afaa讲课内容10.pft伤害预防

1、1Chapter 10INJURY PREVENTION伤害预防5/20072Too Much, Too Soon:过犹不及#1 Cause of Injury损伤原因#1 Cause of Drop-out退出原因Intrinsic Risk FactorsExtrinsic Risk Factorsfor Injury伤害内在风险for Injury外在风险肌肉不协调 不恰当或未热身_骨骼位置不正常 过度或未控制速度旧伤 较多反复次数_肥胖 高强度_关接松弛 姿势不良或技术不正确_致病因素 不合适的鞋子_长短脚 不适当的进程_受限的运动范围/柔软度不良 环境因素_欠佳的躯干稳定性 无法分辨

2、肌肉酸痛 与不适的关节疼痛Ch. 10 5/20073Types of Injuries伤害的种类急性伤害/创伤：扭伤，拉伤，骨折，撞伤 Acute (Traumatic): Sprain, strains, fractures, contusions慢性/过度使用：肌腱炎，滑膜炎，撞击，综合症 Chronic (Overuse): Tendinitis, Bursitis, Impingement Syndrome过度训练症候包括：肌力和肌协调性丧失，食欲降低，肌肉松软，易感冒，小损伤增加，睡眠不良，安静心率提高，免疫功能下降 Overtraining Syndrome symptoms i

3、nclude: decreased muscle strength and coordination, decreased appetite, muscle tenderness, head colds, increased of minor injuries, sleep disturbances, elevated RHR, elevated BP, suppressed immune system functionCh. 10 5/20074炎症和修复的不同阶段Stages of Inflammation and Repair急性：肿痛、发热、发红、疼痛、功能性失去、持续时间4-6天Ac

4、ute: lasts 4-6 days with swelling, heat, redness, pain, and loss of function亚急性：受伤到复原恢复开始到炎症逐渐消失、可能持续14-21天。伤处脆弱很容易再受伤。Subacute: may last 14-21 days after injury. Healing stagerepair begins, inflammation gradually decreases. Site is very fragile and easily re-injured.慢性（形状重构）：开始于14-21天持续到伤痛完全消失，恢复功能

5、。可能持续长时间，并且伴随反复发作的疼痛。复原过程中功能性丧失比较常见，包括功能性减弱或下降。Chronic (remodeling): begins between days 14 & 21lasts until there is pain-free functional use. Can be long-standing with recurring pain episodes. Dysfunction resulting from healing process is common, including weakness & decreased function.Ch. 10 5/200

6、75*休息REST*冰敷ICE*加压COMPRESSION*抬高ELEVATIONCh. 10 5/20076Common Muscle Imbalances常见的肌肉不平衡胸大肌和三角肌前束太紧Tight pectoralis major and anterior deltoids中斜方肌或菱形肌无力或过度伸展 Weak and overstretched middle trapezius & rhomboids后三角肌无力Weak posterior deltoids上斜方肌和提肩胛肌过紧Tight upper trapezius and levator scapulae下斜方肌和胸小肌无

7、力Weak lower trapezius and pectoralis minor肩内旋肌群太紧Tight internal rotators of the shoulder肩外旋肌群无力Weak external rotators of the shoulder腹肌群无力Weak abdominals竖脊肌太紧或无力Tight and/or weak erector spinae髋屈肌太紧Tight hip flexors股内侧肌无力Weak vastus medialis后腿腱肌群太紧Tight hamstrings小腿后腱肌群太紧Tight calf musclesCh. 10 5/2

8、0077Stretch Tight Muscles 伸展太紧肌肉- Strengthen Weak or Overstretched Muscles强化微弱或过度伸展肌肉需要伸展的肌肉、Muscles that need to be stretched 胸大肌，三角肌前束Pectoralis major, anterior deltoids上斜方肌，提肩胛肌 Upper trapezius, levator scapulae肩内旋肌群 Internal rotators of the shoulder竖脊肌Erector spinae髋屈肌Hip flexors后腿腱肌群Hamstrings小

9、腿后腱肌群Calves需强化肌肉Muscles that need to be strengthened中斜方肌，菱形肌，后三角肌Middle trapezius, rhomboids, posterior deltoids下侧斜方肌，胸小肌 Lower trapezius, pectoralis minor肩外旋肌群 External rotator cuff muscles腹肌群Abdominals股内侧肌Vastus medialisCh. 10 5/20078Controversial/ High-Risk Moves具争议性或高风险动作弹震式伸展Ballistic stretchin

10、g跨栏式伸展Hurdlers stretch直膝仰卧起坐Full straight-leg sit-ups强迫高踢腿Forced high kicks膝关节深度弯曲Deep knee bends全梨式Plough全展背/全眼镜蛇式Full cobraV字坐 V sits硬拉 Dead lifts颈后拉背Behind-the-neck lat pull-down没有支持的腰椎屈Unsupported flexion of the lumbar spine没有支撑的屈曲加旋转Unsupported flexion with rotation 没有支撑的腰椎侧屈Unsupported lateral

11、 flexion of the lumbar spine颈椎过度超伸Hyperextension of the cervical spine腰椎过度超伸Percussive lumbar hyperextensionCh. 10 5/20079Anterior View of Shoulder Joint肩关节正面预览Ch. 10 5/200710Rotator Cuff Tendinitis旋转肌袖肌肌腱炎Anterior View正面Posterior View Wall walker, pendulum, and external rotator cuff exercises 背面 靠墙

12、摆动 钟摆式，肩袖肌群外展运动Ch. 10 5/200711Zones of Safe Shoulder Movement肩关节安全运动区间Ch. 10 5/200712Major Mechanisms of Shoulder Injury肩部受伤的主要机制1.肩外旋时过度水平外展（红色区域） Extreme horizontal shoulder abduction while in external rotation (the “red zone”)2.肩外展时内旋 Internal rotation while abducting the shoulder joint3.有力内旋肌群和无

13、力的外旋肌群造成的肌力不平衡 Muscle imbalance between the powerful internal rotators and the weak external rotators4.肩胛上举肌群与肩胛下压肌群不平衡 Muscle imbalance between the scapular elevators and the scapular depressorsCh. 10 5/200713Protect Your Shoulders By:通过以下几点保护肩部避免颈后背部下拉和军事举 Avoiding behind-the-neck lat pull-downs a

14、nd military presses卧推，飞鸟，夹胸时避免过度动作范围 Avoiding excessive ROM in bench presses, flys, and pec-decs减少红区运动时间 Minimizing time in the “red zone”直立划船和侧举使肩外展到90 Keeping upright rows and lateral raises to 90 of shoulder abduction平衡锻炼身体正面肌肉和背面肌肉的 Training posterior muscles as well as anterior muscles保持充足的柔韧性训

15、练Maintaining adequate flexibilityCh. 10 5/200714Ch. 10 5/200715 Exercises Appropriate for Tennis Elbow网球肘适合的运动Ch. 10 5/200716Ch. 10 5/200717Protect Your Elbows and Wrists By:保护肘部和腕关节，注意以下：无论什么情况保持腕关节处于中立位置Keeping wrists in a neutral position whenever possible.尽量减少过度反复或过度用力的腕关节屈曲或伸展 Minimizing repeti

16、tive and forceful wrist extension and flexion.强化前臂肌肉 Strengthening and stretching forearm muscles.定期的手部休息 Periodically resting your hands.用整个手部所有手指来抓取物体 Using the whole hand and all the fingers to grasp an object whenever possible.Ch. 10 5/200718Low Back Pain: A Common Problem背部疼痛80% 的成年人一生会出现背部疼痛。不

17、当的身体姿势是主要可以预防的因素。80% of adults willhave low back painat some point in theirlives. Poor bodymechanics is a majorfactor in preventableback pain.Ch. 10 5/200719SpinalColumn 脊柱Ch. 10 5/200720 Typical Vertebra 有代表性的脊椎骨Vertebral 脊椎骨排列Arrangement Disk圆盘Ch. 10 5/200721Ligaments of the Spine脊柱韧带Ch. 10 5/2007

18、22Forward Head Posture头部前倾/脊柱后弯症训练姿势认知 Teach body awareness.避免颈椎过度伸展 Avoid cervical hyper-extension.伸展上斜方肌和提肩胛肌肉 Stretch the upper trapeziusand the levator scapulae.后部颈椎拉伸 Lengthen the back of the cervical spine. Picture taken from Structural and Applied Kinesiology Lab course packetCh. 10 5/200723E

19、xcessive Kyphosis过度驼背 * 强化中斜方肌和菱形肌 Strengthen middle traps and rhomboids * 强化后三角肌 Strengthen the posterior deltoids * 伸展胸大肌和三角肌前束 Stretch the pectoralis major and anterior deltoids * 训练姿势认知 Teach postural awarenessCh. 10 5/200724Excessive Lordosis过度脊柱前弯症强化腹肌Strengthen Abdominals *伸展髋屈肌 Stretch Hip F

20、lexor * 伸展竖脊肌 Stretch Erector SpinaeCh. 10 5/200725Teach Proper Body Mechanics: Keep Spine in Neutral!训练正确的身体机能，保持脊柱的中立位Ch. 10 5/200726Exercise Hazards for the Low Back危险的下背运动没有支撑的脊柱屈曲 Unsupported Spinal Flexion修正：保持脊柱中立位，双手支撑在大腿上 Solution: keep spine in neutral with hip hinge OR place hands on thig

21、hs for support没有支撑带旋转的脊柱屈曲 Unsupported Spinal Flexion with Rotation修正：保持脊柱中立位，双手支撑在大腿上 Solution: keep spine in neutral with hip hinge OR place hands on thighs for support没有支撑的侧屈曲Unsupported Lateral Flexion修正：一只手支撑在大腿上 Solution: Place one hand on thigh for support腰椎过度后伸展Extreme Lumbar Hyperextension修

22、正：做更加轻度的腰椎伸展动作，眼镜蛇式伸展 Solution: Perform more moderate lumbar extension长撬式牵引Long Lever Traction/ Shearing Forces修正：纠正已发生情况的运动 Solution: Modify troublesome exercisesCh. 10 5/200727Iliotibial Band Tendinitis髂胫束肌腱炎 Stretching the iliotibial band 伸 伸展髂胫束Ch. 10 5/200728Piriformis Syndrome梨状肌综合症 Stretches

23、for the Piriformis 伸展梨状肌Ch. 10 5/200729 The Knee Joint膝关节Ch. 10 5/200730Quadriceps股四头肌群Ch. 10 5/200731Patellofemoral Pain Syndrome髌骨关节综合症Typical Progression for Quad Strengthening:四头肌力量强化训练四头肌Quad sets单脚伸直抬高 二级水平增加阻力 Straight leg raises (add resistance for level 2)终端伸展Short-arc terminal extension (a

24、dd resistance for level 2) 二级水平增加阻力全展 Full arc extensions功能性训练 Functional training (e.g. sit-back squat, wall squat) 后座式深蹲、倚墙式深蹲Ch. 10 5/200732Major Mechanisms of Knee Injury: Avoid These Positions!膝关节损伤的主要机能反复的，长时间的，高强度的膝关节超伸展Repetitive, prolonged, and/or forceful knee hyperextension反复的，长时间的，高强度的膝关

25、节扭转Repetitive, prolonged, and/or forceful knee torque承重姿势，反复的，长时间的，高强度的膝关节屈曲Repetitive, prolonged, and/or forceful deep-knee flexion (hyperflexion) in a weight-bearing positionCh. 10 5/200733Protect Your Knees By:通过一下途径保护膝部在运动和日常生活中保持正确的膝运动机能Practicing proper knee mechanics both while exercising and during ADLs伸展后腿腱肌群，四头肌，和小腿后腱肌群Stretching the hamstrings, quadriceps, and calf muscles保持股内侧肌和股外侧肌平衡性 Maintaining muscle balance between the powerful vastus lateralis and the weaker vastus medialis进行开放链运动和闭锁链运动 Performing both open and closed kinetic chain exercises