[2007.4.1][转贴][APTX青山病院]远离腱子的疼痛，自由地运动

belmont

http://www.medicalnewstoday.com/medicalnews.php?newsid=66495

Get In Swing Without Tendon Pain

Article Date: 31 Mar 2007 - 0:00 PDT

Spring's here. It's time to restring your tennis racquet or dust off the old golf clubs, but that tendon pain in your elbow, shoulder or ankle may force you to keep the clubs in the bag or the racquet in its case.

For some people, resting the affected tendon may be all they need to ease the pain, but others with chronic pain struggle to find relief. The good news is physicians now have a large array of techniques from new approaches to physical therapy and rehabilitation to new, less-invasive treatments that stimulate your body to heal the problematic tendon that can help you keep swinging your racquet or clubs without pain.

"We're altering the landscape in dealing with a lot of these tendon issues," said Robert Dimeff, M.D., medical director of Cleveland Clinic Sports Health. "These are still difficult problems to deal with, but the options are so much better now than they were 10 years ago."

What's causing the pain?

Most people attribute tendon pain to tendinitis (inflammation of a tendon), but more often the pain results from tendinosis, a breakdown of connective tissue resulting in a series of tiny tears in and around the tendon. Experts refer to the two conditions collectively as "tendinopathies," which occur most commonly in the elbow (tennis elbow or golfer's elbow), the ankle (Achilles tendon), in the shoulder (rotator cuff) and the knee.

While tennis, golf and other activities that involve repetitive use and overuse of a tendon are the usual culprits, other daily activities also can trigger pain. Generally, tendinopathies occur in middle and older age, from your 30s to your 70s.

First treatment approaches

If your tendon pain lasts more than a few weeks, see a doctor to rule out another, potentially more serious cause of the pain, such as a stress fracture. If your pain is sports-related, the doctor may have you check the size and weight of your racquet, golf clubs or other equipment and work with a pro on the mechanics of your swing.

The initial treatment for a tendinopathy usually entails warming up the muscle/tendon before exercise, resting it, applying ice and wrapping it shortly afterward, and taking pain relievers. You also may do gentle stretching exercises to prevent stiffness.

Dr. Dimeff also recommends physical therapy and rehabilitation to stretch and strengthen tendons and muscles. The therapy includes eccentric (pronounced "ee-sentric") exercises that elongate the muscle and tendon while strengthening them. The exercises require the guidance of a physical therapist.

On the treatment vanguard

Researchers have learned that with cortisone injections often prescribed for tendinopathies, the tissue damage caused by the injection may be more therapeutic than the cortisone itself. The trauma to the tendon tissue prompts the body to deliver blood and nutrients to the site as part of its healing response.

This idea of creating a healing trauma is behind newer treatments such as noninvasive shockwave therapy and autologous blood injections. In shockwave therapy, the doctor uses high-energy ultrasound waves to hammer problem areas and stimulate healing. The treatment, although somewhat painful and therefore not for everyone, is relatively safe, carries few adverse effects and can be effective for many tendinopathies.

Newer to the treatment armamentarium are autologous blood injections, in which the doctor injects your own platelet-rich blood into the region of the injured tendon to deliver nutrients that help heal it. A study in the November 2006 issue of the British Journal of Sports Medicine found that the blood injections relieved pain in patients with medial epicondylitis ("golfer's elbow"). Side effects include soreness and a minimal risk of infection.

Another newer tendinopathy treatment option under study is the topical nitroglycerin patch. Normally indicated to treat chest pain (angina), the patch is not widely used off-label to treat tendinopathies, but Dr. Dimeff has found it effective in his patients. Nitroglycerin dilates blood vessels and increases blood flow to the tendons. It also increases levels of nitric oxide, which may stimulate healing.

Dr. Dimeff typically prescribes the patch for three months. The patch is easy to use, is relatively inexpensive and carries few side effects (headache and dizziness are the most common). However, nitroglycerin can lower blood pressure, and patients on blood-pressure medications should talk to their physician or cardiologist before using it.

While these newer therapies offer promise in treating tendinopathies, they can require several weeks of treatment, and they don't eliminate the need for physical therapy and rehabilitation, Dr. Dimeff said.

"The important thing is to stick with the program and don't jump from doctor to doctor. Go to somebody who's listening to you and willing to try some of these other new things," he said. "And, I can't emphasize enough the importance of the rehab exercises. With all of these newer treatments, you still have to be doing the rehab exercises."

What You Can Do

- Use moist heat to warm up your problem tendon before exercising. Afterward, apply ice and wrap the tendon with a compression strap or sleeve.

- Use simple analgesics such as ibuprofen, naproxen or acetaminophen before activity and as needed.

- If your tendon pain is sports-related, make sure your tennis racquet, golf clubs or other equipment is sized correctly for you, and have a pro analyze your swing to make sure it's not causing your pain.

- Talk to your doctor about physical therapy, and work with your physical therapist to learn eccentric exercises that elongate and strengthen muscles and tendons.

- Ask your physician if newer tendinopathy treatments such as shockwave therapy, autologous blood injections or nitroglycerin patches are right for you.









Get In Swing Without Tendon Pain

远离腱子的疼痛，自由地运动



Spring's here. It's time to restring your tennis racquet or dust off the old golf clubs, but that tendon pain in your elbow, shoulder or ankle may force you to keep the clubs in the bag or the racquet in its case.
春天已经到了。这时正是你应该重新调整好你的网球拍，或者是把你的老高尔夫球杆上的灰尘拭去出去运动，但是由于你肘部、肩部或者是脚踝里面的腱子的疼痛或许迫使你收回你的高尔夫球杆和网球拍，无法运动。



For some people, resting the affected tendon may be all they need to ease the pain, but others with chronic pain struggle to find relief. The good news is physicians now have a large array of techniques from new approaches to physical therapy and rehabilitation to new, less-invasive treatments that stimulate your body to heal the problematic tendon that can help you keep swinging your racquet or clubs without pain.
对于一些人来说，休息静养或许是他们所能够做到的缓解腱子疼痛的方法，但是另一些有着慢性长期腱子痛的人还在努力寻求缓解疼痛的方法。现在好消息是，医生现在在物理疗法上有新的突破，通过轻微刺激你的身体这种复原疗法，治疗存在问题的腱子，使你能够摆脱疼痛，重新挥舞球拍或者球杆。



"We're altering the landscape in dealing with a lot of these tendon issues," said Robert Dimeff, M.D., medical director of Cleveland Clinic Sports Health. "These are still difficult problems to deal with, but the options are so much better now than they were 10 years ago."
"我们正在改变处理很多腱子病时候的治疗方法,"来自克里夫兰运动健康诊所的医学指导，医学博士Robert Dimeff说。"这些问题依然是我们很棘手的问题，但是处理腱子问题的方法比10年前的时候要好很多了"。


What's causing the pain?
什么原因引发腱子疼痛？


Most people attribute tendon pain to tendinitis (inflammation of a tendon), but more often the pain results from tendinosis, a breakdown of connective tissue resulting in a series of tiny tears in and around the tendon. Experts refer to the two conditions collectively as "tendinopathies," which occur most commonly in the elbow (tennis elbow or golfer's elbow), the ankle (Achilles tendon), in the shoulder (rotator cuff) and the knee.
许多人把腱子疼痛归结于腱炎(腱子部位的发炎)，但是更常见的是这种疼痛是由于腱子退行性病变，也就是在腱子里和腱子周围一系列的微小细线构成的联系组织的衰变所引起。专家们提到这两种情况时，将它们共同称为"tendinopathies"，也就是引起大多数常见的在肘部(俗称网球肘或者是高尔夫球肘)，脚踝(俗称阿喀琉斯[注：希腊神话人物]脚踝)，肩部(俗称旋转套)和膝盖的腱子病。


While tennis, golf and other activities that involve repetitive use and overuse of a tendon are the usual culprits, other daily activities also can trigger pain. Generally, tendinopathies occur in middle and older age, from your 30s to your 70s.
虽然那些包含重复使用和过度使用腱子的网球、高尔夫和其他的一些活动，是引起腱子痛通常的原因，但是其他的一些日常活动也可以引发疼痛。一般来说腱子病变衰退出现在中年和老年，从你的30岁开始一直到70岁。


First treatment approaches
初期治疗方法


If your tendon pain lasts more than a few weeks, see a doctor to rule out another, potentially more serious cause of the pain, such as a stress fracture. If your pain is sports-related, the doctor may have you check the size and weight of your racquet, golf clubs or other equipment and work with a pro on the mechanics of your swing.
如果你的腱子痛持续长达数个星期，应该到医生那里就诊去找出那个潜在的严重的引起你疼痛的原因，比如压迫性骨折。如果你的疼痛和运动有关，医生或许叫你检查网球拍的大小和重量，高尔夫球棒或者是其他的运动装备同时叫你和一个专业人员在你挥舞球拍球杆等动作上给予指导。


The initial treatment for a tendinopathy usually entails warming up the muscle/tendon before exercise, resting it, applying ice and wrapping it shortly afterward, and taking pain relievers. You also may do gentle stretching exercises to prevent stiffness.
早期的对于腱子病变衰退的治疗一般要在联系前活动开肌肉/腱子，放松它们，随后用冰块短时间包裹在肌肉/腱子周围，而后再服用止痛药。你还应该做一些温和型的拉伸运动一次来避免腱子硬化。


Dr. Dimeff also recommends physical therapy and rehabilitation to stretch and strengthen tendons and muscles. The therapy includes eccentric (pronounced "ee-sentric") exercises that elongate the muscle and tendon while strengthening them. The exercises require the guidance of a physical therapist.
Dimeff博士还建议用物理治疗和复原疗法伸展加强腱子和肌肉的柔韧度和强度.这种治疗包括能够在加强肌肉和腱子的同时拉伸它们的牵引练习。这些练习需要一位物理治疗临床医学家的指导。


On the treatment vanguard
治疗先驱


Researchers have learned that with cortisone injections often prescribed for tendinopathies, the tissue damage caused by the injection may be more therapeutic than the cortisone itself. The trauma to the tendon tissue prompts the body to deliver blood and nutrients to the site as part of its healing response.
研究院了解到一般对于腱子病变衰退症都是采用可的松注射的方法，但是由此引发的对于腱子组织的伤害可能更大于可的松本身对于症状的治疗效果。腱子组织损伤的部位在自我恢复的过程中会促使身体将血液与营养物质传送到损伤部位。


This idea of creating a healing trauma is behind newer treatments such as noninvasive shockwave therapy and autologous blood injections. In shockwave therapy, the doctor uses high-energy ultrasound waves to hammer problem areas and stimulate healing. The treatment, although somewhat painful and therefore not for everyone, is relatively safe, carries few adverse effects and can be effective for many tendinopathies.
这个现象所产生的关于制造一个"痊愈损伤"的治疗方法是比现在使用的新治疗方法，比如侵入冲击波疗法和自体移植式血液注射疗法更为先进。在侵入式冲击波疗法中，医生用高能量超声波去击打问题区域，以次来刺激组织的恢复痊愈。这种疗法，虽然稍微有些疼痛，也由此不是能够适应于每个人的情况，但是是一种相对安全，并且对于很多患者来说带有很少副作用的方法。


Newer to the treatment armamentarium are autologous blood injections, in which the doctor injects your own platelet-rich blood into the region of the injured tendon to deliver nutrients that help heal it. A study in the November 2006 issue of the British Journal of Sports Medicine found that the blood injections relieved pain in patients with medial epicondylitis ("golfer's elbow"). Side effects include soreness and a minimal risk of infection.
比侵入式冲击波疗法更先进的是自体移植式血液注射疗法，医生将你自己的富含血小板的血液注射进受损伤的腱子部位中，以此来向部位传递营养物质来帮助损伤部位的痊愈。2006年11月在英国运动医学期刊上出版的一项研究发现，血液注射是注射在上髁炎(高尔夫肘)部位中以缓解病人的疼痛。而副作用包含了疼痛和注射时候的风险。


Another newer tendinopathy treatment option under study is the topical nitroglycerin patch. Normally indicated to treat chest pain (angina), the patch is not widely used off-label to treat tendinopathies, but Dr. Dimeff has found it effective in his patients. Nitroglycerin dilates blood vessels and increases blood flow to the tendons. It also increases levels of nitric oxide, which may stimulate healing.
另一种更新的、在研究过程中的治疗腱子病变衰退症的方法是局部硝化甘油片疗法。硝化甘油片一般是用来治疗胸腔疼痛(交通)，它一般不被广泛用于治疗腱子病变衰退症上，但是Dimeff教授发现它们在治疗他的病人中起到了效果。硝化甘油使血管膨胀增加了向腱子部位流动的血流量。同时能够刺激恢复痊愈的物质一氧化氮的含量也增加了。


Dr. Dimeff typically prescribes the patch for three months. The patch is easy to use, is relatively inexpensive and carries few side effects (headache and dizziness are the most common). However, nitroglycerin can lower blood pressure, and patients on blood-pressure medications should talk to their physician or cardiologist before using it.
Dimeff教授特别为这种病开了三个月的硝化甘油片处方。硝化甘油片易于使用，同时也相对便宜，副作用也很小(大多数情况下会产生头痛和头昏脑胀)。但是，硝化甘油可以降低你的血压，那些进行血压控制治疗的患者应该在使用这个疗法前咨询他们的医生或者是心脏病学家。


While these newer therapies offer promise in treating tendinopathies, they can require several weeks of treatment, and they don't eliminate the need for physical therapy and rehabilitation, Dr. Dimeff said.
虽然这些新疗法提供了治疗腱子病变衰退症的保证，治疗周期仍然需要几个星期，同时它们也不能取代物理疗法和恢复疗法，Dimeff教授说。


"The important thing is to stick with the program and don't jump from doctor to doctor. Go to somebody who's listening to you and willing to try some of these other new things," he said. "And, I can't emphasize enough the importance of the rehab exercises. With all of these newer treatments, you still have to be doing the rehab exercises."
"最重要的是坚持治疗，同时不要不停更换自己的治疗医生。要找一个能够懂得倾听你的病情，同时也愿意尝试一些新治疗方法的医生，"他说。"另外，我不得不强调恢复练习的重要性。即使使用了这些新型治疗方法，你依然需要进行恢复练习。"


What You Can Do
你可以做什么


- Use moist heat to warm up your problem tendon before exercising. Afterward, apply ice and wrap the tendon with a compression strap or sleeve.
在练习前用蒸汽来敷你出现问题的腱子部位。而后，用绷绳或者套子将冰块绑在腱子部位。
- Use simple analgesics such as ibuprofen, naproxen or acetaminophen before activity and as needed.
在活动前按照需要用一些常用的止痛药比如布洛芬，萘普生或者醋胺酚
- If your tendon pain is sports-related, make sure your tennis racquet, golf clubs or other equipment is sized correctly for you, and have a pro analyze your swing to make sure it's not causing your pain.
如果你的腱子痛跟运动有关，确保你的网球拍，高尔夫球杆或者是其他的运动装备是适合给你用的，同时对你的挥拍挥杆等动作进行专业的分析以确保动作不至于引起你的疼痛。


- Talk to your doctor about physical therapy, and work with your physical therapist to learn eccentric exercises that elongate and strengthen muscles and tendons.
向你的医生咨询物理治疗，同时要与你的物理治疗临床医学家合作进行牵引练习以此来拉伸加强你的肌肉和腱子。


- Ask your physician if newer tendinopathy treatments such as shockwave therapy, autologous blood injections or nitroglycerin patches are right for you.
向你的医生咨询如果新的治疗腱子病变衰退症的方法比如超声波疗法，自体移植式血液注射疗法或者是硝化甘油片疗法是否适合你。







编译全文:
春天已经到了。这时正是你应该重新调整好你的网球拍，或者是把你的老高尔夫球杆上的灰尘拭去出去运动，但是由于你肘部、肩部或者是脚踝里面的腱子的疼痛或许迫使你收回你的高尔夫球杆和网球拍，无法运动。

对于一些人来说，休息静养或许是他们所能够做到的缓解腱子疼痛的方法，但是另一些有着慢性长期腱子痛的人还在努力寻求缓解疼痛的方法。现在好消息是，医生现在在物理疗法上有新的突破，通过轻微刺激你的身体这种复原疗法，治疗存在问题的腱子，使你能够摆脱疼痛，重新挥舞球拍或者球杆。

"我们正在改变处理很多腱子病时候的治疗方法,"来自克里夫兰运动健康诊所的医学指导，医学博士Robert Dimeff说。"这些问题依然是我们很棘手的问题，但是处理腱子问题的方法比10年前的时候要好很多了"。

什么原因引发腱子疼痛？

许多人把腱子疼痛归结于腱炎(腱子部位的发炎)，但是更常见的是这种疼痛是由于腱子退行性病变，也就是在腱子里和腱子周围一系列的微小细线构成的联系组织的衰变所引起。专家们提到这两种情况时，将它们共同称为"tendinopathies"，也就是引起大多数常见的在肘部(俗称网球肘或者是高尔夫球肘)，脚踝(俗称阿喀琉斯[注：希腊神话人物]脚踝)，肩部(俗称旋转套)和膝盖的腱子病。

虽然那些包含重复使用和过度使用腱子的网球、高尔夫和其他的一些活动，是引起腱子痛通常的原因，但是其他的一些日常活动也可以引发疼痛。一般来说腱子病变衰退出现在中年和老年，从你的30岁开始一直到70岁。

初期治疗方法

如果你的腱子痛持续长达数个星期，应该到医生那里就诊去找出那个潜在的严重的引起你疼痛的原因，比如压迫性骨折。如果你的疼痛和运动有关，医生或许叫你检查网球拍的大小和重量，高尔夫球棒或者是其他的运动装备同时叫你和一个专业人员在你挥舞球拍球杆等动作上给予指导。

早期的对于腱子病变衰退的治疗一般要在联系前活动开肌肉/腱子，放松它们，随后用冰块短时间包裹在肌肉/腱子周围，而后再服用止痛药。你还应该做一些温和型的拉伸运动一次来避免腱子硬化。

Dimeff博士还建议用物理治疗和复原疗法伸展加强腱子和肌肉的柔韧度和强度.这种治疗包括能够在加强肌肉和腱子的同时拉伸它们的牵引练习。这些练习需要一位物理治疗临床医学家的指导。

治疗先驱

研究院了解到一般对于腱子病变衰退症都是采用可的松注射的方法，但是由此引发的对于腱子组织的伤害可能更大于可的松本身对于症状的治疗效果。腱子组织损伤的部位在自我恢复的过程中会促使身体将血液与营养物质传送到损伤部位。

这个现象所产生的关于制造一个"痊愈损伤"的治疗方法是比现在使用的新治疗方法，比如侵入冲击波疗法和自体移植式血液注射疗法更为先进。在侵入式冲击波疗法中，医生用高能量超声波去击打问题区域，以次来刺激组织的恢复痊愈。这种疗法，虽然稍微有些疼痛，也由此不是能够适应于每个人的情况，但是是一种相对安全，并且对于很多患者来说带有很少副作用的方法。

比侵入式冲击波疗法更先进的是自体移植式血液注射疗法，医生将你自己的富含血小板的血液注射进受损伤的腱子部位中，以此来向部位传递营养物质来帮助损伤部位的痊愈。2006年11月在英国运动医学期刊上出版的一项研究发现，血液注射是注射在上髁炎(高尔夫肘)部位中以缓解病人的疼痛。而副作用包含了疼痛和注射时候的风险。

另一种更新的、在研究过程中的治疗腱子病变衰退症的方法是局部硝化甘油片疗法。硝化甘油片一般是用来治疗胸腔疼痛(交通)，它一般不被广泛用于治疗腱子病变衰退症上，但是Dimeff教授发现它们在治疗他的病人中起到了效果。硝化甘油使血管膨胀增加了向腱子部位流动的血流量。同时能够刺激恢复痊愈的物质一氧化氮的含量也增加了。

Dimeff教授特别为这种病开了三个月的硝化甘油片处方。硝化甘油片易于使用，同时也相对便宜，副作用也很小(大多数情况下会产生头痛和头昏脑胀)。但是，硝化甘油可以降低你的血压，那些进行血压控制治疗的患者应该在使用这个疗法前咨询他们的医生或者是心脏病学家。

虽然这些新疗法提供了治疗腱子病变衰退症的保证，治疗周期仍然需要几个星期，同时它们也不能取代物理疗法和恢复疗法，Dimeff教授说。

"最重要的是坚持治疗，同时不要不停更换自己的治疗医生。要找一个能够懂得倾听你的病情，同时也愿意尝试一些新治疗方法的医生，"他说。"另外，我不得不强调恢复练习的重要性。即使使用了这些新型治疗方法，你依然需要进行恢复练习。"

你可以做什么

在练习前用蒸汽来敷你出现问题的腱子部位。而后，用绷绳或者套子将冰块绑在腱子部位。

在活动前按照需要用一些常用的止痛药比如布洛芬，萘普生或者醋胺酚。

如果你的腱子痛跟运动有关，确保你的网球拍，高尔夫球杆或者是其他的运动装备是适合给你用的，同时对你的挥拍挥杆等动作进行专业的分析以确保动作不至于引起你的疼痛。

向你的医生咨询物理治疗，同时要与你的物理治疗临床医学家合作进行牵引练习以此来拉伸加强你的肌肉和腱子。

向你的医生咨询如果新的治疗腱子病变衰退症的方法比如超声波疗法，自体移植式血液注射疗法或者是硝化甘油片疗法是否适合你。

wangyuankai

支持青山病院的贴子。大家共同进步。

祭·奠

一开始看这帖子的风格还以为是KAIKAI的MJ- -0
。。。。PS 分类不是这样分的哦~LZ下次要注意：）

belmont

谢谢前辈们了~~~~发帖的时候忘了分类~~结果到编辑模式里面反而不能分类了....

APTX青山病院

没关系的:)第一次嘛~已经申请斑斑帮你改分类了.

帖子很好恩~
希望你继续支持本院哦.