💥 ACL Tear Anniversary(附中文)
“ No Surgery: Function > Structure “
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6th May 2020 marks the day of my right ACL anniversary playing 🏈. It has been one o...
💥 ACL Tear Anniversary(附中文)
“ No Surgery: Function > Structure “
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6th May 2020 marks the day of my right ACL anniversary playing 🏈. It has been one of the most devastating injuries by far as I still remember I heard a “snap” when I was trying to go past the offensive line
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I decided not to have surgery. Nothing was more difficult than walking stairs after the tear. But I looked on the flip side as being a physical therapist myself, I read all the journals I could find and designed my own rehab program. Day in and day out of the gym now I can squat 160 KG again
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If you went to a doctor after an injury like this they would 10/10 suggest a surgery. After a year of research and working with ACLR clients , I have made a conclusion of 3 scenarios where you should consider Rehab before surgery:
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1️⃣ Isolated full ACL tear : No complications on meniscus or lateral ligaments. No pain after acute swelling
2️⃣ Grade 2 partial-tear : No acute swelling after injury. Still remnants of ACL ligament can be strengthened with strength training to stimulate ligamental growth
3️⃣ Unidentified : No acute swelling after injury, nor pain. Unclear to reach diagnosis on MRI
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🎯 As long as you can maintain good “function” of your leg, like day to day commute, full squat without pain. There is not an urgent need for surgery, and instead, rehab training should be prioritized to maximize “function“
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🧠 Function + Movement > Structural Damage
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💥前十字韌帶斷裂滿一週年
“沒有十字韌帶不可怕"
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這週是我因為打美式足球時右腳前十字韌帶斷裂的一週年。這一年來，從走樓梯都有困難，到現在可以深蹲回到160公斤，真的花了很長一段時間。很幸運自己是一位物理治療師，復健自己做，為自己設計課表，從開立十字韌帶訓練團課，到現在一對一的術後訓練，把學過的看過的，融會貫通，幫助那些像我一樣，走出傷痛，重回運動的懷抱
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可以不開刀嗎？ 這是我常被問的問題，受傷後我並沒有開刀
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如果你去看骨科，醫生一定叫你開刀。好像沒了韌帶，就不能跑，不能跳，不能回去正常生活，不過事實是如此嗎?
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綜合了我這一年的經驗，與病人的交談，看過的學術文獻，得出以下3種情況，可以先不做十字韌帶重建手術:
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1️⃣ 只有前十字韌帶斷裂，沒有合併半月板受傷(Isolated ACL tear): 我的狀況就是這樣，我只有斷前十字韌帶，沒有半月板或其他軟組織受傷，所以也不會疼痛
2️⃣ 前十字韌帶第二級拉傷(Grade 2 Tear): 第二級的意思是指斷了一些，沒有全斷，可以透過物理治療做訓練，加強膝關節周邊肌肉，增加膝蓋穩定度
3️⃣ 不清楚是不是斷裂(Unidentified): 受傷後沒有腫脹，沒有痛，也沒有聽到「啪」一聲，照核磁共震也看不太清楚，我建議先不要急著開刀，先自我訓練，或找物理治療師評估
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🎯 重點是，只要功能是可以的，不影響日常生活，能繼續上健身房，打球不會痛不會覺得不穩，那就不用急著去開刀，當然這跟病人自身的目標也有關。假如是在打社會組，競技性比賽，一般還是建議直接選擇開刀，術後趕快做物理治療
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🧠 功能+動作 > 結構性損傷
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#jamesthephysio signing out
stimulate中文 在 淋巴水腫專科物理治療師/陳品君物理治療師 Ping- Chun Chen Physiotherapist Facebook 的最佳貼文
❌不需要直接按壓淋巴結
⭕刺激淋巴管,❌而不是刺激淋巴結
促進淋巴流動,加速淋巴循環. 其實是要傳送訊號給淋巴收集管上方的肌肉。
當平滑肌接收到訊號,就會整體加快收縮。
✅但大部分淋巴結是沒有平滑肌
(極少部分的器官旁淋巴結上可能有,但那也是觸碰不到的深層)
👩⚕️個案問,
要不要壓腋下淋巴結 ?? 要不要壓腹股溝(鼠蹊)淋巴結 ??要壓幾下，多大力??
👉其實是不需要直接按壓在淋巴結
上的
👩⚕️常常個案都把腋下和鼠蹊周邊的組織壓到紅腫,這反而是反效果。
因為不但沒有加速循環和加快流動,後續還造成周邊組織發炎,產生更多組織液。
而因為摸不到淋巴結,個案都力道過大想要壓到淋巴結,導致其他腋下或鼠蹊周邊紅腫,這也會影響到治療師治療時的判斷。
淋巴結有沒有腫大,是治療師每次執行治療時都需要去觀察的,若有莫名腫大,我們需要判斷是否有急性感染, 是否身體免疫系統出現問題,若出現問題,我們才能加快轉診或提醒個案注意皮膚傷口或免疫狀況。
👩⚕️
✅若是想加速上肢或下肢的淋巴循環～
👉上肢: 可以藉由延展stretch手臂內側皮膚或身體側邊靠近腋下的位置,給予神經訊號在這些鄰近位置來幫忙,但不需要真的壓到淋巴結
👉下肢: 同樣可以延展大腿內側,臀部,下腹部位置的皮膚給予淋巴管道刺激, 而不需要壓鼠蹊部.
（以下英文精簡版，看中文版比較清楚喔！）
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👩⚕️No need to press the lymph
nodes directly
✅Stimulate the lymph vessels, not the lymph nodes.
Increase lymphatic flow and accelerate lymphatic circulation. In fact, it is to send a signal to the smooth muscles of the collector lymphatic vessel.
When the nerves of the smooth muscle receives the signal, it will accelerate the contraction.
But most lymph nodes have no smooth muscle.
🔽
The cases asked,
Do they need to press the axillary lymph nodes?? Do they want to press the groin lymph nodes??
How much pressure, how many times?
👉Actually, you don’t need to press directly on the lymph nodes.
If you want to speed up the lymphatic circulation of the upper or lower limbs:
Upper extremity: You can stretch the skin on the inside of the arm or the side of the body near the armpit. (Give nerve signals to the smooth muscles and help in these nearby locations, without actually pressing the lymph nodes directly.)
Lower limbs: It can also stretch the inner thighs, buttocks, and lower abdomen to stimulate the lymphatic vessels.
No need to press the groin lymph nodes directly.
#drvodderlymphedema
#drvodderlymphaticdrainage
#drvodder
#淋巴系統
#taichunglymphedema
#lymphaticdrainage
#Lymphaticsystem
@ Taichung, Taiwan
stimulate中文 在 Eric's English Lounge Facebook 的最佳解答
［時事英文］臺灣六大戰略產業
In President Tsai’s inauguration speech, it was mentioned that Taiwan will develop six core strategic industries to transform it into a critical force in the global economy. Below are the six industries and plans for developing them.
Are you ready for the development of next generation technologies?
蔡總統於就職演說時提到，臺灣將利用當前六大戰略產業的機遇，使臺灣蛻變為全球經濟的關鍵力量。以下為六大戰略產業及其發展計劃。你準備好開發下一個世代的科技了嗎？
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Six Core Strategic Industries
First, we will continue to develop our information and digital industries. We will take advantage of Taiwan's strengths in the semiconductor and ICT industries to secure a central role in global supply chains, and make Taiwan a major base for the development of next generation technologies, including IoT and AI.
1. information and digital industries 資訊與數位產業
2. semiconductor 半導體
3. ICT (Information and Communication Technology) 資訊與通訊科技
4. secure a central role 獲得一個核心地位
5. a major base 重要的基地
6. IoT (Internet of Things) 物聯網
7. AI (Artificial Intelligence) 人工智慧
六大核心戰略產業
第一，台灣要持續強化資訊及數位相關產業發展。我們要利用半導體和資通訊產業的優勢，全力搶占全球供應鏈的核心地位，讓台灣成為下一個世代，資訊科技的重要基地，全力促進物聯網和人工智慧的發展。
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Second, we are going to develop a cybersecurity industry that can integrate with 5G, digital transformation, and our national security. We will strive to create cybersecurity systems and an industrial chain that can protect our country and earn the world's trust.
8. cybersecurity industry 資安產業
9. integrate with 結合
10. digital transformation 數位轉型
第二，台灣要發展可以結合5G時代、數位轉型、以及國家安全的資安產業。我們要全力打造可以有效保護自己，也能被世界信賴的資安系統及產業鏈。
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Third, we are going to create biotech and medical technology industries integrated with the rest of the world. Throughout this pandemic, Taiwanese teams have proven that they are capable of working with world-class technologies to produce reagents and develop new drugs and vaccines. We are going to give these industries our utmost support, and transform Taiwan into a key force in the global battle against infectious diseases.
11. biotech and medical technology 生物與醫療科技
12. capable of 有能力做……
13. world-class 世界級的；世界一流的
14. reagent 試劑；試藥
15. vaccine 疫苗
16. utmost support 全力扶持；最大的支持
17. key force 關鍵力量
18. infectious diseases 傳染病
第三，我們要打造接軌全球的生物及醫療科技產業。這次疫情中，無論是試劑製造、或是新藥和疫苗的研發，「台灣團隊」都有足夠的能力，跟全球頂尖技術接軌。我們要全力扶持相關產業，讓台灣成為全球克服疫病挑戰的關鍵力量。
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Fourth, we are going to develop national defense and strategic industries by integrating military and civilian capabilities. In addition to domestically-produced naval vessel and aircraft programs that are currently underway, we will push harder to promote technological integration between the military and the private sector, to stimulate private sector production capabilities, and advance into the aviation and space industries.
19. national defense 國防
20. strategic industries 戰略產業
21. domestically-produced 國內製造
22. naval vessel 軍艦
23. underway 正在進行的；正在發生的
24. push harder 更加努力
25. technological integration 技術整合
26. stimulate 激發；刺激
27. private sector 私營部門（即民營）；民間
28. the aviation and space industries 航空與太空產業
第四，我們要發展軍民整合的國防及戰略產業。除了已經在進行當中的國艦國造、國機國造，我們會更強力推動軍民技術整合，激發民間製造能量，更進一步進軍航空及太空產業。
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Fifth, we are going to accelerate the development of green energy and renewable energy industries. Over the past four years, renewable energy has experienced explosive growth, and Taiwan has become a hotspot for international investment. Building on this foundation, I am confident that we will achieve our goal of deriving 20% of our overall energy from green sources by 2025. We are going to make Taiwan a center for green energy in Asia.
29. green energy 綠能
30. renewable energy 再生能源
31. explosive growth 飛躍性地增長
32. hotspot 熱點
33. derive sth from sth 從…中得到，從…中獲得、取得
第五，我們要加速發展綠電及再生能源產業。過去四年，再生能源有飛躍性的發展，台灣成為國際再生能源投資的熱點。在這個基礎上，2025年綠能占整體能源百分之二十的目標，我有信心可以達成，台灣將成為亞太綠能中心。
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Sixth, we are going to establish strategic stockpile industries that can ensure the steady provision of critical supplies. Facing changes to the global order, we need to keep key industrial chains in Taiwan and maintain a certain degree of self-sufficiency in the production of face masks, medical and daily supplies, energy, and food.
34. strategic stockpile industries 戰略儲備產業
35. the steady provision of critical supplies 關鍵物資的穩定供應
36. the global order 全球秩序
37. key industrial chains 重要的產業鏈
38. a certain degree of 一定程度的……
39. self-sufficiency 自給自足
第六，我們還要建構足以確保關鍵物資供應的民生及戰備產業。面對未來的全球秩序變化，從口罩、醫療及民生用品、能源到糧食供應，我們要把重要的產業鏈留在國內，維持一定的自給率。
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蔡總統就職演說全文英文版：https://bit.ly/2AM9RFN
蔡總統就職演說全文中文版：https://bit.ly/36m0bxp
圖片出處：Google Search
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How might we develop these industries? What would be the first step to take?
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時事英文講義：https://bit.ly/2XmRYXc
時事英文大全：http://bit.ly/2WtAqop
如何使用「時事英文」：https://bit.ly/3a9rr38