Treating the patient

If you are injured and want to use exercise as a modality it is important that you realise that the exercise does not treat pain directly.

Exercise may alleviate discomfort and improve functional ability.  But it does not “treat” the pain. Likewise, when you seek the advice of a Biokineticist or exercise specialist they should not have the goal of trying to “treat” your pain. They need to treat you. The patient. Not the pain. In the process of the exercise journey the pain may diminish. This is more often than not (depending on the condition) due to the exercises addressing the causative factors rather than just the symptoms/consequences of your particular injury.

Biokinetics Cape Town


Often practitioners and patients alike get stuck “looking down the microscope”. They are so focused on pain that they miss the factors that contribute to the pain.  Pain viewed from a “catastrophic model” perspective puts pain in the centre of attention. Something is wrong. There is a crisis, and the symptoms of that crisis need to be addressed immediately. And at a localised level. But you and your injury are more than just pain. Pain is complicated. It is multi-factorial. There are physical factors, biological factors, social factors, psychological factors, and even environmental/lifestyle factors.  For this reason the treatment approach should be multi-factorial. Causation rather than catastrophe.

Your treatment team needs to keep this in mind and work as a unit rather than as individuals. Each team member has a role to play in the management of your injury. Doctors / Physiotherapists / Biokineticists / Osteopaths / Chiropractors need to work in unison to meet your treatment goals.

Biokinetics Neil Hopkins

Voltaire was a philosopher in the 1700’s. He apparently wrote the following phrase: “Doctors/Physicians are like wizards/magicians, they enact trickery while the body effects the cure”. Given the right environment, and treatment approach, your body does the healing work. The therapists that you work with are privileged enough to be along for the ride. They may be highly educated/skilled, but your recovery is your responsibility and your achievement.

If you are injured and think that you could benefit from seeing a Biokineticist, speak to your Specialist / Doctor / Physiotherapist / Osteopath / Chiropractor, to see if you are a suitable candidate for Biokinetics exercise rehabilitation. Otherwise feel free to visit your local Biokineticist. If your injury is too acute, or in need of more physical therapy the Biokineticist will refer you to a Specialist / Doctor / Physiotherapist / Osteopath / Chiropractor for appropriate management and care.



Microscope image: Techtimes
Pain image: PBS Newshour
Voltaire image: Amazing people

Biokineticist Cape Town

Should I see a Biokineticist?

There is often confusion about the role of a Biokineticist.

Ask any Biokineticist, it is their biggest frustration. People don’t know who they are, or what they do.

Granted, there are a lot of similarities to Physiotherapy and personal training, the two disciplines that are most frequently referred to when you mention Biokinetics. But they are not Physiotherapists, nor are they personal trainers. But they do fill the void between the two. The reality is that you can actually be seen by all three, at the same time (no, not the same consultation, but the same time period). Conjunctive care is possible provided that there is no distinct overlap of services. The best management of your injury/condition is a patient-centric approach, not an egocentric approach. Your needs have to be taken into account and for that to happen medical professionals and trainers need to play as a team, not as individuals.

Image 1) Team play: Below is an info-graphic of a hypothetical treatment team scenario.

Cape Town Biokinetics

So when can a Biokineticist help you?

The answer in terms of “time” on a timeline is quite contentious, particularly with the scope of Physiotherapy (Scope: Physiotherapy) and Biokinetics (Scope: Biokinetics) being discussed at the HPCSA (Health Professions Council of South Africa). The time frame also depends on the injury/condition.

Certain skills/services are not within the scope of Biokinetics and most likely never will be. As a rule of thumb the Biokineticist you see should provide you with exercises. Their primary role is exercise rehabilitation. In the scope of practice document reference is made to the role of the Biokineticist commencing when exercise is the primary modality of care. ie: when 51% of your session with a primary care giver becomes exercise you can start to consider seeing a Biokineticist.

When it comes to rehabilitation you as the consumer have the power to choose who you wish to see. However, it is important to know what is in scope and what is not. If you choose to see a personal trainer for injury rehabilitation and something goes wrong their liability cover may not come into effect as they are not qualified or insured for exercise rehabilitation. The same applies to Biokinetics, if you are seeing a Biokineticist and they are treating you out of their scope you may not be covered.

Image 2) Biokinetics? Below is a guide of how a Biokineticist can help you (please note that not all Biokinetics practices are the same)

Biokineticist Cape Town

Orthopaedic / Injury rehabilitation:

The branch of medicine that deals with the prevention or correction of injuries or disorders of the skeletal system and associated muscles, joints, and ligaments is called orthopaedics. You can see a Biokineticist for an orthopaedic injury, depending on the nature and severity of your injury.  You may require to have clearance from a Doctor/Physio/Chiro/Osteo before commencing your exercise rehabilitation. Each injury needs to be assessed on a case by case basis. If the injury is too acute the Biokineticist must refer you on/back to a Doctor/Physio/Chiro/Osteo.

In terms of a treatment timeline you can see the Biokineticist for the initial consultation and programme and then decide on weekly training based on the nature/severity of your injury, as well as your compliance to exercise rehabilitation. It may be necessary to see the Biokineticist more frequently in the early stages of rehabilitation and then slowly wean off into independence. Please note that it is not implicit that you see the Biokineticist weekly. You can visit them sporadically provided that you are compliant with your exercise rehabilitation programme.

Chronic disease risk reduction and reversal:

The treatment timeline for chronic diseases will be different to orthopaedic injuries. Due to the nature of the illness/disease you may require ongoing guidance. This does not imply weekly sessions and a huge financial burden. You can see a Biokineticist sporadically or join a group class. However it is important to stress that just going for the initial consultation will not be sufficient. Once off sessions are not beneficial as you will need guidance and someone to monitor your progress.

High performance and general conditioning:

Athletes who are injured, have been injured in the past, or who just need planning/guidance can see a Biokineticist. A Biokineticist can assist with a structured exercise programme and plan, no matter what level of competition or the nature of your sport. The Biokineticist can address the athletes needs with supervised sessions or comprehensive exercise programmes. The Biokineticist is not your coach and will never replace the role of your coach. They are there to mentor and guide you as part of the training team.

The general gym goer can see a Biokineticist if they have not trained in a long time and need guidance to navigate the complexity of the gym environment. The Biokineticist is not stealing from personal trainers, the Biokineticist is there to work along side trainers for guidance and input. You can start with the Biokineticist and progress to the trainer once you have improved your fitness and strength.

If you are a seasoned gym goer and you struggle with the occasional ache and pain you can see a Biokineticist to work on form and technique. The Biokineticist can give you input on injury advice and injury avoidance. They are more like a mentor that you touch base with when the need arises. If you have an acute injury the Biokineticist may refer you on to a Doctor/Physio/Chiro/Osteo.

Fitness assessments:

You can see a Biokineticist for a fitness assessment depending on your medical aid and medical aid rewards scheme. The goal of the fitness assessment is obviously to get points so that you can enjoy the rewards. However, it can be so much more. It is a window into your current health and well being, and a starting point for Biokinetics training. The Biokineticist can use the information from the assessment to assist you with your training goals. Unfortunately this is not part of the fitness assessment itself. It is a stand alone service that will require you to come for a follow up consultation (with cost implications).

Million dollar question:

With so many people offering the “same” service it is hard to decide. It is best to do your homework on your individual condition and whether it responds with exercise. Sometimes ego’s get caught up in the referral process on both sides. But you as the patient have the right to choose who you would like to see. The burden of care rests with the individual therapist/trainer to know when they are out of their depth. Most people will benefit from seeing a Biokineticist, but there are some people who will need additional care before they start. The best thing to do is to ask. Reach out to your local Biokineticist/Doctor/Physio/Chiro/Osteo and see if you are a suitable candidate.

The best advice is to keep well and keep exercising.



Image acknowledgement:

Full time Biokinetics position available for 2018

Biokinetics business opportunity

Looking for a registered Biokineticist, or intern currently completing internship (2017), that wishes to work in private practice in Cape Town starting full time January 2018 (part time 2017 negotiable).

If you are a hardworking male/female Biokineticist, and would like to be a part of a professional team in 2018, then please send your application to:

1. Fully qualified Biokineticist or 2017 intern
2. HPCSA registered
3. BASA registered (requirement for fitness assessments)
4. Level II first aid with AED and Airway management
5. Professional liability insurance
6. Knowledge of orthopaedics and exercise rehabilitation
7. Discovery Vitality fitness assessment registered (or intent to register)
8. Momentum Multiply fitness assessment registered (or intent to register)

Please note: this practice is not an accredited internship facility. There are no internships offered for 2017/2018. This business opportunity is for big thinkers, and forward planners, looking for a full time Biokinetics position in 2018.

Exercises for surfing

Biokinetics and Surfing

Surf conditioning:

In the past couple of years surfing has become more and more popular. Especially with people who previously would not normally have ventured out into the water. This is partly due to the advances in surfboard design. But also thanks to the current holistic approach to health and wellness, which surfing offers. There is a wide range of surfers now from the pro-surfer to the social surfer. And they are all jockeying for a spot in the line up.

Surfing itself is great fitness, as it conditions the entire body. A surf session will not only give you a cardiovascular work out, but a strength conditioning and core training session as well. It is an antidote to the modern way of life. The working adult spends far too much time sitting and stressing. Surfing offers the opposite. It promotes back extension to counteract the detrimental affects of sitting. And it is in an environment where you can switch off and relax without stressing about your worldly woes.

It may take some time to master surfing if you are a complete novice, but practice and additional exercise conditioning can help. Strengthening your upper body will help with paddling strength and technique. While conditioning your lower body will improve leg strength and agility.

A Biokineticist or Personal Trainer can help get you fit for surfing by designing an appropriate strength and conditioning programme. An exercise programme for surfing will normally consist of: Strengthening the back extensors, shoulders and legs; Core stability; Flexibility; and Plyometrics for pop-ups, turns and explosive airs. A Biokineticist can either design a strength and conditioning programme for your surfing or refer you to a surf conditioning coach who can.

High performance surf conditioning:

The nature of high performance surfing has changed. Elite surfers are now considered to be highly conditioned athletes rather than seasoned “beach bums”. The advent of the athletic surfer has resulted in a number of changes. There is now a lot more consideration into the planning and conditioning as a surfer. It is no longer adequate just to surf. Diet, Psychology, and Exercise conditioning all have to be factored into a carefully structured routine. A surfer’s performance can be vastly improved if a holistic approach to elite surfing is considered. A Biokineticist can offer specialist advice and high performance periodization programmes for elite surfers. Individual or group training sessions can also be arranged (in a gym or on the beach) following an initial consultation.

Biokinetics exercise rehabilitation

Equipment for Biokinetics

It is difficult to know where to find good quality equipment. There are numerous stores and online platforms but it is difficult to discern which ones offer the best quality and the service to back it up. The following post is a guide for patients and practitioners in Cape Town to find the right store for their equipment needs.

Conflict of interest declaration:  This is an independent review. The stores listed below are independent businesses. There is no financial remuneration for writing this post / there are no incentives for referring patients to any of the stores mentioned.
There are other stores out there so feel free to shop around. You would be surprised where you may find hidden gems. Equipment is also available from larger companies such as Sportsmans Warehouse, Game, Makro, and Mr Price Sport.


Specialist stores:

1) Independent Lifestyle Company (LINK)

Primary: Elderl

Secondary: Mobility

Why: This online store is great for walking aids and lifestyle products for the elderly. There is also a catalogue that is distributed to old age homes and retirement villages. The great thing about this store is that it sells the simple things that make life easier.

Who: Elderly friends/family/patients, amputees, post joint replacement patients, post surgery patients, patients that have limited mobility / restricted motion / limited ability.

Chin and Partners

2) Chin & Partners  (LINK)

Primary: Bracing

Secondary: Ergonomics

Why: This store (online or walk in) is based in Cape Town CBD or at the Vincent Pallotti Hospital. It is stocked with various braces and the latest ergonomic aids. The bonus is the expert advice and service provided by registered medical professionals. Medsport is also the home of it’s founder Jayson Chin (CPO) and associates. If you need foot orthotics or expert bracing advice give them a try.

Who: Friends/family/patients, amputees, post joint replacement patients, post surgery patients, patients that have limited mobility / restricted motion / limited ability, patients that need bracing, patients that need foot orthotics, anyone who sits at a desk for more than 5 hours per day.

3) HiTech Therapy (LINK)

Primary: Medical devices

Secondary: Rehabilitation equipment

Why: For medical professionals looking for medical products and advanced electronic treatment devices. An industry leader in supplying anything from rolls of theraband to EMS devices and CPM units. They have a comprehensive catalogue and they deliver.  

Who: Practitioners (this is a wholesale store for medical professionals)

4) Ergonomics Direct (LINK)

Primary: Ergonomics

Secondary: Exercise

Why: This store (online or walk in) is based in Cape Town. It is stocked with latest ergonomic aids. The bonus is the expert advice and service provided by registered medical professionals.

Who: Friends/family/patients, anyone who sits at a desk for more than 5 hours per day.

5) GetOne (LINK)

Primary: Ergonomics


Why: This company designs and sells chairs and work station accessories. The products are reasonably priced and designed by industry experts.

Who: Friends/family/patients, anyone who sits at a desk for more than 5 hours per day.

6) JustSports (LINK)

Primary: High performance

Secondary: Exercise rehabilitation

Why: For medical professionals and coaches looking for exercise rehabilitation or sports conditioning equipment.  An home grown industry leader in supplying sports conditioning and testing equipment, as well as small rehabilitation equipment.

Who: Practitioners and coaches (this is a wholesale store for medical professionals and coaches).