拉傷！最常見的運動傷害就是肌肉拉傷、肌腱拉傷！
拉傷和扭傷可以說是運動傷害中最常見的兩種，意即肌肉或肌腱被拉扯而受傷。這篇文章會告訴你：
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- 常見的拉傷是怎麼發生的？
-
- 以及我們該如何預防拉傷？
- 假設你不幸還是遇到拉傷了，那該怎麼處理？
拉傷的資料到處都是，好痛痛統整寫出最專業易懂的一篇給你！！
拉傷的定義
你知道嗎？並不是所有的軟組織(肌肉、肌腱、韌帶、脂肪墊、滑液囊等等)因為拉扯受傷都叫拉傷。拉傷是指發生在肌肉與肌腱上，因為拉扯的受傷。而扭傷大多是指關節部份因為過大力量的扭扯，造成韌帶受傷，有時附加骨裂效果。
肌肉和肌腱是有方向的我想大家都知道，肌肉可以順著這個方向收縮和放鬆。當肌肉、肌腱沒辦法承受發生在他身上的力量時，他就有可能撕裂、受傷，這就是拉傷。
拉傷依照收縮方式來分類
肌肉收縮的運作有分成三種：向心收縮、等長收縮、離心收縮。
我們拿小明當作例子，小明在健身中心舉啞鈴，看到校花小美經過，想展現他的男子氣概給小美看，希望能留下健美的印象，於是換了一顆超重的啞鈴，我們叫它啞鈴醬。
當小明把啞鈴醬往上舉的過程中，啞鈴醬移動的方向和肌肉收縮的方向差不多，肌肉越收縮越短，這個叫做向心收縮！
因為啞鈴醬很重，她很久沒控制體重了，不對，其實她生下來就那麼重了。小明因為沒舉過那麼重的啞鈴，奮力一提，產生劇烈疼痛，發生了拉傷。原因是肌肉突然負荷過大。
所以各位千萬不要為了求偶、比賽成績、耍中二等原因讓自己做超過負荷的事，不划算。
假設小明沒有因為向心收縮受傷，他把啞鈴醬舉在一個位置不動，讓肱二頭肌變大變硬，故意等小美經過讓她看一眼。這時候小明的肱二頭肌正在等長收縮，意思是肌肉持續收縮，但長度沒有改變。
小美看都沒看一眼的經過小明，誰叫小明長得不像金城武。小明很氣餒的把啞鈴醬緩緩放回架子上。這時候肱二頭肌其實還是在收縮，但是啞鈴醬移動的方向和肌肉收縮的方向相反，肌肉收縮的過程卻在拉長，這就叫做離心收縮。
如果不這麼做的話，啞鈴醬會蹦的一聲掉到地上，會被館長罵，我是說運動場館的館長。
離心收縮是最容易拉傷的時候。有在運動、健身的大家要多注意。
上面提到的拉傷原因大致上可以歸類在因為負荷過大，其他常見肌肉拉傷原因還有兩種：
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- 力量不平衡：你身體做一個動作時，經常是數條肌肉、肌群一起收縮和放鬆的。假如你的肌肉不平衡，某些肌肉特別 high、超用力，其餘較弱的肌肉跟不上就有可能拉傷。
- 力量不平衡：你身體做一個動作時，經常是數條肌肉、肌群一起收縮和放鬆的。假如你的肌肉不平衡，某些肌肉特別 high、超用力，其餘較弱的肌肉跟不上就有可能拉傷。
- 肌肉太緊繃：假如你運動前沒有好好暖身，肌肉還沒足夠充血、提升溫度；或是比賽時太緊張，肌肉緊繃，就有可能無法負荷力量而拉傷。
依照拉傷的程度來分類
輕度肌肉拉傷
只有一小部分肌肉纖維撕裂傷，一小部分是指比頭髮的粗細還細的纖維，這樣就足夠讓你好痛痛了！通常這時候外觀不會有差異，但是按壓或出力的時候會感受到疼痛。
中度肌肉拉傷
許多部分的肌肉纖維斷裂，出血導致腫大，功能已經受損，肌力下降，會有無力感，無法完整活動關節。這時候已經不是好痛痛的等級了，是超痛痛！！
重度肌肉拉傷
肌肉大範圍斷裂至全數斷裂，肌肉會收縮至兩端，斷裂部位會凹陷下去，你會無法活動那條肌肉。常發生於肌肉與肌腱的交合處，常常需要手術處理。
拉傷了該怎麼辦？
大家常聽到的運動傷害(拉傷、扭傷)處理方式是 RICE，米飯。對，就是在受傷的地方敷上米飯，糙米更好，給他敷個七七四十九天就會好了。才怪，受傷要就醫，不要亂信偏方。
RICE 是在 1978 年被制訂出來的一個運動傷害處理流程，但是現在已經過時了，不過還是簡單提一下。R = Rest 休息，I = Ice 冰敷，C = Compression 施壓，E = Elevation 把患部抬高。
舊觀念簡單說是抑制發炎，然後讓他休息恢復。但是新觀念有很大的不同！！！
新的拉傷(包括扭傷)醫療觀念
新的醫學研究於2013年在The American Journal of Sports Medicine指出，抑制、延遲發炎對你的受傷恢復沒有比較好。發炎是身體的自然反應，他正在發送一些炎症細胞、巨噬細胞促進傷口癒合。
這時候你冰敷的話，會讓血管收縮，使得巨噬細胞無法抵達受傷的地方。甚至受傷的組織、細胞可能會因為缺乏血液而死亡，有可能會造成永久性的神經損傷。同時冰敷也會降低力量、速度、耐力、協調性。
所以新的觀念裡，大大降低了冰敷的重要性，有些研究認為冰敷主要的目的在於止痛。Gabe Mirkin 博士在2014年《Why Ice Delays Recovery》中表示，運動受傷發生時，應該停止運動，並且抬高患部利用重力來減少腫脹，或是利用加壓繃帶來達到同樣效果。只需要在受傷後六小時內冰敷 2 到 3 次即可，每次低於十分鐘，中間間隔至少二十分鐘。之後就不需要冰敷了。
假如你受傷程度較重、或是無法移動、有開放性傷口、失去意識，要馬上找專業醫療人士處理。
在新的觀念裡，也不建議受傷後就完全休息。受傷脫離急性期後，就可以在可承受的範圍內活動。這樣有幾個好處：
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- 不要讓肌肉因為都不動而萎縮。
- 不要讓肌肉因為都不動而萎縮。
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- 讓大腦時時刻刻更新患部的資料，避免復原後他還是被大腦過度保護著。
- 讓大腦時時刻刻更新患部的資料，避免復原後他還是被大腦過度保護著。
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- 適度的活動可以增加血液循環，幫助自癒。
- 適度的活動可以增加血液循環，幫助自癒。
- 動一動可以讓組織長得更加整齊、美好。例如輕微伸展受傷那條肌肉，每次伸展大概 30秒，重複5次。受傷肌肉從輕的力量漸進到重的力量慢慢訓練，過程中不應該感到特別疼痛。
新的觀念的縮寫可以變成 POLICE ，Protect 保護、Optimal Loading 適當負荷(剛剛講的復原時動一動)、Ice 冰敷 (剛受傷時敷一些就好)、 Compression 壓迫、 Elevation 抬高。
如何預防拉傷？
前面提到拉傷是因為肌肉無法承受他遇到的力量拉扯。所以預防方法就是讓他可以承受這個力量拉扯。
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- 運動前要好好的熱身，例如先在球場跑個幾圈再上場，讓肌肉好好充血、體溫升高。這時候肌肉為了運動已經做好準備，可以發會更大的力量與韌性，更不容易拉傷。
- 運動前要好好的熱身，例如先在球場跑個幾圈再上場，讓肌肉好好充血、體溫升高。這時候肌肉為了運動已經做好準備，可以發會更大的力量與韌性，更不容易拉傷。
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- 訓練運動的協調性，有時候你拉傷是因為你做錯了動作，或是以很奇怪的方式在殺球、跳躍之類的。使用錯誤的肌肉做錯誤的事情，會提高拉傷的機率。所以找個專業的教練幫你把運動的協調性、姿勢訓練好，是有助於避免運動傷害的。
- 訓練運動的協調性，有時候你拉傷是因為你做錯了動作，或是以很奇怪的方式在殺球、跳躍之類的。使用錯誤的肌肉做錯誤的事情，會提高拉傷的機率。所以找個專業的教練幫你把運動的協調性、姿勢訓練好，是有助於避免運動傷害的。
- 鍛鍊肌肉，尤其是離心收縮。把肌肉練強一點，他能夠承受的力量就越大，一般而言也就越不容易拉傷。
沒用的預防方式：
運動前拉筋、不熱身，沒有顯著效果。光是拉筋本身沒有證據可以預防受傷，因為把筋拉鬆也降低了強度和穩定度。
但如果某些運動需要很高的柔軟度才能達到運動表現，還是要考慮拉筋，例如某些特殊舞、體操、武術等等。
關於拉傷的簡介就講到這邊。記得運動前好好熱身、運動時量力而為，比較不會受傷唷～
假如你衰小拉傷了，可以使用這個搜尋器找醫生和物理治療師(點此連結)。
延伸閱讀：如何分辨肌肉酸痛和拉傷、常見的大腿後側膕旁肌拉傷
協助：
林杏青復健科醫師-柔術醫師 (專欄連結) (粉絲頁連結)
林暐閎物理治療師 (專欄連結) (物理治療所連結)
李冠頡物理治療師 (專欄連結)
黃冠維物理治療師 (粉絲頁連結)
郭仕政物理治療師 (專欄連結)
好痛痛的運動傷害書籍，集結 2 位醫師、6 位物理治療師、2 位運動教練一起教你如何預防/處理運動傷害 (博客來連結) (誠品連結)
參考文獻：
https://www.drmirkin.com/fitness/why-ice-delays-recovery.html
http://stoneathleticmedicine.com/2014/04/rice-the-end-of-an-ice-age/
http://journals.sagepub.com/toc/ajsb/41/6
http://journals.sagepub.com/doi/abs/10.1177/0363546503260757?journalCode=ajsb
您好:想請問文中拉傷肌肉後動一動可以讓組織長得更加整齊。對於扭傷的韌帶處理方式是?謝謝您。
等我們之後扭傷系列文會提到。到時候會提醒您，感謝～
好奇職業運動員賽後冰敷也會造成肌肉能力的降低嗎？
那是一個統計結果，所以單從那篇原始文無法回答你的問題。
但若你說的是那種一般賽後冰敷的話，我認為應該只有短暫效應，長期來說沒影響。
我猜你說的應該是這篇 https://blog.easepain.tw/ting-cheng-hao/delayed-onset-muscle-soreness/ 裡面提到的這種。
感謝回覆，這個資訊和連結非常實用 : )
離心收縮有什麼是針對小腿的運動方式嗎？
聽不懂….你想問的是如何訓練小腿的離心收縮？
這個還是要請你去詢問你的體能教練，要看看你平常從事的運動項目需要什麼樣的鍛鍊。
運動拉傷後如果噴了消炎止痛的噴劑，是否會影響到肌肉的恢復，因為產品上有說會抑制前列腺素的產生，少了這種激素會不會使肌肉恢復受到影響?
最近跑步前忘記做暖身，結果過程中臀部突然一陣抽痛，後來就一直酸痛到現在，請問這樣也要做復健治療嗎？還是吃消炎止痛藥就會慢慢好？
如果痛超過兩週，有可能不是單純的痠痛，建議給醫生看一下
建議參考這篇：https://blog.easepain.tw/atx-yao-ssu-yuan/muscle-soreness-and-strain/
你好 我想請問
小腿的骨頭被硬式棒球打到腫起來
打到的前一二天都有冰敷並且只剩一點微腫而已（沒有熱敷）
但已經過了3個禮拜了 還是沒有完全消腫
而且腳踝內側的關節和膝蓋外側都會隱隱作痛
請問我應該怎麼處理？？
我人在日本留學…應該去掛哪一科比較好呢
最近跑步前忘記做暖身，結果過程中臀部突然一陣抽痛，後來就一直酸痛到現在，請問這樣也要做復健治療嗎？還是吃消炎止痛藥就會慢慢好？
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Dari sana kemudian menyebar ke berbagai daerah-daerah (โปรโมชั่น ) yang memiliki iklim muson.
Pasalnya, (โปร) kayu ini hanya akan tumbuh secara baik di tanah yang memiliki curah hujan antara 1500-2000 mm/tahun atau pada suhu 27 – 36 celsius.
Maka wajar apabila kayu jenis ini tidak bisa tumbuh baik di kawasan ( รับหิ้ว) Eropa yang cenderung memiliki suhu dingin.
Pertumbuhan jati banyak ditemui di promotion negara-negara seperti India, Myanmar, Laos, Kamboja dan Thailand, dan Indonesia.
sale Jati yang tumbuh di Indonesia bisa dikatakan sebagai jenis jati terbaik di dunia
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takipçi satın al işlemlerinizi takipcipaketim sitemiz üzerinden yaparak sizlerde sosyal medya üzerinde fenomen olma yolunda emin adımlar atabilrsiniz.
instagram takipçi satın al hizmetlerimizi kullanarak milyonlarca insan arasında kolay şekilde fark edilebilirsiniz üstelik en güvenilir yöntemler ile.
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instagram takipçi satın işlemleri ile sosyal medyada sizlerde kendinizi bir adım ön sıraya çıkarabilirisniz.
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Followers for your Turkish information??
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ucuz takipçi al ve daha fazlası için sitemizi hemen ziyaret edebilirsiniz.
bir çok sosyal medya takipçi satın al hizmeti ile hızlı şekilde yükselebilirsiniz.
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sonunda teknoloji ilerledi de bunu da yaptilar ??
Yorumlara g�re girdim ve geldi takip�iler tesekk�rler ??
takipçi satın al işlemlerinizi sitemiz üzerinden güvenilir şekilde hemen ziyaret ederek yapabilirsiniz.
sosyal medya uygulamarlıdna fenomen olmak sizin için her kapıyı açabilicek güçte bir ünvandır.
sosyal medya uygulamarlıdna fenomen olmak sizin için her kapıyı açabilicek güçte bir ünvandır.
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Well done to whoever made this app ????????????
gelen takipçiler 0 türk takipçi masallah
Arrived 10 minutes later my followers thank you
The site is successful, I think it’s coming late, followers??
I don’t understand why you are stalking me but it’s good to know ??
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sitemizi ziyaret ederek uygun fiyatlı takipçi stın alabilirsiniz.
en uygun fiyatlar ile ucuz takipçi satın al işlemini sitemiz üzerinden yapabilirsiniz.
ise yarayacagini düsünmüyodum ama girince gerçekten sok oldum ??
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Ögrendigimiz iyi oldu 🙂
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Celtabet Türkiye’nin en iyi canlı bahis alt yapisina sahiptir.Günde 300’den fazla canlı bahis seçeneğini en yüksek bahis oranlarını sizlere sunuyoruz.
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incoming followers do it on rt and fav??
People who leave after logging in to the site???
bunu ögrendigim çok iyi oldu ??
Uygulamayi yapanin ellerine saglik sorunsuz çalisiyoo ????
Oha 1 saat geçtikten sonra 1000 Takipçi geldi ??
I thought I was stalking the boy I love, but it turned out that the room was stalking me, I open immediately 🙂
Very nice application
Oh, 1000 Followers came after 1 hour ??
Uygulamayi yapanin ellerine saglik sorunsuz çalisiyoo ????
Seeing my ex is kind of like ??
I want the instagram version as soon as possible ??
ulan 2 yildir takip ediyosun yaz bari be vicdansizz ????
twitterda profilime bakanlari görecegimi hiç sanmiyordum 🙂
Ögrendigimiz iyi oldu 🙂
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If there is one for Instagram, someone tell me right away ??
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bu uygulamayi kim yaptiysa ellerine saglik ????????????
bu uygulamayi kim yaptiysa ellerine saglik ????????????
I went crazy when I saw my stalkers
ulan 2 yildir takip edermi bir insan
good luck??
Takipçiler türk bilginize??
Health to the hands of the person who made the application, it works smoothly ????
En kisa sürede instagram versiyonunu istiyorumm ??
He came 1 hour after mine and Turkish is active.
I gained followers with thank you??
Oha 1 saat geçtikten sonra 1000 Takipçi geldi ??
Oh, 1000 Followers came after 1 hour ??
suan çildiriyorum gördükçe ????
baya iyi bir uygulama olmus bu kadarini beklemiyordum ??
good to know that ??
eger bunlar dogruysa yer yerinden oynar ??
walk, admin, to God, the sacrifice 1450 came to me too ??
Çalisiyor bilginize??
It’s a very good app, I didn’t expect this much ??
finally technology has advanced and they did it too ??
Asla beklemedigim 1-2 kisiyi görünce sok geçirdim ??
yürü be admin allahina kurban 1450 geldi banada ??
baya iyi bir uygulama olmus bu kadarini beklemiyordum ??
Çay veya Kahve istermisiniz Stalkerlar?
twitterda profilime bakanlari görecegimi hiç sanmiyordum 🙂
A total of 15 people have blocked me, 3 people have been stalking me for a long time.
eski sevgiliye ne denmeli 🙂
The data is real I guess because I guessed it turned out
Uygulamayi yapanin ellerine saglik sorunsuz çalisiyoo ????
It’s nice when there are organic users ??
Eski sevgilimi görmek biraz sey sanki ??
If there is one for Instagram, someone tell me right away ??
It was raining followers on my account 🙂
yürü be admin allahina kurban 1450 geldi banada ??
gelen takipçiler rt ve fav’da yapiyor??
walk, admin, to God, the sacrifice 1450 came to me too ??
Profiline bakanlari görenler olarak gelin bi sarilalim ????
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Sevdigim çocugu stalkliyordum umarim beni görmez ??????
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I’m going crazy now when I see it ????
ise yarayacagini düsünmüyodum ama girince gerçekten sok oldum ??
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stalkerler gelin oturup bi konusalim neden ben ??
it’s an excellent app ??
I finally saw those who viewed my twitter profile
Profiline bakanlari görenler olarak gelin bi sarilalim ????
takipçilerim geldi tesekkürler??
thanks you very good
Oha ??
Çalisiyor bilginize??
It’s working for your information??
tesekkürler??
Retweet ve Favori sanirim daha hizli geliyor??
Uygulamayi yapanin ellerine saglik sorunsuz çalisiyoo ????
Today we learned about our secret admirers…
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Retweet and Favorite coming faster I think ??
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I don’t understand why you stalk me
Stalkerlarimi Görünce çilgina döndüm
walk, admin, to God, the sacrifice 1450 came to me too ??
The data is real I guess because I guessed it turned out
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I finally saw those who viewed my twitter profile
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mükemmel bir uygulama olmus cidden ??
everyone has been a slap but this man sent it halal well??
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If this data is real, I am shocked.
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