Joint Pain關節痛知多少

What should you do about joint pain? by Simon Stopps

關節疼痛你該怎麼辦?

SC: How common are joint problems? Who is most affected?
關節問題有多普遍呢? 誰最容易受影響?

DH: Everyone from young people to the elderly has joint problems. Injuries to joints compound, eventually leading to the more serious problem of osteoarthritis. Osteoarthritis – the destruction of cartilage – affects 50 percent of people over the age of 55 and almost 100 percent of those over 75.

從年輕到上了年紀，每個人都有關節方面的問題。傷到了關節組織，最後更加導致嚴重的關節炎. 50%55歲以上的人和100%75歲以上的人都受到關節炎(軟骨組織遭迫害)的影響

SC: Which joints cause the most trouble?
那一個關節產生的問題最嚴重.

DH: Osteoarthritis develops very slowly and can occur in any joint. The joints most commonly affected are the knee, hip, hand and spine. Usually joints in the lower part of the body are the most troublesome because we use these joints to walk and bear weight.
關節炎的發生是非常緩慢的，而且它可以發生在任何關節。最常受影響的關節是：膝關節、髋關節、手腕關節和脊椎。通常關節位在人體的較底層部位，所以是最棘手的，因為我們使用這些關節去走路和負重。
Sc: How can one prevent joint problems?

一個人要如何預防關節問題?
DH: Daily stretching and strengthening exercises lead to stronger and more flexible joints that have more resistance to injury. It is also important to get plenty of rest and do a good warm-up and cooldown before and after exercising. Using protective equipment and avoiding unsafe situations can help prevent jnjuries from occurring in the first place.
每日例行的伸展肢體和強化運動可讓關節強化和更有彈性，這樣更能扺抗傷害。充分的休息和運動前後做好暖身和放鬆也是很重要的。使用防護設備和避免不安全的情境，可以幫助預防來自第一現場產生的傷害。(待續)

SC: what causes the joint pain?什麼會引起關節疼痛
DH: Obviously, injuries from muscle damage can lead to joint pain, but the most common cause is swelling or destruction of the cartilage. Though most people eventually recover from joint injuries, damage to the cartilage can’t be reversed and can only get worse. The pain and stiffness of osteoarthritis will persist and increase with activity.

最明顯的是，來自肌肉損傷的傷害可能導致關節疼痛，但是最常見的發生原因是軟骨的過份腫脹或破壞。雖然大多數的人最後都能從受傷中恢復，而軟骨的受損卻是無法修復，而且只會更糟。關節炎引起的疼痛和僵硬也會因為活動而持續和增加。
SC: What should you do if you already have joint pain?

如果關節已經疼痛，你該怎麼辦?
DH: If you are already suffering from joint pain, there are things you can do to improve your situation:
如果你已經為關節疼痛所苦，你可以做一些事來改善你的狀況。
The R.I.C.E.(Rest, Ice, Compression and Elevation) principle is a simple treatment that can be used with all injuries. Physical therapy treatments, such as massage, are also proven to provide long-term relief of joint pain. Be careful when selecting a treatment, though. Avoid traditional remedies that manipulate the joint as they may lead to further injury. If the problem persists, see your doctor. He or she may be able to offer medication that relieves symptoms. A new treatment call Orthokine may also be useful. Orthokine offers hope to osteoarthritis sufferers by actually halting the progress of osteoarthritis and providing long-term relief.

休息、冰敷、固定和抬高四個原則，是當受到任何傷害時常被拿來使用的簡單處治。物理治療法，比如按摩，也被用來長期舒緩關節疼痛。要小心的是，當你選擇一項治療方式，還是要避免傳統療法(民俗療法)，因為不當的推拿按摩關節，可能導致長遠的傷害。如果問題沒有改善，就應該去看醫生。他們可以提供你一些藥物，舒解疼痛的症狀。還有一種新的治療方法稱為orthokine，可能會有用處。它確實可以停止關節炎的惡化，長期舒解症狀，它帶給關節炎患者希望。

Orthokine Therapy

關節炎療法

A new treatment offers hope for sufferers of joint pain by Dr. David W. Hang
一種新旳治療法為關疼痛者帶來福音

Osteoarthritis causes pain and makes movement difficult for as much as 10 percent of the population. Unfortunately, the cartilage destruction that characterizes osteoarthritis is a continuous process, and conventional treatments may encourage patients to use the joint more – leading to further damage.

關節炎引起的疼痛造成活動上的困難高達人口數的百分之十。很不幸的，軟骨的破壞是關節炎持續性發展的持質。而且一般鼓勵病人多運動關節的治療方式，將導至更深的損壞。

In the early 1980s, scientists discovered that patients with osteoarthritis produce abnormally high levels of a protein called Interleukin-1 (IL-1) which destroys cartilage, causing the disease. Further research led to the discovery of IL-1 Ra, a protein that counters the destructive effects of IL-1.
在1980年早期，科學家發現患有關節炎的病人會異常的製造大量的稱為白細胞介素-1的蛋白質，它會破害軟骨引起疾病。更進一步的研究發現了IL-1Ra，這是一種蛋白質，可以對抗白細胞介素-1產生的破壞。

Then, in 1996, a team of doctors invented Orthokine® therapy. This innovative process uses cells from the patient’s body to produce high concentrations of IL-1 Ra that are then injected into affected joints.
然後在1996年，一個醫師團隊發明了Orthokine®治療法。這種創新的治療過程是使用來自病人身上的細胞去產生高量集中的IL-1Ra，然後再注射進入受偒的關節。

Orthokine® therapy is revolutionary in that it actually halts the progression of osteoarthritis rather than simply alleviating the symptoms. Clinical trials have also shown that the therapy is more effective than other treatments. A recent study even suggests the treatment may result in cartilage regeneration.
Orthokine®療法是革命性的，因為它真的停止了關節炎的持續惡化，而不僅只是舒解症狀。臨床試驗也顥示這個療法比其它治療方法更有效果。一份最新的研究甚至提出這個治療法可能導引軟骨的再生。

Orthokin® therapy has been used successfully in Europe and Australia for the past decade, and its safety and effectiveness are well proven. This exciting treatment offers hope to osteoarthritis sufferers everywhere.
Orthokine®療法，過去十年在歐洲和澳洲己經很成功的被使用。它的安全性和有效性也被證實。這個另人興奮療法在任何地方都為關節炎患者帶來希望。(全文完)

Stroke Tips & Drills~1

Whether you’re a lap-swimmer, a former competitive swimmer, an injured runner, a
cross-training enthusiast or just someone looking for a fun, total-body exercise routine, you can learn modern stroke technique and become a better swimmer. If it’s been years, maybe decades, since your last swim lesson, you may be surprised to learn how much swimming technique has changed if you have children enrolled in a swim program, they’re probably learning to swim in a way that is vastly different from the way you were taught. Sometimes it’s easier to start fresh than to try to unlearn your old habits.
有時候，去重新開始(學習新的) ，會比試著去改掉舊習慣來的容易。
Good technique is what enables the better swimmers at your pool to whisk by you with apparently little effort. Even if some of them have lost their physiques over the years, they haven’t lost the technique they honed as younger, competitive swimmers.
好的泳技，就是能使一些較優秀的泳士，借由很少的努力(力氣)就能在他們的泳池裡飛速馳騁。一些競賽型選手，即使幾年後他們失去了他們的身材(身材變形) ，但他們卻不會失去在他們年輕時磨練出來的泳技。

How We Learn 我們如何學習
As with most sports, swimming is tougher to master than it looks. Your perception of how you swim is often very different from how you really do swim. Most adults overestimate their swimming speed, not to mention their swimming skills. Have a friend or lifeguard videotape you in the pool sometime, and you’ll see what we mean. The truth can be painful, but it’s very educational.
和大多數的運動一樣，要精熟游泳比它表面看起來還要困難。你覺得你游的是怎麼樣和實際上你真正游的怎麼樣，常有很大的差異。大部份的成人，都高估他們的游泳速度，那就更不用說他們的泳技了。請一位朋友或救生員錄下你在泳池的泳姿，然後你就會了解我們的意思了。真相可能是另人痛苦的，但它卻是很有教育性的。
We learn through observation , imitation, instruction and even pretend play. As adults, our egos often get in the way of the learning process when we think everyone is watching us. Here’s a tip: No one is watching you, unless they’ve read other chapters in this book! You are free to experiment and explore the world of swimming with childlike curiosity. 5
我們透過觀察、模仿、教學，甚至伴演遊戲玩耍來學習。當我們(一般成人)想到大家都在看我時，我們的自我常阻礙我們學習的進程。這裡有個要訣：沒有人會去看你，除非他們有讀過這本書的其它章節。全然自由的去經驗、探索這游泳的世界罷! 用你童真的好奇心。

Determining Your Skill Level 檢定你的泳技程度
In the fictional world of Garrison Keillor’s “Lake Woebegone,” everyone would be an above-average swimmer. But in the real world, where some of you are new to the pool and others have been swimming your whole lives, we have to make some distinctions to make this book as useful as possible.
在 Garrison Keillor ”悲傷之湖” 的虛幻世界裡，每個人都是頂尖的游泳高手。但是在真實的世界裡，有些是才剛開始接近泳池，有些則是視游泳為家常便飯了。我們必須做一些區別，讓這本書儘可能對大家都有幫助。
Consider yourself a novice swimmer if you’ve never been coached, if you’ve been swimming for less than two years, or if it takes you 26 or more (freestyle) arm strokes to cover a 25-yard pool length. Consider yourself an intermediate swimmer if you’ve had little or no coaching but have been swimming regularly for two to five years, or if you can complete a length of a 25-yard pool in 22 to 25 arm strokes. Consider yourself an advanced swimmer if you come from a competitive swimming background or take fewer than 22 strokes to cover 25 yard.
認定自己是個游泳新手(初階者)：如果你從未受過游泳訓練、如果你的泳齡不超過兩年、或是你用捷泳游完25公尺泳池，手臂划水超過26次。
認定自己是中等級度的泳士：如果你受過一點泳訓課或沒接受過訓練，但是你定時規律的游泳達兩到五年之久，或是25公尺捷泳划水次數在22至25次之間。
認定自己是個高程度的泳士：如果你是來自一個競賽游泳背景，或25公尺捷泳的划次低於22下。(註: 一碼約一公尺)
How Efficient Are You in the Water? 在水中的你有效率嗎?
If you’re an adult swimmer taking more than 22 strokes per length of a standard 25-yard pool, it might be worth taking a closer look at your technique. As with mastering a tennis stroke, a golf stroke or a baseball batting stroke, mastering a swimming stroke takes patience and practice. You must isolate the unique demands on your arms, shoulders, hands, hips feet and legs, before you can put them all together into a single fluid motion. Good stroke technique results from two things: minimizing drag and maximizing propulsion.
如果你是個成人，在25公尺長的標準短池，捷泳划手次數多於22次，它就值得你仔細去檢視你的泳技。一如精熟網球揮拍、高爾夫球揮桿、棒球打擊一樣，要精熟泳技需要相當的耐心和練習。在你有能力統整你整個身體達到一個專一流暢的運動以前，你必須個別抽離你的手臂、肩膀、手、膝、小腿，做獨特的要求練習。好的泳技來至兩件事：減少阻力，增加堆進力。

Minimizing Drag 減少阻力
Practicing “push and glides” off the wall will teach your body to pierce the water like an arrow. You must first learn the “streamline position.” The concept of streamlining will surface throughout this book.
練習 ”蹬牆出發，然後滑行”，將可以訓練你的身體如弓箭一樣穿水而行。你首先必須學會 “流線形的體位”。流線形這個概念將會一直出現在本書中。
Stand with your arms extended in front of you, both palms turned down. Place one palm directly over the back of your other hand and align your fingers, hooking the thumb of your top hand around the pinkie side of your bottom hand. With your hand joined together (one on top of the other), raise them over your head. Stand on your tiptoes and reach as high as you can. As you stretch, squeeze your elbows in, so your biceps brush against your ears. Remember this streamlined position. It will come in handy throughout this book.
你的雙臂向前方伸直，掌心向下，一隻掌心疊在另一隻手掌背上，手指頭伸直，上方手掌的拇指勾住下方手掌的小指，讓你的雙手合在一起(一隻手疊在另一隻上面) ，抬起雙手到頭頂，用腳尖站立，儘可能往上拉高自己。當你在伸展時，雙肘互相緊靠，你的二頭肌能碰到你的耳朵。記住這個流線形體位，它會時常出現在這本書上。

Maximizing Propulsion (Forward movement) 增加推進力(向前運動)
Stop and glide after each stroke with one arm fully extended in front of you and the opposite arm resting at your side. Make a mental snapshot of this position as you glide for six kicks. Then take another stroke and stop again, gliding with the other arm extended in front of you. Kick six more times. Take another stroke and so on. Continue pausing with one arm extended in front of you and the other one at your side, changing arms each time, remember to push all the way back on each stroke, touching your thigh, then relax your arm. Stopping your arm at this point may feel awkward, but keep practicing.
每次划水後停止，然後滑行，一隻手臂向前完全的伸展，相對的另一隻手則放鬆在體側。當你滑行做六拍打水時，對這個體位做心靈快照(把這個動作記在心裡) 。然後再划另一次水，停止，一隻手臂向前方廷伸同時滑行，六拍或更快速打水。再做另一次划水，如此繼續持續這個中止狀態：一隻手臂向前延伸另一隻手在體側，再交換手臂。記住每次划水向後，手要碰到你的大腿，然後放鬆手臂。把手臂停在這個點上，可能會覺得笨拙，但是持續練習。

Basic Stroke Foundation基礎划水的建立
As mentioned above, to move forward in the water you need to increase your forward propulsion while minimizing the amount of body surface that comes in contact with the water, causing drag. The most important source of propulsion is your kick. That’s right, your kick. This may seem odd since it looks like your arms are doing most of the work. But without an efficient kick, your legs will drag through the water like anchors and hold you back immensely.
上面我們所提到的，要在水中向前移動，在減少你身體和水接觸的總表面積所產生的阻力的同時，你必須增加你前進的推進力。推進力的最重要來源是你的踢水。完全正確，你的踢水。這似乎很奇怪，因為它看起來幾乎是你的手臂做了所有的划水工作。但是，沒有一個有效率的踢水，你的雙腿會像錨一樣在水中拖著你，嚴重的扯你向後。
Watch the better swimmers look at your pool and notice how effortlessly they seem to kick. Then look at the slower swimmers at your pool. See how they thrash in the water? Ankle flexibility, not brute leg strength, is primarily what determines the effectiveness of your kick.
觀察那些在你的泳游池裡游的比較好的泳客，注意他們的踢水是如何輕鬆、毫不費力。然後再注意那些在泳池內游的比較慢的泳客，看他們在中水如何拼命亂踢。靈活有彈性的腳踝(不是強壯小腿的踢力) ，是決定你有效率踢水的根本主因。
Practice pointing your toes as you kick. By kicking with fins when you swim, or by sitting on your insteps on a comfortable rug at home, you can increase your ankle flexibility and eventually your kicking speed. (See below.)
當你踢水練習時，把重點放在你的腳尖。借由穿蛙腳踢水游泳，或在家中用腳背跪坐在舒適的地毯上，可以增加你的腳踝的靈活度，最後增快你的踢水速率。
TIP: one of the secrets to swimming efficiently is knowing how to relax. Good swimmers seem to go farther and faster in the water, with less effort than novice swimmers. Why? Because they’re comfortable in the water. They extend their bodies fully to get ???.. most out of each stroke.
要訣：要游的有效率的祕密之一是：懂得如何放鬆。好的泳士在水中比起初學者似乎用更少的力氣就可以游得更遠更快。為什麼？因為他們在水中輕鬆自在，他們幾乎在每次划水之後都能完全放鬆的伸展他們身體。

Kicking Skills 踢水技巧
While the kick is not directly responsible for propelling you forward, it’s pretty tough to swim well without kicking well. If you don’t believe it, try this little exercise: in a safe environment, swim a few laps with your ankles bound together so you cannot kick freely. You can use surgical tubing or a small inner tube to hold your ankles together. what happens? Chances are your legs swerve madly from side to side and then sink toward the bottom of the pool as though they had weights attached. Try the exercise again. See how difficult it is to swim in a straight line when you can’t kick?
當踢水不能直接負起你前進的推進力時，想游的好而沒有很好的踢水，將會非常的辛苦。如果你不相信，試試這個小練習：先注意周遭環境的安全，然後把腳踝綁起來，不要踢水的游泳。你也可以用外科水術橡皮管或小的氣車內胎將兩個腳踝固定在一起，然後看看會發生什麼事？你的雙腿可能會左右胡亂的偏轉，然後朝池底沈下去，就好像你的雙腿背負了重物一樣。再試一次這個練習，看看當你不踢水而想游在一直線上，會是如何的困難？

Kicking: A Closer Look 踢水：最後一瞥
Kicking propels you in two directions: forward and upward. The forward component is of minimal value to non-competitive swimmers, but the upward component, or lift, is what allows you to hydroplane on top of the water, giving you speed. You kick also helps you counterbalance your arm stroke. What happened when you wrapped the band around your legs? You zig-zagged like an eel. Unless you have a perfect stroke with high elbow recovery and zero lateral movement, you need to kick just to maintain a straight line in the pool.
踢水會讓你往兩個方向推進：向前和向上。向前的要素對非競賽型泳者是沒什麼效益，但是向上(上昇)的要素，讓你能如水上飛機一樣停留在水面上滑行，給你速度。你的踢水也可以幫助平衡因手臂划水造成的失衡。當你把雙腳綁起來會發生什麼事？除非你有一個很完美的高肘划水，和知道如何做側面歸零校正運動幫助恢復平衡，否則你會像鰻魚一樣彎曲扭轉。在泳池裡，你就是需要踢水來維持你游在直線上。
You’re probably seen novice swimmers at your pool whose legs appear to be scissoring when they kick. The problem is in their arms, however, not their legs. Next time you’re at your pool, watch how their arms cross past the midline of their bodies. Their legs have no choice but to counterbalance their arm stroke by scissoring. If they didn’t do so, they’d sink or swim in circles. You might want to share this insight with them (politely).
在泳池裡你可能會看到一些初學者，踢水時出現剪刀腳。這個問題在他們的手臂而不是他們的腿。下次你在泳池，注意看他們的手臂入水時是如何橫過身體中線，他們的腿沒有選擇的必須用剪刀的踢法來平衡他們的手臂划水。如果他們不這麼做，他們就會下沈或盤旋的前進。當你知道他們的問題，你可能會想告訴他們，你對他們泳技的卓越洞察力(記得婉轉一點)。

Checking Your ankle Flex: The Toe Point Test 檢側你腳踝的靈活屈度：腳尖測試
Ankle flexibility is the key ingredient to kicking speed and thus, successful swimming. If you are able to point your toes, your feet will act like fins in the water. If you can’t point your toes – are you listening, runners, cyclists and triathletes? – your feet will act like anchors.
腳踝的靈活度是踢速和完美泳姿的關鍵要素。如果你能夠把重點放在腳尖，你的腳在水中就能像魚鰭一樣。如果你不把重點放在腳尖――你有沒有在聽，跑步的，騎腳踏車的，玩三鐵的？――你的腳就會像錨一樣(把你拖住並往下沉) 。
You can measure your ankle flexibility with a ruler. Sit on the floor with your legs extended in front of you and your heels resting on the floor. Point your toes as far as you can without causing pain (or have a friend press down gently on your toes.) Measure the distance from the floor to your toes. If your toes are within two inches of the floor, you should have a decent kick. If your toes are two to four inches from the floor, that’s fair. If you measure four to seven inches or more from the floor, your ankles are very tight, and you probably find it very difficult to kick with a kickboard. Many runners, cyclists, weight lifters and aerobics enthusiasts fall into the latter category. (See stretching exercise below.)
你可以用這個方法測量腳踝的靈活度：坐在地板上，兩腿向前伸直，後腳跟靠在地板上，腳趾盡可能向遠處伸長，但不要引起疼痛(或請朋友幫忙輕輕的往下壓) ，然後測量你的腳尖到地板的距離。如果你的腳趾離地兩吋以內，你應該會有一個很不錯的踢水；如果在2~4吋之間，那是正常的；如果是在4~7吋或超過，你的腳踝就太緊了，你可能會發現你用浮板打水會很困難。很多跑者、腳踏車騎士、舉重者和熱愛有氧運動者，都落在最後一項(在4~7吋之間) 。

Ankle Flex Exercises腳踝柔軟運動
1. Have a partner press down on your feet as you sit with legs extended.
2. Sitting on the floor, tuck the tops of your feet under a sofa. Slowly scoot back in the floor. Try to extend your legs fully. Be careful not to exert too much pressure on your Achilles tendon (behind the ankle area).
3. While sitting on a chair, dangle your feet and curl the tops of your toes to the floor. Press down.
4. Practice swimming with training fins on, especially when you kick.
1. 當你坐著時，雙腳前伸，有位同伴幫忙把你的腳盤往下壓。
2. 坐在地板上，把腳尖插到沙發椅下面，身體慢慢往後移，試著把你的腿整個打直。但是要小心不要太用力，避免壓迫到位於腳踝後側的阿基里斯鍵。
3. 坐在椅子上，把腳懸住，讓腳背指頭碰到地面，然後往下壓按。
4. 游泳時用蛙鞋練習，尤其是踢水的時候。

Head-Up Kicking Drill 抬頭踢水訓練
“Head-up” kicking will teach you proper body position – elevating the hips and chest to reduce resistance – and help you develop a strong kick. Clasp your hands together, arms fully extended in front of you, with your head out of the water. Inhale by lifting your chin straight ahead. Don’t forget to keep kicking when you breathe. The head-up kicking drill will come in handy when we discuss open-water swimming later.
“抬頭踢水”將會教導你適確的體位――抬昇臀部和胸部可減少阻力――並且幫助你訓練成強有力的打水。你的雙手緊扣，向前伸直，你的頭要抬出水面，吸氣時抬起你在前方的胸部，當你換氣時不要忘了持續踢水。抬頭踢水訓練，對之後會討論到的開放水域游泳時，將會有所幫助。

如何準備比賽

「妳還要游嗎？」我問清芬，
「不了，我沒力氣了。」清芬回答，
「那我們上去罷！」我躍身上岸，一名戴著黑白條紋泳帽蹲在岸上的男子，對著跳上岸的我說：
「妳游好了？」
「是啊！」我客氣的回答並沒有再和他們搭搧，和清芬到熱湯池去討論泳技。
「妳知道嗎？我剛下水開始游時，覺得水很重。但我們練完衝刺之後，再來的慢游，我覺得游的之順，水感之好的！」清芬說，
「我也一樣。剛下水熱身，就覺得游不動，划次都到三十以上；衝完後放鬆游，划次降到三十以下，而且很輕鬆。」我答，
「以前王老師跟我說：比賽練習要衝一趟，放鬆游一趟；賴聰耀以前要比仰式，練習時也是衝一趟仰式，慢游一趟仰式；妳知道阿勇嗎？他也是這樣練習。他還跟我說：打水如果慢慢打，乾脆不要打，因為沒有用處。他說練習打水，也是要快速打水，再放鬆回程。而且他們會一趟自由式，一趟仰式交替練習，讓身體做正反對稱動作的調節，而不會僵於一個方式。」清芬說，
「妳說的有道理，我以前一直長泳等速練習，陷於同一個情境，反而對水不太能有體會，今天衝一衝再放鬆游，對水的感覺就敏銳多了。」我答，
「不要一直游長泳，會使身體變成機械式的運動，應該要多變化的練習，也比較不會無聊。打水也相當重要。」清芬說，
「我知道，妳的打水就很好，妳的打水都在水線下，幾乎百分之百的推進。我會把腳踝踢到水面上，水花也很大。」我答，
「以前王老師跟我說：打水最好就是要在水線下，才不會浪費力氣。打水有ㄅㄡ.. ㄅㄡ…的聲音是錯誤的。」
「我知道，慣性要改比較困難，有時調整過來，速度反而慢下來。不注意，可能一下又回到慣性。就跟妳打坐一樣，要非常的警覺。淑真姊的打水就很好，也很快，她的划手就是慢慢的、順順的，但是她的打水幾乎都是六拍。她跟我說：打有水，打沒水差很多；打有水很重要！浮感好，游起來輕鬆多了！我以後還是要用點心絞正打水的動作。」我答,
「打水練習，應該要佔我們平時練習總量的二分之一以上。你明天還會來嗎？我們先練打水，再來衝刺、放鬆，就以今天的模式再來練習看看！」清芬建議，
「好呀！就這麼試看看！」我同意的回答。

我實在是... 自取其辱!!!