MANDY KNAAP - PHYSIOTHERAPIST

I have a special interest in treating shoulder injuries, dancing injuries, sports injuries  and neck and back pain.
I have lived in Table View since the age of 2. I attended Table View Primary School and matriculated from Milnerton High School in 1986. I graduated from Stellenbosch University with a BSc degree in Physiotherapy in 1990. My first physiotherapy post was at Groote Schuur Hospital, but after only 3 months, I accepted a job in private practice and started working at Bayside Centre in Table View in April 1991.
After being employed there for 2 years, I bought the practice and in 1995 moved to Blaauwberg Therapy Centre (BTC). BTC is a multidisciplinary Centre where myself and my physio colleague, Karen, work with other professionals: psychologists, psychiatrist, dietician, occupational therapist, speech and language therapist, mediator, reflexologist, massage therapist and a beautician.    

KAREN ROUX - PHYSIOTHERAPIST

Karen has a special interest in treating cervicogenic headaches (headaches originating from the neck) and neck and back pain.  
Karen matriculated as one of the top 50 students in the Western Province from Charlie Hofmeyer High School in Ceres in 2002. She graduated in 2006 with a BSc degree in physiotherapy from Stellenbosch University. In 2007 she performed duties as a Community Service physiotherapist at the National Hospital in Bloemfontein and at Westfleur Hospital in Atlantis. She was registered as an independent practice physiotherapist by the HPCSA in the same year. Karen joined my practice as a physiotherapist in January 2008.

Ongoing training:
Karen and myself regularly attend courses and lectures to keep current with the latest research and to constantly expand our knowledge so as to improve the treatments we are able to offer.

We treat acute and chronic conditions and do maintenance treatment.

Treatment:

Physiotherapy can help for almost any condition that affects muscles, joints or nerves.

Common problems that we treat include:

• Shoulder injuries: e.g.
  Rotator cuff impingement (RCI)
  Rotator cuff tears

• Dancing injuries: e.g.
  Labral tears
  Femoroacetabular impingement (FAI) of the hip     
  Hamstring strains/tears
  Ankle sprains
  Dislocations 

• Sports injuries: e.g.
  Patella-femoral pain syndrome (PFPS)
  Ilio-tibial band syndrome (ITB)
  Arm pump        

• Spinal conditions: e.g.
  Lower back pain
  Upper back pain
  Neck pain or injuries including whiplash and wryneck/torticollis
  Headaches including cervicogenic and ‘tension’ headaches
  Vertebral injuries: e.g. ‘Slipped disc’

• Muscle strains, tears or dysfunction

• Tendon strains: e.g.Achilles tendonitis / tendonosis  

• Ligament sprains or tears

• Acute or chronic pain relating to nerves, muscles or joints (neuromuscular-skeletal problems)

• Neurological conditions: e.g.
  Nerve pain
  Nerve entrapment: e.g.
  piriformis syndrome
  Nerve root compression
  Sciatica

• Joint or articular injuries or pain: e.g
  PFPS/Chondromalacia
  TMJ pain and dysfunction
  Knee meniscus injuries

• Temporomandibular joint (TMJ) problems: e.g.
  Painful jaw joint or pain on chewing
  Inability to open your mouth

• Dislocations of joints: e.g.
  Shoulder joint dislocations
  Acromio-clavicular (AC) joint dislocations
  Patella dislocations/subluxations
  Elbow joint dislocations

• Overuse injuries: e.g.
  Tennis elbow
  Golfers elbow
  Plantar fasciitis

• Repetitive strain injury (RSI): e.g.
  Carpal tunnel syndrome
  Tendonitis
  Tenosynovitis

• Post-orthopaedic surgery: e.g.
  Knee, hip or shoulder replacements
  Muscle repairs: e.g. Rotator cuff repairs
  Menisectomies

• Ligament repairs: e.g.
  ACL repairs
  Internal fixation after fractures
  Arthroscopies
  Spinal discectomies, fusions, disc replacements

• Fractures

• Pregnancy related problems: e.g.
  Back pain
  Carpal tunnel syndrome
  
  
• Breastfeeding related problems: e.g.
  Mastitis
  Bleeding or painful, cracked nipples
  Engorged breasts
  Blocked milk ducts
  
  
• Post-mastectomy problems: e.g. Shoulder stiffness or pain

• Osteoarthritis (OA) related problems: e.g.
  Joint pain and stiffness
  Dysfunction
  Resultant poor posture

• Ankylosing spondylitis (AS) related problems: e.g.
  Joint pain and stiffness
  Dysfunction
  Resultant poor posture 

Although OA and AS cannot be cured, treating the symptoms can be effective and the altered biomechanics can be improved.

• Respiratory conditions: e.g.
  Acute and chronic emphysema
  Asthma
  Bronchitis
  Cystic fibrosis

• Sinusitis

• Trigger Finger

• Fibromyalgia and other chronic pain conditions

• Bursitis

• Bedsores

• Benign paroxysmal positional vertigo (BPPV): BPPV is a spinning type of dizziness/vertigo brought on by head movement. It is caused by displacement of the calcium carbonate crystals (otoconia) usually attached to the hair cells in the inner ear. These otoconia are then free floating in one of the fluid filled tubes inside your inner ear, causing you to feel dizzy.

Who do we treat?

• Sportsmen, women and children 
• Dancers
• Pregnant women
• People of all ages with any of the above conditions.

Some of the expected treatment outcomes:

• Decreased pain
• Decreased swelling
• Improved circulation
• Decreased inflammation
• Improved mobility
• Improved muscle length 
• Increased flexibility and range of movement
• Decreased muscle spasm
• Increased muscle strength and endurance
• Improved stability, balance, co-ordination, proprioception
• Improved gait (walking pattern)
• And ultimately: Improved function and improved quality of life.

How do we treat?

We will choose techniques that we have found to be the most effective in treating the presented type of condition. We will adjust these techniques based on the outcome of previous sessions and as your condition improves and changes.

We have electrotherapy machines should they be needed, but our emphasis is on hands-on techniques. We will mostly use a combination of different techniques (evidence based practice).  Using hands-on techniques and a combination of different techniques has been researched to be the most effective.

Techniques we may include in your treatment:

• Spinal mobilisation - mobilisation of the joints of the spine using specific techniques, such as Maitland, Mulligan, McKenzie and Kaltenborn.

• Peripheral mobilisation - mobilisation of all the other joints other than the spine, such as knees, shoulders and jaw (TMJ).

Mobilisation loosens joints, reduces pain and reduces swelling.

• Manipulation

• Soft tissue mobilisation - specific soft tissue mobilisation, cross-friction, deep muscle massage.

Massage improves circulation, decreases swelling, decreases pain and decreases muscle spasm. 

• Triggerpoint (TP) release - a triggerpoint is a taut band in a specific area in a muscle. It causes muscle tightness and pain – local and referred. These triggerpoints can be relieved by various manual techniques: manual compression, deep stroking massage, sustained myofascial tension and dry needling.  

• Dry needling - dry needling involves inserting a sterile needle into the painful area or tight muscle or TP to loosen the muscle or triggerpoint to decrease pain or muscle spasm in the area. This is different from acupuncture which is part of traditional Chinese medicine. 

• Neural tissue mobilisation - mobilisation of an individual nerve or the whole neural system.

• Taping
  
  • Rigid taping - this immobilises an area to prevent certain movements and stabilises the joint.
  • Kinesiotaping - improves circulation, relieves pain, promotes healing, corrects muscle function and enhances performance without restricting the body’s movement.
  • McConnell taping - improves faulty biomechanics to decrease pain and improve function and also unloads soft tissue.
    
    
• Rehabilitation/exercise prescription
• Stretching
• Strengthening
• Muscle re-education
• Injury-specific exercise
• Individual-specific home-programmes
• Post-operative rehabilitation

Exercise improves posture and muscle strength, increases flexibility and endurance, increases mobility, improves balance and proprioception.

• Advice and education to the patient, other family members, helpers and/or carers.
• Ergonomics - computer work-station set-up
• Kinetic handling - lifting methods
• Preventative back and neck care
• Posture correction
• Pain Management
• Exercises – as per rehabilitation/exercise prescription above

• Traction - this is effective for treatment of nerve-root compression. 

• Electrotherapy - laser, ultrasound, tens, interferential, combination therapy.

• Heat

• Ice

• Chest physiotherapy techniques
• Nebulising - patients may need to bring their own medication
• Postural Drainage positioning – this assists drainage of phlegm/secretions 
• Percussion
• Vibration and shaking – this helps to loosen phlegm/secretions
• Breathing Exercises
• Suctioning – babies up to about 6 months old (only done by Mandy Knaap)

Additional information:

Our treatments are usually 45 minutes long. This provides enough time for us to properly assess and treat your condition and to give you relevant advice and demonstrate exercises. You may be given the exercises to do at home so that your treatment can continue between sessions. This may well limit the number of sessions needed for you to recover.

Home visits can be arranged when necessary.

Karen and I are both bilingual.

We charge the recommended medical aid tariffs and submit directly to medical aid for your convenience.

We accept Debit and most credit cards.

Treatment is available from 8am to 6.30pm on weekdays and 8.30am to 12.15pm on Saturdays.

Contact Delia de Abreu, the practice Secretary, or Natalie Mentor, our Receptionist, on
(021) 5576066  for any further queries or to make an appointment. You are also welcome to email myself or Karen on mrknaap@mweb.co.za.