Ukuvuselela Ukulimala Kwama-Hamstring Acute

Uma ubuyela emdlalweni othile womuntu, ingozi yokulimala kabusha ngokuvamile iba phezulu phakathi namaviki angu-2 okuqala. Lokhu kwenzeka ngenxa yobuthakathaka bokuqala be-hamstring, ukukhathala, ukuntula ukuguquguquka, nokungalingani kwamandla phakathi kwe-eccentric hamstrings kanye ne-quadriceps ejulile. Isici esiphezulu esinikelayo nakuba kukholakala ukuthi sixhunywe ohlelweni olunganele lokuvuselela, olungase luhambisane nokubuyela ngaphambi kwesikhathi emsebenzini womzimba. Ubufakazi obusha bubonise izinzuzo zokusebenzisa ngokuyinhloko izivivinyo zokuqinisa i-eccentric ekuvuseleleni i-hamstring okwenziwa ngemithwalo eyengeziwe yobude obude be-musculotendinous.
I-semitendinosus, noma i-ST, i-semimembranosus, noma i-SM, kanye ne-biceps femoris amakhanda amade namafushane (BFLH ne-BFSH) ayingxenye yeqembu le-hamstring muscle. Ngokuyinhloko zisebenza ngokunwetshwa kwe-hip nokuguquguquka kwamadolo kanye nokuhlinzeka ngokuzinza kwe-multi-directional ye-tibia ne-pelvis. Le misipha emithathu eyakha iqembu lemisipha ye-hamstring, iwela isici esingemuva kokubili kwe-hip namadolo, okwenza kube yi-bi-articular. Ngenxa yalokho, zisabela ngokungaguquki kumandla amakhulu emishini adalwe umlenze ongaphezulu, isiqu, nokuhamba kwemilenze engezansi njengendlela yokuhlanganisa okugxilile kanye ne-eccentric. Ngesikhathi semidlalo, lawa mandla azovame ukwanda, akhulise imvamisa yokulimala.

Ocwaningweni olwenziwa eNyuvesi yaseMelbourne, abahlaziyi be-biomechanical balinganise ubunzima be-musculotendinous, isivinini, amandla, amandla, umsebenzi, kanye neminye imithwalo ye-biomechanical etholwa ama-hamstrings phakathi nesikhathi sokusprinting phezu komhlaba futhi baqhathanisa umthwalo we-biomechanical kuwo wonke umsipha ngamunye. umsipha.

Ngokuyisisekelo, ama-hamstrings angaphansi komjikelezo wokufinyeza lapho ugijima, futhi isigaba esinwebekayo senzeka phakathi nokushwibeka kwetheminali futhi isigaba sokufinyeza siqala ngaphambi nje kokushaya unyawo ngalunye, siqhubeke kukho konke ukuma. Khona-ke, umthwalo we-biomechanical emisipha ye-bi-articular hamstring yanqunywa ukuthi ibe namandla ngesikhathi sokushwibeka kwetheminali.

I-BFLH yayinobunzima obukhulu kakhulu be-musculotendinous, i-ST yabonisa isivinini esikhulu sokwandisa i-musculotendinous, futhi i-SM yakhiqiza amandla aphakeme kakhulu e-musculotendinous futhi kokubili amunca futhi akhiqiza amandla amakhulu kakhulu e-musculotendinous. Ucwaningo olufanayo luphinde lwahlukanisa ubunzima be-musculotendinous obuphakeme njengengxenye enkulu ekulimaleni noma ekulimaleni kwemisipha, okuvamise ukulimaza kakhulu umsipha, esikhundleni samandla emisipha aphezulu. Yingakho ukuqiniswa kwe-eccentric ngokuvamile kuyizincomo zokuvuselela ukulimala okunamandla kwe-hamstring.

Indawo Nobukhulu Bokulimala

Ocwaningweni olungahleliwe nolulawulwayo kubadlali bebhola baseSweden abangochwepheshe, amaphesenti angama-69 okulimala abekwe ngokuyinhloko e-BFLH. Ngokuphambene, amaphesenti angu-21 wabadlali ahlangabezane nokulimala kwawo okuyinhloko ngaphakathi kwe-SM. Nakuba okuvame kakhulu, cishe amaphesenti angu-80, abhekana nokulimala kwesibili ku-ST kanye ne-BFLH noma i-SM, amaphesenti acacile we-94 amaphesenti okulimala okuyinhloko atholakale ewuhlobo lwe-sprinting futhi atholakala ku-BFLH, kanti, i-SM indawo evame kakhulu yokulimala - uhlobo lokulimala, olubalelwa cishe kumaphesenti angama-76. Lokhu okutholakele kusekelwe kwesinye isihloko esifanayo.

Ukuhlukanisa ukulimala kwezicubu ezithambile, okuhlanganisa ukulimala okunamandla kwe-hamstring, kuncike kakhulu ohlelweni lokugreda olusukela: I, omnene; II, emaphakathi; futhi III, ezinzima. Izigaba ezihlukene zinikeza izincazelo eziwusizo zohlobo ngalunye lokulimala kwezicubu ezithambile phakathi kochwepheshe bezokunakekelwa kwempilo phakathi nokuxilongwa komtholampilo kanye nokubikezelwa ngemva kokulimala okukhulu. Ukugreda okumaphakathi kuchaza ukulimala lapho inani elincane lemicu yemisipha libandakanyeka ekuvuvukeleni okuncane, ukungaphatheki kahle, ukuncipha okuncane noma ukuncipha kwamandla, noma ukuvinjelwa ukunyakaza. Ukulinganisa okumaphakathi kuchaza ukulimala okudabuke kakhulu imicu eminingana yemisipha, ubuhlungu nokuvuvukala, amandla ancishisiwe, nokuhamba okulinganiselwe. Ukulinganisa okunzima kuchaza ukulimala lapho kudabuke khona kuso sonke isigaba esiphambanayo somsipha, ngokuvamile ukuhushulwa okubuhlungu, kanye nombono wokuhlinzwa kungase kudingeke. Iphinde yasetshenziswa njengohlelo lokuhlukanisa lwezindlela ze-radiological, ezifana ne-magnetic resonance imaging, noma i-MRI, noma i-ultrasound uma kudingeka ukuze kuqinisekiswe ukuxilongwa okuhambisanayo.

Ithimba le-British Athletics Medical Team liphakamise uhlelo olusha lokuhlukanisa abalimele ukuze kuthuthukiswe ukunemba kokuxilonga kanye nokubikezela ngokusekelwe ezicini ze-MRI.

Ukunquma izikhathi ezinembile zokubuyela ekudlaleni kulandela ukulimala okuningi okubuhlungu kwe-hamstring kuye kwafakazelwa ukuthi kunzima. Isibonelo, ukulimala okubandakanya i-tendon ye-intramuscular noma i-aponeurosis enemicu yemisipha eseduze ngokuvamile idinga izikhathi ezimfushane zokululama kunalezo ezibandakanya i-proximal free tendon kanye/noma i-MTJ.

Kubuye kube nokuxhumana phakathi kokutholwe yi-MRI ngokuya ngendawo yokulimala kanye nokubuyela ekudlaleni. Ikakhulukazi, kuye kwacatshangelwa ukuthi ibanga elifushane phakathi kwesigxobo esiseduze sokulimala kanye ne-tuberosity ye-ischial etholakala ekuhloleni kwe-MRI ngokufanayo kunqunywe ukuba khona kwe-edema, isikhathi sokubuya sizoba side. Ngendlela efanayo, ubude be-edema bubonisa umphumela ofanayo ngesikhathi sokululama. Uma ubude bubude, ukululama isikhathi eside. Ukwengeza, isikhundla sobuhlungu obuphakeme ngesikhathi esisodwa kulandela ukulimala okunamandla kwe-hamstring nakho kuhlotshaniswa nezikhathi zokuphumula ezikhulayo.

Ngaphezu kwalokho, kube nemizamo yokucacisa ukuhlobana phakathi kokuhlelwa kokulimala okunamandla komsipha kanye nokubuyela ekudlaleni. Ocwaningweni oluzoba yiqembu labadlali bebhola abakhokhelwayo abangu-207 abalimele kabi imisipha yomsipha, amaphesenti angama-57 ahlonzwe njengebanga I, amaphesenti angama-27 ahlonzwe njengebanga lesi-II, futhi amaphesenti amathathu kuphela ahlonzwe njengebanga lesi-III. Abasubathi ababelimele ebangeni I babuye bazodlala phakathi nezinsuku eziyi-3. Abasubathi abalimele ebangeni lesi-II babuye zingakapheli izinsuku ezingama-17 kanti labo abalimele ebangeni lesithathu babuya cishe phakathi kwezinsuku ezingama-22. Ngokocwaningo, amaphesenti angu-73 alokhu kulimala athinta i-BF, amaphesenti angu-84 ama-SM, namaphesenti angu-11 e-ST. Kodwa-ke, kwakungekho umehluko obalulekile ngesikhathi sokuyeka ukulimala emisipha emithathu ehlukene. Lokhu kuqhathaniswe nezinsuku ze-5-5 ngokulimala kwebanga I-II, kanye nezinsuku ze-23-28 zebanga I-III kwezinye izifundo ngokulandelanayo.

Ukuvuselelwa Kokulimala Kwama-Acute Hamstring

Abacwaningi abahlukahlukene baye baphikisana ngaphambili ngezinzuzo zokuqiniswa kwe-eccentric kulandela ukulimala okunamandla kwe-hamstring ngokumelene nokuqiniswa okugxilile lapho kugxilwe ekunciphiseni izikhathi zokubuyela ekudlaleni. Iphuzu eliyinhloko lale ngxabano liwukuthi ngobuningi bokulimala kwe-hamstring acute okwenzeka ngesikhathi sokulayisha oku-eccentric, ukuvuselelwa kufanele kufane nesimo esithile esibangele ukulimala kwasekuqaleni. Olunye ucwaningo lubonise umehluko omkhulu phakathi kohlelo lokuvuselela i-eccentric kanye ne-concentric kulandela ukulimala okunamandla kwe-hamstring kubadlali bebhola bebhola elite nabangewona ama-elite.

Ukuhlolwa komtholampilo okungahleliwe nokulawulwa okwenziwa kubadlali bebhola bebhola abangu-75 eSweden, kubonise ukuthi ukusebenzisa izinhlelo zokuqinisa i-eccentric kunezinhlelo eziqinisa kakhulu, kunciphisa isikhathi sokubuyela ekudlaleni ngezinsuku ezingu-23, kungakhathaliseki ukuthi hlobo luni lokulimala noma indawo yokulimala. . Umphumela ubonise inani lezinsuku zokubuyela ekuqeqeshweni okugcwele kweqembu kanye nokubakhona kokukhethwa komdlalo.

Ngaphezu kwalokho, izivumelwano ezimbili zokuvuselela zasetshenziswa izinsuku ezinhlanu ngemva kokulimala. Bonke abadlali bathole ukulimala kohlobo lwe-sprinting ngenxa yokugijima ngesivinini esiphezulu noma ukulimala kohlobo oluzelulayo ngenxa yokukhahlela okuphezulu, ukuhlukana kwezindawo, kanye nokugwedla. Imibandela ethile yayingafakwanga kulolu cwaningo, okuhlanganisa ukulimala okudlulele kwe-hamstring, ukuhlukumezeka ethangeni elingemuva, umlando oqhubekayo wezinkinga eziphansi emuva, nokukhulelwa.

Bonke abadlali bafakwe ekuhlaziyweni kwe-MRI izinsuku ezingu-5 kulandela ukulimala, ukuze baveze ukuqina nendawo yokulimala. Umdlali ubhekwe njengofaneleka ngokwanele ukuthi angabuyela ekuqeqeshweni kweqembu eligcwele esebenzisa uhlolo olwaziwa ngokuthi i-Askling H-test esebenzayo. Ukuhlola ukuthi i-positive ilapho umdlali ehlangabezana nanoma yikuphi ukungavikeleki noma ukwesaba lapho enza uhlolo. Ukuhlolwa kufanele kuqedwe ngaphandle kokugoba okugcwele kweqakala.

Cishe amaphesenti angu-72 abadlali bathole ukulimala kohlobo lwe-sprinting, kuyilapho abangamaphesenti angu-28 bathola ukulimala okuzilulayo. Kulaba, amaphesenti angu-69 alimala ku-BFLH, kanti amaphesenti angu-21 atholakala ku-SM. Ukulimala kwe-ST kwagcinwa kuphela njengokulimala kwesibili, cishe amaphesenti angu-48 ne-BFLH kanye namaphesenti angu-44 ne-SM. Ukwengeza, amaphesenti angu-94 okulimala kohlobo lwe-sprinting atholakala ku-BFLH kuyilapho i-SM iyindawo evamile yokulimala kohlobo olunwebekayo, okubalwe ngamaphesenti angaba ngu-76 okulimala.

Amaphrothokholi amabili okubuyisela asetshenzisiwe ayebhalwe ukuthi i-L-protocol kanye ne-C-protocol. Iphrothokholi ye-L igxile ekulayisheni ama-hamstrings ngesikhathi sokwelulwa futhi iphrothokholi ye-C yayihlanganisa ukuzivocavoca ngaphandle kokugcizelela ekwandiseni. Iphrothokholi ngayinye yayisebenzisa izivivinyo ezintathu ezingenziwa noma kuphi futhi zingancikile kumathuluzi athuthukile. Baphinde bahlose ukukhomba ukuguquguquka, ukuhlanganisa, i-trunk, ne-pelvic kanye / noma ukuzinza kwemisipha kanye nokuqeqeshwa kwamandla athile kuma-hamstrings. Konke kwenziwa endizeni ye-sagittal ngesivinini nokuqhubeka komthwalo.

Isiphetho Sesifundo

Isikhathi sokubuya sanqunywa njengesifushane kakhulu kuphrothokholi ye-L uma siqhathaniswa nephrothokholi ye-C, isilinganiso sezinsuku ezingama-28 nezinsuku ezingama-51 ngokufanelekile. Isikhathi sokubuya sasimfushane kakhulu ku-L-protocol kune-C-protocol yokulimala okunamandla kwe-hamstring kokubili uhlobo lwe-sprinting kanye nohlobo olululayo kanye nokulimala kwezigaba ezahlukene zokulimala. Kodwa-ke, kusenombuzo wokuthi ingabe i-C-protocol icacile ngokwanele ukuze kusebenze i-hamstring ukudala ukuqhathanisa okusemthethweni.

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