多數運動員肌腱病變的源頭: 筋骨交接處之"著骨點"修補不足, 而非發炎(AJSM 2009) By 英國的Dr. Nochola Maffulli

Gaby Maliqilic April 20, 2009

Management of Tendinopathy  
多數運動員肌腱病變的源頭: 筋骨交接處之"著骨點"修補不足, 而非發炎(AJSM 2009)

By Jonathan Rees, MSc, MRCP (UK), FFSEM (UK) (--), Nicola Maffulli, MD, MS, PhD, FRCS(Ortho) (osa14@keele.ac.uk) and Jill Cook, PhD (--)

這篇由國際知名的肌腱研究大師, 英國的Dr. Nochola Maffulli教授發表在2009二月份的"美國運動醫學雜誌(American Journal of Sports Medicine, AJSM)的研究, 再次確認了之前我們所強調的事實:

"多數運動員肌腱病變的源頭: 筋骨交接處之著骨點(osteotendinous junction, or enthesis)修補不足, 而非發炎"

一般我們在看醫生時, 常會聽到類似'肌腱炎"的診斷, 但一而再, 再而三的臨床與基礎研究結果, 卻越來越指向"修補不足所產生的肌腱退化"才是疼痛真正的來源; 疼痛的肌腱裡, 鮮少有真正可證明的發炎現象! 故而, 治療運動員或一般民眾肌腱退化(更精確的說:著骨點退化)的中心思想, 就集中在如何使退化或修補不足的著骨點再度修補, 才能真正且根本地解決疼痛的問題.

文中已經提到我們之前說過的"生長因子(growth factor)注射", "幹細胞注射(stem cell injection)", 甚至著骨點的微創手術等等; 但因為這些治療目前在台灣還並不普遍, 而且價格十分昂貴, 筆者還是建議以局部在著骨點注射葡萄糖作為修補刺激劑之"增生注射療法" , 作為現階段治療的主要手段.

 

圖片: http://www.schusterchiropractic.org/img/img_soft_tissue03.jpg


參考文獻

Management of Tendinopathy Am J Sports Med published 2 February 2009

http://ajs.sagepub.com/cgi/content/abstract/0363546508324283v1?papetoc

Abstract


Overuse disorders of tendons, or tendinopathies, present a challenge to sports physicians, surgeons, and other health care professionals dealing with athletes. The Achilles, patellar, and supraspinatus tendons are particularly vulnerable to injury and often difficult to manage successfully. Inflammation was believed central to the pathologic process, but histopathologic evidence has confirmed the failed healing response nature of these conditions. Excessive or inappropriate loading of the musculotendinous unit is believed to be central to the disease process, although the exact mechanism by which this occurs remains uncertain. Additionally, the location of the lesion (for example, the midtendon or osteotendinous junction) has become increasingly recognized as influencing both the pathologic process and subsequent management.

The mechanical, vascular, neural, and other theories that seek to explain the pathologic process are explored in this article. Recent developments in the nonoperative management of chronic tendon disorders are reviewed, as is the rationale for surgical intervention. Recent surgical advances, including minimally invasive tendon surgery, are reviewed. Potential future management strategies, such as stem cell therapy, growth factor treatment, and gene transfer, are also discussed.

如果你一天只需要做一個動作就能得到最棒的伸展～請作 全世界最好的伸展 Master the World's Greatest Stretch

如果你一天只需要做一個動作就能得到最棒的伸展～請作
全世界最好的伸展 Master the World's Greatest Stretch

Encourage your Physisian prescribe your workout prescription鼓勵醫師開立運動處方

Encourage your Physician prescribe your workout prescription 鼓勵醫師開立運動處方



如果數個大型醫療團體的公關推動成功的話，你將可以常常聽到醫師告訴你前面那句話；這些團體包括美國醫學會(AMA)以及美國運動醫學院，呼籲醫師囑咐病患規律運動。

這項活動名稱為"運動就是醫療 Exercise is medicine " 。




醫療團體、保險公司，甚至政府高層，數年來致力於說服美國人多運動，希望促進一個更穩定的美國社會；一而再，再而三地警告表示，經濟無法滿足三分之二美國成人過重或肥胖的照護花費。

現在醫師團體表示，他們的成員必須參與行動。

美國運動醫學院主席Robert Sallis醫師表示，醫師現在必須進行適當運動，且推廣到他們的病患；每一位醫師、專科醫師都必須知道這件訊息。

(你有規律運動嗎？為什麼或為什麼不？在WebMD的健康咖啡訊息版告訴我們。)




【運動作為治療】
疾病管制局(CDC)建議成年人每週至少要有5天適度運動30分鐘，適度運動包括散散步或和小孩踢足球，可以顯著降低肥胖相關問題，如心臟病和糖尿病的風險。

AMA主席Ron Davis醫師在華盛頓舉行的簡報中向記者表示，運動是免費的醫療。

Davis醫師表示，運動不應該只是一個選擇，而是對血壓或者膽固醇等不可或缺的；他表示，一個人的運動程度必須視為一種生命跡象。

快速又有趣的燃脂秘方 cosmopolitan柯夢波丹 (2008-12-17)

版權：Text by Stacey Colino；編譯 林怡君

版權：Text by Stacey Colino；編譯 林怡君

自 然界最殘酷的玩笑之一就是：有些女人儘管吃下高熱量的食物，也完全不會變胖。而其他女人為了能穿上小一號的牛仔褲，卻只能看著起司漢堡望梅止渴。沒錯，要 自己別嫉妒那些想吃什麼，就能吃什麼的女生，的確有一點難，特別是提到新陳代謝的時候──透過新陳代謝這個生理過程，我們的身體將食物轉換成熱量，然後將 之燃燒成能量。那些女孩的新陳代謝似乎又快又有效率。而新陳代謝的速度，據說是我們無法控制的。

不過，隨著越來越多研究結果出 爐，事實是，妳真的有辦法控制新陳代謝的速度！雖然妳也許無法從代謝如龜速般緩慢的人，搖身一變成為卡路里的焚化爐，但要讓妳的身體以完美的速率進行新陳 代謝，卻是有方法的。怎麼做呢？減重專家解釋說：「不管是休息時或玩樂時，運用一些能夠讓身體更快速燃燒熱量的小技巧。」而且，這些技巧與異常的飲食習 慣、瘋狂密集的健身課程、稀奇古怪的營養補給品一點關係都沒有，甚至不需要挨餓。不管妳是想要再瘦幾公斤，還是想吃更多卻同時維持目前的體重，妳都該看看 以下這些經由研究背書的燃脂技巧。不管妳照單全收，還是只嘗試一兩個方法，妳都一定能看見成果。

來一杯清涼冷飲

妳一旦缺水，身體功能運作的速度就會慢下來，包括新陳代謝的速度也會變慢。因此，每天固定要喝至少8杯水，喝越多越能促進代謝。喝冰水也是個不錯的方式。冰水更能加強身體燃燒卡路里的能力，因為妳的身體需要燃燒額外的能量以便回溫。

享用異國料理

紅 辣椒與芥末籽是在泰國、中國與墨西哥料理中都很常見的香料，能夠幫助妳的身體燃燒多餘的卡路里，這都要感謝它們含有唐辛子這種複合物。有一項研究發現，當 人們攝取將近1茶匙的芥末與1茶匙的辣椒醬，他們身體代謝的速度會飆高大約25%。晚餐時，點泰式辣味雞肉或印度蒜味咖哩，這兩道菜都有含有上述香料。再 加上它們都有點辣，也可以避免妳不小心吃太多。

變換妳的運動模式

如果妳已超過30歲：因為妳的新陳代謝已比20幾歲時慢，做高強度運 動時，多做3分鐘。間歇訓練比光是運動更能夠促進妳的新陳代謝。所謂的間歇訓練指的是交替從事高強度運動（例如跳躍運動）與低強度運動（例如慢跑）。怎麼 開始呢？健身教練表示，盡量用力伸展妳的身體，持續3分鐘之後，再回到舒服的節奏3分鐘。每30分鐘的運動時間中，輪流交替高低強度的運動4次。

…完整內容請閱2008年12月號柯夢波丹。

6 TRX Moves to Build Total-Body Strength 六個動作 TRX 建立你全身的力量

Movement

6 TRX Moves to Build Total-Body Strength

Evan Gray April 9, 2012

The TRX is a versatile piece of training equipment that can be used to build total-body strength and stability, and we’ve just added dozens of instructional videos to our TRX section. To help you get started using the TRX, we asked our performance specialists for a few of their favorite moves:

Leg Curl - Alternating (TRX)

“This is a great exercise to work your glutes, hamstrings, and pillar,” says Athletes’ Performance physical therapist Thomas Knox. “It builds muscle balance because you have to ensure equal pressure in each strap to keep the TRX from slipping back and forth.”

Plank with Alternating Hip Flexion - Hands in TRX

“This move encourages proper running form. It’s a difficult move, and in order to perform it without swaying side-to-side, you need stability from your shoulders to your glutes,” says Knox.

Biceps Curl - Assisted Stance (TRX)

Performance specialist Anthony Slater likes this move because it challenges the stability in the glutes and back in addition to working your biceps. “I don’t like spending time and effort training my arms in isolation, but using the TRX lets me get an arm blast while still developing pillar strength,” he says.

Triceps Extension - Assisted Stance (TRX)

“What’s great about this move is that it helps activate your abs at the same time you use your upper body,” says Slater. “I find it easier to justify doing arm work when I know I’m challenging my torso and getting whole-body benefits.”

Pillar Bridge with Shoulder Flexion - Feet in TRX

“I use this one a lot with my professional cyclists and runners,” says performance specialist Darcy Norman. “It teaches the athlete how to dissociate their lower half by not allowing the body to use it for extra stability. You’ll build a strong pillar, useful for almost every sport or activity.”

Squat with Hand Support (TRX)

“I like this one because it gives the body the opportunity to understand how to perform a fundamental movement pattern like the squat,” says Norman. “Every person should aspire for perfect squat mechanics. It’s something we are born with and somewhere along the line we lose it.”

Visit our TRX section for more exercise videos and training tips >