20170524-004sportential
【體路專欄】運動嚟講,腳傷最普遍嘅,都係集中係腳掌、腳髁。當中最常見,一定非拗柴(Ankle Sprain)莫屬啦。就算唔係運動人,都經常會有人中招。

有幾常見?
例如英國,大概有5%去急症室嘅人係因為拗柴。而喺運動受傷層面,37項 NCAA D1(National College Athletic Association)運動當中,腳掌、腳髁佔全部受傷27%。如果成隻腳睇,拗柴同膝頭,都係長居第一二位。如果用數字話你聽,大概就係每1000個運動員入面,就會有1.37人中招;又或者你每玩1000個鐘,就會中招4.9次 。

韌帶撕裂?!
拗柴可以好小事,但亦可以好麻煩,主要取決於你嘅受傷程度,有冇骨折等等(當然仲有你聽唔聽話,同埋你嘅康復能力)。以上各樣都取決於你係點整親,所以拗柴嘅人搵到我,都會比我煩死,因為會問佢,拗邊邊,點樣拗,傷嗰時仆去邊,跳緊定轉向,有冇聲,有冇即腫,行唔行到⋯⋯

Any肥,好重要嘅一樣嘢係,我最憎人睇完西/中嘅專業人士之後,黎搵我執手尾,而上一手淨係同佢講「你韌帶撕裂喎!」然後自己就驚到世界末日咁。唔該,十之八九嘅拗柴,都有韌帶撕裂(Ligament Tear / Disruption),但唔等於斷左,因為分3個gradings,grade 3先係斷(所以我一般會以講拉傷,無啦啦嚇人做咩啫)。而且就算斷咗,只要你rehab做得好,都係可以冇事一樣。

好幾耐?認識下解剖
內側拗柴(Inversion Ankle Sprain)係最common,難嘢唔講,一般有三條韌帶最易中招。中邊條,取決於拗得勁唔勁(Severity)同埋方法(Mechanism of Injury)。

1)前踝關節韌帶(Anterior Talofibular Ligament, ATFL)

1)前踝關節韌帶(Anterior Talofibular Ligament, ATFL)

2)跟腓韌帶(Calcaneofibular Ligament, CFL)

2)跟腓韌帶(Calcaneofibular Ligament, CFL)

3)後踝關節韌帶(Posterior Talofibular Ligament, PTFL)

3)後踝關節韌帶(Posterior Talofibular Ligament, PTFL)

最最最常見嘅,可以話係ATFL,所以好多時,外側腳眼嘅前面,都會有啲唔舒服或者蹲嗰時頂著頂著咁,因為腫咗丫麻!如果你係人類,而條韌帶傷到grade 2,唔好問我點解兩三個星期仲係頂,因為你係人類。同埋仲有好多嚴重少少嘅拗柴相關受傷會影響,例如High Ankle Sprain、OCD、Multiple Ligament Disruption,如果你係咁不幸中咗嚴重嘢,咁就再耐啲。

如果好官方咁講,拗柴後幾耐可以玩返運動,可以由2星期至3個月不等。但因為大家都有少少唔同,所以我鍾意用基準推進(Criteria-based Progression),再加埋POLICE principle。

所以,我今日想大家得到嘅係,如果你睇完醫生,撞著個淨係同你講韌帶撕裂嘅,你應該識得問:
1. 你淨係傷韌帶,定係有其他嘢?
2. 傷幾多條?
3. 傷到乜程度(grade 1,2,3)?
4. 需要有幾多保護?
5. 康復進程應該如何?

Reference:
1. Yung P, Fong DT, Hong Y, Chan L, Yung PS, Chan K. A Systematic Review on Ankle Injury and Ankle Sprain in Sports A Systematic Review on Ankle Injury and Ankle Sprain in Sports. Sport Med. 2007;37(1):73–94.
2. Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The Incidence and Prevalence of Ankle Sprain Injury : A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies. Sport Med. 2014;44:123–40.
3. Hunt KJ, Hurwit D, Robell K, Gatewood C, Botser IB, Matheson G. Incidence and Epidemiology of Foot and Ankle Injuries in Elite Collegiate Athletes. Am J Sports Med. 2017;45(2):426–33.

撰文:註冊物理治療師 Nelson Cheng、NSCA私人健身教練Hin Leung
資料來源:Sportential 運動潛能資訊

image_pdfimage_print

Comments