💥 Bench press wrist pain (附中文) “Simple solution” - 🗣 Dating back a couple posts, we talked about the three main reasons for having wrist pain in bench press. First is a TFCC injury, or cartilage compression injury, in the radiocarpal or midcarpal joint. Second is the wrist joint being a non-weight bearing structure itself. And third is shoulder instability - 🧠 Hot packs and E-stim will only subside the pain by no means it will fix the situation. Like I always tell my patients, not having pain is inequivalent to full recovery, nor is it equivalent to lift heavy ass weights yet - 👨🏻‍⚕️ Clinically, I love to teach my client this exercises to relieve pain in bench press or push-ups. Here is how to do it: - 1️⃣ Fixate a band at a lower angle 2️⃣ Put the painful wrist through the band 3️⃣ Hand on the bench, band on the wrist 4️⃣ Bend the wrist out(extension) with bodyweight 5️⃣ Should feel slight joint distraction 6️⃣ Adjust the tension of the band for better outcomes - 💡 This is a method been broadly practiced by physical therapists to create joint space and movement fluidity. I recommend deloading to 60-70% 1RM after the first therapy session. If it is still painful, back off from pressing movements, turn to active range of motion exercises including resisted wrist extension, pronation and supination - 👥 Tag your gym partner ————————————————— 💥卧推手腕疼痛：該做什麼 “關節鬆動運動” - 🗣上次有講到卧推腕關節會疼痛的三個原因，那我們這次來看一下可以做什麼減緩疼痛的問題。一般如果是三角軟骨受傷，如果不太嚴重，可以做健保的電療熱敷，症狀能得到短暫的改善。不過沒有疼痛，並不代表已經好了；同樣，沒有疼痛，不代表可以開始大重量訓練 - 💡 在臨床，遇到手腕疼痛的病人，不管是卧推還是做俯地挺身，我都會教這個運動： - 1️⃣ 將彈力帶固定在一端，建議是斜下方 2️⃣ 患側手腕穿過彈力帶 3️⃣ 手腕撐在椅子上，彈力帶扣在腕關節上 4️⃣ 利用體重把手腕做出伸直動作(往外折) 5️⃣ 關節會有輕輕分離的感覺 6️⃣ 可調整彈力帶的張力以達到關節鬆動的目的 - 🧠 透過增加關節的空間，能暫時減緩腕關節內的壓力，讓訓練能繼續進行。如果三角軟角受傷了，建議看完第一次物理治療後需要降低訓練重量(Deload)到1RM的60-70%，避免繼續重壓關節。嚴重的個案會建議避免推舉動作的訓練，進行主動腕關節輕阻力運動，包括內旋、外旋、伸直三個方向，而不是完全休息 - 👥 標記你的訓練好朋友 - #jamesthephysio signing out

💥 卧推手腕疼痛成因(English scroll down) “運動物理治療師 vs 會運動的物理治療師” - 🤔 最近朋友讓我看一個影片，影片的內容大概是一個物理治療師Youtuber在解釋為什麼卧推會疼痛的原因。他把疼痛的原因歸納為三個： - 1️⃣ 伸腕肌群受傷 2️⃣ 肩膀卡住了 3️⃣ 脖子壓到神經 - 👀 問題是問：「卧推為什麼手腕會疼痛」其實聽完他講的東西後，我有點黑人問號，不太能認同，根據他的說法，也不符合卧推技巧會使用到肌群。這邊我綜合了我的臨床經驗(健身傷害的個案)，以及我的個人訓練經驗，歸納出三個卧推時手腕出現疼痛的成因 - 1️⃣ 手腕三角纖維軟骨複合體受傷：簡稱三角軟骨(TFCC)，包括了橈腕關節(radiocarpal joint)跟腕中關節(midcarpal joint)的周邊韌帶、軟骨、肌腱。三角軟骨有穩定關節跟保護關節的作用。在重覆性重壓或扭轉的動作下，三角軟骨便會受傷，因而產生腕關節周邊的疼痛 2️⃣ 手腕非承重關節：日常生活中姿勢多維持在站、坐或仰躺。當我們在四足跪姿，手腕支撐上肢體重時，或卧推握槓，手腕呈伸直或過度伸直(往後折)的位置。這位置是腕關節最緊密的位置(Closed-pack position)，這時關節內壓力會增加，如果並不常讓手腕負重，腕關節內壓力瞬間增加，便會產生疼痛 3️⃣ 肩關節穩定度不佳：卧推的動作跟深蹲有異曲同工之妙。踝關節的不穩會影響骨盆，肩關節的不穩會影響手腕。卧推重量很重的時候，總會有一邊肩膀往下掉(內轉)，會使手腕過度伸直，之後的便是上面講的兩個成因了，關節與關節之間的動作會互相影響，肩關節穩定度變好，卧推力量傳導也會改善 - ❓每位治療師都有自己的看法，重點還是把病人治好。那位Youtuber提出的三個原因，我想各位可以思考一下是否合理。想知道疼痛的問題怎麼處理？在下面留言，標記你的朋友 ——————————————————————— 💥 Wrist pain in bench press “Sports Physiotherapist vs Physiotherapist does sports” - 🤔 In early September a dear friend of mine sent me a video, which is a physical therapist Youtuber explaining to a fitness Youtuber the cause of wrist pain in bench press. He stated three reason as below: - 1️⃣ Injury of wrist extensor group 2️⃣ Shoulder is stuck( I hate the word stuck) 3️⃣ Cervical spine nerve compression - 👀 My brain could not think of anything but question marks. Personally I do NOT agree with his statement, first it might lead to misunderstanding of the public, second it makes no sense at all. So I thought I would combine my clinical experience and self-training recount in the best of my knowledge, to summarize 3 main reasons for wrist pain in bench pressing - 1️⃣ Triangular Fibrocarilage Complex(TFCC) injury: the complex contains ligaments, tendons and cartilage laying around the mid-carpal and the radiocarpal joint. It protects and cushions from compressive forces. Repetitive combined extension and rotational movement put unnecessary stress to the complex that may cause pain - 2️⃣ Wrist joint as a non-weight bearing joint: a lot of people are not accustomed to bearing bodyweight on the wrist joint, especially in all four-position where the wrist joint(Continued in the comment)