《修復關節炎28天計畫》閱讀心得 (by 郭仕政物理治療師)
每個人每一天都會活動，為了活，就要動。每個人每一天都會慢慢變老一點，而每一次的活動都會使用到關節，難道關節就真的如同電視廣告中的一點一滴磨損、退化了嗎？
不，並不是這樣的。
一本與眾不同的健康知識書籍
以往寫給民眾看的保健類別書籍，內容大多只會告訴你酸痛的時候可以如何自我處置，放鬆這邊、放鬆那邊、伸展伸展，好一點的會教你怎麼做一些簡單的運動，但那些運動很可能只稱得上活動，再告訴你什麼是正確的姿勢之類的。
但是這本《修復關節炎28天計畫》不一樣，這本書有9個章節，就花了7個章節的篇幅來告訴你為什麼關節是如何運作的、發炎的機制是什麼、關節為何會發炎、疼痛代表什麼意思。這本書也告訴大家目前常見的止痛藥、玻尿酸注射、更換人工關節等退化性關節炎的處置方式，其實無法真正改善問題，只能抑制疼痛、延長問題而已。
這本書最讓我讚賞的地方在於作者佩特拉．布拉赫特博士特別解答了一般民眾常見的迷思，例如：
- 體重過重、年紀、基因會是關節炎的主要影響因素嗎？
- 如果有吃止痛藥的話，何時是適當的停藥時機呢？
- 什麼時候該裝人工關節？什麼時候不適當？
- 什麼是幹細胞療法？
- 已經磨損的軟骨有可能再生嗎？
相較坊間常見的書籍常常只是作者個人的觀點，這本書有許多科學文獻來佐證、支持作者的論點，是一本具有實證性的好書。
德國與台灣的醫療環境
書中有提到在德國的醫療狀況，這是讓我蠻感興趣的部分。在德國，醫療制度讓醫生無論在醫院或診所都需要看非常大量的病人，時間不足的狀況下只能透過直覺與經驗來判斷，無法仔細評估病患的問題，頗令作者感到無奈。
這點我心有戚戚焉，我考取物理治療師執照後，先後在醫院、診所服務了數年，執行過健保與自費的治療。在台灣健保制度下，和關節退化與關節發炎最相關的復健科醫生與骨科醫生也需要在短時間內診斷大量的病人，而物理治療師光是應付此起彼落的儀器聲響就耗盡了體力。實在難為每一位病人給予客製化的治療處方。但是我認為因為每個人的身體狀況都不同，應該要依據年齡、工作與生活狀態、體能程度、疼痛方式等等，給予不同的治療方式、運動治療處方、衛教、改善環境，才是真正有效的作法。
利用運動來戰勝關節疼痛
書中有提到一點和現代的物理治療觀念不謀而合的地方：只有下定決心開始運動的人，才能真正戰勝疼痛、擺脫關節炎。
新的醫療觀念推翻了以往認為疼痛就休息、不去動關節就不會磨損的老舊觀念。事實上人體是活的，人體不是機器，是越動越健康的，不動反而會衰退。你應該鍛鍊肌肉，讓肌肉來幫助緩衝關節所受到的力量，而非一天到晚坐著休養身體，年長者一直靜止休養下去只會得到肌少症。
「那我該如何開始呢？」或許你會這麼問。
這本書的作者佩特拉．布拉赫特博士和羅蘭．利伯沙細心安排人體由上至下各部位的運動運動方法，透過作者獨創的「利伯沙與布拉赫特」運動與滾動式筋膜按摩方式，針對不舒服的部位，利用滾球或滾棒，將已過度使用而產生沾黏部位放鬆，再伸展緊繃的肌肉。在可接受的痠痛程度下做訓練，來達到增強過於虛弱的關節活動角度。依循作者書中建議的呼吸方式、刺激層度、按摩方向、運動的時間等等，可以改善關節的狀況。
假如你對關節發炎、退化的醫學原理比較不感興趣，想趕快執行運動實作的部分，可以直接從第8章開始也是不錯的！
但這邊提醒各位讀者，假如你的疼痛無法簡單處理掉，且影響到生活的時候，建議還是要找專業的醫生和物理治療師做診斷和評估，讓他們來幫助你。
補充營養也是很重要的！
除了運動，飲食也是非常重要的環節，因此佩特拉．布拉赫特博士也在書中提供了許多營養食材與食譜，配合上運動，更能有效對抗關節炎。其中我最喜歡的是冰沙，在重量訓練後來一杯，清涼又能補充大量為他命、礦物質、電解質。同時再來一杯乳清更棒了！
環境是最容易被忽略的地方
最後，最讓我感到佩服的是這本書提到了環境對於人體健康、關節退化與發炎的影響。這是大多數書籍忽略掉的關鍵點。
為什麼呢？因為你身處的環境、工作方式、生活方式，會主導你如何使用身體，而你使用身體的習慣，則會大大影響你的健康與疼痛。其中影響最大的便是寢室與工作場所，因此也是最需要好好調整的地方。這些觀念都和新的醫療研究不謀而合。
「動起來才能活得更美好」以及「久坐就是慢性自殺」是我最常告訴病人的兩句話，同時也是為什麼我要練得那麼壯的原因之一。難得看到坊間有推廣運動來克服關節退化與疼痛問題的書，就像遇到難逢的知己，我決定把它黏在我的槓片上！(誤)
合作撰寫：
好痛痛(粉絲頁連結)、郭仕政物理治療師(專欄連結)
註：本書由出版社贈書給物理治療師，但未干涉、影響本文的撰寫，好痛痛與合作物理治療師保有其獨立性。
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