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!

Sacroiliac Joint Dysfunction - Melissa Biffi (Paladin Biokineticists)

What is the (SI) Joint?

The sacroiliac (SI) joints are formed by the connection of the sacrum (triangular-shaped bone at the base of the spine) and the right and left iliac bones (two large bones that make up the pelvis). While most of the bones (vertebrae) of the spine are mobile, the sacrum is made up of five vertebrae that are fused together and do not move. The SI joints connect the spine to the pelvis and the sacrum and the iliac bones are held together by a group of strong ligaments.

There is relatively little motion at the SI joints, most of the motion in the area of the pelvis occurs either at the hips or the lumbar spine. When and individual is sitting upright of standing these joints  need to support the entire weight of the upper body, which places a large amount of stress across them and this can lead to wearing of the cartilage of the SI joints if the supporting muscles and ligaments are not strong enough.

Causes of SI joint dysfunction

SI joint dysfunction is a term used to refer to a condition that causes pain in the SI joints from a specific cause. There are a few common causes of SI joint dysfunction and these are conditions that change the normal walking pattern which places additional stress on the SI joints, This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle or foot.

Degenerative arthritis is a common cause of SI joint dysfunction. As with most other joints in the body, the SI joints have a cartilage layer covering the bone. The cartilage allows for some movement and acts as a shock absorber between the bones. When this cartilage is damaged or worn away, the bones begin to rub on each other, and degenerative arthritis occurs. This is the most common cause of SI joint dysfunction.

Another common cause of SI joint dysfunction is pregnancy. During pregnancy, hormones are released in the female's body that allows for relaxation of ligaments which prepares the body for childbirth. Relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear. The additional weight and walking pattern associated with pregnancy also places increased stress on the SI joints, 

What are symptoms of SI joint dysfunction?

The most common symptoms of SI joint dysfunction is sacroiliac pain. Pain in the SI joint is often related to either too much motion (hypermobility) or not enough (hypomobility) in the joint. Individuals often experience pain in the lower back or the back of the hips and can also be present in the groin and thighs. The pain is typically worse with standing and walking and improved when lying down. Inflammation and arthritis in the SI joint can also cause stiffness and a burning sensation in the pelvis.

How can Biokinetics help SI joint dysfunction?

 Biokinetics will focus on prescribing a specific individualised exercise regimen according to the needs of each person. The program will consist of low-impact aerobic activities , range of motion exercises for flexibility ,strength training  to improve muscle tone and stretching exercises. Exercise can help reduce pain and fatigue and improve muscle and bone strength. It is very important that the correct exercises be prescribed and done obediently, as incorrect exercises; a lack of effective management of SI Joint dysfunction and poor compliance of the individual can lead to progression of and increase pain of the SI Joint.

Melissa Biffi obtained her BCom Sports Management Degree at the University of Johannesburg and completed her Honours in Biokinetics at the University of Witwatersrand.

She has a special interest in dancing and other sports such as soccer and hockey, which lead to her interest in orthopaedic rehabilitation, particularly knee rehabilitation.

Melissa is also very passionate about working with children in specific areas such as rehabilitation and development of individuals from very young ages all the way through to adolescents.

Melissa can be contacted on 082 822 9677 or melissabiffi@kinetics.co.za 

Joint Laxity... Are you bent out of shape? - Nicole Robson (Paladin Biokineticists)

Ligaments connect bone to bone and therefore play an important role in joint stability. When ligaments are lax, there is less stability and the ligaments are termed “loose.” When this affects more than one joint in the body it is termed hypermobility and is often the cause of chronic pain. Causes are either genetic or as a result of an injury (torn ligament). Individuals with lax ligaments are more pre-disposed to injury and resultant joint degeneration with increasing age.

Common symptoms include

•  pain and stiffness in the joints and muscles
• clicking joints
• pre-disposition to dislocation.
• fatigue (extreme tiredness)
• recurrent injuries – such as sprains

Exercise is a great way to help manage pain and create stability around the joints. As a biokineticsist we can determine which joints are more hypermobile than others and therefore can determine which muscles are compensating. It is important to have specific exercise prescribed so that strength can develop and assist with stabilisation. It is also important to learn what normal range of motion is for each joint, in order to avoid hyperextension.

It is important to concentrate on both isometric and concentric strengthening exercises. In isometric exercise, the joint doesn't actually move, but the muscles around it are contracting. This enables the joint to remain stable whist gaining strength. With concentric exercises, muscles shorten as they contract (i.e. when you lift a weight in a bicep curl).

Emphasis should focus on the most susceptible joints such as your shoulders, elbows, knees and ankles. Core strengthening surrounding joints in your lower back, pelvis and hips is also of vital importance. A strong core assists with overall stability and therefore less chance of injury.