除了關節本身以外
肌肉也是代償機制中的重要角色
另一種常見的代償模式為相同動作的代償
In addition to the joint compensation,
the muscle also plays an important role in the compensation mechanism.
Another common compensation type is the muscles that have the same movement.
每一個動作都有他的主要動作肌肉
但光靠這條肌肉無法動作, 需要其他的協同肌與拮抗肌一起完成
當主要動作肌肉失去功能, 協同肌轉變成為主要角色時, 代償就會出現
Every movement has its primary mover.
However, primary mover alone can not execute the movement,
you need other synergists and antagonists to finish it.
When the primary mover gets trouble and the synergists kick in, the compensation will show up.
這是大腦自動調控的結果
你依舊可以完成想要做出來的動作
但是錯誤的動作不管做了多少次, 還是一個錯誤的動作
只是把現在的失能推遲到以後的某一天
Your brain do it automatically for you.
Let you finish the movement you want.
But the wrong movement is wrong, it can't be corrected by just doing it.
Shit in, shit out.
It just covers the dysfunction now to make bigger problem in the future.
這種代償的問題如下:
What's wrong with this kind of compensation:
1. 永遠沒有一條肌肉可以完全取代另一條
它們也許在矢狀面上動作一樣, 但在其他平面可能完全相反
這也是我們在看動作分析時候的一個重點
1. There's no muscle can 100% cover the other.
They might have the same movement on one plane but do the totally opposite on the other.
It's also one critical point while assessing the movement.
2. 你一次只能專心做好一件事情
當協同肌被拿去用於當作主要肌肉時
會導致自己本來該做的事情無法做好
然後你的身體就需要再去找另一條取代, 造成連鎖的效應
2. "You can be good at many things, but you can't be good at all of them in the same time"
- Dr. Kathy Dooley
The muscle can only master one movement at a time.
Once you have your synergist to replace the primary mover,
it might lose the ability to do its own movement.
Next your body might find another muscle to cover it, then you'll see the chain reaction.
舉例來說
髖外展在步態周期中是一個非常重要的動作
主要的動作肌是臀中肌與臀小肌
協同肌包含了臀大肌上側纖維, 闊筋膜張肌, 以及縫匠肌
For example
The hip abduction is a critical movement during gait.
Primary movers are Glu Med/Min
Synergists include superior Glu Max, TFL, and Satorious
當臀中肌/小肌失去功能的時候
闊筋膜張肌是常見的代償者之一
臨床上也常看到闊筋膜張肌疼痛的患者, 抱怨褲子口袋的位置疼痛
或是慢慢發展成我們熟悉的髂脛束症候群
TFL is a common compensator to Glu Med/Min get dysfunction.
You'll see patients complain of the pain over the pocket area and rub it all day.
Or the old friend, ITBS.
闊筋膜張肌雖然也作外展的動作, 但並不是主要動作肌
因此在代償的動作模式下就會看到外展伴隨髖屈曲/骨盆前傾的動作
造成關節的錯誤排列與受力
TFL is not the primary mover during hip abduction.
With compensation, hip abduction will accompany with hip flexion/pelvic anterior tilt.
Lead to the joint misalignment and improper loading share.
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| sequencewiz.org |
更進一步的了解肌肉動力學可以給予更多找出真正問題的線索
這是如何成為動作分析專家的基礎
學習它, 應用它
Understanding kinesiology more can give you more clues to find the true issue.
That's how you can be a movement specialist.
Learn it. Apply it.
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。
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