分類彙整: 教室及研習訊息,Studio

各位，你們真是太棒了，太優秀了！

在這個艷陽高照的美妙的周六中午，割捨台北繁華的街景不逛，願意挨著肚皮，遠從市區搭捷運，小黃（計程車），還有前輩從台南搭飛機遠道而來，前輩，在此受Judy的一拜，也有人搭火車從台中新竹風塵僕僕地趕來參加樂活瑜伽所舉辦的全台第一場瑜伽醫學研討會，各位前輩們，你們路上真是辛苦了．歷史會留下這筆見證的．

還好，沒讓各位失望，本次研討會圓滿成功，在各位勤做筆記，笑聲不斷之下，相信各位一定有收穫，你們上課有收穫，我一切的辛苦都值得了，老實說，辦這個網誌及相關的活動，真的是一條不歸路，有人說：練瑜伽是一條不歸路，現在，我又比各位多了一條，那就是辦網誌

每天，我都在求進步，因為背負的各位的期望，有人跟我說：
”我每天一開機就先看你有沒有新文章出現”
難怪，有時，我一早開機趕稿時，就發現”天啊！有幾個瘋子竟然比我還早上線，完了，得趕快交稿”
各位，我好像又重回當年跑新聞的樣子，你們已經成為我的報老闆，她最常唸”你這傢伙，你的稿子什麼時候才生出來！”

所以囉！我都不敢太偷賴，感謝各位的支持，讓我的網誌不斷地成長，也讓我的夢想正像太空梭一樣直衝宇宙的天際，大家和我一起乘著夢想～～起飛吧！！

昨天的研討會，看到滿滿的人潮，近四十雙飢渴求知的眼神，我知道，我找到一群同好，一群對瑜伽醫學有興趣的同好，真好～～說實話，我還真怕被各位放鴿子，但事實證明，各位是重承諾的君子，預約報名，果然都如約前來，真是太感動了！！你們若來得少，我這老臉往那放，下回想要再邀重量級的專家前來時，人家一定不感興趣，”小貓兩三隻，粉難看”我自己恐怕也意興闌珊．

還好，有各位熱情的捧場，本次研討會大大地成功，我幫各位準備的講義，絕對值回票價，因為內容涵蓋，國外原文講義，解剖課本內容及運動醫學和復健醫學的內容，全都和膝蓋有關，不錯吧！！這都是我個人的藏書，我這個人，沒別的嗜好，就是愛看書，尤其和健康相關的，我全都愛．

對於無緣與會的同學，我會儘快整理當天演講的內容，但可能不如親臨現場來得精彩，因為有好多動作，要現場親身參與，才會有同感．下回，記得來參加，有參加的人，不要偷懶，趕快回應上來，順便給我一些建議，讓我下回辦得更精彩，對了，當天有拍照的人，記得寄給我啊you_loveyoga@yahoo.com.tw

最後，要感謝的人太多了，首先是各位參與的同好，以及梵瑜伽的春玲和那位櫃枱美女，再來，就是當場表演倒立的簡文仁理事長，他聽到要幫各位瑜伽大師上課，輸人不輸陣，練了幾招如意招，一招即出，果然驚動萬教．
最後最後，要感謝的人，是我老公～～小條，你們管叫：條哥，就對啦！！
他常常提醒我，
”辦活動，要認真，內容要充實，最好像醫學會一樣，有深度．．．
，還有，收費不要太貴，要便宜”
”是，遵命”

其實，各位，我是夫管嚴，很怕老公碎碎唸滴，”小條，你覺得這樣寫，口以嗎！”

現在,大家可以回應上來,說一下你在那裡,那我就知道你是誰了,不好意思那天都沒什麼空和你們相認,因為太忙了.我是最後一排右二,在帥哥旁的那位熟女judy

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好快，轉眼間，這個周六就要辦活動了，兩個月前，大夥還在把酒言歡，依依不捨地分離，沒想到，真沒想到，咱們這個周六就要見面了，真是人生一大樂事，哇！哈～哈～哈，豈不暢快，寫這麼多，就是一個字，爽！！！

好朋友相見，當然快樂，而且我們還不是鬼混打屁殺時間，我們可是在研習喲，林老師一定很欣慰，大家都如此上進可取，很好，很好．老師在～～～高雄～～也可感到欣慰了．

有些同學實在是太謙虛了，一直要我翻一下講義，害我情人節大餐差點泡湯，只保留十分鐘．還好，趕去還來得及，又吃了一頓好料．只是多了個八燭光的強力燈泡，我女兒，一直問，為什麼爸比今天要請客，為什麼要請我和媽咪，其實，你是跟班的，我才是女主角．你是前世情人，那媽咪是爸比的前世什麼人啊！！！這～～可能是你爸比的老媽吧！老公臉上三條線．
好了，不鬼扯了，現在就老老實實地翻一下文章．但我的英文也不太好，各位將就一點，而且，我也留了一個意外的禮物給各位，大家才有參與感嘛！！！

現在要報名的同學還來得及，因為我們希望這麼的活動，各位都能參與．將來那一天各位為人師表，這些知識一定用得上，再次提醒各位，

時間：8月5日(六)11:30~14:00
地點:梵瑜伽(捷運板南江子翠站四號出口即可看到,雙十路上,可看右側網站有介紹)
內容:討論膝關節,以下面文章為主
費用：500元(附議義,數量有限,晚來者可於事後至網站自行下載)
報名:請電梵瑜伽02-82534335
ps:理事長演講是12:30~13:30 11:30~12:30聯誼和溫習時間
(不附中餐,現場禁食,但附議義,數量有限,晚來者可於事後至網站自行下載)

各位猜猜看，那一張圖是正確的盤腿姿勢

答案就在下文自己看了？？

Protect the Knees in Lotus and Related Postures盤腿及其相關體位之膝蓋保護

By learning basic anatomical principles, you can teach your students how to safely open their hips without injuring their knees. 透過學習基本的解剖學理論你可以指導學生如何安全地打開髖關節,而不會傷到膝蓋

By Roger Cole

Lotus Pose (Padmasana) is a supreme position for meditation, and Lotus variations of other asanas can be profound. However, forcing the legs into Lotus is one of the most dangerous things you can do in yoga. Each year, many yogis seriously injure their knees this way. Often the culprit is not the student but an overenthusiastic teacher physically pushing a student into the pose.
蓮花式(雙盤)是冥想最至高無上的姿勢,其相關體位法也是較深奧的,然而強壓小腿硬做雙盤其實是練瑜伽最危險的動作之一．每年，都有許多瑜伽研習者因此而受傷，其實罪過都不是出在學生本身，而是教學過度熱心的老師不斷地督促學生做此動作

補充：（此指學生髖關節未全開時，老師就要求學生做雙盤，其實是造成學生膝關節受傷的主因)

Fortunately, there are techniques that make Padmasana much safer to learn. Even if you don’t teach full Lotus, you can use the same techniques to protect students in related postures, such as Ardha Baddha Padmottanasana (Half-Bound Half-Lotus Forward Bend), Baddha Konasana (Bound Angle Pose), and Janu Sirsasana (Head-to-Knee Pose). These poses can do wonders for the hip joints and the muscles around them. Unfortunately, many students feel a painful pinching sensation in the inner knee in all of them. To understand why, and how to prevent it, consider the underlying anatomy.
可喜地是,現在有許多技巧可以讓學習雙盤變得更安全，即使你不教雙盤，你也可以讓學生在做相關的體位法，使用相同的技巧保護學生，例如: Ardha Baddha Padmottanasana(Half-Bound Half-Lotus Forward Bend直立單盤前彎式) Baddha Konasana (Bound Angle Pose)坐式曲膝雙腳腳掌相對,或是Janu Sirsasana (Head-to-Knee Pose)坐式單腳伸直另一腳單盤腳掌抵在另一腿之內側.這些動作對髖關節及其周圍肌肉有意想不到的好處.不幸地是,很多學生在做這些動作時,膝蓋內側會有好像被人捏痛的感覺.看一下右圖你就可以了解為何會如此,以及該如何預防

註：下圖左方是安全圖，主因在於股骨頭有外轉，看箭頭就知道，右方是未做外轉的預備動作即盤腿，看到膝關節那條藍色韌帶了嗎？由於膝與小腿的外側角度太大它被拉得太徹底，是告成膝蓋受傷的主因．

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Figure 1Safe Knee Placement　　　　Figure 2 Unsafe Knee Placement

The problem starts at the hip joint, where Lotus and its relatives require an astounding degree of mobility. When you move from a neutral, seated posture, such as Dandasana (Staff Pose), to Baddha Konasana, the ball-shaped head of the thighbone must rotate outward in the hip socket about 100 degrees. Bending the knee and placing the foot in preparation for Janu Sirsasana requires somewhat less external rotation,

徵結來自髖關節的活動力，雙盤及相關姿勢要求其要有驚人的活動角度．當你從Dandasana (坐姿上身挺直，雙腳伸直，注意此動作之髖關節角度是零)變化成Baddha Konasana（束角式＝將腿打開腳掌呈翻書姿勢）時,股骨頭上方有個股頭頸會從髖關節窩外旋100度,若是做Janu Sirsasana (單腿交換伸展式＝坐姿一腳伸直另一腳抵大腿內側)要求的外旋角度會比較小一點．

but as a student bends forward in the pose, the tilt of the pelvis relative to the femur brings the total rotation to about 115 degrees. Padmasana requires the same amount of external rotation (115 degrees) just sitting upright, and the angle of rotation is somewhat different, making it more challenging for many students. When we combine the Padmasana action with a forward bend, as we do in Ardha Baddha Padmottanasana, the total external rotation required at the hip joint jumps to about 145 degrees. To put this in perspective, imagine that if you could turn your thighs out 145 degrees while standing, your kneecaps and feet would end up pointing behind you!

但是，當學生上身挺身前彎時，骨盆會稍稍離地前傾，此時股骨頭的外旋角度將呈115度．Padmasana（雙盤）要求的外旋角度也是115度,但上身若坐得很正，外旋的角度還是會有點小差異，然而這對學生而言，卻是極大的挑戰．當我們以立姿前彎的動作再結合雙盤即所謂的Ardha Baddha Padmottanasana,（直立單盤前彎式）整個髖關節的外旋角度約145度,也就是說,想像一下當你成功完成這個外旋145度的直立單腳單盤前彎式時,你的膝蓋和腳將你身後結束??(救命啊！這句我不是很懂！但重點就是大腿要儘量外旋就對了)

If a student can achieve all of this outward rotation at the hip in Lotus, they can then safely lift the foot up and across onto the opposite thigh without bending the knee sideways (see Figure 1). Some people with naturally mobile hips can do this easily, but for most people, the thighbone stops rotating partway into the pose. This limitation may be due to tight muscles or tight ligaments or, in some cases, to bone-to-bone limitations deep in the hip. When the femur stops rotating, the only way to get the foot up higher is to bend the knee sideways. Knees are not designed to do this-they are only designed to flex and extend.
假如學生能輕鬆地將大腿外旋得很徹底，那她們就能安全地抬起腳放到對側大腿上完成雙盤動作，而不會彎曲到他們的膝蓋（也就是說根本沒用到膝蓋，見上圖一），有些人天生髖關節就比較靈活可以很輕易地完成，但大部分的人只能做到某種程度．這種局限性是由於大腿的肌肉或韌帶太緊所引起，或是，在某些案例，是髖關節等骨頭太硬所造成．當大腿無法外轉，只能將腳抬高地斜彎膝蓋．膝蓋的使命不是設計來做這些動作的，它的主要功能是曲膝（蹲下）或伸展．

If an overzealous student continues to pull the foot up after his thigh stops externally rotating, or if a student or teacher forces the knee downward, the thighbone and shinbone will act like long levers that apply great force to the knee. Like a pair of long-handled bolt cutters, they will pinch the inner cartilage of the knee between the inner ends of the femur and tibia. In anatomical terms, the medial meniscus will be squeezed between the medial femoral condyle and the medial tibial condyle. In layman’s terms, the inner ends of the thigh and shin will squeeze the inner cartilage of the knee (See Figure 2). With even moderate force, this action can seriously damage the meniscus. Such injuries can be very painful, debilitating, and slow to heal.
假如學生求表現也不管髖關節是否有充分外旋的能力就拚命練盤腿，或是學生或老師太雞婆地跑去強壓翹起的膝頭，大腿和小腿的動作就像是使用膝蓋為軸心的長槓桿，這將導致股頭及小腿內側部分的疼痛感．以解剖學的名詞來說，就是指膝蓋內側的半月板會被內側股骨髁以及脛骨髁所擠壓．以外行人的話來說，就是指大腿及小腿的內側將擠壓膝蓋內側的軟骨板（見上圖），即使是輕柔地施力，也會嚴重地傷害半月板，像這樣的傷害會使得你的膝蓋變得疼痛，功能衰退，最後只好求助醫療．

以上這張圖膝蓋俯視圖，左邊是外側，右邊是內側，各位可以看到medial meniscus內側半月板及外側半月板lateral meniscus

左圖是右膝伸直,中間有髕骨patella,很多時候是patella角度跑掉,造成knee pain.右圖是彎曲,可以清楚看到patella 和股骨femur的角度.

Poses like Baddha Konasana and Janu Sirsasana can cause similar pinching. In these postures, we do not usually pull up on the foot, so the problem comes mainly from the lack of outward rotation of the thigh relative to the pelvis. Let’s first look at Baddha Konasana.
像這個Baddha Konasana（翻書動作）和Janu Sirsasana（坐姿單腿交換伸展式）也會引起同樣的疼痛感．這些動作也不太須要盤腿，因此問題出在髖關節沒有外轉．就先來看看翻書這個動作啦

Remember, to stay upright and stable while placing the feet in Baddha Konasana, the heads of the femurs will turn strongly outward-about 100 degrees-in the hip sockets. Because this requires so much flexibility of the entire hip region, many students instead allow the top rim of the pelvis to tilt backward while placing the feet in Baddha Konasana. They move the thighs and pelvis as a single unit. This requires little rotation of the heads of the femurs in the hip sockets, and it demands little flexibility. It also defeats the aim of mobilizing the hip joints and causes the entire spine to slump.
記得，翻書這個動作，上身挺直挺穩當腳掌兩兩相對，股骨頭才能有有地朝外轉100度，因為這個需要髖關節有強大的靈活度，但很多學生無法做到只好讓屁股稍往後倒才能抓到自己的雙腳．這時，骨盆和大腿已成為一體．其實，這個動作並不難，只要少許的大腿外旋角度以及少許的彈性就能成功．這個動作，也同時可以強化髖關節的靈活性並讓你的脊椎穩穩地向下挺直．

As a teacher, you may find yourself instructing the slumping student to tilt the top rim of the pelvis forward in order to bring them upright. If their hips are loose enough, this instruction won’t create a problem; the pelvis will tilt forward, the thighs will remain externally rotated, and the spine will come upright. But if the hips are too tight, the femurs and pelvis will roll forward as a single unit. While the thighbones rotate forward, the shins will not, resulting in the aforementioned pinching in the inner knees. This explains why some students do not feel any knee pain in Baddha Konasana until they attempt to tilt the pelvis completely upright.

Ps:從現在起，你們就自己看了，真的有點難翻．但看得比較快，比手劃腳也快，就是要手打出來很慢．我不逐字翻了，下回我會寫心得，這還比較快．接下來，靠大家接力翻了．這就是禮物啦，送大家，自己挑一段，翻好自動po上來．

Some students complain of knee pain only when they bend forward in poses that require external rotation. That’s because a forward bend like Janu Sirsasana demands even more external rotation at the hip joint. Again, in the tight student, the pelvis and femur roll forward as a single unit, pinching the inner knee. Of course, in either Baddha Konasana or Janu Sirsasana, pushing the knee(s) downward makes the problem worse, because tight muscles make the femur rotate forward as it is pressed.

Now back to Lotus Pose. Forcing the knees into Padmasana by lifting up on the ankles can also injure the outside of the knee. When a student lifts the shinbone without adequately rotating the thigh, it not only closes the inner knee, it opens the outer knee, overstretching the lateral collateral ligament. If a student then forcibly turns the feet so the soles point upward (which people often do to get the feet higher up on the thighs), they can worsen the strain. This action of turning the soles actually pulls the anklebone away from the knee, creating a chain reaction all the way up to the lateral collateral ligament.

What’s the solution? First, use common sense. Never force a student into Lotus or related poses, and discourage students from forcing themselves. Teach students not to push into pain, especially knee pain. Do not adjust the pose by pulling on the foot or ankle, nor by pushing down on the knee. Instead, either teacher or student should apply firm outward rotating action to the thigh, turning the femur around its long axis, using the hands or a strap. (For full instructions on how to do this adjustment, see the sidebar.)

If your student already has knee pain but can do basic standing poses comfortably, teach these poses first, with careful alignment. This can bring her a long way toward recovery. When you reintroduce problem seated poses such as Baddha Konasana and Janu Sirsasana, use the hands or a strap to apply the same outward rotating action described above for Lotus.

For students who are ready to learn Lotus, introduce it gradually, working from poses that require less external rotation at the hip (such as sitting in Ardha Baddha Padmottanasana without bending forward) to those that require more (such as full Padmasana). Wait until last to introduce poses that require the most external rotation (forward-bending variations of full Padmasana). As students are learning these poses, teach them to rotate their thighs outward either with a hands-on adjustment or a self-adjustment. Instruct them to monitor and avoid pinching sensations in the inner knees.

Encourage your students to go slowly, be patient, and persist. In time, they may be able to sit comfortably and meditate deeply in Padmasana. If not, remind them that true meditation lies not in some specific posture but in the spirit of their practice. Help them find a posture that suits them, then guide them to settle in and experience the stillness that is yoga.

Adjustments instructions

Adjustment Instructions

It’s always a good idea to ask a student for permission before you do an adjustment. You can perform this one with or without a strap. (See Figure 1 to view strap placement.)

To begin, kneel behind and to one side of the student. To do the adjustment manually, grip the upper one-third of the thigh with both hands and turn it firmly outward. To use a strap, encircle the upper one-third of the thigh with it once or twice. Pass the free end through the buckle the first time around. When you’ve finished setting up the strap, make sure that the loose end is to the outside of the thigh, so that pulling outward on the strap will externally rotate the thigh.

Use one hand to pull firmly outward and slightly downward, being careful not to force the knee downward. Place the other hand on the back of the pelvic rim and use it to prevent the pelvis from tilting backward. While adjusting, ask the student for feedback and heed what he says. Watch his facial expression and look for signs of relief, not discomfort. When done correctly on a healthy student, the rotating action can be quite strong without causing injury.

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相信各位一定和我一樣，大吃一驚，我們上報了．

是的，今天下午接到蘋果日報醫藥記者麗玲的來電，希望能談瑜伽的運動傷害，我很訝異她能找到我，原來是因為骨科今天收治了一個病人，正是瑜伽老師，是位很資深的老師，在做別針式時，即站正前彎頭碰小腿雙手抱在小腿肚後．這個動作，她平常常做，但今天這一做，就再也不能動了，全身動彈不得，最後緊急送到醫院救治．於是她透過簡理事長的介紹，要採訪一位懂得瑜伽醫學保健的專家，其實，理事長認識許多瑜伽界名師，承蒙理事長的愛戴，他請蘋果採訪我．

各位聽到上述這個案例，對各位或許很震憾，但我在醫療圈近十年的生涯中，這一點也不意外，因為這是長期傷害造成的，絕非一朝一夕就發生，就像那位受傷的瑜伽老師主訴，我平常做都好好的，為什麼今天會這樣？？？冰凍三尺非一日之寒．有些苦練瑜伽過頭的人，可以做到直立後彎手抓腳跟的境界，但除非先天骨頭就很軟，否則硬是超過身體極限逹到完美動作的後果，就是導致你的脊椎關節變得不穩定，因為脊椎一塊一塊地疊在一起，就像疊疊樂一樣，才能承受身體的跑跳碰，分散重量等功能，今天你把身體反折成一個o字型，想想看，你的脊椎就像是恐龍背上的朿一樣，上端開花，下端被壓迫得喘不過氣，這樣難保不會出問題．

人體最易受傷的脊椎是腰椎，尤其是第三四五塊，若沒充分熱身，即伸展前彎，做極限的頭碰膝動作，很自然會將脊椎的椎間盤前端壓迫得很徹底，導致椎間盤裡的髓核凸出，壓迫到一旁的脊神經，若情況嚴重，則全身猶如被點穴一樣，無法動彈，只能直挺挺地坐進救護車到醫院急救，萬一不小心動到，那種痛是痛徹心屝，無語問蒼天的痛，有些病人甚至覺得生不如死，而當時在醫療線上的我很無助，只能安慰病人要多忍耐．

我深知，苦練，對認真的瑜伽老師而言，是每天必做的功課，但練到成慢性傷害，可就成為職業病，或許會葬送未來的教學生涯也不一定．建議大家，先懂得自我保健，再誠實地面對自己的優缺，不是每個體位法都要做到完美無缺，才是好的瑜伽老師，這個想法是不對的，因為一山還有一山高，永遠比不完．就像林正雄老師今年去印度回來，有感而發地向大家所講的，

”任何高級體位法在大師的面前，都與初級體位法一樣，因為體位法必須因人而異，在印度，每個人都在練自己的瑜伽，同一個體位法，每個人練的都不盡相同，沒有你比較厲害，我比較差的想法，因為大家練瑜伽的目的，不在體位法，而是透過體位法，進入冥想放鬆的境界，因此當所有人都在唱頌時，那種天地共鳴的場面，是令人敬畏，也令人感動不已．”

林老師這番話，令我心有所感，也衷心祝福每位研習瑜伽的同修，平安．

ps:我想了想，我們協會的中文名稱就叫”樂活瑜伽醫學協會”因為樂活，是強調追求身心靈合諧的生活，這個精神與瑜伽醫學協會的宗旨不謀而合．對了，我最近會去奇摩登錄瑜伽醫學協會，下次就不會被你們唸”厚，真的很難找耶！”，打樂活瑜伽醫學，或瑜伽醫學，應該就ok．

7/12(二)記得看一下蘋果日報,今天一早我老公看報竟然認不出照片裡是我,當然臉沒曝光,名字也打錯一個字,無所謂,我只希望大家能更重視瑜伽醫學保健就夠了

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一個天大的好消息，今天我特地親赴國泰醫學中心拜訪簡文仁理事長，承蒙他百忙之中抽冗撥見，會談時，我冒昧又誠摯地邀請他成為我們這次研討會主講人，他欣然同意，硬是在八月五日那天擠出一個空檔給我們，我們的會議是十一點半開始，理事長會在十二點半到，主講一小時，研討會會於兩點前結束．所以會晚一點到的同學千萬不要放棄這個難得的機會

簡理事長是個非常親切的醫療界前輩，出了幾本書都是在談如何透過復健的觀念，來保護自己的身體，各位，或許現在身強體壯，但身體這部機器卻無法抵抗大自然的嚴苛的定律，如何在練瑜伽的當下，同時掌握復健醫學的觀念，避免練過頭，或是練受傷，是我訂定這次主題的主因．

簡理事長，他是物理治療全國聯合會的理事長，同時也是學會的常務理事，台大及陽明的臨床講師，標準檢驗局的委員，更是國泰醫學中心的組長，能夠請他親臨會場為我們親自主講，各位真是太有福氣了，我相信透過這次的研討會，你們一定更了解如何保養與復健自己的膝蓋，而且還可以學到相關的物理治療知識，這種機會很難有，希望大家一定要把握喲．

若你剛好膝蓋在痛，或是你周遭的瑜伽同修有膝蓋痛的毛病，都歡迎你轉告他們這次研討會的內容，這是我的夢想開始實現的第一步，感恩，簡理事長的支持與鼓勵，更感謝各位同修對我的期望與回應，我相信有了第一次成功的經驗，以後，就會更有制度，感謝各位的拜讀，再次祝福各位

平安健康
JUDY

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我們這群瑜伽愛好者，在一起練習時，大家都體會到瑜伽和健康的重要性，因此相約八月的第一個星期六，要在一起聚會討論這方面的議題．時間是十一點半至兩點，地點上次都提過．，因此，我先訂定下一次研討會的主題 ，根據大家受傷機率最高的部位－－膝蓋來做討論，講義是在yoga journal期刊上的專欄，其中有一篇特別探討Lotus posture，他寫很仔細，又有圖片，網址如右：http://www.yogajournal.com/teacher/978_1.cfm (好像會跳掉,沒關係,我附原文如下,這是教學用,不會侵犯著作權,大家有空可以多去這個網站汲取新知)

探討盤腿為什麼容易受傷，還好要如何調整盤腿的角度才不會受傷，其實人體各個部位的關節，在三十多歲以後就漸漸地老化，但你可能不自知，因為你尚未有感覺，只是覺得腿勁沒有以前來得好，這也是我深深覺得暖身的重要，尤其，有些骨科醫生甚至要求病人在尚未有嚴重症狀時，爬山及上下樓時要戴護膝，為的就是減緩對膝蓋的壓迫．

如果，順利的地話，我會邀請醫師或復健師過來講課，畢竟他們對這一方面比較專業，大家可以先看看講義，再把它印下來即可，若萬一他們時間沒法配合，我就先去上課，問清楚相關細節，再整理中文講義,當天由我主講給大家聽，希望大家的膝蓋，會愈來會愈強壯．

回歸醫學，才是我的夢想．

judy

ps:大家一起想想還有那些動作是和膝蓋有關的，可以回應，以便資料整理 ps:大家若有膝蓋方面的問題可以回應上來，我會一併整理請教專家，若你也想參加，也可以回應上來，因為場地不大，所以有名額的限制，費用定在五百元以下，若醫生肯來，最好，因為要付專家費．若不肯來，則費用訂２５０元，場地費１５０元，現場講義一份１００元．

注意，要來的同修，請務必寫”我要參加此一研討會”才會先幫你保留名額，因為我們會保障先前一起研習的同學的名額，所以名額不多，先報名先參加，僅對外開放２５個名額．

時間：8月5日(六)11:30~14:00
地點:梵瑜伽(捷運板南江子翠站四號出口即可看到,雙十路上,可看右側網站有介紹)
內容:討論膝關節,以下面文章為主
人數:有限制,因場地不太大.

膝關節是由股、脛、臏骨等構成上下槓桿長，構造複雜，是容易發生損傷的關節。膝關節的主要功能為屈伸運動，在半屈或屈90度時有輕微的旋轉運動。它周圍的肌肉和肌腱，內、外側副韌帶，前、後十字韌帶以及外側半月半，共同維持膝關節的穩定性。

雖然股骨和腓骨上的強壯肌肉能幫助支撐身體進行多樣的運動，但保持左右平穩必須要靠兩條韌帶。當膝關節旋轉超過韌帶限度時，軟組織會首先受損傷，整個關節是由髕骨後滑囊中分泌的滑液來潤滑的。大腿肌肉、小腿肌肉及與之相連的肌肉負責關節的活動，膝關節承受運動負荷產生的壓力的能力取決於這些肌肉的力量。

　　田徑運動中經常性的跳躍運動會導致膝蓋囊炎(和瑜伽某些串連動作是一樣的,也是大師兄所提到的問題.)。這是一種肌腱炎，液體分泌過多會造成滑囊炎；關節的滑動和不平穩常常導致膝關節習慣性脫位，單純的膝部外傷或日積月累的許多小傷會慢慢的釀成骨關節炎、慢性疼痛和關節僵硬；相反，肌肉和關節長期不運動也會患關節炎。以上是一般性關節炎的受傷的原因。

學生的訓練強度應由小到大，遵守循序漸進的原則。運動量大，強度小，轉為量小強度大，此時，如果忽視訓練中的循序漸進的原則出現訓練強度忽大忽小，或長期保持較高強度，則會引起機體過度疲勞現象。有時因為氣溫的回升，運動員興奮性較高，往往掩飾了機體的這種不適應的現象，因而在大強度中，容易出現膝關節的損傷。 

結論和建議

結論

• 4.1.1通過自己的調查、訪問找出膝關節損傷的主要原因在與專項動作技術不合理和準備活動不充分，以及過度的訓練，訓練安排不當。
• 4.1.2膝關節的確是經常易發生損傷的關節。在訓練中我們要特別注意膝關節，防止膝關節損傷。

建議

• 4.2.1訓練前必須作好準備活動，特別是下肢的活動，使膝關節運動靈活協調。
• 4.2.2加強肌肉力量練習，特別是股四頭肌以及小腿三頭肌與膀肌的力量訓練，使之強健有力。
• 4.2.3做好運動場地的義務監督，避免場地因素損傷。盡可能不在崎嶇不平的跑道上練習，尤其是進行短期的練習。
• 4.2.4當持久訓練出現反應遲鈍時，應終止基本部分練習。

  左圖是右膝伸直,中間有髕骨patella,很多時候是patella角度跑掉,造成knee pain.右圖是彎曲,可以清楚看到patella 和股骨femur的角度.

   

  左圖是右腳的解剖圖,右圖是膝關節的俯視圖.

Protect the Knees in Lotus and Related Postures

By learning basic anatomical principles, you can teach your students how to safely open their hips without injuring their knees.

By Roger Cole

	Figure 1 Safe Knee Placement View in Detail
	Figure 2 Unsafe Knee Placement View in Detail

Lotus Pose (Padmasana) is a supreme position for meditation, and Lotus variations of other asanas can be profound. However, forcing the legs into Lotus is one of the most dangerous things you can do in yoga. Each year, many yogis seriously injure their knees this way. Often the culprit is not the student but an overenthusiastic teacher physically pushing a student into the pose.

Fortunately, there are techniques that make Padmasana much safer to learn. Even if you don’t teach full Lotus, you can use the same techniques to protect students in related postures, such as Ardha Baddha Padmottanasana (Half-Bound Half-Lotus Forward Bend), Baddha Konasana (Bound Angle Pose), and Janu Sirsasana (Head-to-Knee Pose). These poses can do wonders for the hip joints and the muscles around them. Unfortunately, many students feel a painful pinching sensation in the inner knee in all of them. To understand why, and how to prevent it, consider the underlying anatomy.

The problem starts at the hip joint, where Lotus and its relatives require an astounding degree of mobility. When you move from a neutral, seated posture, such as Dandasana (Staff Pose), to Baddha Konasana, the ball-shaped head of the thighbone must rotate outward in the hip socket about 100 degrees. Bending the knee and placing the foot in preparation for Janu Sirsasana requires somewhat less external rotation, but as a student bends forward in the pose, the tilt of the pelvis relative to the femur brings the total rotation to about 115 degrees. Padmasana requires the same amount of external rotation (115 degrees) just sitting upright, and the angle of rotation is somewhat different, making it more challenging for many students. When we combine the Padmasana action with a forward bend, as we do in Ardha Baddha Padmottanasana, the total external rotation required at the hip joint jumps to about 145 degrees. To put this in perspective, imagine that if you could turn your thighs out 145 degrees while standing, your kneecaps and feet would end up pointing behind you!

If a student can achieve all of this outward rotation at the hip in Lotus, they can then safely lift the foot up and across onto the opposite thigh without bending the knee sideways (see Figure 1). Some people with naturally mobile hips can do this easily, but for most people, the thighbone stops rotating partway into the pose. This limitation may be due to tight muscles or tight ligaments or, in some cases, to bone-to-bone limitations deep in the hip. When the femur stops rotating, the only way to get the foot up higher is to bend the knee sideways. Knees are not designed to do this-they are only designed to flex and extend.

If an overzealous student continues to pull the foot up after his thigh stops externally rotating, or if a student or teacher forces the knee downward, the thighbone and shinbone will act like long levers that apply great force to the knee. Like a pair of long-handled bolt cutters, they will pinch the inner cartilage of the knee between the inner ends of the femur and tibia. In anatomical terms, the medial meniscus will be squeezed between the medial femoral condyle and the medial tibial condyle. In layman’s terms, the inner ends of the thigh and shin will squeeze the inner cartilage of the knee (See Figure 2). With even moderate force, this action can seriously damage the meniscus. Such injuries can be very painful, debilitating, and slow to heal.

Poses like Baddha Konasana and Janu Sirsasana can cause similar pinching. In these postures, we do not usually pull up on the foot, so the problem comes mainly from the lack of outward rotation of the thigh relative to the pelvis. Let’s first look at Baddha Konasana.

Remember, to stay upright and stable while placing the feet in Baddha Konasana, the heads of the femurs will turn strongly outward-about 100 degrees-in the hip sockets. Because this requires so much flexibility of the entire hip region, many students instead allow the top rim of the pelvis to tilt backward while placing the feet in Baddha Konasana. They move the thighs and pelvis as a single unit. This requires little rotation of the heads of the femurs in the hip sockets, and it demands little flexibility. It also defeats the aim of mobilizing the hip joints and causes the entire spine to slump.

As a teacher, you may find yourself instructing the slumping student to tilt the top rim of the pelvis forward in order to bring them upright. If their hips are loose enough, this instruction won’t create a problem; the pelvis will tilt forward, the thighs will remain externally rotated, and the spine will come upright. But if the hips are too tight, the femurs and pelvis will roll forward as a single unit. While the thighbones rotate forward, the shins will not, resulting in the aforementioned pinching in the inner knees. This explains why some students do not feel any knee pain in Baddha Konasana until they attempt to tilt the pelvis completely upright.

Some students complain of knee pain only when they bend forward in poses that require external rotation. That’s because a forward bend like Janu Sirsasana demands even more external rotation at the hip joint. Again, in the tight student, the pelvis and femur roll forward as a single unit, pinching the inner knee. Of course, in either Baddha Konasana or Janu Sirsasana, pushing the knee(s) downward makes the problem worse, because tight muscles make the femur rotate forward as it is pressed.

Now back to Lotus Pose. Forcing the knees into Padmasana by lifting up on the ankles can also injure the outside of the knee. When a student lifts the shinbone without adequately rotating the thigh, it not only closes the inner knee, it opens the outer knee, overstretching the lateral collateral ligament. If a student then forcibly turns the feet so the soles point upward (which people often do to get the feet higher up on the thighs), they can worsen the strain. This action of turning the soles actually pulls the anklebone away from the knee, creating a chain reaction all the way up to the lateral collateral ligament.

What’s the solution? First, use common sense. Never force a student into Lotus or related poses, and discourage students from forcing themselves. Teach students not to push into pain, especially knee pain. Do not adjust the pose by pulling on the foot or ankle, nor by pushing down on the knee. Instead, either teacher or student should apply firm outward rotating action to the thigh, turning the femur around its long axis, using the hands or a strap. (For full instructions on how to do this adjustment, see the sidebar.)

If your student already has knee pain but can do basic standing poses comfortably, teach these poses first, with careful alignment. This can bring her a long way toward recovery. When you reintroduce problem seated poses such as Baddha Konasana and Janu Sirsasana, use the hands or a strap to apply the same outward rotating action described above for Lotus.

For students who are ready to learn Lotus, introduce it gradually, working from poses that require less external rotation at the hip (such as sitting in Ardha Baddha Padmottanasana without bending forward) to those that require more (such as full Padmasana). Wait until last to introduce poses that require the most external rotation (forward-bending variations of full Padmasana). As students are learning these poses, teach them to rotate their thighs outward either with a hands-on adjustment or a self-adjustment. Instruct them to monitor and avoid pinching sensations in the inner knees.

Encourage your students to go slowly, be patient, and persist. In time, they may be able to sit comfortably and meditate deeply in Padmasana. If not, remind them that true meditation lies not in some specific posture but in the spirit of their practice. Help them find a posture that suits them, then guide them to settle in and experience the stillness that is yoga.

Adjustments instructions

Adjustment Instructions

It’s always a good idea to ask a student for permission before you do an adjustment. You can perform this one with or without a strap. (See Figure 1 to view strap placement.)

To begin, kneel behind and to one side of the student. To do the adjustment manually, grip the upper one-third of the thigh with both hands and turn it firmly outward. To use a strap, encircle the upper one-third of the thigh with it once or twice. Pass the free end through the buckle the first time around. When you’ve finished setting up the strap, make sure that the loose end is to the outside of the thigh, so that pulling outward on the strap will externally rotate the thigh.

Use one hand to pull firmly outward and slightly downward, being careful not to force the knee downward. Place the other hand on the back of the pelvic rim and use it to prevent the pelvis from tilting backward. While adjusting, ask the student for feedback and heed what he says. Watch his facial expression and look for signs of relief, not discomfort. When done correctly on a healthy student, the rotating action can be quite strong without causing injury.

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