如何訓練出強壯的肌腱？文獻整理
恭喜 Klay Thompson 重回 NBA 賽場！！聽到介紹出場 heeeeeees back差點哭出來。
整理這篇文章是希望大家不要等到受傷了才注意肌腱的健康，根據不負責任統計，百分之九十八的人聽到肌腱是伴隨著傷痛一起出現，例如：肌腱界最有名的阿基里斯腱斷裂、髕股肌腱炎、股四頭肌腱鈣化等等。百分之一是自己是醫療人員，另外百分之一可能是剛好在討論半筋半肉麵。
在這個巨即正義的年代，大部分有在重訓的人都把注意力放在肌肉量、最大肌力上面，很少人會去在意肌腱的發展，只知道他是個肌肉與骨頭的連接仔。畢竟大肌腱對吸引異性似乎沒什麼幫助。
但其實肌腱跟動作品質（１）、爆發力、跳躍力很有關。肌腱是有彈性的結締組織，在伸長量8%以內都屬於彈性變形，也就是拉長後可以儲存能量釋放，基本上除了健力之外其他所有運動項目或多或少都會用到肌腱彈性，而在跑步、投擲、跳躍中彈性位能的貢獻佔到總做功五成以上（２），肌腱使用效率大幅影響了這幾項運動的表現。
那到底肌腱要怎麼變強？
然肌肉跟肌腱是串連的結構，你在做重量訓練時力量會同時通過兩者，但因為通過肌肉跟肌腱血流量不同，肌腱的生長跟修復比肌肉慢很多，阿基里斯腱需要2個月以上的訓練，才會促進增加膠原蛋白合成（ 3），相對的肌肉8天可以達到結構改變。因此當肌腱跟不上肌肉的強度，很容易在猛然的加大訓練量的時候成為力線上的弱環節。
圖片來源：tennis elbow classroom
肌腱使用效率跟兩項力學性質有關。
剛性（stiffness）
指的是材料抵抗形變的能力，剛性(K)大小跟截面積（Ａ）、彈性模數-取決於纖維排列品質（Ｅ）、長度（Ｌ）有關 k=AE/L 。剛性越高的肌腱在同樣伸長量下可以儲存越多彈性位能＝1/2kx^2（延伸閱讀：不同運動需要什麼剛性）
黏滯性 （Hysteresis）
指的是外力消失後多快回到原本的長度，這影響到肌腱釋放能量的速度也就是功率，肌腱的黏滯性越低、動作過程能量損失越少、使用就越有效率。
有特定的練法可以提升這幾項力學性質。以下是訓練原則
一、慢速離心訓練
這是當你有慢性肌腱炎時物理治療師會開給你的運動處方，像是離心期6秒的保加利亞蹲，離心運動被證實可以促使亂長一通的肌腱纖維回到良好的排列。既然可以治療受損的肌腱，合理推測也能強化健康的肌腱。
二、增強式訓練
在一項實驗中發現（4）進行14周的增強式訓練，包含深跳、反向跳、跨欄跳等等需要用到肌腱回彈力量的訓練可以降低肌腱的黏滯性，但是對截面積跟長度沒什麼改變，只是單純改變效率。不過有趣的是訓練的前8周，啥屁都沒發生，代表肌腱的適應或許需要夠長的時間。
三、最大努力等長收縮
這邊的等長不是單純不動，而是用全力施力在一個不會動的物體，例如全力推牆壁、大腿中段拉等等。研究(5)顯示等長收縮對肌腱剛性還有跳躍高度的提升效果跟增強式訓練是差不多的，但對關節的衝擊小很多，有興趣的人可以去看操作方法。
四、全活動度
肌腱對長度變化敏感，重量訓練盡量選擇大的關節活動範圍、可以將肌腱伸展到最長的動作，舉例：前蹲舉相較背蹲舉，股四頭肌腱可以被拉的比較長。
五、有疼痛可不可以練？
前面講過離心訓練是慢性肌腱變性治療的一部份，最痛10分的話過程中5分以下疼痛是可以接受的，或是訓練結束後24小時內會消失的痛是可以被接受的（請參考load tolerance test）但不確定疼痛原因的話建議先請醫療人員評估。
六、訓練量與訓練頻率
截面積跟機械應力（mechanical stress）最相關，然而肌腱跟肌肉一個最大的差異在於，肌腱是被動元件，不像肌肉要考慮什麼運動單元徵招率、firing rate、肌耐力等等神經支配跟能量系統問題，只需要考慮總訓練量 。
對應力的反應似乎只要超過一定門檻即可（待驗證），不需要用到-舉例來說 90％以上 1RM去刺激神經適應。 反而更頻繁地去刺激他效果更好，因此訓練的安排上中重量、高訓練頻率、高訓練量應該是較好的選擇。
（根據涂俐雯醫師的文章，肌腱細胞對訓練的反應間隔是六小時）
結論：
1 大肌肌之餘別忘了照顧一下肌腱
2 練肌腱不只是為了避免受傷，更可以增加運動能力
3 目標：增加剛性、降低遲滯
4 訓練原則：中重量、高訓練頻率、離心、伸長
OK就這樣，祝大家成為肌腱富翁。
ref:
(1) Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. 2016
(2) Movement Strategies for Countermovement Jumping are Potentially Inuenced by Elastic Energy Stored and Released from Tendons. 2018
(3) Time course of changes in the human Achilles tendon properties and metabolism during training and detraining in vivo
(4) Plyometric training effects on Achilles tendon stiffness and dissipative properties
(5) Plyometric vs. isometric training influences on tendon properties and muscle output
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)
It’s a pretty interesting post. I accidentally found your blog and read your post. I saw a few more of your other posts because it was interesting. I was searching several blogs to get good information. I’m very lucky to find your blog. Thank you for the good information. 사설토토
No one would agree with you more completely than I do me. It’s a really logical and elegant summary of what I want to say. I want to look around your blog more. I’m sure there are more good topics on my blog that you can write about. Please come and check. 메이저놀이터
This blog is really awesome. At first, I went around your blog lightly, but the more I read, the more gem-like articles I read. I like reading your writing. Many people are looking for topics related to your writing, so you will be of great help to them. 스포츠토토사이트
I’ve been looking for photos and articles on this topic over the past few days due to a school assignment, casinocommunity and I’m really happy to find a post with the material I was looking for! I bookmark and will come often! Thanks 😀
As I am looking at your writing, baccarat online I regret being unable to do outdoor activities due to Corona 19, and I miss my old daily life. If you also miss the daily life of those days, would you please visit my site once? My site is a site where I post about photos and daily life when I was free.
HUGE WINS! I PLAY EVERY QUICK HIT SLOT MACHINE IN THE 먹튀검증사이트! Winning W/ SDGuy1234
The Path to Becoming a Successful 바카라카지노슬롯 Player
The Path to Becoming a Successful 藍色小藥丸價格
Facts About 퍼스트카지노 Online
Everyone! Come here and read this! It’s a unique posting that you can’t see anywhere else. I feel like my vague mind is being clearly organized. Your expression is amazing. Why don’t I have the same ability as you? From now on, I will write comments on all the posts you write. 안전토토사이트
What’s so easy? It’s almost empty. Actually, I was preparing for a long time to write a column about the topic you wrote. I had a lot of worries about how to solve difficult concepts easily, but I was shocked to read your post. You’re so talented. I want you to post various topics related to this on my blog. 메이저토토사이트
Thanks to you, I’m glad I got good information. Thank you for mentioning what I might have missed. I hope you will continue to share useful information through your blog. 😀 먹튀검증
The assignment submission period was over and I was nervous, baccarat online and I am very happy to see your post just in time and it was a great help. Thank you ! Leave your blog address below. Please visit me anytime.