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如何治疗肌筋膜炎？什么是软组织肌肉松解术？
&& 松解肌筋膜的局部粘连，是消灭肌筋膜炎MPS的触痛点的基本技术，Patrick认为针刺的关键是对疼痛触发点的机械性破坏而不在于注射什么药水，并主张注射时让针尖在局部反复探索分离组织，机械性破坏疼痛触发点。
&& 慢性疼痛疾病中有85%的病人原发或继发肌筋膜炎CMPS：如症、椎间盘突出症、颈椎病、后支综合征、骨性或强直性脊柱炎等。解除肌筋膜部分的疼痛是整个治疗计划中的一个重要部分,为此在治疗开始前要明确诊断和做好治疗计划并使病人理解。老年人或全身多部位肌筋膜炎或体弱者，往往伴发有高血压、、心肺脑血管、精神或心理疾病，应该予以计划性综合治疗。
&& 目前能用于肌筋膜炎MPS的的治疗方案：
&&&& 1.直接切开或剥离肌筋膜疤痕点的小针刀疗法&&
& && 2.在刺入的针杆上加艾绒燃烧使针道的细胞蛋白凝固和毛细血管长入的密集型温质针治疗。&&
&& &&3.更为精确微创的射频热凝疗法，尤其适合颈部或臀部等含有重要神经的部位的肌筋膜松解治疗&&&&
&&& &4.起到水压分离作用的痛点注射生理盐水法（川枝疗法）&&&
&&&&&5.可发挥溶解局部结蒂组织功用的类固醇注射法（封闭疗法）。
我疼痛目前针对肌筋膜炎的几类主要微创治疗手段，结合超声引导实时动态治疗过程（提高治疗到位率，降低治疗创伤及风险):
&&&&& 射频热凝肌肉松解术：仪器将一束约300KHZ的高频率电流通过电极，使电极周围组织中的离子振荡质点相互磨擦产热，在组织内形成所需范围的蛋白凝固灶而发生局部细胞毁损。我们应用射频针到达和热凝肌筋膜炎的触痛点，达到分离组织粘连、松解挛缩和促进局部组织血流供应的作用类似密集型温质针而没有其环境污染的缺点。射频仪还可以调节射频输出功率的大小和时间，精确控制局部组织加热的温度、时间、热凝的程度和范围，可烧灼局部增生的末梢神经。仪器具有的神经刺激功能可辨别针尖所在组织的性质和针尖周围至少3CM以内的重要神经，尤其适合在含有重要神经的肌筋膜区域如梨状肌区、椎间孔附近和大腿根部等处的治疗。康复后注意教育病人纠正不良姿势和加强肌肉锻炼以减少MPS复发。射频松解技术因其灵活可控，能较好适应各个病人的具体情况，当治疗期间出现不舒服时可随时中止操作。因此，射频治疗CMPS，具有镇痛好和可控性的优点，显示了良好的疗效而没有严重副作用。
&& 小针刀：小针刀是一把形状象银针，但针干较粗且针尖为0.8cm宽的刀刃。在70年代由江苏金陵骨伤科医生朱汉章发明，能有效切开或剥离局限性软组织的粘连或小结节。与以往针灸不同之处是小针刀的治病机理除了有经络刺激调整作用外，更多的是用于解剖学上肌筋膜粘连的分离。小针刀首先是机械刺激和分离，使局部组织活动能力加强和淋巴循环加快，局部被切开的疤痕组织被吸收。因其简单易用，在国内曾推广很快。但小针刀治疗是一种闭合性手术，在一些含有重要神经血管或器官的部位，如颈椎、梨状肌或跟腱等部位要慎用。我科结合超声实时引导治疗过程，大幅度降低了微创盲视治疗所面临神经血管损伤风险。
&& 密集型温银针：60年代，上海骨科医师宣哲人作了大量的慢性肌筋膜痛剥离手术，因为创伤太大不容易被病人接受。宣氏在其丰富的骨科肌筋膜分离手术经验上，受中医经络温针疗法启发，他在在原来需要手术的病变肌筋膜区域密集下银针，针尾点燃艾球加温，针身温度大于100℃，在病人体表是55℃，在体内针尖部是48℃,肌筋膜与骨面粘连处的组织细胞发生蛋白凝固达到分离的目的。密集刺入的温质针代替手术分离粘连肌筋膜，新生的微血管从针孔处长入，对急性和慢性MPS均取得治愈率90.6%,1-4年的复发率6.5%的优异疗效。密集型温银针治疗后的病变区局部组织血流增加50-150%,1个月后仍增加20-40%，局部温度增加1.14℃，形成了以温针针道为中心的圆柱形热传导生物反应区，加温60℃和70℃的热反应区最大面积是半径2.4mm和2.8 mm，不但保持正常骨骼肌血供途径还能促进新生毛细血管长入肌筋膜，改善肌肉血液供应。他认为针刺并加热时在病变组织的肌筋膜与骨膜中具有深部的热疗效应，可消除骨骼附着点的软组织原发性炎症反应，温质针的镇痛机理可能类似激光打孔治疗心肌梗死。在搭桥手术也不能逆转的难治性心肌梗死心绞痛病人中，坏死心肌被激光打孔血液灌注针孔致使心肌再血管化,术后6个月仍有68%的孔道开放。
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软组织，肌肉筋膜炎。。。
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&&足底筋膜炎是一种常见运动损伤，主要表现为足底靠近足跟处疼痛。一般健身人群、专业运动员以及中老年人为高发人群，在剧烈的跑跳运动中，足跟处的疼痛尤为明显。&&这样一种损伤&&究竟是如何产生的呢？&&&&我们知道，足的结构就像一张弓，骨骼构成了弓背，连接各骨之间的肌肉、韧带、筋膜、皮肤则共同构成了弓弦。在运动中，尤其在前脚掌蹬地发力或落地缓冲的时候，冲击力经过前脚掌传导到脚心、脚跟及踝关节，此时弓弦应迅速拉紧以保证弓背结构的稳定。在这个过程中，如果肌肉不能高效协同发力，其他软组织就会承担更大的牵拉力，在各个结构中，皮肤的弹性最好，韧带的强度最高，只有足底筋膜相对脆弱，也就最容易发生损伤。对于运动损伤，需要以彼之道还施彼身，运动疗法就是最好的应对手段。&&&&对其他软组织的&&放松和牵伸&&&&足底筋膜炎一旦发生，一切涉及前脚掌发力的动作都会造成疼痛，疼痛的部位往往就是筋膜损伤的部位。为了防止损伤愈合过程中的瘢痕挛缩，先要对损伤周围软组织进行温和的放松，将一个网球踩在脚下前后柔和滚动就有不错的效果。&&&&整体、全面的肌肉功能训练&&&&只有被动的牵拉还是不够，上面说到了，足周小肌肉是协同发力保护足底结构的重要环节。用脚趾用力抓毛巾、踝关节屈伸翻转的抗阻运动、患侧单足在软垫子上的平衡站立等手段，对于强化足周小肌肉群的功能有很好的效果。这些练习方式安全性高、效果好，认真练习可以强化下肢力量与稳定，能够有效防止损伤的发生。&&&&细致入微的全面运动保障&&&&对于运动者来说，合适的运动装备必不可少。在运动中，穿着合体的运动服装可以有效减少运动时来自体外的额外阻力。对于下肢存在损伤或隐患的人来说，盲目运动反而可能造成新的损伤，这个时候，也可以适时适度地依靠一些辅助性护具，在运动中有效分担下肢压力。&&中老年人群可能患有骨质疏松症，在散步和其他户外活动中使用专用步行杖或普通手杖助行也是一种很好的选择，可以迅速减轻下肢负荷，降低下肢劳损的风险。这样还可以将单一的下肢运动转化为全身运动，从而调动起更多的肌肉，还有更好的锻炼效果。&&&&&&&&&(李佳/整理)
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今日生活报筋膜健康：神经肌腱膜网络训练-未来健身的大趋势（毕义明博士原创）
Fascial Fitness: Training In
The Neuromyofascial Web
筋膜健康：神经肌腱膜网络训练-未来健身的大趋势
Research shows why taking a
different approach to exercise and the movement brain is the wave
of the future.
肌筋膜训练法
If you are interested in the
role of fascia in fitness training, the following questions lead to
new take-aways:
假如你对筋膜在健身训练中的作用感兴趣，下面几点你可以思考一下：
Most injuries are
connective-tissue (fascial) injuries, not muscular injuries—so how
do we best train to prevent and repair damage and build elasticity
and resilience into the system?
There are 10 times more sensory
nerve endings in your fascia
therefore, how
do we aim proprioceptive stimulation at the fascia as well as the
Traditional anatomy texts of
the muscles and fascia are inaccurate, based on a fundamental
misunderstanding of our movement function—so how can we work with
fascia as a whole, as the “organ system of stability”?
大多数的损伤是结缔组织（筋膜）损伤，而不是肌肉损伤-那么我们如何才能通过训练来防止和修复伤害，如何重新建立筋膜系统的弹性呢？
筋膜中的感觉神经末梢的数量是肌肉中的10倍，那么我们如何才能像训练肌肉的本体感觉训练一样，训练筋膜的本体感觉呢？
传统的解剖学课本上关于肌肉和筋膜的解释是不正确的，进而我们现在的建立于此基础上的对于运动的理解也是不正确的-那么，我们如何才能以整体的观点来看待肌筋膜呢？这是一个“身体的稳定性器官”
Consciously or unconsciously,
you have been working with fascia for your whole movement career—it
is unavoidable. Now, however, new research is reinforcing the
importance of fascia and other connective tissue in functional
training (Fascia Congress 2009). Fascia is much more than “plastic
wrap around the muscles.” Fascia is the organ system of stability
and mechano-regulation (Varela & Frenk 1987). Understanding
this may revolutionize our ideas of “fitness.” Research into the
fascial net upsets both our traditional beliefs and some of our new
favorites as well. The evidence all points to a new consideration
within overall fitness for life—hence the term fascial
fitness. This article lays out the emerging picture of the
fascial net as a whole and explores three of the many aspects of
recent research that give us a better understanding of how best to
train the fascial net.
无论是有意识的还是无意识的，你在整个运动过程中都会使用到筋膜，这是不可避免的。现在，更多的研究都再次表明了筋膜和其他结缔组织在功能训练中的重要性（Fascia
2009）。筋膜不仅仅是“肌肉的弹性紧身衣”，筋膜是一个关于稳定性机械规律性的器官系统。理解这一点也许会革命性的对我们对于健康概念的认识-“筋膜健康”。
The Neuromyofascial
神经肌筋膜网络
Fascia is the Cinderella of
body tissues—systematically ignored, dissected out and thrown away
in bits (Schleip 2003). However, fascia forms the biological
container and connector for every organ (including muscles). In
dissection, fascia is literally a greasy mess (not at all like what
the books show you) and so variable among individuals that its
actual architecture is hard to delineate. For many reasons, fascia
has not been se therefore we have been
ignorant of fascia’s overall role in
biomechanics.&
筋膜就像身体上的灰姑娘-一直受我们的忽视，被分离掉或在解剖中直接删除掉。但事实上筋膜是我们身体每一个器官（包括肌肉）的容器和连接线。在解剖中，筋膜实际上是一个滑滑的，像充满油脂一样的“东西”（完全不像书上告诉我们的）。筋膜在不同人身上也是不一样的，而且是一个用语言很难描述出性状来的“东西”，因此我们对于筋膜在生物力学方面的作用一直没有重视。
Thankfully, the integrating mechano-biological nature of the
fascial web is becoming clearer. It turns out that it really is all
one net with no separation from top to toe, from skin to core or
from birth to death (Shultz & Feitis 1996). Every cell in your
body is hooked into—and responds to—the tensional environment of
the fascia (Ingber 1998). Alter your mechanics, and cells can
change their function (Horwitz 1997). This is a radical new way of
seeing personal training—stretching, strengthening and
shape-shifting—as part of “spatial medicine” (Myers
谢天谢地，筋膜网络的整体机械-生物特性逐渐被人们所认清。这个网络是完整的、从头到脚、从皮肤到核心、从生到死没有间断的。我们身体中的每一个细胞都是在筋膜的张力环境下相互连接、相互反应的。改变身体的生物力学，细胞就会改变其功能。这个概念让私人教练的工作-拉伸、力量和形体训练有了新的意义-“空间医药”
Given the facts, many would prefer the term neuromyofascial
web to the fascia-dissing musculoskeletal system
(Schleip 2003). As accustomed as we are to identifying individual
structures within the fascial web—plantar fascia, Achilles tendon,
iliotibial band, thoracolumbar aponeurosis, nuchal ligament and so
on—these are just convenient labels for areas within the singular
fascial web. They might qualify as ZIP codes, but they are not
separate structures (see the sidebar “Muscle Isolation vs. Fascial
Integration”).
You can talk about the
Atlantic, the Pacific and the Mediterranean oceans, but there is
really only one interconnected ocean in the world. Fascia is the
same. We talk about individual nerves, but we know the nervous
system reacts as a whole. How does fascia webbing function as a
我们会说出很多大海的名字，“大西洋”“太平洋”“地中海”，但无论是哪个海洋，实际上都是连接在一起的，实际上整个地球上的水流都是一体的，只有一个海洋。筋膜也是一样的，筋膜网络是一个整体的，肌肉会通过收缩来分配整个筋膜的张力调整，内脏器官就像是悬挂在该系统内的水母，甚至身体内的每一个细胞都是镶嵌、悬挂、被包裹与该系统内的”小鱼“
Magically extracted as a whole,
the fascial web would show us all the shapes of the body, inside
and out. It would be just one big net with muscles squirming in it
like swimming fish. Organs would hang in it like jellyfish. Every
system, every organ and even every cell lives embedded within the
sea of a unitary fascial net.
This concept is important
because we are so strongly inclined to name individual structures
and think that way clinically: “Oh, you tore your biceps,”
forgetting that “biceps” is our conception. Our common scientific
nomenclature gives a false impression, while the New Age shibboleth
is more literally true: the body—and the fascial net in
particular—is a single connected unity in which the muscles and
bones float.
身体-尤其是筋膜-是一个统一的连接体，肌肉和骨骼是漂浮于其中的
You can tear this net in
injury, cut it with a surgeon’s scalpel, feed and hydrate it well
or clog it with high-fructose corn syrup. No matter how you treat
it, it will eventually lose its elasticity. In your eye’s lens, for
instance, the net stiffens in a very regular way, requiring you to
use reading glasses at about age 50. In your skin, the net frays to
cause wrinkles. Key elements like hip cartilage may fail you before
you die, and need replacement, but when you finally breathe your
last breath your fascial web will still be the same single net you
started with.
It’s no small wonder that this system, like the nervous and
circulatory systems, would develop complex signaling and
homeostatic mechanisms (Langevin et al. 2006). The larger wonder is
that we have not really seen or explored the connective-tissue
system’s responses until now.
A Definition of
In medicine, the term fascia
designates tissues with specific topology and histology, as
distinct from tendon, ligament or other specified tissues. In this
article, however, we are using fascia as an overall name for this
systemic net of connective tissue, because there is no generalized
term (Huijing & Langevin 2009). Connective tissue includes the
blood and blood cells, and other elements not part of the
structural net we are examining. Perhaps the closest term would be
extra-cellular matrix (ECM), which includes everything in
your body that isn’t cellular (see Figure 3). The ECM has three
main elements:
也许給与筋膜最贴切的名字是细胞外基质（ECM），它是指身体中除细胞之外的任何事情，主要包括三类：
fibers: the strong
pliable weave—consisting primarily of collagen (which has 12
types) and its cousins elastin and reticulin—that both
separates compartments and binds them together
glue: the variable and
colloidal gels like heparin, fibronectin and hyaluronic
acid that accommodate change and provide the substrate for
other cells like nerves and epithelia
water: the fluid that
surrounds and permeates the cells as
with the glue to make materials of
the fibers wet and pliable
纤维：是一种强韧柔软的编织物-主要有胶原质、弹性蛋白、网状蛋白组成-他们彼此隔开但又绑在一起。
胶合物：是指各种的像胶水一样的物质，如肝磷脂、纤维连接蛋白、玻尿酸等，他们会适应变化，并为其他细胞（如神经细胞、上皮细胞等）提供基质。
水：围绕和渗透于细胞的液体，它承担这交换媒介的作用；与胶合物结合让筋膜呈现出不同的特性，保持纤维的湿润和柔软。
Though the ECM will be our
topic just below, the term fascia as we define it also includes
fibroblasts and mast cells, which give rise to the
fibers and glue and then remodel them in response to the demands of
injury, training and habit.
筋膜还包括成纤维细胞和肥大细胞，他们会引发纤维和胶合物的再调整，来面对受伤、训练和运动生活习惯的需要
The principal structural
element in the ECM comprises the fibers collagen, elastin and
reticulin. Collagen is by far the most common of these, and by far
the strongest. This is the white, sinewy stuff in meat. The
collagen fib if it was a half-inch thick, it
would be about a yard long and look like an old three-strand rope
(Snyder 1975). Collagen fibers can be arranged in regular
directional rows, as they are in tendons or ligaments (dense
regular), or in random crisscross ways, like felt (dense or loose
irregular).
细胞外基质的主要组成部分是纤维胶原质、弹性蛋白和网状蛋白，其中胶原质是最主要的，也是最强壮的。在肉中发白的、像腱状的就是它。它是一种三链螺旋结构，假如它有半英寸粗的话，它将会有一英里长，就像跳3股的大绳子。胶原质可以是排列整齐的，如韧带或肌腱（密集而有规律）；也可以自由的交错排列，就像粘结一样（稠密或疏松，但无规律）
The collagen fibers cannot
actually stick to each other but are glued together by other
proteins called glycoaminoglycans (GAGs), which are
mucopolysaccharides, both of which are long words for snot.
We are held together by mucous, a colloidal substance, which, by
varying its chemistry slightly, can display a surprising array of
properties, from thick and sticky to fluid and lubricating. The
fernlike molecules of mucous open to absorb water (they are
hydrophilic) or close and bind to themselves when water is absent.
Depending on their chemistry, they either bind layers together or
allow them to slide on each other (Grinnell 2008).
纤维胶原质是不能彼此相连的，除非胶状物将他们连接在一起，这些胶状物叫做粘多糖。我们的身体使用这种胶状体粘结在一起的。这些胶状物会通过他们化学成分的细微改变，而展示出惊人的特性的改变，从固态到液态、从黏着到润滑。这些胶合物的羊齿状分子会在水分充足的情况下打开吸收水分或当水分不足的时候关闭和分子间彼此捆绑。通过他们的化学成分的变化，他们既可以使筋膜层之间见胶着，又可以使各层之间相互滑动。
The phenomenon we call
“stretch” or lengthening (and that scientists call “creep” or
hysteresis) is a function not of the collagen fibers lengthening
but of the fibers sliding along each other on the glue of the
hydrated GAGs (Sbriccoli et al. 2005). Take the water out of the
GAGs, and the result is tissue that is mightily reluctant to
stretch (Schleip 2003).
我们所谓的伸展或拉长现象，其实不是纤维胶原质被拉长，而是纤维之间产生滑动，但前提条件是粘多糖必须是多水的；但粘多糖缺水的时候，纤维就会黏着在一起，不容易产生伸展。
Most injuries occur when
connective tissue is stretched faster than it can respond. The less
it is hydrated, the less elastic response it has in it.
大多数的损伤的发生就是发生在伸展的过快，超出了身体可反映的时间。以及当粘多糖缺水，身体的弹性反应亦会变差。
The Body Electric?
Connective-tissue cells produce the fibers and the GAGs, and these
materials are then altered to form a remarkable variety of building
materials. If you were to try to recreate your structural body out
of items you could buy at Home Depot&, what would you need? Wood or
PVC for the bones, silicon rubber for the cartilage, lots of
string, wire, tubing, plastic sheeting, rubber bands, cotton, nets,
grease and oil—the list goes on. Would you try to build a body
without duct tape?
Your body manufactures all
these materials and many more by mixing together various
proportions of the ECM’s fibers and glue and altering the chemistry
in different ways (Snyder 1975). In bone, the fiber matrix is
there—much like leather—but the mucousy ground substance has been
systematically replaced with mineral salts. Cartilage has the same
leathery substrate, but the glue has been dried into a tough but
pliable “plastic” that permeates the fibrous leather. In ligament
and tendon, almost all the glue has been squeezed out. In blood and
joint fluid, the fiber exists only in a liquid form, until it hits
the air, when it forms a scab. This manufactory in your body is
fascinating: the dentin in your teeth, your gums, your heart
valves, even the clear cornea of your eye—are all formed in this
Remodeling and
Tensegrity&
重构与张拉整体结构
Your muscles may determine your shape in the training sense, but
connective tissue determines your shape in the overall sense. It
holds the bones together, pulling in on them as they press out
(like see Figure 2).
The ECM is capable of
remodeling itself in a variety of ways (Chen et al. 1997). Just as
your muscles remodel themselves in response to training, the fascia
remodels itself in response to direct signaling from the cells
(Langevin et al. 2010); injury (Desmouli`ere, Chapponnier &
Gabbiani 2005); long-held mechanical forces (Iatrides et al. 2003);
use patterns (including emotional ones); and certain
chemistry within your body (Grinnell & Petroll 2010). The
complexities of remodeling are just now being
the details will be revealed over the coming decade.
The idea of tensegrity
(tension and integrity) and the phenomenon of remodeling are the
basis for structural therapy, including yoga and the forms of
manual therapy commonly known as Rolfing& or Structural Integration
and its deep-tissue relatives, including foam rolling. Change the
demand—as we do in bodywork and personal training—and the fascial
system responds to that new demand. This common theme points to a
future where manual therapy and movement training combine to form a
powerful method for
张拉整体结构和重构理论是现在身体结构治疗方法的基础，其中包括瑜伽和其他形式的手法治疗，比如”罗夫按摩“或”结构整合“、深层组织疗法。在我们做身体疗法和私教训练的时候，我们需要改变思维和目标，这两者一定要结合起来形成一种更强大的方法-肌筋膜疗法，它能够让我们获得：
restoring natural settings for
steering small problems away
from developing in
easing the long-term
extending functional movement
farther and farther up the age scale.
恢复身体姿态与功能的自然设置
在细小的问题变为大问题之前就将其”扼杀在摇篮之中“
改善源于损伤的长期的慢性问题
发展在患者其年龄阶段内的功能动作水平
How to Train the
Neuromyofascial Web
如何才能训练神经肌筋膜网络呢
If the fascia is a singular
space-organizing adjustable tensegrity that traverses the whole
body and regulates—both locally and as a whole—the biomechanics of
tension and compression, we can then ask: How can we train this
system, in conjunction with our work on muscles and neural control,
to prevent and repair injury and build resilience into the
The answer to this question is
still developing—rapidly—both in the laboratory and on the training
floor. Some research is confirming our images and practices as they
have developed and are traditionally applied. Here we focus on a
few surprising sets of findings that are (or soon will be) changing
our ideas of how the neuromyofascial web really works and what role
connective tissue plays in developing overall fitness for
Finding #1:Specific training
can enhance the fascial elasticity essential to systemic
resilience.
发现1：特殊的训练可以加强筋膜的弹性能力
Fascial elasticity has not been
recognized until recently, and the mechanisms involved are still
being studied (Chino et al. 2008). Nevertheless, applications to
training are already evident. The basic news is that connective
tissue—even dense tissues like tendons and aponeuroses—is much more
significantly elastic than previously thought. The second essential
part of that news is that fascial elasticity is stored and returned
very quickly. In other words, it is more like a superball than a
Nerf& ball. Thus, fascial elasticity is a factor only when the
motion is cyclic and quickly repeated, as in running, walking or
bouncing, but not as in bicycling, in which the repetitive cycle is
far too slow to take advantage of fascia’s elastic
properties.
身体的结缔组织，如肌腱和腱膜，要比过去想想的更加具有弹性。
第二个发现是筋膜弹性的储存和恢复非常快速。换句话说，他们更像橡胶球，而不像玻璃球。
筋膜的弹性只会发生在循环和快速重复的动作中，如跑步、走路和弹跳等，但自行车不会，因为这个循环动作太慢了，以至于筋膜的弹性根本用不上。
Measurements of calf
lengthening during running have shown that much of the length
required for dorsiflexion is coming from an elastic stretch of the
fascia, while the muscle is contracting isometrically (Kubo et al.
2006). This contradicts our previous understanding that the tendon
was nonelastic, and that the muscles were lengthening and
shortening during these cyclic motions prior to and following
在跑步中测量足背屈时小腿三头肌拉长的长度，这个长度只能说明是筋膜拉长的长度，而肌肉此时只在等长收缩。这个事实完全颠覆了我们过去对于肌肉和筋膜的理解-肌腱是没有弹性的，是肌肉的拉长和缩短产生了运动！
The runners who train for and
employ more of this elasticity will be using less muscle power
(read: less glucose) during their runs, as they are storing energy
in the stretch and then getting it back during the release. Thus,
they will be able to run longer with less fatigue.
经过训练的会使用筋膜弹性的跑者会在跑步中更加节省肌肉能量（糖原），因为筋膜的弹性是不需要能量的，所以他们的疲劳会比别人更加推迟。
Building in this elasticity is
a matter of putting a demand on the tissues to act in this way.
Doing this slowly (compared with muscle training) is a definite
attribute of fascial training (it may take 6&24 months to build
fascial elasticity).
What’s in:
要建立这种的筋膜弹性，我们就必须让筋膜以这种形式来工作。这项工作可能要比肌肉训练来的更满意点，可能需要6-24个月的时间：
Bouncing. When you land
on the ball of your foot, you decelerate and accelerate in such a
way that you not only make use of but actually build elasticity
into the tendons and entire fascial system. The best training
effect seems to follow the pleasure principle: feel for that sense
of elegance, an ideal resonance with minimum effort and maximum
Preparatory
Countermovement. Preparing for a movement by making a
countermovement—for example, flexing down before extending up to
standing, winding up before a pitch, or moving the kettlebell
toward the body before moving it away—makes maximum use of the
power of fascial elasticity to help make and smooth out the
弹跳：当你脚前掌着地的时候，你的减速和加速不但是利用了筋膜的弹性，而且是加强的肌腱和整个筋膜系统的弹性。为了达到最佳训练效果必须遵循的原则：去感受其中的优雅-最少的用力和最大的轻松！
准备性反向运动：通过预先的反向运动为目标运动做准备-欲擒故纵-向前先向后，向左先向右，充分利用筋膜的弹性
What’s out:
Jerky Movements and Abrupt
Changes of Direction. Imagine jumping rope but landing only on
your heels. The stress on all your systems would be enormous, and
you would not build elasticity into the fascial system.
Big Muscle Demand for
Push-Off. Using the fascial elastic recoil lessens the demand
for huge muscle effort during push-off, making movement more
controllable, less arduous and less fuel-consumptive.
Finding #2: The fascial
system responds better to variation than to a repetitive
发现2：筋膜系统更倾向于不同的计划，而不是一成不变的计划
The evidence suggests that the
fascial system is better trained by a wide variety of vectors—in
angle, tempo and load (Huijing 2007). Isolating muscles along one
track (e.g., with an exercise machine) may be useful for those
muscles but is less than useful for all the surrounding tissues.
Loading the tissue one way all the time means it will be weaker
when life—which is rarely repetitive—throws that part of the body a
curve ball.
What's in:
Whole-Body Movements.
Engaging long myofascial chains and whole-body movements is the
better way to train the fascial system.
全身运动：应用肌筋膜链和全身动作是更好的训练及筋膜系统的方法
Proximal Initiation.
It’s best to start movements with a dynamic pre-stretch (distal
extension) but accompany this with a proximal initiation in the
desired direction, letting the more distal parts of the body follow
in sequence, like an elastic pendulum.
中央起始：做动作的时候尽量以近端来发力，远端只是随着近端的意图进行随之摆动
Adaptive Movement.
Complex movement requiring adaptation, like parkour (see the
beginning of the James Bond movie Casino Royale for a great
example), beats repetitive exercise programs.
What's out:
Repetitive Movement.
Machines (or minds) that require clients to work in the same line
again and again do not build fascial resilience very
Always Practicing With
Upper-Level Loads. Variable loads build different aspects of
the fascia. Sticking with near-limit loads will strengthen some
ligaments but weaken others. Varying the load is the better
Always Training in the Same
Tempo. Likewise, varying the tempo of your training allows
different fascial structures to build strength and
elasticity.
Finding #3:The fascial
system is far more innervated than muscle, so proprioception and
kinesthesia are primarily fascial, not muscular.
发现3：肌筋膜系统要比肌肉含有更加丰富的感觉神经末梢，所以我们练习本体感觉的重点应该是筋膜，而不是肌肉
This is a hard concept for many
fitness professionals to get their heads around, but it is a fact:
there are 10 times as many sensory receptors in your fascial
tissues as there are in your muscles (Stillwell 1957). The muscles
have spindles that measure length change (and over time, rate of
length change) in the muscles. Even these spindles can be seen as
fascial receptors, but let’s be kind and give them to the muscles
(Van der Wal 2009). For each spindle, there are about 10 receptors
in the surrounding fascia—in the surface epimysium, the tendon and
attachment fascia, the nearby ligaments and the superficial layers.
These receptors include the Golgi tendon organs that measure
load (by measuring the stretch in the fibers), paciniform
endings to measure pressure, Ruffini endings to inform
the central nervous system of shear forces in the soft tissues, and
ubiquitous small interstitial nerve endings that can report
on all these plus, apparently, pain (Stecco et al. 2009; Taguchi et
al. 2009).
筋膜中包含的神经末梢是肌肉中的10倍，其中包括高尔基腱器官（感受肌纤维牵张）、帕西尼小体（感受压力）、鲁夫尼小体（感受剪切力）和间隙神经末梢（感受上述所有，尤其是疼痛）
So when you say you are feeling
your muscles move, this is a bit of a misnomer. You are “listening”
to your fascial tissues much more than to your muscles. Here are
three interesting findings that go along with this basic
eye-opener:
Ligaments are mostly arranged
in series with the muscles, not in parallel (Van der Wal 2009).
This means that when you tense a muscle, the ligaments are
automatically tensed to stabilize the joint, no matter what its
position. Our idea that the ligaments do not function until the
joint is at its full extension or tor for
example, ligaments function all through a preacher curl, not just
at the ends of the movement.韧带在动作启动的时候就开始动用，而不是在动作的末端
Nerve endings arrange
themselves according to the forces that commonly apply in that
location in that individual, not according to a genetic plan, and
definitely not according to the anatomical division we call a
muscle. There is no representation of a “deltoid” inside your
movement brain. That’s just a concept over in your cortex, not in
your biological
organization.肌肉不懂得单独的肌肉是什么，他所懂得是肌筋膜系统张力的调整来使用身体内部或外部的需求，肌肉收缩只是该张力调整的一部分。所以单块肌肉的收缩，对于大脑的功能性支配是没有任何意义的
Apparently, sensors in and near
the skin are more active in detecting and regulating movement than
the joint ligament receptors (Yahia, Pigeon & DesRosiers
皮肤及附近的神经在感受和调节运动中所起的作用要比韧带大得多。
What's in:
Skin and Surface Tissue
Stimulation to Enhance
Proprioception.&
皮肤和组织表面的刺激会增强本体感觉
Rubbing and moving the skin and
surface tissues is important to enhance fascial proprioception. One
weightlifter is having good results scrubbing himself with a
vegetable brush before going into competition.
Directing Clients to Feel
Their Fascial Tissues. 引导客户感知他们的筋膜系统Taking attention—your own
and your client’s—away from the muscles and putting it into the
surrounding fascial tissues can help prevent injury and make the
perception of kinesthesia more accurate and fully informed.
Sensuous body activity coupled with a high level of kinesthetic
acuity (think: cat) may prevent injury better than being
What's out:
Isolated Muscle
Orientation. Exercising a single muscle or muscle group is
every exercise is stimulating multiple nerves,
involving multiple muscles and employing fascial tissues all around
the site of effort, as well as “upstream” and “downstream” from
Joint-Receptor Emphasis.
Given that the ligaments are often tensed by the muscles, the
emphasis on joint receptors—while important—needs to be replaced
with a more general attention to the whole area, from the skin on
This discussion has focused on
b it has omitted nutritional and humoral
considerations, as well as constitutional differences in fascia,
which have recently come up for study. A deeper understanding of
the role of fascia in training changes your perspective, your work,
your words and your effect. Fascia is not just cling
For the latest research,
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Sidebar: Muscle Isolation Vs.
Fascial Integration
单块肌肉收缩与筋膜整体性
Most fitness professionals have
studied muscle function in isolation. Essentially, Western
kinesiological anatomy asks: What would the action of the biceps be
if it were the only muscle on the skeleton? Left to itself, the
biceps is a radio-ulnar supinator, an elbow flexor and some kind of
weak diagonal flexor of the shoulder. When we have that down, we
imagine we understand the biceps and what it does. That is one way
of looking at it.
大多数的教练或专家都会研究孤立肌肉的功能，那么，肱二头肌的功能是什么呢？假如他只是”一块“连接在骨骼上的肌肉，那么它会屈肘、肘外旋，还能有一小部分的屈肩功能，这只是我们对它的一小部分认识，但还远远不够。
The only thing is, the biceps
never works in isolation. Isolating muscles to study their function
is the very opposite of integration and holism. What is the
practical difference? Studying the muscle solo leaves out four
vital fascial factors in daily muscle function:
因为肱二头肌永远不会孤立工作
The Effect From and on
Neighboring Medial or Lateral Muscles. The biceps has
force-transmitting fascial connections with the coracobrachialis,
the brachialis and the supinator and even across the septa into the
triceps. These fascial connections affect the functioning of the
biceps and the arm (Huijing 2007).
肌肉的功能是建立和起始与其周围肌肉上的。肱二头肌的张力会传递与喙肱肌、肱肌、旋后肌，甚至跨过肌间隔到达肱三头肌
The Effect From and on
Muscles That Are Connected Proximally and Distally. The biceps
has connections distally with the interosseous membrane and the
fascia around the radius, as well as the bicipital aponeurosis into
and proximally with the pectoralis minor and
supraspinatus via the short and long head respectively (see Figure
1) (Myers ).
肌肉的功能会建立在”肌筋膜链“的近端和远端。肱二头肌远端会连接于前臂骨间膜、桡侧骨膜、肱二头肌腱膜（与前臂屈肌相连）；近端与胸小肌和冈上肌相连
The Effect Muscle
Contraction Has on Local Ligaments. Contracting the biceps
exerts a stabilizing influence on the ligaments of both the
shoulder and the elbow. Our assumption that ligaments are arranged
in parallel to the muscles is an incorrect one. Most ligaments are
dynamically integrated with the muscles in series so that muscle
contraction helps the ligaments stabilize the joint at all angles
(Van der Wal 2009).
肌肉的功能与韧带的固定相呼应。肱二头肌的收缩会激活肩关节与肘关节韧带的稳定。我们之前认为肌肉与韧带的串联形式是不对的。大多数的韧带都会与肌肉动态相连，在肌肉激活的时候韧带也会激活，来为止关节角度的稳定。
The Fact That Every Muscle
Has to Be Supplied by Nerves and Blood Vessels. These “wires
and tubes” arrive encased in a fascial sheath. If this sheath is
twisted or impinged, or if it becomes too short through bad
posture, muscle function is affected (Shacklock 2005)
每条肌肉都需要神经与血管的供应。神经和血管都会镶嵌和穿过于筋膜鞘，假如这层筋膜鞘扭曲或挤压，或由于不良姿势而变得过短，肌肉的功能会受影响。
Sidebar: Figure 1. Deep Front
Arm Line 手臂前伸线
Anatomy Trains maps out fascial connections
that link single muscles--like the isolated biceps shown in the
sidebar--into functional wholes.
以上所讲的肱二头肌的功能，其实就是肱二头肌在手臂前伸线中所起的作用。
Sidebar: A Few Of The Many
Forms Of Fascia
This article uses the
generalized term fascia to denote the interconnected net of fibers
and glue. A. Two muscles held together by “fuzz”—areolar
tissue. B. The “strapping tape” nature of the fascia
covering the quadriceps. C. (courtesy of Dr. J-C Guimbertau)
The very delicate, gluey tissue that allows change and movement
beneath our skin, between our muscles, and anywhere anatomical
structures have to slide on each other.
Sidebar: Figure 2.
Tensegrities
Once you understand the fascial
system as a whole, rather than as a series of parts, the body
presents itself as an animated version of a tensegrity
(“tension-integrity”) (Fuller 1975). The struts are like the bones,
pushing out, and the fascial net is like the strings or membranes,
pulling in. The whole thing achieves a balance we call “shape.” It
is now evident that our bodies work this way cellularly as well as
on the macro level (Ingber 2008). Of course, our human tensegrity
is animated by our nervous systems, and is very adjustable via the
muscles, but exploring the properties of these structures in terms
of our bodies is worthwhile.
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