游泳教練研討會 游泳前之熱身運動與游泳受傷之預防 合適做與不合適做的 李志端博士 香港体育學院 運動醫學部 預防運動受傷 Prevention of occurrence (發生傷患) Prevention of recurrence (傷後復發) Swimmer’s shoulder 游泳者肩 Shoulder Impingement syndrome 肩撞激綜合症: Trapping of the soft tissues 軟組織 between humerus 肱骨 and the scapula 肩胛骨 leading to inflammation and pain. •Repetitive重複多次 •Overhead movements 過頭動作 •Tendons of Supraspinatus 剛上肌, and/or Long tendon of the biceps 二頭肌 長頭 肌腱 •Bursa 滑囊 •Swimmer, tennis players, throwers and weight lifters 運動受傷的原因: 內在的 外在的. 内在的 筛选 体能的准备 热身和调整 正确的手法和训练 良好的状态. 1. 筛选 太重—不要长跑 太高—不要举重 大于30岁—不要运动 游泳— 两侧相同 肩關節柔軔性強 (肩內旋) 上肢肌力相對大 本体能力強 指尖最大矩與身高比例 掌長與上肢比例 脂肪與其他組織的比例 水性強 白/有色人 還有什麼? 2. 体能的准备 三個要素 : 肌肉 关节活动度 身体协调,本体能力. 游泳有什麼肌肉要準備 1. 腰背肌 2. 股四頭肌 3. 肩內旋肌 4. ? 5. 肌肉方面 肌肉的力量(峰力矩) 在哪个角度发生 肌肉的耐力 肌肉的总功量 肌肉的爆发力 上、下肢对比 前后肌对比 肌肉的单独性 Get fit to play 準備好,才上路 什麼做得更有效? 肌肉訓練 等速運動 Something about isokinetic: • Invented by James Perrine 1960’s • Must be achieved on a device (the Dynamometer) • Speed can be preset 体能方面要注意 1 循序渐进 2 对符合人体的机械 3 比赛前要达标 4 每一次做这些训练之前要完整的热身 5 对某种运动足够的专项需求 6 最好由专业人士来指导 7 整个赛季都要保持. 游泳柔韧性关节活动度 过伸 完整的角度 功能 两侧的对比 須要肌肉力量支持. 游泳有什麼关节的活动度要 準備 1.肩關節 2.髖關節 3.腰背 4.? 5. 游泳者关节柔韧性測試 肩內外旋測試 肩水平開展 倒鑵測試 髖關節內外旋. 牵拉运动 步骤: 体温上升1度 把机体放到开始的角度 把软组织牵拉到尽头,疼痛利害就先停下 维持30秒-2分钟,直至适应 在牵拉一点,直至疼,停止 重复2—3遍. 游泳平衡/本体/协调準備 上肢/下肢/整体 蹦床(渐进式过程) 平衡板(渐进式过程). 3. Warm Up 熱身運動 body T 1º C 升高体温 Stretching 组织牵拉 Joint Mobilization 活动关节 Specific rehearsal Maneuvers 专项练习 討論: 作牽拉運動時該有痛的感覺嗎? Injuries due to improper “ ” technique 由不正確的 “物理治療動作” 做成的損傷 10 种热身带来的受伤 1 转头/颈 2 颈椎过伸 3 负重转膝 4 直腿仰卧起坐 5 双腿直腿抬高 6 当帼绳肌牵拉时,另一条腿内旋 7 当帼绳肌牵拉时,该腿放得太高 8 用上肢走路 9 兔跳或蹲走 10 彈伸 Ballistic. 4. 正确的手法和训练 合資格的教練 一對一比例 從少做起 5.保持良好状态,不要: 疲劳 注意力不集中 太想赢 失望沮喪 焦慮. 外在的 适当的使用护具 周围环境的观察和留意 正确的使用器材和设施 对于规则要严格遵守 更新要及时. 正确的使用护具 眼镜 护膝 护胫 固定包扎. 合适的体育衣着 泳衣 鞋(蛙鞋) 正确的功能(訓練) 大小要合适 减震要强 鞋一旦破了就不再穿 要舒服. 正确地使用器材和设备 地面的质地, 地面平滑,有无凹凸记水 室内光线,窗户,玻璃. 注意外在的环境 1. 温度 温度太低会 hypothermia 温度太高会中暑 太熱太潮濕会呼吸困难 太晒会皮肤灼痛 2. 高度 高于3000米会得高原综合症 潜水深于15米压力会增大 3. 冬季運動 太白 雪盲 注意外在的环境. 受傷後 :康復治療 回到赛前2周的计划制定 1 观看并熟悉比赛的速度和要求 2 参加训练但是仅涉及未受伤的肢体 3 参加训练逐步涉及受伤的肢体 4 开始练习所需的特定姿势 5 开始進行模擬比赛,不重视得分 6 开始友好比赛要输得起 最后一步:参加联盟杯或更激烈的比赛 赛前2周制定的计划. 赛前2周的计划制定 观看并熟悉 健肢的訓練 患肢訓練 特定姿势, 模擬比赛 友好比赛 準備好,才上路 預防勝於治療 将康复带回家 有關游泳牽拉運動的認識 針對性, 個別性 單邊及雙側 單關節及多關節 先收縮,後放鬆 拉多深層 有關游泳牽拉運動的認識 如何多加一點點 關節的傷害 身体其他部份的配合,上下及雙側 利用其他人 利用器材 在水裏做—暖, 浮. Stretching exercise (Williamson, M.S.) Stretches for side of neck: 1. Sit or stand with arms hanging loosely at sides 2. Turn head to one side, then the other 3. Hold for 5 seconds, each side Repeat 1 to 3 times Stretches side of neck 1. Sit or stand with arms hanging loosely at sides 2. Tilt head sideways, first one side then the other 3. Hold for 5 seconds Repeat 1-3 times Stretches back of neck 1. Sit or stand with arms hanging loosely at sides 2. Gently tilt head forward to stretch back of neck 3. Hold 5 seconds Repeat 1-3 times Stretches side of shoulder and back of upper arm 1. Stand or sit and place right hand on left shoulder 2. With left hand, pull right elbow across chest toward left shoulder and hold 10 to 15 seconds Repeat on other side Stretches shoulder, middle back, arms, hands, fingers, wrist Interlace fingers and turn palms out 2. Extend arms in front at shoulder height 3. Hold 10 to 20 seconds, relax, and repeat 1. Stretches triceps, top of shoulders, waist 1. 2. 3. 4. 5. Keep knees slightly flexed Stand or sit with arms overhead Hold elbow with hand of opposite arm Pull elbow behind head gently as you slowly lean to side until mild stretch is felt Hold 10 to 15 sec Repeat on other side Stretches middle back Stand with hands on hips 2. Gently twist torso at waist until stretch is felt (you may also sit to do this) 3. Hold 10 to 15 sec 1. Repeat on other side Keep knees slightly flexed Stretches ankles Stand and hold onto something for balance 2. Lift right foot and rotate foot and ankle 8 to 10 times clockwise, then 8 to 10 times counterclockwise. 1. Repeat on other side can also be done sitting) Stretches calf Stand a little way from wall and lean on it with forearms, head resting on hands 2. Place right foot in front of you, leg bent, left leg straight behind you 3. Slowly move hips forward until you feel stretch in calf of left leg 4. Keep left heel flat and toes pointed straight ahead 5. Hold easy stretch 10 to 20 seconds Repeat on other side Do not hold breath and Do not bounce 1. Stretches front on thigh (quadriceps) Stand a little a way from wall and place left hand on wall for support 2. Standing straight, grasp top of left foot with right hand 3. Pull heel toward buttock 4. hold 10 to 20 sec 1. Repeat on other side Relaxes hamstrings, stretches calves, achilles, and ankles Stand with feet shoulder-width apart 2. Keep heels flat, toes pointed straight ahead 3. Assume bent knee position (quarter squat) 4. Hold 30 sec 1. Stretches inner thigh, groin Stand with feet pointed straight ahead, a little more than shoulder-width apart 2. Bend right knee slightly and move left hip downward toward right knee 3. Hold 10 to 15 seconds 1. Repeat on other side If necessary, hold on to something (chair, etc.) for balance Stretches side of hip, hamstrings Sit on floor with right leg straight out in front 2. Bend left leg, cross left foot over, place outside right knee 3. Pull left knee across body toward opposite shoulder 4. Hold 10 to 20 seconds 1. Repeat on other side Breathe easily Stretches lower back, side of hip, and neck Sit on floor with left leg straight out in front 2. Bend right leg, cross right foot over, place outside left knee 3. Bend left elbow and rest it outside right knee 4. Place right hand behind hips on floor 5. Turn head over right shoulder, rotate upper body right 6. Hold 10 to 15 seconds 1. Repeat on other side Breathe in slowly Stretches back of leg and lower back 1. 2. 3. 4. 5. Sit on floor, legs straight out at sides Bend left leg in at knee Slowly bend forward from hips toward foot of straight leg until you feel slight stretch Do no dip head forward at start of stretch Hold this developmental stretch 10 to 20 seconds Repeat on other side, Foot of straight leg upright, ankles and toes relaxed. Use a towel if you cannot easily reach your feet Stretches shoulders, arms, hands, feet and ankles 2. Lie on floor, extend arms overhead, keep legs straight Reach arms and legs in opposite directions 3. Stretch 5 sec, relax 1. Thank You