[進階肌動學] 如何伸展豎脊肌 How to stretch your erector spinae

豎脊肌(Erector Spinae)是背部三組肌肉的總稱
由外至內分別是髂肋肌(Iliocostalis), 最長肌(Longissmus), 以及棘肌(Spinalis)
每一組肌肉又都可以各自區分出三個區塊
Erector spinae is the name for 3 back muscle groups
From lateral to medial, they're iliocostalis, longissmus, and spinalis
Each of them can also be divided into 3 sub muscles

 

髂肋肌在最外側, 可分為腰髂肋肌, 胸髂肋肌, 與頸髂肋肌
腰髂肋肌下端連接在髂骨, 薦骨, 下胸與腰椎脊突, 以及髂腰筋膜上
上端連接在第六到第十二肋骨下緣
胸髂肋肌的下端連接在第六到第十二肋骨上緣, 在腰髂肋肌連接處的內側
上端連接在第一到第六肋骨下緣, 有些人會到第七頸椎的橫突
頸髂肋肌的下端則是連接在第一到第六肋骨, 下端在第四到第六頸椎橫突上
產生的動作都是後彎, 同側側彎, 以及同側旋轉
Iliocostalis locates at the most lateral side, including iliocostalis lumborum, thoracis, and cervicis
The lower part of lumborum connects to the iliac, sacrum, lower thoracic and lumbar SP, and iliolumbar fascia.
The upper part of lumborum connects to the lower border of rib 6 to 12
The lower part of thoracis connects to the upper border of rib 6-12, medial to the lumborum
The upper part of thoracis connects to the lower border of rib 1-6, some may have it to C7 TP.
The upper part of cervics connects to the rib angle 1-6, upper part to C4-6 TP
They have the same actions: extension, ipislateral sidebend, ipislateral rotation

最長肌在中間, 可分為胸最長肌, 頸最長肌, 與頭最長肌
胸最長肌下端與腰髂肋肌共享連接處
上端連接在胸椎橫突, 上腰椎橫突, 以及所有肋骨的結節到肋骨角之間
頸最長肌下端連接在第二到第五或六胸椎橫突上, 上端連接在第二到六頸椎橫突
頭最長肌下端連接在中到下頸椎的橫突與關節面上, 上端連接到乳突
同樣產生後彎, 同側側彎, 與同側旋轉
Longissmus locates at the middle of erectors, including logissmus thoraci, cervicis, and capitis
The lower part of thoracis share the same connection with iliocostalis lumborum.
The upper part of thoracis connects to the thoracic TP, upper lumbar TP, and all rib between rib tubercle and rib angle
The lower part of cervicis connects to T2-5 or 6 TP, upper part to C2-6 TP
The lower part of capitis connects to middle to lower cervical TP and articulate process.
The upper part of capitis connects to the mastoid process that can affect head movement.
They have the actions of extension, ipislateral sidebend, and ipislaterl rotation

棘肌在最內側, 分為胸棘肌, 頸棘肌, 與頭棘肌
胸棘肌的下端同樣與其他豎脊肌共用, 上端連接在胸椎第三到第八節的棘突上
頸棘肌的下端連接在第六頸椎到第十二胸椎棘突上
上端接在第二頸椎棘突, 有時會延伸到第三會第四頸椎
頭棘肌的下端連接在下頸椎與上胸椎棘突上, 上端連接在上下頸線處
動作是後彎, 同側側彎, 而只有頭棘肌會做出同側旋轉
Spinalis locates the most medial side of erectors, including spinalis thoracis, cervicis, and capitis
The lower part of thoracis also share the connections with other lumbar erectors
The upper part of thoracis connects to T3-8 SP
The lower part of thoracis connects to T6-12 SP and the upper part to C2 SP, some may goes to C3-4
The lower part of capitis connects to the lower cervical and upper thoracic SP.
The upper part of capitis connects to the superior and inferior nuchal line.
They have the actions of extension and ipislateral flexion. Only the capitis can do ipislateral rotation

伸展的基本原則就是往反方向做動作
但如果缺少了脊椎間的相對動作
反而會無法伸展到我們想要的區域
The basic principle of stretch is doing the opposite directions of the muscle actions.
However in erector stretching, we can't get it without intersegmental movement.
Instead, it might get worse like the picture shown below.

http://www.bandhayoga.com/keys_PNF.html

如果有足夠能力能主動控制動作
貓拱背(Cat-Camel)的動作會是一個很好的伸展
注意脊椎間的動作要完整呈現出一個漂亮的弧線
下面紅褲子哥就有腰椎活動不足以及過度拱背的問題
If your client has enough ability to control their movement.
Cat-Camel exercise is a good one to stretch erector spinae bilaterally.
Remember you should see a nice spine cure while stretch it.
The second picture shows over stretch at thoracic with low mobility of lumbar.

 

被動的伸展則可以用膝蓋抱胸或是跪趴的姿勢處理

The passive stretch can be performed by knee to chest or worship postion

 

 

如果是要強調單側的話

需要加入側彎或是旋轉的元素

同樣的有足夠能力主動控制時

可以嘗試下圖的伸展姿勢, 這是右側豎脊肌伸展

If you want to focus on one side only

you could add rotation or sidebending in the stretch.

When your client is capable to do the following movement

it's nice to try stretching in this position.

The picture shows the R erector spinae stretch

http://www.g4physio.co.uk/blog/common-stretches-advice/kneeling-back-rotation-stretch/

或者是被動的伸展姿勢

Or you can do it passively.

 

這些都是很好的伸展方式

取決於個案的能力與需求

Those are few good stretches.

You can create you own by following the basic principle.

It depends on your client's need and ability.

如果你想要伸展上段的豎脊肌 就要加入更多頭頸部動作

如果你想要伸展中段的豎脊肌 就要加入更多胸腔的動作

如果你想要伸展下段的豎脊肌 就要加入更多腰椎骨盆的動作

If you want to stretch upper part erector, add more head-neck movement.

If you want to stretch middle part erector, add more thoracic motion.

If you want to stretch lower part erector, add more lumbar-pelvic movement.

藉由上面的解剖學說明

也可以藉由固定部分脊椎或肋骨

或者是加壓伸展的方式

去更專注在目標肌群的伸展

With the understanding of the anatomy,

you can also fix part of the spine or rib or compress specific area 

to focus more on your target muscles.

 
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。