Orthopedic Rehabilitation
Biokineticists specialize in clinical exercise rehabilitation for joint replacements, ligament repairs, and the like. My approach focuses on restoring functional mobility, proprioception, strength, and balance through evidence based movement protocols.
In the case of a surgery, to start you’ll have a post-operative consultation with your surgeon and you’ll be cleared for treatment with a physiotherapist - this is called the “acute” rehabilitation phase. This is absolutely crucial! Your physio will do manual soft tissue therapy and joint mobilization, and they’ll take you through the process of doing basic activities of daily living safely. They’ll give you some exercises to get you started with strengthening the joint and getting it back to adequate range of movement. If things go smoothly, this should last between 4 to 8 weeks.
You’ll then be referred to a Biokineticist for “‘post-acute-phase” rehabilitation. That’s where we come in!
We get into the intricacies of getting you back to full functionality. We make sure that your muscles are strong, your ligaments are durable, your joint is mobile, your balance is proficient, and that you have the confidence to use that limb as if you never had surgery in the first place.
Now, there’s a lot that goes into this process and it isn’t generally a quick fix. We follow protocols that are based on gradual progression - this ensures that everything happens at the right time and that there are minimal setbacks (and minimal odds of re-injury).
But keep in mind that full recovery from major surgery takes time, effort, and consistency.
Management of Arthritis & Other Inflammatory Joint Conditions
Biokineticists frequently work with degenerative, inflammatory, and auto-immune joint conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile arthritis, age-related spinal degeneration, and psoriatic arthritis.
We work in conjunction with physiotherapists, chiropractors, general practitioners, and rheumatologists, and together we form a team of healthcare practitioners with the primary goal of keeping our patients functional and to minimize flare ups.
The process begins with desensitization, which is the most difficult part, but absolutely crucial! Your physiotherapist and/or chiropractor will be essential in assisting with this. We focus on breaking the chronic pain cycle by systematically introducing safe, non-harmful stimuli to "re-educate" your central nervous system. This simultaneously addresses your fear (and possibly avoidance) of movement.
The rest of the journey involves maintaining joint mobility, ensuring functional muscle recruitment patterns, improving movement fluidity, increasing strength and joint stability, improving overall functionality and your ability to perform daily activities, reducing flare-up frequency, and maintaining a healthy body weight and adequate muscle mass. We introduce (and encourage) frequent low-impact exercise.
Because these conditions are often chronic, your treatment might have to be ongoing in order to maintain a healthy and functional lifestyle. However, considering that the alternative to consistent maintenance and exercise may be progressive deterioration, chronic pain, loss of function, and surgery, I strongly believe that Biokinetics is the best course of action.
Musculoskeletal Injury Recovery
Biokineticists are well trained in sports-specific rehabilitation following muscle strains, ligament sprains, tendinopathies, and other over-use syndromes. We bridge the gap between injury and return-to-play.
Initially, it's recommended that you see your chiropractor or physiotherapist for management of inflammation and pain in the acute phase, immediately following injury. They’ll do manual soft tissue therapy, joint mobilization, needles, ultrasound, shockwave therapy, and/or other similar modalities. The time spent in this phase will depend on the severity of the injury and how long you've been dealing with it - but we're looking at anything from 2 to 8 weeks.
You'll then be cleared for "post-acute-phase” rehabilitation with a Biokineticist.
We focus on maintaining mobility, ensuring adequate joint stability and muscle recruitment patterns, regaining strength and power, restoring agility and balance, and (very importantly) preventing similar future injuries. The ultimate goal is that you have the confidence to play your sport as if you never sustained an injury in the first place.
In order to get you back to full functionality and strength, we follow specific evidence-based protocols that are based on gradual progression. We have to achieve certain movement outcomes before we can progress to the fancy, Instagram-worthy stuff. This ensures that everything happens at the right time and that there are minimal setbacks - and minimal odds of re-injury. Real, comprehensive rehab is NOT a quick fix - particularly for high impact and quick change-of-direction sports.
Acute and Chronic Pain
Management
This concerns individuals that suffer from conditions such as chronic neck and back pain, frequent migraines and headaches, neuropathic pain (e.g. as a result of cancer treatment, nerve injury from surgery, traumatic events such as motor vehicle accidents, diabetic neuropathy), fibromyalgia, and rheumatoid arthritis - to name a few.
Severe chronic pain is best managed by an interdisciplinary healthcare team that treats the whole person, integrating methods that address both physical and mental wellbeing. These specialists may include Biokineticists, physiotherapists, chiropractors, general practitioners, rheumatologists, psychologists, occupational therapists, psychiatrists, and craniosacral therapists. In complex cases, no single specialist will have all the answers - so a cohesive team will be most effective to restore your daily function, improve your quality of life, and teach long-term coping mechanisms.
As a crucial part of this team, Biokineticists will integrate passive mobilizing, neuromuscular re-education, stability work, and gentle strength exercise. This restorative movement program is designed to break the chronic pain cycle and improve your quality of life by allowing you to perform daily tasks with minimal pain - depending on the severity of your condition. Afterall, you cannot have a fulfilling life without movement.
There is always hope. You will never come to this practice and have your pain dismissed.
Common Questions
What is a Biokineticist and how can one help me?
A Biokineticist is an HPCSA accredited healthcare professional that specializes in enhancing physical health through individualized clinical exercise therapy. We commonly treat and assist in the management of orthopaedic injuries & surgeries, neurological conditions, metabolic diseases, cardiovascular & pulmonary conditions, geriatric patients, pain pathologies during pregnancy, chronic pain, inflammatory & degenerative joint conditions, dysfunctional posture, childhood motor development deficits, and more. Our goal is to manage your pain and help you regain functionality through restorative movement - so that you can take control and continue doing the things that make life worth living.
What should I expect during my first consultation?
The purpose of the first appointment is to explore your pathology, listen to your most significant complaints, and to ascertain any contributing factors so that we can come up with a plan that will address these problems.
Your Biokineticist will take a comprehensive medical history, including past injuries, surgeries, illnesses, hospitalizations, and chronic conditions. It's always helpful to bring your most recent medical imaging, as well as a list of your current prescribed medications to assist in building a risk profile.
This will be followed by a physical assessment to identify any musculoskeletal dysfunctions or deficits that may be contributing to your problems. This may include muscle strength testing, measurement of joint range, functional & special testing, palpation, agility & balance testing, a postural analysis, measurement of limb symmetry, gait analysis, and blood glucose & cholesterol testing, to name a few.
All the information gathered in this primary assessment will be used to draft and implement your exercise rehabilitation therapy in subsequent sessions - individually tailored to your body's restorative needs.
What do we do in rehab sessions?
The process begins by addressing joint mobility deficits. We need your joints to be able to move through their full range (within the limitations set by your particular pathology), pain free, in order to regain full functionality. Your body won't feel "normal" or have the ability to move with fluidity until your joints are adequately mobile.
If warranted, we'll include desensitization protocols to break your chronic pain cycle. This involves systematically introducing safe, non-harmful stimuli to "re-educate" your central nervous system, which addresses your fear (and possibly avoidance) of movement. In essence, we teach your brain that movement will help, not harm. In our realm, this includes isometric strength exercise, assisted passive limb movement, targeted EMS to bring proprioceptive awareness to stabilizing muscles, and gentle release strategies.
Next is the cognitive stage - more thinking than moving. This phase may be the least interesting part of rehab, but it is absolutely crucial for ensuring joint stability and preventing future injuries related to the same dysfunctional movement patterns. We focus on isolation exercises that ensure sufficient stabilizing muscle fibre activation. We also correct dysfunctional muscle recruitment patterns that may be contributing to overuse syndromes and joint instability.
We then reach the associative stage, where we start refining movements, reducing errors, improving fluidity, and increasing muscular strength and endurance. You will develop a better sense of your body's position and movement in space. We will focus on your ability to feel what your body is doing and making adjustments independently, rather than having me cue corrections. Naturally this will translate to your everyday movements, which will prevent future injuries and flare ups.
Finally we enter the autonomous stage, where we start doing advanced exercises that will challenge dual-tasking, high adaptability, and "feedforward" control. We focus on your ability to predict and anticipate what is required to achieve a movement outcome correctly, with minimal cognitive effort.
In all of this, we need to keep symmetry in mind. The vast majority of injuries are the result of differences between right and left. Movement compensation patterns develop as a result of these differences, which may lead to musculoskeletal pathologies. In order to address and rehabilitate the problem, we need to strive for symmetry of joint mobility and stability, strength, and muscular endurance. This will prevent future injuries from occurring as a result of the same deficits.
How many sessions will I need for recovery?
The number of sessions required to fully rehabilitate your pathology varies vastly, and will depend on the nature of your condition and your personal goals. We cultivate a supportive environment together - one where we can reach your goal in a timely manner. I will listen to your concerns, and we can create a plan that will best achieve what we need to, keeping in mind that different musculoskeletal tissues and injury grades heal on different timelines (I can do a lot, but I can't change the rules of physiology). We will adjust your treatment frequency as you progress towards optimal physical health.
Do I need a doctor's referral to book?
While we work closely with other healthcare professionals (physiotherapists, general practitioners, chiropractors, orthopaedic surgeons, rheumatologists, and neurologists), a referral is not always mandatory. Your healthcare practitioner may refer you to a Biokineticist if they determine that the best course of action is exercise rehabilitation. However, you can schedule an assessment directly with your Biokineticist to begin your rehabilitation journey toward optimal physical health.
Are Biokineticists able to claim from medical aid schemes?
Biokineticists are accredited HPCSA healthcare practitioners, so we are authorized to claim from medical aid schemes. Whether your medical aid covers the treatment or not will depend on your MA scheme and plan. You can contact your medical aid to enquire about their policies and whether your treatment will be covered, as well as how many sessions will be covered. Not all Biokineticists opt to claim directly on your behalf (this will depend on individual practice policies), but they should be able to send you the coded invoice which will allow you to submit the claim to your medical aid for reimbursement.