王建民- 用全身力量投球的範例 - 棒球

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X-Ray vision: Chien-Ming Wang an example of pitching from arm to foot

X光診療室: 王建民-用全身力量投球的範例

Sunday, May 10th 2009, 1:34 AM



Drs. Positano (DPM) and Dines (MD) practice sports medicine at the Joe
DiMaggio Sports Medicine Center at The Hospital for Special Surgery and at
the NY Presbyterian/Weill Cornell Medical Center

作者為Positano及Dines醫生, 他們在紐約一家特殊外科手術專門醫院裡的
迪馬喬運動醫療中心執業.


The recent placement of Yankees starter Chien-Ming Wang on the DL reminds us
of the complex and delicate balance of the kinetic chain in competitive
pitchers. To the cursory glance, it may appear that throwing athletes rely
only on the strength of their shoulder and arm to generate velocity. Overhead
athletes who pitch in excess of 90 miles per hour, however, generate these
impressive velocities using their whole body and rely more on the forces
created by the trunk and lower extremities than the arm itself. Subtle
weakness and imbalance in the feet, legs, trunk, and thorax can therefore
manifest in loss of velocity and accuracy at the mound.

最近小王被放到DL, 再次讓我們意識到投手在投球時的身體各部位運動機制
的平衡的重要性及複雜性. 乍看之下, 好像只有肩膀及手臂被用來催球速,
然而對高壓型投手而言, 動則超過90英里的速球是用身體的力量投出來, 而
且反而更依賴身體及下半身所產生的力量. 若是腳比較沒力, 或是腳-腿-軀
幹-胸之間的出力有一環比較弱的話, 上對投手上丘後所展現的速度及準確
度將有極大的影響.



In Wang's case, he has been plagued by a mid-foot (Lisfranc)
sprain sustained last season that has thrown off his kinematics
and reportedly resulted in weakness of his hip abductors. The
Lisfranc ligament is a tough band of tissue that links the
midfoot and forefoot, and plays a critical role in maintaining
the alignment and arch of the foot. Sprains or ruptures of the
ligament can occur from direct, traumatic injuries such as motor
vehicle accidents or heavy objects falling on the foot. In sports,
however, the more common mechanism is an indirect twisting or
pivoting of the foot. Lisfranc injuries can often be difficult
to detect but should always be suspected in the presence of foot
swelling and pain bearing weight. Bruising on the bottom of the
foot should also raise significant suspicion for Lisfranc injury.
It is critical to seek the counsel of a physician if such injuries
are suspected as failed recognition and treatment of a Lisfranc
ligament disruption or midfoot fracture can lead to post-traumatic
arthritis and chronic pain in the future. X-rays can sometimes
detect injuries to the Lisfranc ligaments but oftentimes MRI is
used to detect more subtle pathology.

就小王而言, 他的腳板在上季扭傷, 造成他無法跑步, 且據說導致了
'尻傖'(註:屁股是也)無力.小王扭傷的地方是一塊連接腳背及腳掌的蹠跗
關節,其功用在構建足弓. 這塊肌腱若受傷了, 不管你是撞車時撞到,
搬東西時砸到, 或是運動時扭到, 可能會診斷不出來, 但是若是你的腳腫得
像豬腳或是無法支力, 那就有可能是這塊肌腱受傷. 若是腳底黑青的
話, 那機會更高. 這時, 要趕快去找醫生, (找醫生幹嘛? 當然是大聲
且自豪的說你跟王葛格一樣扭到蹠跗關節), 不然, 會有關節炎或是疼
痛的後遺症. X光有時對這種傷害的診斷能派上用場, 但用MRI會更準確.


Lisfranc sprain injuries can be managed without surgery but can
take a long time to fully heal and be pain-free. Patients are
placed in a cast or boot and kept non-weight bearing for up to
8 to 12 weeks. Patience is often the key, particularly with high-
level athletes who place higher than average demands on their
feet and lower extremity. Coming back too soon can be a setup
for further injury to the lisfrac ligaments or lead to an injury
somewhere else as the athlete tries to protect his foot. Some
Lisfranc injuries require surgery to fix the fracture/dislocation.
Oftentimes athletes can get back to their previous level of play
(Michael Strahan had a similar injury the year before the Giants
won the Super Bowl), but a long-term complication of these
injuries is arthritis.

治療蹠跗關節扭傷可以不用開刀, 這樣雖然較不痛, 可是痊癒的時間也較
長. 患部可能要恐固力(註:上石膏之類), 且有8至12週不能使力. 癒後的
狀況的關鍵在病患本身, 運動員可能會傷得比較重, 但又急於去使用患部,
這樣可能會造成舊傷復發, 或是因為要保護患部而牽拖到其它部分. 有些
蹠跗關節扭傷可能要開刀, 不管怎樣, 患者應該可以完全復原, 回復十成
功力, (美式足球巨人隊的Michael Strahan扭傷的隔年便幫球隊拿下超級
盃冠軍) 但長期而言, 要注意關節炎這個併發症.



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