聊運動傷害、動作品質，也聊FMS (by 謝小強教練)
這幾年台灣的運動風氣有慢慢變好，雖然還不及澳洲以及一些歐美國家，但是總是一件好事。做為一名體適能教練，最常被問的問題不外乎「哪一種運動最適合我？」、「做某項運動會不會傷膝蓋？」之類的。
你適合哪一種運動呢？
只要你沒有重大疾病、嚴重的肢體上的問題，基本上只要你喜歡、順眼的運動，都可以嘗試看看。因為現代人已經養成久坐的生活方式，椅子都快變成身體的一部份了，所以只要去運動，就算只是快走，都比坐著追劇還要好、還要強！
什麼？你說你都躺著追劇？那我也認了。
有些人選擇運動種類的其中一個考量是怕受傷，確實運動就會有受傷的風險，例如許多鋼琴音樂家是不願意打籃球的，深怕一個吃蘿蔔會影響到演出。除了這類型的考量，我認為不必太害怕受傷，怕受傷而不運動，反而長期來說讓整體健康衰弱的風險更大。
思考運動傷害這件事有兩個要點：一個是運動的種類、一個是運動時的強度。
如果你從事的是接觸性的運動，例如美式足球、拳擊之類的，那受傷機率一定會比較高。所以如果你是靠臉吃飯的朋友，那建議選擇不打臉的運動會好點。
再來我們聊運動的強度，相信大家都看過各種運動選手的受傷新聞，例如Kobe Bryant 的阿基里斯腱斷裂、Stephen Curry 腳踝嚴重扭傷、Tiger Woods 也傷過十字韌帶。什麼？連高爾夫球都會傷膝蓋，那我還是坐輪椅好了。但輪椅也可能傷到手，真心不騙。
其實有件事被忽略掉了，那就是他們是職業運動員，運動強度很大，訓練量也很大，因為他們都在討戰人體的極限，來獲得最好的成(ㄐㄧㄣ)績(ㄑㄧㄢˊ)。大家如果只是為了健康，不要過度拼命的話，其實沒那麼容易受嚴重傷害的。不過這當然和你身體本身的強度有關，強壯點比較不會因為小事情受傷，不過凡事總有很多不確定的地方。
運動和關節退化有沒有關係？
這個問題很難講，且和運動的方式、強度，每個人的狀況都有關。我認為以正確的方式去運動，增強肌力，並不會造成關節磨損和退化。甚至有更多的肌肉可以幫助你穩定關節、吸收關節衝擊力，讓關節更健康！
但更細節要如何運動，建議找物理治療師、專門教老人運動的教練來討論運動菜單。我們可以看一下羅一強物理治療師如何建議有退化性關節炎的年長者做哪些運動。
我會用FMS做運動前的評估
我個人蠻推薦使用 FMS (Functional MoveMent Screen) 功能性動作檢測作為運動前的身體評估方法之一，當然評估方法不是只有一種，只是這是我目前習慣且順手的。但FMS有些地方對我來說不太合用，稍後會說。
先來簡介一下 FMS ，最簡單的說法，就是一套可以知道你身體能不能好好做一個動作的評估。如果你關節活動不好，無法正常蹲下，那你說要去練深蹲，要練多好是不太可能的，就算硬做也很容易受傷。
因此 FMS 把身體運動時常見的動作拆開來分別檢測，主要看以下幾個項目：
- 身體的活動能力
- 身體的穩定能力
- 身體兩側對稱性
先確定你的身體能夠好好做一個動作，才能正確的去訓練那個動作。不好的例子是：肩膀活動不好，投球投不好，古老年代會叫你就多投幾次，投到變好為止。但通常手就壞掉了。
所以在現代我們應該去找出手和肩膀做不好的原因。原因通常分成兩種，一種是不會做，第二種是做不到。
不會做就多練習，如果是身體做不到，那就必須要找出身體出問題的地方在哪裡。是關節卡住了呢？還是穩定性不好？無法好好控制身體？
所以我們必須：
- 先確定關節有足夠的活動範圍
- 能夠良好的控制身體做出正確的動作，並且要穩定
- 再來才訓練動作
我重視動作現象大於分數
回到FMS，他利用一共十種測試，包含七的動作和三個排除動作，來知道你身體目前的狀況，細節可見下圖。然後使用0~3分來位這個動作打分數。3分表示做得很完美，2分表示做得到，1分表示做不到，0分表示做的過程會痛。
但我自己對這個評分方式並不滿意，我認為更重要的是「現象」而不是分數。你做一個動作過程中發生了哪些現象是我更在意的事。這些現象包括：
1, 動作是否對稱？
例如過頭深蹲時是否一邊太傾斜，或是弓箭步時其中一邊膝蓋太歪。這些動作可能一樣都是評為2分，但是背後隱含的意義大不相同。
2, 你如何穩定軀幹的方法？
例如四肢旋轉穩定性測試或是躺姿抬單腳(ASLR)時，有沒有用其他憋氣、拱腰、聳肩的代償。
3, 肩部跟髖關節的交互關係。
手舉不高時是不是因為髖部的穩定度不佳，反過來說腳抬不高時有沒有可能是因為肩膀卡住的關係? 這些狀況除了分析檢測結果之外，我也常常用SFMA(精選功能性動作評估)、NKT(神經動能療法)等方法做進一步的確認。
現階段 FMS 並無法滿足所有的運動，也無法滿足所有的人，但是對於想要練健康的人來說已是相當足夠。而且對於物理治療師與運動教練來說，是一個還不錯的溝通橋樑。
以上就是我今天想和大家分享的。第一，做你喜歡做的運動，有動比沒動好，而且你不會那麼容易受傷。第二，先確定你的身體可以做到一個動作，穩定、正確的做，再去要求力量以及技術，長遠來說對身體是比較好的！
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