運 動 傷 害

廖雅芳 物理治療師

定義定義 Sports or physical activities

Practice competition

運動而來 ?

分類 (Time)

Acute stage ：– Moment of onset

–可明確知道傷害發生原因、在傷害發生時可察覺到明顯的生理改變。

Overuse/chronic/repetitive stress ：–無法明確描述傷害發生經過與機轉。會因長時間運動而逐漸累積、或是由急性傷害後轉化造成。

分類 (Sign)

Acute stage– Swelling, redness, heat, pain and disturbance of

function 4 to 6 days Subacute stage

– Inflammation decrease, end range pain 10-17 days last up to 6Ms

Chronic stage– No inflammation, resistance pain 12 to 18 Ms

Type

Bone Muscle Ligament Tendon

骨折 拉傷 扭傷 挫傷 ( 傷口護理 )

您能做些什麼？

PRICE Protection Rest/Functional rest Ice Compression Elevation

您能做些什麼？ 時間

– 24 小時之內 目的

– 1.to protect the area from further injury

– 2.to reduce the effects of inflammation and promote progression to reparative stage

– 3.to prevent the degradation effects of immobility

Protection

Splinting or taping the injured joint to limit movement

In more serious injuries, crutch fitting and sling suspension may be used

Gait instruction if the lower extremity is injured

Rest/ functional rest

Any activity which stresses the injured tissue is avoided immediately, but other activities are allowed

protected mobilization

Ice

Reduce pain

Cause local vasoconstriction, thus reducing bleeding and swelling

Reduce the metabolic rate of tissue, thus lowering demands on oxygen and nutrients

Decrease inflammation and muscle spasm

How to use ice?

Every 1-2 hrs in the first 1-2days after injury 15 mins, rest 10 mins Direct contact Contraindication ： Infant 、 elder 、 S

LR Allergy 、 Cardiovascular dis. To be car

efully.

Compression

Bandaging from distal to proximal the site of bleeding

Overlapping ½ Limit the formation of edema Check the circulation During and after ice application

Elevation

The involved part should be elevated higher than the heart

Gentle isometric or short range isotonic exercise

Venous return and lymphatic drainage (muscle pumping exercise)

Prevention

Warm-UP Cool-Down Protective equipment Suitable equipment Appropriate surfaces Appropriate training-preventive conditioning

Warm-Up

Purpose– To prevent injury– To enhance performance

Include– Gentle exercise– Stretching– Some sport-specific activities– Psychological preparation

Cool-Down

To prevent pooling the blood in the extremities

To prevent fainting, myocardial ischemia and arrhythmias

To enhance the recovery period with the oxidation of metabolic waste and replacement of the energy stores

To help reduce some of DOMS

Warm-Up V.S. Cool-Down

1.General stretching 2.Jogging: 10-15 min or mild sweating 3.Stretching 4.Sport-specific activities 5.Rest period: about 10 min 6.The event 7.Post-event gentle activities:3-8 min 8.Stretching

Prevention

Taping and bracing Protective equipment Suitable equipment Appropriate surfaces Appropriate training-preventive

conditioning

慢跑

選擇適當的場地。（柔軟地面） 穿著輕便、易吸汗的服裝。 穿著一雙舒適且能吸收振盪的慢跑鞋。 運動前的伸展活動必須確實完成。 正確的跑步姿勢。 依個人最適宜的運動強度，循序漸進的增加負

荷。 持之以恆的從事運動，必能夠擁有健康且愉快

的跑步樂趣。

DOMS

Delayed-onset muscle soreness Post exercise 24-48hrs top Possible factors:

– 廢物堆積– Muscle spasm theory– Microtrauma to m. fibers or connective tissue

Muscle creep

肌肉不自主的強直收縮現象 Possible

– Dehydration– Inadequate carbohydrate intake– Electrolyte imbalance– Training faults– Muscle fatigue– Poor circulation– Excessively tight muscle

Muscle creep

Management– Gentle and static stretching– Contraction of the antagonist muscle

(reciprocal inhibition)– Ice or heat– Massage– Electrolyte supply

Muscle creep

Prevention– Regular muscle stretching and strengthening– Correction of muscle balance and posture– Adequate warm-up and cool-down– Adequate fluid, carbohydrate and electrolyte intake

Tennis elbow( 網球肘 )

Tendinitis Extensor carpi radialis brevis Extensor digitorum communis Site of pain ： lateral epicondyle to proxim

al forearm extensors mass

PS ： Golfer’s elbow pronator teres and flexor carpi radialis

De Quervains’s disease( 媽媽手 )

Extensor pollicis brevis Abductor pollicis longus tendons