans can be compared to baldness – it happens with age and overall genetics and there isn’t much we can do about it except for preventing further degeneration.

4.      More pain does not mean more damage! This might sound a bit strange, but this may be related to changes in environments or hypersensitivity. So when you’re having a bad day at work (murphy’s law) that little pain may just come about to aggravate you even more.

5.      When a disc or joint is ‘out of place’ it also doesn’t necessarily mean that this is the result of your pain. Yes in some cases it may be, but let’s not get ahead of ourselves and go for the whole manipulation thing unless it is really diagnosed and required.

6.      Bed rest is NOT the answer! Yes ok you may be in pain, and resting a day or two after your painful incident such as spraining an ankle is a good idea. However when it comes to back pain, depending on your symptoms, bed rest will only make your condition worse.

7.      Surgery… no! Just no. As a biokineticist we avoid this at all costs if possible and believe that conservative treatment is the way to go, unless it’s seriously debilitating and preventing those daily activities of yours.

8.      For most of us a good night’s sleep is hard to come by, and often this is related a shoddy night’s sleep. Improving your sleeping routines can help reduce the pain.

9.      Schoolbags are schoolbags, how else would you like to carry around those books? Research shows that weighted schoolbags aren’t necessarily the cause of your kid’s back pain and often, seeing as most kid’s these days just take it easy on the couch, it may be a simple way to get some physical activity into their daily agenda of xbox, play station and television.

10.  Stress levels can negatively affect your pain. So put a smile on your dile, take up something you enjoy and reduce that anxiety and those mood swings.

11.  Lifting goods and bending is seen as a no go when you have back pain. This may sometimes cause some strain and result in you being pretty immobile, relying on others to carry out your demands, which may not be such a bad thing. However this may become quite annoying for your newly acquainted ‘butlers.’ The key is to perform your movements carefully, avoiding them will just make them a whole lot worse to execute.

12.  Exercise is one of the most effective and drug free remedies you can use to help out with the pain, and the most awesome part about it, is that it’s free! Physical activity relaxes muscle tension, releases endorphins and generally improves your immune system. Under-used muscles tend to feel more pain and often need a couple sessions to wake up.

13.  The perfect sitting position doesn’t quite exist. I bet you’re all sitting up straight now aren’t you? Contrary to belief, everybody sits differently and obviously this is comfortable for you. Instead of sitting or standing in a super rigid posture, loosen up and move in a relaxed manner.

14.  ‘Persistent’ back pain can indeed get better! Treatment can take a while, and may not happen immediately. Take all of the above mentioned factors into consideration when seeking treatment, one form ain’t gonna make the cut! 

     Natasha completed her BSc Sports Science undergraduate degree at The University of Johannesburg and her BHSc honours degree in Biokinetics at The University of the Witwatersrand. 

She has a passion for a variety of sports in particular soccer, tennis, running and kickboxing which have contributed to a strong interest in orthopaedic rehabilitation and working with athletes. Other areas of focus include diabetic and cardiac rehabilitation, as well as weight loss and a keen enthusiasm for working with children of all ages. 

Natasha can be contacted on 082 476 9727 or natashaeekhout@kinetics.co.za

Can walking be as effective a form of exercise as running? - Tony Paladin (Paladin Biokineticists)

Whenever we are going to relate things to one and other, it is always best to adopt the old adage of “comparing apples with apples”. Comparing apples with say bananas makes for good conversation; but it doesn’t actually address the cold, hard facts.

The debate about walking vs. running and the respective health benefits of each has swung like a pendulum for decades between Doctors, Surgeons, Biokineticists, Physiotherapists, Athletics coaches and Personal Trainers.

Before we can critically comment on whether walking can be as effective as running we would need to define what exactly: “form of exercise” means. If we loosely reference the World Health Organisation’s definition of “exercise”, we can break the components into functional / balance, flexibility, strength and cardiovascular.

If we use these components as indicators, we can critically assess whether walking is as “effective” as running.

From a functional / balance perspective, the slower the movement the greater the stimulus. Generally walking is a good choice for people who need to improve basic function, increase activities of daily living and enhance balance. The function / balance components can be respectively varied in difficulty by offering assistance or creating instability. Verdict = when it comes to training basic function and balance, walking wins.

Flexibility. Unfortunately on this front, neither walking nor running has much to offer in terms of increasing muscle and joint range of motion. If I had a loaded gun to my head and was asked to make a call, I would have to say that across the walking / running echelon, sprinting would probably elicit the greatest effect on flexibility due to the ballistic and elastic components of the activity. Verdict = Do Yoga or full range of motion exercises such as squats in conjunction to your walking and running program.

When we introduce strength into the walk / run debate, we end up with a chicken and egg situation. Does one need to be strong to walk and run or does walking and running make you strong? Lets make walking the chicken and running the egg. Walking is the most elementary form of movement; it is literally one step harder than sitting. From the perspective of rudimentary movement, it is logical that one should start with the basics prior to advancing the activity. The “basics” in this case, is walking and when advanced, is running. Strength however, nestles itself quite firmly in between the two activities: you need to be strong to run. Do we go with the chicken or the egg? Since neither walking nor running really develops strength, it is advisable to include other movements in your program, which do. Verdict = Walking should be progressed to incline walking which should be progressed to fast incline walking which should be progressed to running. Strength exercises should be included across the entire stratum.

Then we have the cardiovascular component. In short, the faster your heart beats, the more “cardiovascular” the modality of exercise is. One could argue that it is a no brainer that running elevates your heart rate more than walking does, but does it really? Running sloppily on a flat surface at a slow pace versus brisk walking with a backpack up a hill is like comparing apples with bananas. If we compare apples with apples; as a general rule running elicits more of a cardiovascular response on the body due to the speed of the activity. The body needs to work harder to run than to walk. If we are going to get walking to obtain the same level of work, we need to make it more difficult. This can be done with speed, resistance, hills and direction. Verdict = from a cardiovascular perspective, walking with purpose has the potential to topple lackadaisical running.

So… Shall I walk or shall I run? For the non-injured and mostly healthy community, running has the ability to elicit more of an exercise response than walking and should probably be the mode of choice. For individuals with joint problems or who are simply not fit enough to run, walking is a heck of a lot better than bum sitting in terms of exercise response. Even when walking is too easy and running is too hard, walk-running is also an alternative to get the heart rate up but still allow for bouts of rest. The bottom line is your ability: exercise is meant to be both challenging and enjoyable.

With regards to general health benefits, increased fitness, toning and weightloss; the American College of Sports Medicine (ACSM) recommends that adults get at least 150 minutes of moderate-intensity cardiovascular exercise per week; strength train each muscle group two to three days a week; do flexibility exercise two to three days per week; and finally, do functional exercise two or three days per week. Whether you choose to walk or run is your choice, just make sure your heart is beating while you are doing it!

Tony’s Primary areas of focus include: Orthopaedic rehabilitation through strengthening (mainly backs and knees). He works with regaining function in ACL (anterior cruciate ligament) reconstructions and total knee replacement patients.

Tony also has an interest in sport specific testing and training (primarily rowing, cycling, running and triathlon).

Tony can be contacted on 011 807 9877 or tonypaladin@kinetics.co.za. 

In case of an emergency, he can be contacted on 082 921 6776.

What is Hypertension and how does a Biokineticist play a role in addressing it? - Anca Wessels (Paladin Biokineticists)

So you’ve heard of the term “high blood pressure”, but what does it really mean?

When your heart beats, it pumps blood out. The pressure it produces is called your systolic measurement (top reading) and should average at around 120.

When your heart is resting in between beats, it gets filled up with new blood. The amount of pressure needed to do this is called your diastolic measurement (bottom reading) and should average at 80.

If your blood pressure measurement is higher than 120/80 (eg. 150/100), you could be suffering from high blood pressure (hypertension). This means that the amount of pressure needed to pump and fill your heart is higher than normal and could lead to your heart being over worked. If left undiagnosed and untreated for an extended period of time, you could suffer from a heart attack or heart failure.

If you’ve been diagnosed with hypertension, one of the treatments that can assist in decreasing your reading is regular specific exercises. This is where Biokineticists come in.

Exercise for hypertension is specifically designed to train your heart how to deal with access pressure. These pressures can include anything from being overweight, to additional work stress, to being very unfit, to financial problems, etc.  By increasing your heart’s capability to adapt to different situations, you will lower your blood pressure and increase your quality of life.

For more info on high blood pressure and exercise, contact us now. You don’t have any time to waste!

Are your hips moving just a little too much! - Bianca Bunge (Paladin Biokineticists)

So if there ever was an 'All great ruler' of the lower body it would most probably have been the Hip joint! The hip joint is one of the most important and widely used joints in the human body, it allows us to do just about EVERYTHING, and plays a vastly essential role in mobility as it allows us to walk, jog, run, hop, jump, skip - whatever floats your boat - the list goes on and on...!! It is responsible for baring our body's weight (and after piling on a few killos after winter even more so) and is considered as an essential region of force transmission. The hip joint must therefore be able to accommodate various repeated, extreme forces during intense physical activity.

Furthermore, as the hip joint is a ball-and-socket joint it is also considered as one of our most flexible joints as it allows for a greater range of motion than most of the other joints in our body. Therefore, functionally, the hip joint enjoys a very large range of motion. It would therefore make sense that the hip joint should be stabilized before it gets completely out of control and goes on a free range rampage!! Poor hip stability can therefore be seen as the long lost answer to various deep (and shallow for that matter) rooted problems! Poor hip stability can further result in various movement dysfunctions and muscle compensations that can in the end be detrimental and lead to various aches, pains and even injuries!

Hip instability can be viewed as the common thread to a variety of different problem. Hip instability is a problem that's far more common than we like to admit! But as they say, admitting you have a problem is the first step, then comes the hard part, FIXING IT!! And this is far more of a daunting task. But the best way is to approach your 'Hip dysfunction and instability problem' is using a step-by-step approach! The fact is there can be a vast variety of different contributing factors, causes, compensations and imbalances that can be the culprits of your deep rooted problem! But don’t fear, that’s exactly what we’re here for – we’ll stabilise those hips of yours one step at a time!

Step 1: Deep tissue mobility - A tight muscle is not necessarily a strong muscle! Look at it like this, when you're feeling all stressed out and tensed up you don't want to work, and effectiveness and efficiency is the last thing on your mind - same thing with your muscles, when they're strained and tight there's no way they’re going to want to work effectively! Muscle tightness will result in reduced range of motion ultimately negatively influencing your performance and movement patterns! So basically what it comes down to is that you need to be loosened up, and soon too!

Step 2: Isolated strengthening - Time to put in that good old hard work, let that sweat roll down your face and get those muscles strong - because a weak muscle is definitely not going to take you the distance you want it to! But, it's all about specificity - target the RIGHT muscle and achieve the RIGHT results!!

Step 3: Functional strengthening - Cause in the end of the day you need to be functional - you need to be up and about doing your thing!! Here we get you up on your feet and strengthen you in a dynamic and functional way – this most definitely gets those muscles firing!

Step 4: Dynamic Stabilizing - So now that you've secured some good old hip stability it's important to make sure this stability carries over into dynamic, quick, functional movements!

Step 5: Time to show off your brand spanking new hip stability!

Time to develop some stable, well-functioning hips that will get Shakira raving!

Achilles Tendonitis - Michael Irvine (Paladin Biokineticists)

The Achilles tendon is the largest and strongest tendon in the human body. It is a tough band of fibrous tissue which inserts onto the calcaneus of the foot. The Achilles tendon is the common tendon to the gastrocnemius and soleus calf muscles. When these muscles are contracted, the Achilles tendon pulls on the calcaneus causing plantar flexion of the ankle. This is a common movement which makes walking, running, jumping and standing on toes possible. The Achilles tendon is said to withstand forces up to seven times one’s body weight, showing how much force the Achilles tendon is made to withstand during sporting activities.

Achilles Tendinitis is a condition which involves the inflammation of the tendon surrounding the ankle joint. Tendinitis within the heel complex is either due to a single cause, or may involve a variety of mechanisms. Although the Achilles tendon is an extremely strong structure and able to withstand large forces placed on it, it is still vulnerable to injury. This is due to a large amount of tension placed on it, as well as tendons having a limited amount of blood supply.

Achilles tendinitis is an inflammatory condition which involves the degeneration of the Achilles tendon. This is a result of micro tears which have developed within the structure which directly causes instability and a decrease in the tendons tensile strength.

There are two types of Achilles tendinitis:

• Acute Achilles Tendinitis

This is usually the result of abrupt or sudden onset, with the individual experiencing moderate pain 2 – 3 cm proximal to the tendons insertion on the heel. The pain is pinpoint tenderness and pain will increase when palpated.

• Chronic Achilles Tendinitis

This is generally an injury which occurs from overuse. Chronic Achilles Tendinitis exhibits a similar pain to Acute Achilles Tendinitis except the pain is usually at the insertion of the Achilles tendon. This injury generally occurs from repetitive micro trauma to the tendon and if left untreated, it could progress to an Achilles Tendon Rupture.

Aetiology:

It has been highly speculated that runners are more susceptible to Achilles tendinitis due to the repetitive micro trauma. This micro trauma is produced by:

1.       Eccentric Loading of fatigued muscles

2.       Excess pronation which produces a whipping action of the Achilles tendon

Therefore, all Achilles tendon injuries tend to be a result of either structural or dynamic disturbances of the lower leg. The main cause of Achilles tendon complex is due to overuse/overtraining.

Causes:

•     Overuse/changes in training
•     Ageing
•     Biomechanical faults (Pronation)
•     Tight calf muscles
•      Lack of ankle instability
•     Inappropriate show wear (resulting in biomechanical faults)

Signs and Symptoms:

Unless acute Achilles tendonitis, symptoms tend to develop gradually and become worse over time.

•         Local and tender pain in Achilles which tends to increase with specific activities
•     Crepitus (Grating or crackling sensation within the tendon upon movement)
•      Redness/swelling around the area
•      Affected tendon may appear thicker
•      Stiffness in tendon in morning which gets better with movement
•      Pain experienced with active or passive stretching
•      Reduced flexibility
•      Weakness and pain when standing on toes

Exercise as treatment:

Due to the Achilles tendinitis being an overuse injury, it is important to reduce activities that place strain on the Achilles tendon. Research has found that there are passive as well as active methods which can be prescribed to treat Achilles tendinitis. Aggressive stretching of the Achilles tendon complex should be implemented and incorporated into the training program to loosen the calf muscles and relieve the tendon of some of the tension placed on it. Exercises can be done to improve one’s biomechanical faults such as pronation which can help reduce the strain on the Achilles tendon.