Ukuvuselela ukulimala okuHlonayo

Xa ubuyela kumdlalo othile womntu, umngcipheko wokulimala kwakhona uphezulu ngokubanzi kwiiveki ezi-2 zokuqala. Oku kwenzeka ngenxa yobuthathaka bokuqala, ukukhathala, ukungabikho kokuguquguquka, kunye nokungalingani kwamandla phakathi kwe-hamstrings eccentric kunye ne-quadriceps edibeneyo. Eyona nto inegalelo elikhulu nangona kukholelwa ukuba inxulunyaniswe nenkqubo yokubuyisela kwisimo sangaphambili enganelanga, enokuthi ihambelane nokubuyela kwangaphambi kwexesha kumsebenzi womzimba. Ubungqina obutsha bubonise iingenelo zokusebenzisa i-eccentric yokuqinisa i-eccentric yokuvuselela i-hamstring eyenziwa ngokunyuka kwemithwalo yobude obude be-musculotendinous.
I-semitendinosus, okanye i-ST, i-semimembranosus, okanye i-SM, kunye ne-biceps femoris iintloko ezinde kunye nezifutshane (i-BFLH kunye ne-BFSH) ziyingxenye yeqela le-hamstring muscle. Ngokuyinhloko zisebenza kunye nokwandiswa kwe-hip kunye nokuguqa kwedolo kunye nokubonelela ngokuzinza kwe-multi-directional ye-tibia kunye ne-pelvis. Ezi zihlunu zintathu ezenza iqela le-hamstring muscle, liwela i-posterior aspect of both hip kunye namadolo ahlangeneyo, okwenza kube yi-bi-articular. Ngenxa yoko, bahlala besabela kumandla amakhulu omatshini adalwe ngumzimba ophezulu, i-trunk, kunye ne-locomotion yamalungu angaphantsi njengendlela yokudibanisa kunye ne-eccentric mobilization. Ngexesha lemisebenzi yezemidlalo, le mikhosi iya kuthambekela ekunyukeni, ikhulise ukuphindaphinda kokulimala.

Kuphononongo olwenziwa kwiYunivesithi yaseMelbourne, abahlalutyi be-biomechanical balinganisa ubunzima be-musculotendinous, isantya, amandla, amandla, umsebenzi, kunye neminye imithwalo ye-biomechanical efunyenwe yi-hamstrings kulo lonke ixesha lokuhamba phezu komhlaba kwaye bathelekisa umthwalo we-biomechanical kuwo wonke umntu ngamnye. isihlunu.

Ngokusisiseko, i-hamstrings ixhomekeke kumjikelezo wokunciphisa xa i-sprinting, kunye nesigaba sokwandisa esenzeka ngexesha lokuguquka kwesiphelo kunye nesigaba sokunciphisa siqala ngaphambi kokuba unyawo ngalunye lubethe, luqhubeke kulo lonke ukuma. Emva koko, umthwalo we-biomechanical kwimisipha ye-hamstring ye-bi-articular yayizimisele ukuba yomelele ngexesha lokuguquka kwesiphelo.

I-BFLH yayinomdla omkhulu kakhulu we-musculotendin, i-ST ibonakalise i-musculotendinous velocity eninzi, kwaye i-SM ivelise amandla angama-musculotendin aphezulu kwaye zombini yamandla kwaye yavelisa amandla angama-musculotendin. Uphando olulinganayo luye lwahluke kakhulu kwi-musculotendinous strain njengegalelo elikhulu kumonakalo we-muscle okanye ukulimala, ngokuqhelekileyo ukuxhaphaza ngokukhawuleza, kunokunyamezela amandla omzimba. Yingakho ukuqiniswa kokwakhiwa komzimba kudla ngokuphindaphindiweyo isincomo sokuvuselela ukulimala kancinci.

Indawo kunye nobunzima bokulimala

Kuhlolisiso olungaphendulwanga kwaye olulawulwayo kumdlali wabadlali bebhola baseSweden, i-69 ekhulwini lokulimala yayikho i-BFLH. Ngokwahlukileyo, i-21 yeepesenti yabadlali bafumana ukulimala kwabo okuphambili kwi-SM. Ngexesha elona liqhelekileyo, malunga neepesenti ze-80, lahlelwa yicala lokulimala kwi-ST kunye ne-BFLH okanye i-SM, i-94 ekhulwini yezinto eziziimfuno eziphambili zifunyenwe ukuba zihlobo lwe-sprinting kwaye zifumaneka kwi-BFLH, kanti i-SM indawo eqhelekileyo yoluhlu lolwabiwo, ukubalwa malunga neepesenti ze-76. Ezi ziphumo zaxhaswa kwelinye inqaku elifanayo.

Ukuhlelwa kokulimala kwezicubu ezithambileyo, kubandakanywa nokulimala kwe-hamstring acute, kuxhomekeke kakhulu kwinkqubo yokulinganisa ukusuka: I, imnene; II, phakathi; kunye no-III, ezinzima. Ulwahlulo olwahlukileyo lunika iinkcazo eziluncedo kuhlobo ngalunye lokulimala kwezicubu ezithambileyo phakathi kwabasebenzi bezempilo ngexesha lokuxilongwa kweklinikhi kunye ne-prognosis emva kokwenzakala okuqatha. Ukuhlelwa okuncinci kuchaza ukulimala apho inani elincinci lemicu ye-muscle libandakanyeka ekudumbeni okuncinci, ukungahambi kakuhle, ukulahleka okuncinci okanye ukungabikho kwamandla, okanye ukukhawulelana nokunyakaza. Ukuhlelwa okuphakathi kuchaza ukwenzakala ngokukrazula okubalulekileyo kwemicu yemisipha emininzi, intlungu kunye nokudumba, amandla ancitshisiweyo, kunye nokuhamba okulinganiselweyo. Ukuhlelwa okunzima kuchaza ukulimala apho ukukrazula kwenzeke kuyo yonke i-cross-section of muscle, ngokuqhelekileyo i-tendinous avulsion, kunye nombono wokuhlinzwa unokufuneka. Ikwasetyenziswe njengenkqubo yokuhlelwa kwiindlela zeradiyoloji, ezinje ngeimaging resonance magnetic, okanye iMRI, okanye i-ultrasound ukuba iyafuneka ukuze kuqinisekiswe ukuxilongwa.

I-British Athletics Medical Team iqulunqe inkqubo yokuhlengahlengiswa kwenkqubo entsha yokuphucula ukuchaneka nokuchongwa ngokusekelwe kwiimpawu ze-MRI

Ukumisela amaxesha achanekileyo okubuyela ekudlaleni emva kokulimala kwe-hamstring eninzi kuye kwangqinwa ukuba kunzima. Ngokomzekelo, ukwenzakala okubandakanya i-tendon ye-intramuscular okanye i-aponeurosis enemicu ye-muscle ekufutshane ngokubanzi idinga ixesha elifutshane lokubuyisela kunezo zibandakanya i-tendon yamahhala kunye / okanye i-MTJ.

Kukwakho unxibelelwano phakathi kweziphumo zeMRI ngokwengingqi yokwenzakala kunye nokubuyela ekudlaleni. Ngokukodwa, kuye kwacatshangelwa ukuba umgama omfutshane phakathi kwesibonda esisondeleyo sokulimala kunye ne-tuberosity ye-ischial efunyenwe kwiimvavanyo ze-MRI ezifanayo ezinqunywe bubukho be-edema, ixesha elide lokubuya liya kuba. Ngendlela efanayo, ubude be-edema bubonisa umphumo ofanayo kwixesha lokubuyisela. Ubude obude, ixesha elide ukuchacha. Ukongezelela, indawo yeentlungu ezibuhlungu ngaxeshanye emva kokulimala kakhulu kwe-hamstring nayo ihambelana nokunyuka kwexesha lokubuyisela.

Ukongezelela, kuye kwenziwa iinzame zokucacisa ukudibanisa phakathi kokubanjelwa kwenzakala yokulimala kunye nokubuyisela ukudlala. Kwisifundo seqela elijongene nabadlali bebhola lebhola le-207 elinobungozi obunzima, i-57 iipesenti zachongwa njengegrade I, i-27 iipesenti zachongwa njengeGrade II, kwaye i-3 kuphela iipesenti zachongwa njengeBakala III. Abagijimi abanokulimala kwamabanga amabakala babuya badlala kumyinge weentsuku ze-17. Iimbaleki ezinobungozi beBakala II zibuyiselwe kwiintsuku ze-22 kwaye abo benokulimala kwebanga lesi-III babuya malunga neentsuku ze-73. Ngokwezifundo, iipesenti ze-84 zale nzakala zachaphazela i-BF, i-11 ipesenti yeS SM, kunye ne-5 ipesenti ye-ST. Nangona kunjalo, kwakungekho nto ephawulekayo kwixesha lokulahla lokulimala kwiintlobo ezintathu ezahlukeneyo. Oku kuqhathaniswa neentsuku ze-5-23 kunye nokulimala kwebanga I-II, kunye ne-28-51 iintsuku ze-grade I-III kwezinye izifundo ngokulandelana.

Ukubuyiselwa koMonakalo oKhuselekileyo

Abaphandi abaphambili baye baphikisana neenzuzo zokuqiniswa kwamanyathelo emva kokulimala kancinci ngokumalunga nokuqiniswa okugxininiswe xa kugxila ekunciphiseni ixesha lokubuyela-kudlala. Umgca wolu ngqungquthela kukuba ngobuninzi bokulimala kancinci okwenzeka ngexesha lokulayisha ngokukhawuleza, ukulungiswa kufuneka kufane neemeko ezithile ezibangele ukulimala kwindawo yokuqala. Olunye uphando lubonisa umehluko omkhulu phakathi kwenkqubo yokuvuselela i-eccentric and concentric rehabilitation emva kokulimala kancinci kwinqanaba elincinci nelingabalandeli bebhola.

Ulingo lwekliniki olungenamkhethe kunye nolulawulwayo olwenziwe kubadlali bebhola bebhola be-75 eSweden, lubonise ukuba ukusebenzisa iinkqubo zokuqinisa i-eccentric kunokuba iinkqubo zokuqinisa ezigxininisiweyo, zanciphisa ixesha lokubuyela ekudlaleni ngeentsuku ze-23, kungakhathaliseki ukuba luhlobo luni lokulimala okanye indawo yokulimala. . Iziphumo zibonise inani leentsuku zokubuyela kuqeqesho olupheleleyo lweqela kunye nokufumaneka kokukhethwa komdlalo.

Ngapha koko, iiprothokholi ezimbini zokubuyisela kwisimo sangaphambili zisetyenziswe kwiintsuku ezintlanu emva kokwenzakala. Bonke abadlali baye bagcina ukulimala kohlobo lwe-sprinting ngenxa yesantya esiphezulu sokubaleka okanye uhlobo oluthile lokulimala ngenxa yokukhaba okuphezulu, ukuhlukana kwezikhundla, kunye ne-glide tackling. Iikhrayitheriya ezithile zazingabandakanywa kwisifundo, kubandakanywa ukulimala kwangaphambili kwe-hamstring, ukuxhatshazwa kwithanga elingasemva, imbali eqhubekayo yeengxaki eziphantsi, kunye nokukhulelwa.

Bonke abadlali baxhomekeke kuhlalutyo lwe-MRI iintsuku ze-5 emva kokulimala, ukwenzela ukuba ziveze ubunzima kunye nendawo yokulimala. Umdlali uthathwa njengelungeleyo ukubuyela ekuqeqesheni kweqela elipheleleyo usebenzisa uvavanyo olubizwa ngokuba luvavanyo olusebenzayo lwe-Askling H. Uvavanyo olulungileyo xa umdlali efumana ukungaqiniseki okanye ukukhathazeka xa eqhuba uvavanyo. Uvavanyo kufuneka lugqitywe ngaphandle kokutshitshiswa okupheleleyo kwe-ankle.

Malunga nama-72 ekhulwini abadlali bonzakala, ngoxa abangama-28 ekhulwini benzakala. Kwaba, i-69 ipesenti yafumana ukulimala kwi-BFLH, ngelixa i-21 ipesenti yayifumaneka kwi-SM. Ukulimala kwi-ST kwagcinwa kuphela njengokulimala kwesibini, malunga neepesenti ze-48 kunye ne-BFLH kunye neepesenti ze-44 kunye ne-SM. Ukongezelela, iipesenti ze-94 zokulimala kohlobo lwe-sprinting zifumaneka kwi-BFLH ngelixa i-SM yayiyona ndawo ixhaphakileyo yokulimala kohlobo lokwelula, malunga neepesenti ze-76 zokulimala.

Iiprotokholi ezimbini zokubuyisela kwisimo sangaphambili ezisetyenzisiweyo zazibhalwe i-L-protocol kunye ne-C-protocol. Iprotocol ye-L igxininise ekulayisheni i-hamstrings ngexesha lokwandisa kwaye i-C-protocol yayiquka ukuzivocavoca ngaphandle kokugxininisa ekwandiseni. Iprothokholi nganye isebenzise imithambo emithathu enokwenziwa naphi na kwaye ibingaxhomekekanga kwizixhobo eziphambili. Kwakhona bajolise ekujoliseni ukuguquguquka, ukuhlanganiswa, i-trunk, kunye ne-pelvic kunye / okanye ukuzinza kwemisipha kunye nokuqeqeshwa kwamandla athile kwi-hamstrings. Zonke zenziwe kwinqwelomoya ye-sagittal ngesantya kunye nokuqhubela phambili komthwalo.

Ukupheliswa kweSifundo

Ixesha lokubuyela linqunywe ukuba lifutshane kakhulu kwiprotocol ye-L xa kuthelekiswa ne-C-protocol, i-avareji yeentsuku ze-28 kunye neentsuku ze-51 ngokufanelekileyo. Ixesha lokubuya lalifutshane kakhulu kwiprotocol ye-L kune-C-protocol yokulimala kwe-hamstring acute of both sprinting-type kunye ne-stretch-type kunye nokulimala kweentlobo ezahlukeneyo zokulimala. Nangona kunjalo, kusekho umbuzo malunga nokuba i-C-protocol ichanekileyo ngokwaneleyo ukwenzela ukuba kusebenze i-hamstring ukudala uthelekiso olusemthethweni.

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