分类汇整: 教室及研习讯息,Studio

各位，你们真是太棒了，太优秀了！

在这个艳阳高照的美妙的周六中午，割舍台北繁华的街景不逛，愿意挨着肚皮，远从市区搭捷运，小黄（出租车），还有前辈从台南搭飞机远道而来，前辈，在此受Judy的一拜，也有人搭火车从台中新竹风尘仆仆地赶来参加乐活瑜伽所举办的全台第一场瑜伽医学研讨会，各位前辈们，你们路上真是辛苦了．历史会留下这笔见证的．

还好，没让各位失望，本次研讨会圆满成功，在各位勤做笔记，笑声不断之下，相信各位一定有收获，你们上课有收获，我一切的辛苦都值得了，老实说，办这个网志及相关的活动，真的是一条不归路，有人说：练瑜伽是一条不归路，现在，我又比各位多了一条，那就是办网志

每天，我都在求进步，因为背负的各位的期望，有人跟我说：
”我每天一开机就先看你有没有新文章出现”
难怪，有时，我一早开机赶稿时，就发现”天啊！有几个疯子竟然比我还早上线，完了，得赶快交稿”
各位，我好像又重回当年跑新闻的样子，你们已经成为我的报老板，她最常唸”你这家伙，你的稿子什么时候才生出来！”

所以囉！我都不敢太偷赖，感谢各位的支持，让我的网志不断地成长，也让我的梦想正像航天飞机一样直冲宇宙的天际，大家和我一起乘着梦想～～起飞吧！！

昨天的研讨会，看到满满的人潮，近四十双饥渴求知的眼神，我知道，我找到一群同好，一群对瑜伽医学有兴趣的同好，真好～～说实话，我还真怕被各位放鸽子，但事实证明，各位是重承诺的君子，预约报名，果然都如约前来，真是太感动了！！你们若来得少，我这老脸往那放，下回想要再邀重量级的专家前来时，人家一定不感兴趣，”小猫两三只，粉难看”我自己恐怕也意兴阑珊．

还好，有各位热情的捧场，本次研讨会大大地成功，我帮各位准备的讲义，绝对值回票价，因为内容涵盖，国外原文讲义，解剖课本内容及运动医学和复健医学的内容，全都和膝盖有关，不错吧！！这都是我个人的藏书，我这个人，没别的嗜好，就是爱看书，尤其和健康相关的，我全都爱．

对于无缘与会的同学，我会尽快整理当天演讲的内容，但可能不如亲临现场来得精彩，因为有好多动作，要现场亲身参与，才会有同感．下回，记得来参加，有参加的人，不要偷懒，赶快回应上来，顺便给我一些建议，让我下回办得更精彩，对了，当天有拍照的人，记得寄给我啊you_loveyoga@yahoo.com.tw

最后，要感谢的人太多了，首先是各位参与的同好，以及梵瑜伽的春玲和那位柜枱美女，再来，就是当场表演倒立的简文仁理事长，他听到要帮各位瑜伽大师上课，输人不输阵，练了几招如意招，一招即出，果然惊动万教．
最后最后，要感谢的人，是我老公～～小条，你们管叫：条哥，就对啦！！
他常常提醒我，
”办活动，要认真，内容要充实，最好像医学会一样，有深度．．．
，还有，收费不要太贵，要便宜”
”是，遵命”

其实，各位，我是夫管严，很怕老公碎碎唸滴，”小条，你觉得这样写，口以吗！”

现在,大家可以回应上来,说一下你在那里,那我就知道你是谁了,不好意思那天都没什么空和你们相认,因为太忙了.我是最后一排右二,在帅哥旁的那位熟女judy

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好快，转眼间，这个周六就要办活动了，两个月前，大伙还在把酒言欢，依依不舍地分离，没想到，真没想到，咱们这个周六就要见面了，真是人生一大乐事，哇！哈～哈～哈，岂不畅快，写这么多，就是一个字，爽！！！

好朋友相见，当然快乐，而且我们还不是鬼混打屁杀时间，我们可是在研习哟，林老师一定很欣慰，大家都如此上进可取，很好，很好．老师在～～～高雄～～也可感到欣慰了．

有些同学实在是太谦虚了，一直要我翻一下讲义，害我情人节大餐差点泡汤，只保留十分钟．还好，赶去还来得及，又吃了一顿好料．只是多了个八烛光的强力灯泡，我女儿，一直问，为什么爸比今天要请客，为什么要请我和妈咪，其实，你是跟班的，我才是女主角．你是前世情人，那妈咪是爸比的前世什么人啊！！！这～～可能是你爸比的老妈吧！老公脸上三条线．
好了，不鬼扯了，现在就老老实实地翻一下文章．但我的英文也不太好，各位将就一点，而且，我也留了一个意外的礼物给各位，大家才有参与感嘛！！！

现在要报名的同学还来得及，因为我们希望这么的活动，各位都能参与．将来那一天各位为人师表，这些知识一定用得上，再次提醒各位，

时间：8月5日(六)11:30~14:00
地点:梵瑜伽(捷运板南江子翠站四号出口即可看到,双十路上,可看右侧网站有介绍)
内容:讨论膝关节,以下面文章为主
费用：500元(附议义,数量有限,晚来者可于事后至网站自行下载)
报名:请电梵瑜伽02-82534335
ps:理事长演讲是12:30~13:30 11:30~12:30联谊和温习时间
(不附中餐,现场禁食,但附议义,数量有限,晚来者可于事后至网站自行下载)

各位猜猜看，那一张图是正确的盘腿姿势

答案就在下文自己看了？？

Protect the Knees in Lotus and Related Postures盘腿及其相关体位之膝盖保护

By learning basic anatomical principles, you can teach your students how to safely open their hips without injuring their knees. 透过学习基本的解剖学理论你可以指导学生如何安全地打开髋关节,而不会伤到膝盖

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.
莲花式(双盘)是冥想最至高无上的姿势,其相关体位法也是较深奥的,然而强压小腿硬做双盘其实是练瑜伽最危险的动作之一．每年，都有许多瑜伽研习者因此而受伤，其实罪过都不是出在学生本身，而是教学过度热心的老师不断地督促学生做此动作

补充：（此指学生髋关节未全开时，老师就要求学生做双盘，其实是造成学生膝关节受伤的主因)

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,现在有许多技巧可以让学习双盘变得更安全，即使你不教双盘，你也可以让学生在做相关的体位法，使用相同的技巧保护学生，例如: Ardha Baddha Padmottanasana(Half-Bound Half-Lotus Forward Bend直立单盘前弯式) Baddha Konasana (Bound Angle Pose)坐式曲膝双脚脚掌相对,或是Janu Sirsasana (Head-to-Knee Pose)坐式单脚伸直另一脚单盘脚掌抵在另一腿之内侧.这些动作对髋关节及其周围肌肉有意想不到的好处.不幸地是,很多学生在做这些动作时,膝盖内侧会有好像被人捏痛的感觉.看一下右图你就可以了解为何会如此,以及该如何预防

注：下图左方是安全图，主因在于股骨头有外转，看箭头就知道，右方是未做外转的预备动作即盘腿，看到膝关节那条蓝色韧带了吗？由于膝与小腿的外侧角度太大它被拉得太彻底，是告成膝盖受伤的主因．

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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,

征结来自髋关节的活动力，双盘及相关姿势要求其要有惊人的活动角度．当你从Dandasana (坐姿上身挺直，双脚伸直，注意此动作之髋关节角度是零)变化成Baddha Konasana（束角式＝将腿打开脚掌呈翻书姿势）时,股骨头上方有个股头颈会从髋关节窝外旋100度,若是做Janu Sirsasana (单腿交换伸展式＝坐姿一脚伸直另一脚抵大腿内侧)要求的外旋角度会比较小一点．

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，当学生上身挺身前弯时，骨盆会稍稍离地前倾，此时股骨头的外旋角度将呈115度．Padmasana（双盘）要求的外旋角度也是115度,但上身若坐得很正，外旋的角度还是会有点小差异，然而这对学生而言，却是极大的挑战．当我们以立姿前弯的动作再结合双盘即所谓的Ardha Baddha Padmottanasana,（直立单盘前弯式）整个髋关节的外旋角度约145度,也就是说,想像一下当你成功完成这个外旋145度的直立单脚单盘前弯式时,你的膝盖和脚将你身后结束??(救命啊！这句我不是很懂！但重点就是大腿要尽量外旋就对了)

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.
假如学生能轻松地将大腿外旋得很彻底，那她们就能安全地抬起脚放到对侧大腿上完成双盘动作，而不会弯曲到他们的膝盖（也就是说根本没用到膝盖，见上图一），有些人天生髋关节就比较灵活可以很轻易地完成，但大部分的人只能做到某种程度．这种局限性是由于大腿的肌肉或韧带太紧所引起，或是，在某些案例，是髋关节等骨头太硬所造成．当大腿无法外转，只能将脚抬高地斜弯膝盖．膝盖的使命不是设计来做这些动作的，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.
假如学生求表现也不管髋关节是否有充分外旋的能力就拚命练盘腿，或是学生或老师太鸡婆地跑去强压翘起的膝头，大腿和小腿的动作就像是使用膝盖为轴心的长杠杆，这将导致股头及小腿内侧部分的疼痛感．以解剖学的名词来说，就是指膝盖内侧的半月板会被内侧股骨髁以及胫骨髁所挤压．以外行人的话来说，就是指大腿及小腿的内侧将挤压膝盖内侧的软骨板（见上图），即使是轻柔地施力，也会严重地伤害半月板，像这样的伤害会使得你的膝盖变得疼痛，功能衰退，最后只好求助医疗．

以上这张图膝盖俯视图，左边是外侧，右边是内侧，各位可以看到medial meniscus内侧半月板及外侧半月板lateral meniscus

左图是右膝伸直,中间有髌骨patella,很多时候是patella角度跑掉,造成knee pain.右图是弯曲,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.
像这个Baddha Konasana（翻书动作）和Janu Sirsasana（坐姿单腿交换伸展式）也会引起同样的疼痛感．这些动作也不太须要盘腿，因此问题出在髋关节没有外转．就先来看看翻书这个动作啦

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.
记得，翻书这个动作，上身挺直挺稳当脚掌两两相对，股骨头才能有有地朝外转100度，因为这个需要髋关节有强大的灵活度，但很多学生无法做到只好让屁股稍往后倒才能抓到自己的双脚．这时，骨盆和大腿已成为一体．其实，这个动作并不难，只要少许的大腿外旋角度以及少许的弹性就能成功．这个动作，也同时可以强化髋关节的灵活性并让你的脊椎稳稳地向下挺直．

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:从现在起，你们就自己看了，真的有点难翻．但看得比较快，比手划脚也快，就是要手打出来很慢．我不逐字翻了，下回我会写心得，这还比较快．接下来，靠大家接力翻了．这就是礼物啦，送大家，自己挑一段，翻好自动po上来．

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样，大吃一惊，我们上报了．

是的，今天下午接到苹果日报医药记者丽玲的来电，希望能谈瑜伽的运动伤害，我很讶异她能找到我，原来是因为骨科今天收治了一个病人，正是瑜伽老师，是位很资深的老师，在做别针式时，即站正前弯头碰小腿双手抱在小腿肚后．这个动作，她平常常做，但今天这一做，就再也不能动了，全身动弹不得，最后紧急送到医院救治．于是她透过简理事长的介绍，要采访一位懂得瑜伽医学保健的专家，其实，理事长认识许多瑜伽界名师，承蒙理事长的爱戴，他请苹果采访我．

各位听到上述这个案例，对各位或许很震憾，但我在医疗圈近十年的生涯中，这一点也不意外，因为这是长期伤害造成的，绝非一朝一夕就发生，就像那位受伤的瑜伽老师主诉，我平常做都好好的，为什么今天会这样？？？冰冻三尺非一日之寒．有些苦练瑜伽过头的人，可以做到直立后弯手抓脚跟的境界，但除非先天骨头就很软，否则硬是超过身体极限逹到完美动作的后果，就是导致你的脊椎关节变得不稳定，因为脊椎一块一块地叠在一起，就像叠叠乐一样，才能承受身体的跑跳碰，分散重量等功能，今天你把身体反折成一个o字型，想想看，你的脊椎就像是恐龙背上的朿一样，上端开花，下端被压迫得喘不过气，这样难保不会出问题．

人体最易受伤的脊椎是腰椎，尤其是第三四五块，若没充分热身，即伸展前弯，做极限的头碰膝动作，很自然会将脊椎的椎间盘前端压迫得很彻底，导致椎间盘里的髓核凸出，压迫到一旁的脊神经，若情况严重，则全身犹如被点穴一样，无法动弹，只能直挺挺地坐进救护车到医院急救，万一不小心动到，那种痛是痛彻心屝，无语问苍天的痛，有些病人甚至觉得生不如死，而当时在医疗线上的我很无助，只能安慰病人要多忍耐．

我深知，苦练，对认真的瑜伽老师而言，是每天必做的功课，但练到成慢性伤害，可就成为职业病，或许会葬送未来的教学生涯也不一定．建议大家，先懂得自我保健，再诚实地面对自己的优缺，不是每个体位法都要做到完美无缺，才是好的瑜伽老师，这个想法是不对的，因为一山还有一山高，永远比不完．就像林正雄老师今年去印度回来，有感而发地向大家所讲的，

”任何高级体位法在大师的面前，都与初级体位法一样，因为体位法必须因人而异，在印度，每个人都在练自己的瑜伽，同一个体位法，每个人练的都不尽相同，没有你比较厉害，我比较差的想法，因为大家练瑜伽的目的，不在体位法，而是透过体位法，进入冥想放松的境界，因此当所有人都在唱颂时，那种天地共鸣的场面，是令人敬畏，也令人感动不已．”

林老师这番话，令我心有所感，也衷心祝福每位研习瑜伽的同修，平安．

ps:我想了想，我们协会的中文名称就叫”乐活瑜伽医学协会”因为乐活，是强调追求身心灵合谐的生活，这个精神与瑜伽医学协会的宗旨不谋而合．对了，我最近会去奇摩登录瑜伽医学协会，下次就不会被你们唸”厚，真的很难找耶！”，打乐活瑜伽医学，或瑜伽医学，应该就ok．

7/12(二)记得看一下苹果日报,今天一早我老公看报竟然认不出照片里是我,当然脸没曝光,名字也打错一个字,无所谓,我只希望大家能更重视瑜伽医学保健就够了

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一个天大的好消息，今天我特地亲赴国泰医学中心拜访简文仁理事长，承蒙他百忙之中抽冗拨见，会谈时，我冒昧又诚挚地邀请他成为我们这次研讨会主讲人，他欣然同意，硬是在八月五日那天挤出一个空档给我们，我们的会议是十一点半开始，理事长会在十二点半到，主讲一小时，研讨会会于两点前结束．所以会晚一点到的同学千万不要放弃这个难得的机会

简理事长是个非常亲切的医疗界前辈，出了几本书都是在谈如何透过复健的观念，来保护自己的身体，各位，或许现在身强体壮，但身体这部机器却无法抵抗大自然的严苛的定律，如何在练瑜伽的当下，同时掌握复健医学的观念，避免练过头，或是练受伤，是我订定这次主题的主因．

简理事长，他是物理治疗全国联合会的理事长，同时也是学会的常务理事，台大及阳明的临床讲师，标准检验局的委员，更是国泰医学中心的组长，能够请他亲临会场为我们亲自主讲，各位真是太有福气了，我相信透过这次的研讨会，你们一定更了解如何保养与复健自己的膝盖，而且还可以学到相关的物理治疗知识，这种机会很难有，希望大家一定要把握哟．

若你刚好膝盖在痛，或是你周遭的瑜伽同修有膝盖痛的毛病，都欢迎你转告他们这次研讨会的内容，这是我的梦想开始实现的第一步，感恩，简理事长的支持与鼓励，更感谢各位同修对我的期望与回应，我相信有了第一次成功的经验，以后，就会更有制度，感谢各位的拜读，再次祝福各位

平安健康
JUDY

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我们这群瑜伽爱好者，在一起练习时，大家都体会到瑜伽和健康的重要性，因此相约八月的第一个星期六，要在一起聚会讨论这方面的议题．时间是十一点半至两点，地点上次都提过．，因此，我先订定下一次研讨会的主题 ，根据大家受伤机率最高的部位－－膝盖来做讨论，讲义是在yoga journal期刊上的专栏，其中有一篇特别探讨Lotus posture，他写很仔细，又有图片，网址如右：http://www.yogajournal.com/teacher/978_1.cfm (好像会跳掉,没关系,我附原文如下,这是教学用,不会侵犯著作权,大家有空可以多去这个网站汲取新知)

探讨盘腿为什么容易受伤，还好要如何调整盘腿的角度才不会受伤，其实人体各个部位的关节，在三十多岁以后就渐渐地老化，但你可能不自知，因为你尚未有感觉，只是觉得腿劲没有以前来得好，这也是我深深觉得暖身的重要，尤其，有些骨科医生甚至要求病人在尚未有严重症状时，爬山及上下楼时要戴护膝，为的就是减缓对膝盖的压迫．

如果，顺利的地话，我会邀请医师或复健师过来讲课，毕竟他们对这一方面比较专业，大家可以先看看讲义，再把它印下来即可，若万一他们时间没法配合，我就先去上课，问清楚相关细节，再整理中文讲义,当天由我主讲给大家听，希望大家的膝盖，会愈来会愈强壮．

回归医学，才是我的梦想．

judy

ps:大家一起想想还有那些动作是和膝盖有关的，可以回应，以便资料整理 ps:大家若有膝盖方面的问题可以回应上来，我会一并整理请教专家，若你也想参加，也可以回应上来，因为场地不大，所以有名额的限制，费用定在五百元以下，若医生肯来，最好，因为要付专家费．若不肯来，则费用订２５０元，场地费１５０元，现场讲义一份１００元．

注意，要来的同修，请务必写”我要参加此一研讨会”才会先帮你保留名额，因为我们会保障先前一起研习的同学的名额，所以名额不多，先报名先参加，仅对外开放２５个名额．

时间：8月5日(六)11:30~14:00
地点:梵瑜伽(捷运板南江子翠站四号出口即可看到,双十路上,可看右侧网站有介绍)
内容:讨论膝关节,以下面文章为主
人数:有限制,因场地不太大.

膝关节是由股、胫、膑骨等构成上下杠杆长，构造复杂，是容易发生损伤的关节。膝关节的主要功能为屈伸运动，在半屈或屈90度时有轻微的旋转运动。它周围的肌肉和肌腱，内、外侧副韧带，前、后十字韧带以及外侧半月半，共同维持膝关节的稳定性。

虽然股骨和腓骨上的强壮肌肉能帮助支撑身体进行多样的运动，但保持左右平稳必须要靠两条韧带。当膝关节旋转超过韧带限度时，软组织会首先受损伤，整个关节是由髌骨后滑囊中分泌的滑液来润滑的。大腿肌肉、小腿肌肉及与之相连的肌肉负责关节的活动，膝关节承受运动负荷产生的压力的能力取决于这些肌肉的力量。

　　田径运动中经常性的跳跃运动会导致膝盖囊炎(和瑜伽某些串连动作是一样的,也是大师兄所提到的问题.)。这是一种肌腱炎，液体分泌过多会造成滑囊炎；关节的滑动和不平稳常常导致膝关节习惯性脱位，单纯的膝部外伤或日积月累的许多小伤会慢慢的酿成骨关节炎、慢性疼痛和关节僵硬；相反，肌肉和关节长期不运动也会患关节炎。以上是一般性关节炎的受伤的原因。

学生的训练强度应由小到大，遵守循序渐进的原则。运动量大，强度小，转为量小强度大，此时，如果忽视训练中的循序渐进的原则出现训练强度忽大忽小，或长期保持较高强度，则会引起机体过度疲劳现象。有时因为气温的回升，运动员兴奋性较高，往往掩饰了机体的这种不适应的现象，因而在大强度中，容易出现膝关节的损伤。 

结论和建议

结论

• 4.1.1通过自己的调查、访问找出膝关节损伤的主要原因在与专项动作技术不合理和准备活动不充分，以及过度的训练，训练安排不当。
• 4.1.2膝关节的确是经常易发生损伤的关节。在训练中我们要特别注意膝关节，防止膝关节损伤。

建议

• 4.2.1训练前必须作好准备活动，特别是下肢的活动，使膝关节运动灵活协调。
• 4.2.2加强肌肉力量练习，特别是股四头肌以及小腿三头肌与膀肌的力量训练，使之强健有力。
• 4.2.3做好运动场地的义务监督，避免场地因素损伤。尽可能不在崎岖不平的跑道上练习，尤其是进行短期的练习。
• 4.2.4当持久训练出现反应迟钝时，应终止基本部分练习。

  左图是右膝伸直,中间有髌骨patella,很多时候是patella角度跑掉,造成knee pain.右图是弯曲,可以清楚看到patella 和股骨femur的角度.

   

  左图是右脚的解剖图,右图是膝关节的俯视图.

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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