움직이기 위한 최적의 조건만들기! muscle imbalance syndrome

[문형철]

결국 모든 치료의 끝에는 therapeutic exercise가 있다. 

왜냐하면 인체는 움직이기 위해 존재하기 때문이다. 

치료적 운동을 구분해보면

1. mobilizing exercise

2. Rom exercise

3. stabilizing exercise

4. functional exercise로 구분할 수 있겠다. 

근육은 짝힘으로 힘을 쓸때만 제대로 힘을 발휘한다. 그래서 muscle imbalance를 반드시 치료해야 한다.

muscle imbalance는 어떻게 제대로 교정할까?

joint pain이 없는 좋은 관절, 적절한 viscoelastic한 환경이어야 가능하다

neural tissue가 제대로 기능해야, neural firing이 제대로 작동하는 상태에서 motor endplate에서 제대로 기능해야 한다.

피부, 근육, 힘줄, 인대, 신경, 혈관을 둘러싸고 있는 fascia의 환경이 좋아야 한다.

그리고 근육에 적절한 장력이 제공되어야 한다. 근육 pathology(TrP)에 의한 shortening이 없어야 한다. 

이 모든 환경이 완벽하게 좋아질때 근육의 불균형은 치료된다. 

panic bird..

PRINCIPLES OF MUSCLE IMBALANCE

As stated in Chapter 1, the goal of manipulation is to restore maximal, pain-free movement of the musculoskeletal system in postural balance. When the manipulative intervention has achieved maximum mobility, the question remains, how is it maintained? 

수기치료의 목표인 자세균형내에서 근골격계의 최대 rom회복과 통증없는 움직임에 도달했다고 가정하자.

그것을 어떻게 유지할 것인가? 

The obvious answer is an appropriate exercise program the patient can perform that maintains the functional capacity of the musculoskeletal system within the constraints of the available anatomy. The manual medicine practitioner is limited by the available anatomy, which may be altered by genetic development, single or repetitive trauma, and surgical intervention. 

명백한 대답은 적절한 운동프로그램임. 

Despite the altered anatomy and pathology present, it is surprising and satisfying to both the practitioner and the patient to see the amount of functional capacity that can be restored and maintained by an appropriate exercise program.

적절햔 재활운동프로그램으로 근골격계 질병이 존재하더라도 놀랍게 회복할 수 있음. 

An appropriate exercise prescription provides the patient with the ability, and responsibility, to maintain a high level of neuromusculoskeletal health. It is important  that the patient understands and commits to perform the necessary exercise program. While being as comprehensive as necessary, it should be simple and be performed without depending on specialized equipment or facilities. Obviously, if appropriate equipment is available, its use can be beneficial. Of utmost

importance is that patients understand that following a disabling musculoskeletal condition, it is imperative to continue an active exercise program for the rest of their lives.

Muscle Imbalance Syndromes. 

Janda also described three different syndromes resulting from muscle imbalance. They are the lower crossed syndrome in the pelvic girdle, the upper crossed syndrome in the shoulder girdle, and the layer syndrome from caudad to cranial. 

얀다는 세가지 다른 근육불균형을 묘사함. 

1. 하부교차증후군

2. 상부교차증후군

3. layer syndrome from caudad to cranial

The upper and lower cross syndromes will be described subsequently. The layer syndrome is characterized by alternate bands of muscle tightness and weakness on the dorsal surface of the body beginning from below upward (Fig. 20.4).

The layer syndrome is usually characterized by tightness of the gastrocnemius and soleus muscles, tightness of the hamstrings, weakness of the glutei and the lower lumbar erector spinae, tightness of the lower thoracic and upper lumbar erector spinae, weakness of the rhomboids and lower trapezius, and tightness of the upper trapezius and levator scapulae. 

Another feature of the layer syndrome is "banding" in erector spinae musculature. With close observation, the examiner

can identify sequential areas of hypertonicity and inhibition in various groups of the erector spinae muscle mass, particularly the longissimus. These reflect themselves as layers of fullness and small divots when observing tangentially along the erector spinae mass (Fig. 20.5).