[運動討論] 足球選手的傷害預防(3) Football Injury Prevention(3)

FIFA 11+的第二部份

是六組針對核心, 腿部力量, 平衡與敏捷的訓練
每一組動作又分成三個難度
The second part of FIFA 11+ consists of 6 exercises including core, strength, balance, and agility.
Each exercise has three difficulty level.

我們先介紹前三組動作與困難度的變化
Let's go through the first three movements and their progression.

第一個動作 棒式
Movement 7 Bench

初級
利用前臂與雙腳將自己支撐起來
將肩胛往脊椎收, 腹部與臀部出力
讓身體維持一直線
執行三組, 每組20-30秒
Beginner - The Bench Static
Suppor with forearm and feet.
Pull scapula toward the spine and engage core and gluteus.
Keep trunk straight.
3 sets, 20-30 secs

中級與高級
起始動作與初級相同
中級的動作需要單腳抬起於空中維持兩秒, 雙腳交替
執行三組, 每組40-60秒
高級的動作則須將腳抬離地面10-15公分, 維持20-30秒
執行雙側各三組
Intermediate - Alternate and Advanced - Lift and Hold
The same starting position as the beginner.
Intermediate ask you to raise the leg and hold for 2 sec, then alternating.
3 sets, 40-60 secs
Advanced ask you to raise the leg at least 10-15 cm above ground, and hold 20-30 secs
3 sets on each side

這是一個標準的核心訓練方式
中級與高級動作加入動態下肢動作更能刺激核心的誘發
This is a typical core strengthening.
The intermediate and advanced add lower extremity movement to activate core more.

第二個動作 側棒式
Movement 8 Sideway Bench

初級
側躺, 用上肢與下方的腿支撐
下面的膝蓋彎曲90度
將骨盆與抬起直到身體與膝蓋呈一直線
兩側各執行三組, 每組20-30秒
Beginner - Static
Sidelying, supporting with the forearm and bottom leg
Bending bottom knee to 90 degrees
Raise the pelvis until form a straight line
3 sets on each side, 20-30 secs for each set

中級
與初級相似但下面的腳需伸直
抬高骨盆直到頭到腳成一直線
然後再緩緩放下
兩側各執行三組, 每組20-30秒
Intermediate - Raise and Lower Hip
Similar to the beginner but straight the bottom leg.
Raise pelvis till form a straight line,
and slowly put it down.
3 sets on each side, 20-30 secs for each set

高級
與中級動作相通
再額外加上將上面的腳緩緩抬高放下
兩側各執行三組, 每組20-30秒
Advanced - Leg Lift
Similar to the intermediate.
But lift the top leg up and down slowly while holding the straight line position
3 sets on each side, 20-30 secs for each set

側棒式也是一個標準的核心訓練模式
是用來訓練冠狀面上的穩定
此外還可以訓練到動力鏈中的側鍊
初級與中級的差別在於力臂的變化
而高級加入了動態干擾以及對側髖外展肌整合的能力

示範影片如下
Below is the video demonstrating movement 7 and 8

第三個動作 腿後肌訓練
膝蓋與髖同寬, 雙手抱胸
緩緩向前傾
過程需保持身體到膝蓋一直線
無法維持姿勢時
向前承重在手掌上, 呈現伏地挺身姿勢
初級執行一組, 3-5次
中級執行一組, 7-10次
高級執行一組, 最少12-15次
Movement 7 Hamstring
Kneeling with knees hip-width apart and crossing arms
Slowly lean forward, keep straight from knee to head.
Put the weight over hand in push-up position while you can't hold the lean forward position.
Beginner, 1 set, 3-5 reps
Intermediate, 1 set, 7-10 reps
Advanced, 1 set, at least 12-15 reps

這個動作又稱作北歐式腿後肌運動
是腿後肌離心收縮訓練的經典代表
研究指出對於腿後肌受傷預防以及傷後復健都有很好的成效
This is also known as Nordic Hamstring Exercise.
It's a classic eccentric training of hamstring.
Researches showed this exercise is effective for hamstring injury prevention and rehab.

示範影片如下
Below is the video demonstrating movement 9

本著作由I-Chen Liu, PT, MS, DPT, OCS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[運動討論] 足球選手的傷害預防(2) Football Injury Prevention(2)

、

FIFA 11+的第一部份

包含的低速的跑步與主動伸展總共六個動作
The first part of FIFA 11+ is running exercise.

6 exercises include running at low speed with active stretch.

首先我們要先了解場地的設定
如下圖所示
利用半個足球場進行第一部分的訓練
每個角錐的間距為六公尺
總計六個角錐
First, we need to know how to set the field.
As the picture shown below:
Using half of the football field for part 1 and 3
Each course has six pairs of cones, around 5-6m apart

第一個動作 直線跑
向前跑到最後一個三角錐然後繞回
回程的時候要比去程略快
總共做兩次
Movement 1, STRAIGHT AHEAD
Jog straight to the last cone,
slightly more quickly on the way back
Two sets

這是基本暖身動作
注意的要點是維持上半身的穩定
與維持骨盆下肢良好的排列
This is the basic exercise for all exercises.
The point is to maintain trunk stability and good lower extremities alignment 
第二個動作 開髖
向前跑到第一個三角錐的時候停下
執行一個右髖關節的向外開的旋轉
跑到下一個三角錐時換邊開髖
總共做兩次
Movement 2, HIP OUT
Jog to the first cone. stop and lift your knee forwards. 
Rotate your knee to the side and put your foot down. 
Jog to the cone and do the exercise on the other leg.
Two Sets

第三個動作 收髖
向前跑到第一個三角錐的時候停下
執行一個右髖關節的向內收的旋轉
跑到下一個三角錐時換邊收髖
總共做兩次
Movement 2, HIP IN
Jog to the first cone. stop and lift your knee to the side. 
Rotate your knee forward and put your foot down. 
Jog to the cone and do the exercise on the other leg.
Two Sets

第二與第三個動作強調髖關節的主動伸展動作
同時也需要單腳站立平衡與上半身穩定的能力
下面是示範影片連結
The second and third movement focus on the active stretch of the hip joint.
Also, it challenges the trunk stability and the balance in single leg stance.
Below is the video demonstrating movement 1-3.

第四個動作 繞同伴
向前跑到第一個三角錐
成90度角向同伴水平移動
兩人互繞一個圈後水平移動回角錐處
然後往下一個角錐前進
重複動作
總共執行兩次
Movement 4, CIRCLING PARTNER
Jog forwards to the first cone. 
Shuffle sideways at a 90-degree angle towards your partner
Shuffle an entire circle around one other and back to the first cone.
Jog to the next cone and repeat the exercise.
2 Sets

第五個動作 跳躍肩撞
向前跑到第一個三角錐
成90度角向同伴水平移動
兩人靠近後做水平跳躍讓肩膀互相接觸後平移回角錐處
然後往下一個角錐前進
重複動作
總共執行兩次
Movement 4, JUMPING with SHOULDER CONTACT
Jog forwards to the first cone. 
Shuffle sideways at a 90-degree angle towards your partner
Side jump toward each other to make shoulder contact and back to the first cone.
Jog to the next cone and repeat the exercise.
2 Sets

這兩個動作都加入了冠狀面的移動模式
也是在大多數運動裡面最容易受傷的時候
模擬球場上的移動與對抗
是很有意思的暖身動作
下面是第四與第五個動作的示範連結
Those two movements involve the movement on the frontal plane.
It's also the most vulnerable plane of movement for most exercises.
By simulating the movement and competition on the field,
make it a fun and efficiency as a  warm-up exercise.
Below is the video demonstrating movement 4 and 5

第六個動作 前後衝刺
向前跑到第二個三角錐
然後背向衝刺回到第一個三角錐
重複向前兩個角錐, 向後一個角錐
直到最後一個角錐為止
總共執行兩次
Movement 6 QUICK FORWARD and BACKWARD SPRINT
Run quickly to the second cone then run backward quickly to the first cone, 
keeping your hips and knees slightly bent. 
Repeat, running two cones forwards and one cone backward.

這個動作的注意重點與第一個相同
同樣要維持穩定與排列
但多增加了前後移動的轉換能力
下面是示範影片
The principle is the same as the first movement,
keep trunk stable and good lower extremities alignment.
But adding the transition between forward and backward movement.
Below is the video demonstrating movement 6

第一個階段
強調的重點在於
不同移動情況下維持軀幹穩定與理想下肢排列
這也是避免運動中受傷的基礎之一
In FIFA 11+ Part 1,
Trunk stability and ideal lower limb alignment under different movement situation are emphasized
It is also the basic strategy to prevent sports injury.

本著作由I-Chen Liu, PT, MS, DPT, OCS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[運動討論] 足球選手的傷害預防(1) Football Injury Prevention(1)

四年一次的世界盃足球賽又開始啦

資深老球迷與一日球迷都準備好出動了嗎
Here comes FIFA 2018
Be prepared, all old and bandwagon fans.  

世足賽期間當然要應景寫足球相關的文章

首發的內容當然要遵照我們的重要概念之一 - 預防勝過治療

所以我們要來介紹一個非常有效的足球員傷害預防計畫 FIFA11+

During this festival period, I definitely need to write something about it.

The very first article must accommodate one of our core value - "Prehab than Rehab" 

So here I'd like to introduce a very effective football injury prevention program, FIFA 11+

FIFA 11+是由跨國際專家團隊

在使用各式傷害預防計畫後

藉由他們的實際經驗整合而成

最原始是設計於14歲以上的業餘足球選手

後來也發展出了FIFA 11+ for kid以及

FIFA 11+ is developed by an international group of experts

based on their experience with different prevention program.

It is first implemented to amateur football player above 14 years old.

The program for kid is also developed lately.

根據Barengo et all, 2014的系統性回顧 

在普遍的情況下執行此計畫後可以降低隊伍30-70%的受傷數

另外在每週至少執行1.5次計畫的高配合選手身上

針對所有傷害的機率可以降低35%

According to a systemic review by Barengo et all, 2014

In general, the team which applied this program has the decreased injury number from 30-70%

For the high compliance player who performed the program at least 1.5 time/week,
all injuries risk can be reduced by 35%

FIFA 11+總共分成三個部分, 十五個動作

第一部份是低速的跑步配合主動伸展

第二部分是六組針對核心, 腿部力量, 平衡, 敏捷的訓練

第三部分是中高速的跑步配合急停與切入

There are 15 movements, 3 parts

Part one is running exercise at low speed with active stretch

Part two is a set of six exercises that focus on core, leg strength, balance, and agility.

Part three is running exercise at mod/high speed with plan and cut

未來幾篇文章

我們會深入探討三個部分的動作

配合動作力學上的分析

來看看這些動作的目的以及為什麼會有效

In the future post,

I'll dig deeper into those movements.

With movement analysis,

let's figure out what those movements aim to and why they are effective.

Enjoy you FIFA 2018!

本著作由I-Chen Liu, PT, MS, DPT, OCS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[基礎伸展] 提肩胛肌 Levator scpulae stretch

By modified by Uwe Gille - Gray Image:Gray409.png, Public Domain, Link

提肩胛肌是一條連接頸椎與肩胛的重要肌肉

由頸椎第一至第四橫突, 向下連接到肩胛上角

負責的動作有頸椎後仰, 同側側彎, 同側旋轉

而在肩膀的位置則負責肩胛骨的上提與下轉
Levator scapulae are the muscles that connect cervical and scapula
From C1-C4 transverse process to superior angle of scapula
The movement at the cervical are extension, same side side-bending, same side rotation
And the movement at the shoulder are elevation and downward rotation

提肩胛肌過度緊繃的時候
常見的情況有
1. 頭部旋轉, 側彎活動受限
2. 肩關節活動障礙
3. 在頸部或是肩胛上緣產生酸痛點
Some common conditions while levator scapulae are:
1. Neck side-bending and rotation limitation
2. Shoulder dysfunction
3. Tender point over the lateral neck or superior angle of scapula

靜態伸展提肩胛肌的動作是
1. 頭部向對側旋轉約45度然後往下看
2. 對側手拉住頭部
3. 同側手舉高並貼住頸椎
而伸展這條肌肉的標準模範
由勝文替你示範
The static stretch includes the following movement:
1. Neck rotates to opposite side about 45 degrees and bends down.
2. Opposite hand holds the neck
3. Same side arm raises up and holds the neck
Below is the standard static stretch of levator scapulae.

動態伸展是另一個很不錯的方式
有些時候甚至比起靜態伸展更能維持舒緩的效果
頭部的姿勢維持不變
同一側的手往上舉高, 再移動回來
利用肩胛骨旋轉的動作進行提肩胛肌的伸展
Dynamic is another good way to stretch levator scapulae.
Sometimes it's more effective than the static stretch.
The head and opposite hand position remain.
The same side arm raise all the way up and back down,
using scapula rotation to stretch this muscle.

提肩胛肌是辦公室一族非常容易緊繃的一條肌肉
使用電腦之餘記得做運動
可以大幅降低肩頸僵硬與痠痛的機會
Levator scapula is getting tight easily among office population.
Remember to do some exercise while using the computer.
That can help you decrease the chance of neck stiffness and pain.

本著作由I-Chen Liu, PT, MS, DPT, OCS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[進階肌動學] 產生關節動作的五種方式 Five ways to create joint motion

上一週我們討論了如何精確的描述動作
這週我想要進一步地講解基本但容易被忘記的重要動作元素:
"關節動作的五種模式"
Last week we talked about how to describe the movement.
This week I'd like to share a basic but easily overlooked element:
"Five patterns of joint movement"

現在讓我們再一次用髖關節當作範例
下面是髖關節外轉的動作
這是骨盆靜止 股骨外轉的模式
Let's use hip joint as an example.
Below is the hip external rotation.
Pelvic still, femur external rotates.

http://www.bodbot.com

現在請大家想想
除了這個動作之外 還能想出幾種髖關節外轉的模式呢？
如果你能想出總共五種的模式
恭喜你 你對於關節間的動作是暸如指掌的專家級人物
Now I'd want you to think,
are there any other pattern can make the hip external rotation?
If you can come out all five patterns,
CONGRADULATION, you are the EXPERT of the joint movement.

下面是另一種髖關節外轉
是股骨靜止 骨盆轉向對側的模式
Here is another pattern, or so called close-chain movement.
Femur still, pelvic rotates to opposite side.

https://singaporeosteopathy.com

上面兩種模式大概沒有人會忘記
後面三種模式 可以簡單的物理原理來解釋
身為一個物理治療師 物理還是有點重要啊
The above two patterns should be easy to you.
The last three patterns are a little but tricky.
We can use the simple physic principle to understand those movements.
After all, I am a PHYSICAL therapist :P

上面的圖片展示了最後三種模式
骨盆轉向對側同時股骨外轉
骨盆轉向同側 股骨外轉 但骨盆的速度較慢
骨盆轉向對側 股骨內轉 但股骨的速度較慢
這是相對運動產生的結果
This classic question explains all three patterns pretty well:
Pelvic turns to the opposite side with femur external rotates(away from each other).
Pelvic turns to the same side with femur external rotates, but the pelvic speed is slower.
Pelvic turns to the opposite side with femur internal rotates, but the femur speed is slower.
It's the result of relative movement.

而這三種模式之所以重要
是因為這幾種不同情況
對於髖關節的結果是一樣的
但肌肉的動作模式會有所不同
It is important to know the different because
they ALL have the same result but the muscle activations are different

而這五種模式適用於全部的關節:
1. 近端靜止, 遠端移動
2. 近端移動, 遠端靜置
3. 兩端往反方向移動
4. 兩端向同方向移動, 近端速度較快
5. 兩端向同方向移動, 遠端速度較快
This is the principle that applies to all joint(Mostly):
1. Proximal part still, distal part moves.
2. Proximal part moves, distal part still.
3. Both parts move toward different direction(away or close).
4. Both parts move toward the same direction, proximal part is faster.
5. Both parts move toward the same direction, distal part is faster.

了解相對運動的物理原則
對於肌動學的內涵會有更深刻的了解
Knowing the concept of the relative movement
can help you get more profound understanding of the kinesiology.

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[進階肌動學] 如何正確描述動作 How to describe the movement correctly.

你是否也有過跟人討論動作的時候
大家各講各的 最後發現其實是同一件事情的狀態呢
Do you ever experience that when you discuss some movement with others,
everyone has different thoughts but finally you found you all talk about the same thing?

動作本身非常的有趣
假如你將一個動作無限分割
你會得到無數多的靜態姿勢
The motion itself is fascinating.
If you dissect the movement repeatedly,
you'll get infinite posture.

http://www.zeno.org - Contumax GmbH & Co. KG

所以最重要的事情
是搞清楚你在描述的是姿勢還是動作
So here is the thing,
knowing you are describing POSTURE or MOVEMENT


我們用步態來舉例
Heel strike的時候
髖關節呈現屈曲, 踝關節呈現背曲
這是屬於"姿勢"的描述
Let's take gait as example.
In heel strike, the hip is flexion and the ankle is dorsiflexion.
It is description of posture.

而從Heel Strike到Loading Response之間
髖關節需要伸展, 踝關節執行蹠曲
這是屬於"動作"的描述
From Heel strike to Loading Response,
the hip is extending and the ankle is plantarflexing.
It is the description of the movement.

所以綜合起來
在Heel Strike時
髖關節在屈曲位置, 但要執行伸展動作
而踝關節在背曲位置, 但要執行蹠曲動作
To sum up, during the heel strike,
the hip is flexion but extending, the ankle is dorsiflexion but plantarflexing.

更複雜一點的情況
我們需要考慮到重力,速度, 不同平面以及相對移動的影響
讓我們回頭再看一次髖關節
In the advanced condition,
we need to consider the gravity, velocity, planes, and relative movement.
Let's go back to hip again

髖關節位置是屈曲, 內收, 以及外轉
而執行的動作是伸展, 內收, 以及內轉
所以我們可以看出 重心會往承重腳的方向移動
The hip posture is flexion, adduction, and external rotation
The hip movement is extending, adducting, and internal rotating.
So it obvious that our center of mass is moving toward the front leg.

而臀中肌的主要動作是外展以及內轉
乍看之下似乎呈現一個平面拉長, 一個平面縮短
但因為骨盆的轉動速度比股骨快, 所以反而呈現的是髖關節的外轉
所以臀中肌在這個時期在兩個平面上都呈現離心收縮
為下個階段的移動儲存能量
The GluMed is the muscle that can abducting and internal rotating.
Seems like this important stabilizer is long on frontal and short on transverse plane.
However, because the pelvic movement is faster than our femur,
so now the femur is INTERNAL rotating but the hip joint is EXTERNAL rotating.
That make you GluMed eccentric loading on both planes, storing energy for next phase.

Reiman et al. (2012)

而這只是動作中小小的一部分而已
身為物理治療師與動作專家
這就是我們的日常
And that's just part of our daily movement.
As physical therapists and movement specialists,
it's our daily work.

下次在跟其他人討論時
先確定大家有共同的基準點
才不會發生溝通不良的失能:P
Next time before you initiating any discussion,
making sure you all on the same page.
To prevent possible communication dysfunction:P

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[運動討論] 關肋骨在關什麼 Close your rib, huh?

最近網路上掀起一股關肋骨旋風
當然也有人拿著影片來詢問(?)
既然你誠心誠意的發問了 那我就大發慈悲的回答你
Recently, there's an exercise system teaching you how to "close your rib"
And someone sent me the link to ask my opinion.
No judgment, but let's see how it should work.

我們先來看看肋骨以及在呼吸時肋骨的動作
Here is the picture of the rib structure and the movement during breathing.

我們吐氣的時候橫隔膜上升肋骨會內收
比較之下右邊是不是瘦多了呢？
When we exhale, the diaphragm will go up and the rib will move in.
Compare to left, now you looks thinner, right?

再來我們看看吐氣所用到的肌肉
為了了解為什麼可以小腹凹這邊只列出腹部
Now let'see the expiration muscles.
Because they claim it can shrink your tummy, only ab area muscles are shown.

如果你能夠有效的運用這幾條肌肉
核心有適當的能力收縮
在肋骨內收的同時的確也能夠讓肚子收進去
If you can use those core muscles properly,
it can move your rib down and shrink your belly in.

但是
上面有一條重要的肌肉忘記列出來
那就是大家都愛的六塊肌-腹直肌
如果你錯誤的使用這條肌肉去收緊肋骨的話
除了核心容易失能以外, 有很大的機率造成肋軟骨炎的症狀
BUT,
there's one important ab muscle not on the picture above.
The six packs, everybody loves it.
However, if you close your rib with this sexy rectus dominated, 
not only the core problem but also you might induce potential costochondritis.

另外一個比較大的問題是肋骨的動作
我的讀者一定知道我們很愛講的一句話
通常一個東西會有問題 一定是卡在不上不下的位置
同理 許多人的肋骨其實是卡在中間位置
如果沒有同時訓練擴張的能力
容易造成進一步的呼吸肌失能與肋骨/脊椎活動度問題
The other huge problem of their system is the movement of the rib
My readers are definitely familiar with this:
"Usually something gets trouble because it's stocked in somewhere between"
If we apply it to the rib cage, it's not elevation or depression, it just not move
So when you train their ability to depress but not the expand,  you're in a huge trouble.
Not only rib itself, but you potentially will get breathing dysfunction/spine mobility problem. 

下面是一個物理治療針對呼吸肌訓練的前後比較
是不是也覺得肚子小了 胸肌大了 人都變帥了呢
Below is an example that how physical therapy deal with breathing problem from TCPhysiotherpy.

TCPhysiotherpay

其實這套運動系統(?)某種程度上構想很不錯
但使用了過多的代償動作以及過份卡住肋骨的自然動作
可能會造成以後更多的身體問題
希望對社會有影響力的人物在說出任何東西之前都要思考
Basically, this system is not that bad.
But you can see a lot of compensations and overemphasize to hold your rib during their video.
It might cause more problem in the future
Hope all celebrities, no matter in reality or internet, can really think the consequence before they talk.

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[臨床思考] 什麼是代償 What is compensation

代償這個名詞在這幾年又重新引起風潮
你幾乎可以在每一個地方聽到
而相對產生的就是所謂的矯正性的運動
你是否有想過 什麼是代償 為什麼有代償 代償到底哪裡不好
COMPENSATION is getting fancy again in recent years.
You can hear about it almost everywhere.
Correspondingly, there's so-called CORRECTIVE EXERCISE
However, have you ever wondering
WHAT is compensation? WHY does the compensation happen? Is it really BAD?

用最簡單的方式來解釋代償
就是身體為了執行超出能力的任務所產生的策略
The simplest way to explain what is compensation is
"The strategies that your body corresponds to the task beyond its ability"

身體的設計非常巧妙
有非常多層的保險系統以及很大的容錯空間
你的大腦會在你無意識之下做出許多的調整
正因為如此
動作的分析與矯正才會如此的複雜以及困難
The body is designed to live.
So it has multiple back up plan and ability to tolerate the dysfunction.
Your brain will adjust it unconsciously.
And that makes the movement analysis and correction complicated and difficult.

 
代償的出現可以粗分為兩種情況
一種是需要執行的任務大於身體能力的情況
一種是因為受傷或其他因素使得身體能力暫時下降而不足的情況
雖然看起來很相似 但成因會影響介入的方式
後者特別需要醫療專業人員的介入
The occurrence of the compensation can be divided into two condition:
1. The task you want to perform is over your ability
2. The injury or other factors that temporarily decrease the body ability to perform the task.
They seem alike but that difference will affect how you deal with it.
The second condition must be seen by medical professionals.

如果你是教練/運動訓練員
你需要特別了解第一種情形
只有在能力大於負荷的時候 你才能做出正確的動作
但對於提升運動的表現與能力 代償可能是必需的

取決的你的訓練周期與訓練目標

If you're a trainer or athletic specialty, you need to understand the first situation well

You can only perform the correct movement if your ability is above loading.

But sometimes you might need the compensation to help you perform better in specific movement.

It's all depend on your training period and goal.

如果你是治療師或動作分析專家

這兩種情形你都會遇到

If you're a therapist or movement specialty, you'll face both condition

例如腳踝急性扭傷之後的步態肯定會以代償的方式執行

這種情況下 你需要回復身體的能力同時逐步降低對代償的依賴性

之所以許多人在復原之後反而產生其它問題或是產生反覆同樣的傷害 

多數因為他們的身體無法離開代償的模式

For example, if you get acute ankle sprain, you definitely walk in a compensation way.

You need to make the injury healed and gradually decrease the reliance on the compensation.

The reason why so many people get other problems or repeat the same injury is because that

they don't really get rid of that pattern even though their ability is recovered.  

另一種情況是身體功能由於退化或習慣問題導致不足以應付日常性的動作

此時你的身體會使用各種代償來替你完成

而在日常生活中慢性的積累傷害

例如核心的不活化造成了呼吸模式的異常 長期下來可能造成許多地方的疼痛

Another condition is that your body can't handle the daily task due to degeneration or habit.

Now your body will compensate to finish the task.

And it cause the chronic injury accumulation in your life.

For example, the inhibited core might cause the breathing dysfunction and result in pain at many area.

下一周我們會談談各種不同型態的代償方式

給予臨床上面分析治療時更多的線索去解決問題

Next article I'll talk about some different type of compensation.

Hope that can give you more clues while assessing and evaluating your client.

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[進階肌動學] 呼吸大不同 The different breathing strategies during lifting exercise

上兩周我回到了台灣
第一周忙著協助精繪解剖的團隊在亞洲的首次教學
第二周則是我個人首次的講座課程"呼吸的評估與動作整合"
Couple weeks ago, I came back to Taiwan for 12 days.
I was honor to assist the very first Immaculate Dissection Course in Asia in the first week.
At the second week, I gave my first seminar in Taiwan.
It's the one-day course about breathing assessment and movement integration.

在四天的課程當中
有許多學員提出了非常棒的觀點以及疑問
其中飛熊大特別提出了關於舉重與健力呼吸訓練方式的差異
下面會用課程內提到的內容以及近期的科學研究來討論
During the 4 seminars in 3 different cities, there were many great questions from attendees.
Especially in Tainan, I had a great discussion with FlyingBear.
He's devoted in promoting weight lifting exercise in Taiwan.
We talked about why there's different breathing strategies between weight lifting and powerlifting.
That's a fascinating question I'd like to share and discuss with some material I covered during seminar

如果你搜尋運動時如何呼吸
或者是請教健身房的巨巨
你一定會得到各式各樣的答案
"向心吸氣, 離心吐氣" "吸氣, 閉氣, 用力, 吐氣" "用力吐氣, 放鬆吸氣"
這些都是常見的模式
正確的答案是 不.一.定
If you google "How to breath during training/exercising"
Or asking bros in the gym
You surely can get all kind of answers such as
"Concentric with inhale, Eccentric with exhale"
"Inhale, hold, exhale"
"Exhale while exerting, inhale while relaxing"
That's all common patterns you'll see in the gym.
My answers is "It depends".

就像標準動作需要依照每個人的個體差異來修正
呼吸方式也需要依照你的訓練目的而調整
Just like the standard movement should be modified to fit individual differences.
Breathing pattern should be adjusted with your purpose.

用健力與舉重做一個簡單的比較
舉重的項目有挺舉與抓舉兩項
而健力則是硬舉, 深蹲, 以及臥推三種
Let's back to the question about weight lifting and power lifting.
The weight lifting includes: Snatch, Clean and Jerk.
The powerlifting includes: Deadlift, Squat, and Bench Press.
這兩者間除了動作的差異以外
最大的差異性在於速度
或者我們可以說瞬間爆發力
Other than the movement itself,
The biggest difference between those two competition is SPEED
Or we can mention to POWER

 
Dr. M. Hagins做了一系列腹內壓與呼吸之間關聯性的研究
在研究中, 吸氣並且閉氣時可以產生最大腹內壓
並且在舉重物的過程中, 腹內壓也與承重有相關性
Dr. M. Hagins had a series of researches about breathing and IAP.
In her study, the maximum IAP can be achieved with inhalation and hold.
And the lifting load has a positive relationship with IAP

講座中我們也提到
吸氣後可以達到最穩定的狀態
在核心穩定的情況下
四肢才能夠發揮最大力量
在健力競賽需要挑戰單次的最大極限的情況下
吸氣後閉氣產生脊椎剛性與最大腹內壓
同時利用努責效應
可以讓我們舉起最大重量
In my seminar, we talked about the same concept of IAP
Once you inhale and hold, you can get maximum core stability.
Under that stable condition, the extremities can exert maximum strength.
In the powerlifting competition, you need to challenge body maximum loading in one time.
That's the time you need to inhale and hold to increase spine rigidity and IAP.
Also, this technique can cooperate with Valsalva maneuvre.
Then you can lift, squat, or press the maximum weight in a steady condition.

另外一種會產生最大腹內壓的方式
就是強烈的腹部肌肉收縮
最容易理解的代表動作就是咳嗽
The other way to create maximum IAP is strongly contraction the abdominal muscles.
The typical way to explain it is coughing. That's sometime why your disc herniated after coughing.

在需要肢體協調以及快速的運動中許多人會自然使用這個技巧
經典的代表例子就是網球擊球時的吼聲或者是武術中攻擊時的出聲
除了有心理加強的作用外
這種方式可以產生腹內壓的同時將核心的力量送到四肢
產生瞬間的最大出力的同時又不會失去動作的協調
因此舉重的訓練反而會強調吐氣的重要性

Many people will use this technique in the sport that need body coordination and speed.
Such as the yelling while smashing tennis or fizzing while punching.
This sound can not only provide the mental enhancement,
but also create a strong force that can flow to your extremities.
It produce the maximum force in the short period without impede the movement coordination.
That's the pattern what the weight lifting is aiming for.

呼吸的模式取決於你的使用目的
只要能夠知道自己該使用的方式為何
就是正確的答案
Which strategy you should use is depend on your purpose.
As long as you know why you breath in this particular pattern,
then it's your correct answer.

正確的執行與適合的選擇才是關鍵
"The keys are accuracy and adequacy"

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。

[進階肌動學] 肩胛壓不壓 To derpress, or not to depress

肩胛下壓收緊是一個運動時常見的指示
網路上可以查到許多關於這個動作的正反面意見, 而有趣的是大部分的說法其實是正確的
我們可以從簡單的解剖跟肌動學來分析這個動作
Scapula depression and tighten is a common cue during shoulder exercise.
I see a lot of positive and negative opinions through the internet,
interestingly, both side of their view points are correct.
Let's analyze this movement via anatomy and kinesiology.

 

肩胛下壓內收的這個指示可以分成不同平面上的動作來看:

This shoulder depression/tighten cue can be dissect into different single plane movement:

1. 肩胛下壓(Scapula Depression)

2. 肩胛內收(Scapula Adduction)

3. 常被遺忘的肩胛外轉(Scapula External rotation)

同時能夠執行這三個動作 也是我們最主要該重視的肌肉是下斜方肌以及闊背肌

關於下斜方肌的細節可以參考http://pticliu.blogspot.com/2016/03/lower-trapezius.html

The primary mover for all three movement is lower trapezius and lats

More detail  about lower trap http://pticliu.blogspot.com/2016/03/lower-trapezius.html

在正確執行這個動作時 你的肩胛並不會下旋

相反的 會讓你在肩膀上舉的過程更為順利

If this cue is  executed correctly, it's wont create scapula downward rotation to cause impingement.

On the contrary, it'll help the shoulder movement smoothly during exercise. 

肩胛下壓的cue會產生的錯誤模式有以下幾種

The dysfunction pattern of wrongly executing scapula depression including:

1. 使用胸小肌執行動作, 但產生肩胛前突, 內轉,與下旋

    Facilitating PecMin, causing scapula protrusion, internal rotation, and downward rotation.

2. 使用鎖骨下肌產生動作, 但產生肩胛下旋

    Facilitating subclavius, causing scapula downward rotation

肩胛內收的cue會產生的錯誤模式則有

The dysfunction pattern of wrongly executing scapula adduction including:

1. 使用提肩胛肌, 內收同時下旋

    Facilitating levator scapulae, causing adduction with downward rotation

2. 使用菱形肌, 與提肩胛肌相同

    Facilitating Rhomboid, causing same movement as levator scapulae

由於在我們成長的過程中

逐漸失去了對於肩胛的控制以及身體的感覺

有意識的去訓練這項能力在肩膀運動時格外重要

During the growing process, 

we lose the ability to control the scapula and aware our body position gradually.

Training this function consciously during shoulder exercises is crucial

在執行這項訓練時絕對不是過分要求肩胛做出下壓與內收

而是在動作的過程中不要造成過度的肩胛上提與外展

影片裡面我們可以看到他將肩胛收回適當的位置而非強調內收下壓

Never overemphasizing the movement of scapula depression and adduction.

Instead, focus on not over elevating and abducting your scapula during movement.

The video below shows that he puts the scapula to ideal position rather than depression or adduction.

錯誤的理解會造成肩胛錯誤的下旋以及肩峰關節下軟組織損傷

重點在啟動下斜方與闊背促進手臂活動時肩胛的穩定

The misunderstanding can cause undesirable downward rotation and subacromion soft tissue damage.

The point about the cue is activating lower trap and lat to facilitate scapula stability during arm movement.

在上肢訓練時給予這個指示時

一定要確認你誘發了正確的動作模式

When you give the cue while training upper body,

make sure you activate the correct movement pattern.

任何的運動或是治療都一樣
有沒有正確的執行以及適不適合這個人執行才是最大的關鍵
Every exercise or treatment has the same concept
"The keys are accuracy and adequacy "

本著作由I-Chen Liu, PT, MS製作，以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。