019 拉伸、冷疗与热疗——物理治疗师的工具箱 aka 促进恢复的江湖秘术（二）

按摩、拉伸应该是生活中人们最常接触到的手法放松或者治疗方式，上一期我们聊了一些按摩相关，这一期我们来说一些“拉伸”相关的内容。世界各地的手法治疗都有悠久拉伸历史，在中医可能成为“抻筋”、“拉筋”等等，而在西医发展出筋膜、神经组织等细化的拉伸技术，更准确地说在康复领域，“拉伸”应被称为“牵伸”，运动康复、神经康复领域都在广泛应用牵伸技术来治疗他们的客户或者病人。如果时间允许，我们会继续展开冷疗和热疗的话题，冷热疗是古老的技术，也是前沿的技术，从泗水砭石到液态氮气，人类从未停止的探索与尝试。06:00 上来先问很多女生最关心的问题：拉伸能瘦腿吗？11:14 拉伸有风险吗？16:02 拉伸的机制和效果22:13 拉伸能够改变组织的黏性和弹性29:07 静态拉伸、动态拉伸、弹震式拉伸有什么区别？35:27 静态拉伸对运动表现的影响44:01 柔韧性和跑步经济性之间的关系49:15 拉伸与灵活性之间的关系55:02 冷疗的作用和应用63:00 冷疗的机制和禁忌症68:56 热疗的作用和应用75:22 热疗的机制和禁忌症部分参考文献1. Flexibility and ItsEffects on Sports Injury and Performance. Sports Medicine, 1997. 24(5): p.289-299.2. Mechanisms of enhanced force production in lengthening (eccentric) muscle contractions. J Appl Physiol(1985), 2014. 116(11): p. 1407-17.3. Myofibrils bear most of the resting tension in frog skeletal muscle. Science, 1985. 230(4731): p.1280-2.4. A physiological role for titin and nebulin in skeletal muscle.Nature, 1986. 323(6084): p. 160-4.5. Viscoelastic stress relaxation in human skeletal muscle. MedSci Sports Exerc, 1992. 24(12): p. 1375-82.6. The effects of stretching on strength performance. Sports Med, 2007. 37(3): p.213-24.7. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database SystRev, 2007(4): p. Cd004577.8. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev, 2011(7): p. Cd001256.9. Stretching before exercise does not reduce the risk of local muscle injury: a critical review of the clinical and basic science literature. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 1999. 9(4): p. 221.10. INFLUENCE OF TOPICALLY APPLIED MENTHOL COOLING GEL ON SOFT TISSUE THERMODYNAMICS AND ARTERIAL AND CUTANEOUS BLOOD FLOW ATREST. Int J Sports Phys Ther. 2018 Jun;13(3):483-492.11. Comparison of the effects of ice and 3.5% menthol gel on blood flow and muscle strength of the lower arm. doi: 10.1123/jsr.20.3.355. PMID:21828387.

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