為什麼不練引體向上,及伏地挺身時,肩膀前側會疼痛的問題
《強膝訓練》出版之後,很多人問說:「為什麼你的動作裡面沒有上肢垂直拉的動作呢?像是引體向上。」
對於一般民眾來說,從預防肩膀受傷的觀點,我會希望先專注在上肢「水平」推及拉,比較不會「加劇」原本已經駝背或所謂「上交叉症候群」的問題。由於駝背,肩膀前側的肌肉會緊繃甚至短縮,再加上我們日常生活中大量的使用身體前側的肌肉,像是使用電腦、握方向盤、推門等,使得「推」的肌肉比較發達,而背部肌肉(即拉的肌肉)缺乏訓練,在「推」及「拉」力量的失衡下,容易引起肩膀的不適。這在經典的《Applied Kinesiology》著作有提到:
Pectoralis minor is seldom found to be undertoned. This is because almost everyone has more developed muscle on the anterior side of their bodies than the posterior side. Just about everyone orients themselves toward their desks, steering wheels, etc. This gives their “pushing" muscles lots of activity. Few people even weight lifters, give equal to the pulling and rowing muscles of the back. This can be easily seen in the comparative size of the large and strong anterior deltoids and the typically small and weak posterior deltoids. As a result, all the pectoralis muscles become overly trained, shortened and tight compared to their antagonists.
(胸小肌很少發現是缺乏訓練或活動的,幾乎每個人身體前側的肌肉都比後側發達,幾乎每個人都是將身體前側在面對桌子、方向盤,這使"推"的肌肉得到大量的活動。即使有在從事肌力訓練,也很少有人背部肌肉(拉)及胸前肌肉(推)的力量是相互抗衡的,這很容易地從大而強壯的前三角肌和典型的小而弱的後三角肌的比較大小中看出。 結果,與拮抗肌相比,所有的胸肌都變得過度訓練、縮短和緊繃。)
Pectoralis minor may be shorted in response to a bilateral weakness in the middle or lower trapezius muscles. (胸小肌可能因中斜方肌或下斜方肌雙側無力而縮短。) For lasting correction of shortened pectoralis minor muscles, training to increase the strength of the shoulder extensors ( teres minor, teres major, latissimus dorsi, trapezius, rhomoboids, posterior deltoikds, etc.) is usually required.
(為了持久矯正縮短的胸小肌,通常需要訓練以增加肩伸肌(小圓肌、大圓肌、背闊肌、斜方肌、菱形肌、三角肌後束等)的力量。)
其中書上第141頁提到「典型姿勢困難(typical postural difficulties)」:
In the upper torso, almost everyone has stronger muscle on the front than the back. We are oriented forward and down toward our desks, sinks, automobiles, etc., so naturally the muscles on the front of the chest are more fit than those on the back. In these and other activities we mostly perform motions that inwardly rotate the shoulders. Even sport and fitness enthusiasts typically do more bench presses than rowing movements. So they too have stronger pushing muscle than pulling muscles. This is easily seen in the deltoid muscles. The deltoid is typically large in the anterior and middle sections but quite small in its posterior portion. For various reasons, even athletes who consciously exercise their pulling muscles, tend to ignore the external rotators of the shoulder. Although latissimus dorsi and teres major are used in popular pulling motions like chin ups and rowing, they are also internal rotators of the shoulder.
(在上半身,幾乎每個人的前側肌肉都比後側強。身體前側朝向辦公桌、水槽、方向盤等,所以前側的胸部肌肉自然比背部的肌肉更發達。 在這些和其他活動中,我們主要執行向內旋轉的肩膀動作。 即使是運動和健身愛好者通常做更多的臥推而不是划船動作。所以比起拉的肌肉力量,他們有更強的推的肌肉力量。從三角肌中很容易看到。 三角肌的前側和中間通常較大,但後側非常小。由於種種原因,即使是有意識地鍛煉拉力肌肉的運動員,也往往會忽視肩部的外旋肌群。 儘管背闊肌和大圓肌用於引體向上和划船等流行的拉動動作,但它們也是肩部的內旋肌。)
As a result of these imbalanced activities, the most used muscles of the chest and the inward rotators of the shoulders tend to be comparatively over-strong and shorted. This is called “adaptive shortening". Their opponents tend to be weak, to muscle-test weak and be overly lengthened. The shortened pectoralis muscle and internal rotators pull the shoulders forward and down, rotate them inward and round the back. These changes establish a new and incorrect norm of balance between these sets of muscles. The weakness in the external rotators of the shoulders predisposes them to the common “rotator cuff" injuries. The rotator cuff muscles hold the humerus into the shoulder joint. Actually, the shoulder joint is structurally quite unstable. It is like a ball pulled onto an open pan by the four rotator cuff muscles. These little muscles need to be strong to protect the shoulder from injury. To correct these postural problems, specific exercises are needed to strengthen, and thereby shorten the neglected muscles and also to stretch the incorrectly shortened muscles.
(由於這些不平衡的活動,最常用的胸部肌肉和肩部內旋肌往往相對過於強壯和短小。這稱為“自適應縮短”。 他們的對手往往很虛弱,肌肉測試虛弱並且過度拉長。 縮短的胸大肌和內旋肌將肩膀向前和向下拉,向內旋轉並繞過背部。 這些變化在這些肌肉組之間建立了新的和不正確的平衡規範。肩部外旋肌的弱點使他們容易受到常見的“肩袖”損傷。 肩袖肌肉將肱骨固定在肩關節中。 實際上,肩關節在結構上非常不穩定。 它就像一個球被四個肩袖肌肉拉到一個打開的平底鍋上。 這些小肌肉需要強壯才能保護肩膀免受傷害。 為了糾正這些姿勢問題,需要進行特定的鍛煉來加強力量,從而縮短被忽視的肌肉,並拉伸不正確縮短的肌肉。)
如果有注意到上述的內容,你應該就會發現「引體向上會訓練到肩內旋的肌群」這會加劇原本就已經處於肩內旋的肩膀,加劇原本「肩膀結構失衡」的問題,復健目標是訓練肩膀後側的肌肉,並伸展肩膀前側的肌肉。
在《Applied Kinesiology》書上有提供動作選擇,但我選擇動作是源自於《麥克波羅伊功能性訓練聖經》第八章「肩胛胸廓與肩盂肱關節的訓練」提到的二個動作:「T字母動作」及「站姿的外旋」
T字母動作
T=上臂與身體軀幹呈90度角,拇指朝上指。這個姿勢的重點是肩胛後縮,而且肩膀保持90度角。許多運動員的肩胛縮肌肌力不足,會將兩臂稍微下拉至兩側,目的是要用背闊肌的動作取代肩胛縮肌的動作。這會製造一個內收動作,而不是後縮動作,應該要小心防止。角度千萬不能小於90度角;小於90度角就表示背闊肌取代肩胛縮肌的動作了。
站姿的外旋
本書英文版的第一版並未納入任何肩旋轉肌群的鍛鍊,這或許是一個錯誤。對於旋轉肌群是否有必要單獨鍛鍊,雖然仍然存有一些爭論,但我們採取的是「安全勝過遺憾」的做法。儘管很多所謂的專家主張旋轉肌的獨立鍛鍊沒必要,但幾乎所有美國職棒大聯盟的球隊依然繼續做這項鍛鍊。這可是很重要有力的觀察性證據。
字母T的動作我傾向進行「單手」,而不是雙手同時進行,因為雙手同時進行的時候候,你很難兩邊都兼顧,所以建議一次只進行一側就好,比較能夠專注在動作上。
3A. 站姿的外旋:2組15下/每邊
3B. T字母動作:2組15下/每邊
補充:拳擊、游泳、排球、揮拍型運動等,肩膀需要大量「推」的動作,如果要改善運動表現,在肌力訓練上是否需要去強化推的肌肉力量呢?視每個人的情況而定,若肌力訓練「重複」在訓練運動中經常甚至是過度使用的「動作模式」或「肌肉群」,可能導致「結構失衡」,然後引起「疼痛」,而疼痛就會影響力量的傳遞及輸出,所以反而沒有改善運動表現。如果運動員或運動愛好者,有所謂的「休賽期」,而且沒有受傷,確實可以針對他們運動場上需要的動作模式或肌肉群來進行訓練,否則在肌力訓練的安排上,務必要去考慮較為缺乏訓練的動作模式或肌肉群,來預防結構的失衡,而結構一旦較為平衡,而且「運動」訓練可以有計劃性而且規律的進行,運動表現自然就會上升。
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