The role of the Biokineticist in the treatment of chronic and recurring injuries


In order for us to make sense of the role that exercise can play in the rehabilitation of injuries it is important to distinguish between different types of injuries based on the initial cause, the severity of and duration of the injury.

Chronic injuries refers to injuries which are of long duration and which are usually slow to develop such as Achilles tendinitis as opposed to acute or traumatic injuries such as a fractured bone from a direct trauma.

Overuse injuries are caused by overexerting the body through the use of incorrect exercise practices and not allowing for enough rest in between sessions. The athlete places too much stress on the body with insufficient time for it to recover. This is a very common pattern amongst Comrades runners who start running faster, more regularly and longer distances in February and March of each year.

Recurring injuries are injuries that get better with rest and treatment but which reappear when the person returns to the event that caused it.

At this time it is good to remember that your Biokineticist is an exercise specialist with an Honours degree trained in the clinical prescription of exercise for the prevention and rehabilitation of injuries.

It is also important to understand the role of the doctor and the physiotherapist on the continuum of rehabilitation. If you get injured, regardless of whether it was caused by direct trauma such as a rugby tackle or by pushing too hard and too fast during training, your first stop should be a physician. Depending on the severity of the injury you may go to the emergency care at the hospital or go to see your general practitioner. The doctor is considered the first phase on the continuum and will diagnose the condition and decide which intervention will be best. Options include the prescription of medicine, an operation, immobilization, rest or physiotherapy.

Physiotherapists are considered part of the first and second phase of rehabilitation. Physiotherapists have been recognised as first line practitioners since 1985 and this means that it is recognized that they are able to diagnose and treat injuries. Physiotherapists make use of various modalities including hands on techniques to reduce pain and swelling and to improve range of motion and function. They also play an important role in educating the patient in living and coping with the injury. It is vital to understand that the clinical prescription of exercise also falls within the scope of practice for Physiotherapists. It is in this regard where Biokineticists and Physiotherapists share common ground.

Biokineticists apply exercise in what is known as the third or final phase of rehabilitation. It is also sometimes known as the strength phase. It is vital to understand how your Biokineticist can help you to address the cause of your chronic and recurring injuries. Biokineticists see patients with recurring and chronic injuries generally after they have been treated by the doctor or physiotherapist and the symptoms have been greatly reduced.

Unlike traumatic or overuse injuries the cause of your recurring and chronic injury is not always clear. You have intrinsic and extrinsic forces influencing your body. If these forces are out of balance or if they cause your body’s musculoskeletal system to become unbalanced it can lead to chronic or recurring injuries. Intrinsic forces which can cause injury are muscle imbalances in strength and flexibility, biomechanical anomalies such “knock knees” etc. Extrinsic forces could include wearing the wrong shoes, running on the camber of the road or only running in one direction around a track.

Please note that chronic and recurring injuries do not only apply to athletes but also to people at work and home. The way we move and sit and work can all lead to chronic injuries such as neck and back pain. These movement patterns cause imbalances over time, and this leads to pain. There is not necessarily a pathology but there is pain which is mechanical in nature. These types of injuries are recognised by the fact that the pain diminishes after rest and tends to get worse as the day or the week progresses.

A skilled Biokineticist will be able to determine through a thorough consultation and scientific assessment what the cause of your chronic and recurring injuries are. By looking for the cause of the problem and by not just chasing the symptoms the biokineticist will be able to address the cause and educate you in managing the problem going forward.

Once it has been established what is wrong the Biokineticist can then address the problem in a structured way by applying clinical exercise as a tool in correcting the problem.

The goal of training is not to change how the body looks, but to improve how the body moves”

Athletic body in balance. Gray Cook.

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Stephen Louw is a registered Biokineticist practicing in Benoni. Stephen studied through the University of Pretoria and the University of Zululand.

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