《腰背维修师》Dr.Stuart McGill讲腰背特痛原理
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:00 | to you all. | 敬你们大家 |
| 0:03 | Ken, Dr. Ford, thank you so much for inviting me down here and I've really | 肯,福特博士,谢谢你邀请我来这里 我真的... |
| 0:09 | enjoyed getting to know you. | 很高兴认识你 |
| 0:10 | It's been a terrific experience. | 这是一个伟大的经验。 |
| 0:14 | And Michelle Bowers, I don't know | 还有米歇尔·鲍尔斯 我不知道 |
| 0:16 | if she can... Oh, there she is back there. | 如果她可以的话... 哦,她在这里。 |
| 0:17 | Michelle, thank you for your professionalism | 米歇尔,谢谢你的专业精神 |
| 0:20 | in getting me down here in one piece. | 带我到这里一个完整的。 |
| 0:21 | I'm not an American, I'm a foreigner, I'm Canadian | 我不是美国人 我是外国人 我是加拿大人 |
| 0:26 | and it's quite a treat to get across your border these days. | 这阵子能穿越你的边境真是不错 |
展开字幕全文（1192 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | to you all. | 敬你们大家 |
| 2 | Ken, Dr. Ford, thank you so much for inviting me down here and I've really | 肯,福特博士,谢谢你邀请我来这里 我真的... |
| 3 | enjoyed getting to know you. | 很高兴认识你 |
| 4 | It's been a terrific experience. | 这是一个伟大的经验。 |
| 5 | And Michelle Bowers, I don't know | 还有米歇尔·鲍尔斯 我不知道 |
| 6 | if she can... Oh, there she is back there. | 如果她可以的话... 哦,她在这里。 |
| 7 | Michelle, thank you for your professionalism | 米歇尔,谢谢你的专业精神 |
| 8 | in getting me down here in one piece. | 带我到这里一个完整的。 |
| 9 | I'm not an American, I'm a foreigner, I'm Canadian | 我不是美国人 我是外国人 我是加拿大人 |
| 10 | and it's quite a treat to get across your border these days. | 这阵子能穿越你的边境真是不错 |
| 11 | Well, we have a little | 我们有一点 |
| 12 | bit of a history here in Pensacola. | 在彭萨科拉有段历史 |
| 13 | Some of you may know this. | 你们有些人可能知道这个 |
| 14 | We had a tripartite deal. | 我们有三方协议 |
| 15 | We were down here for over a year working with the Pensacola Fire Department, Athletes | 我们在这里工作了一年多 与彭萨科拉消防局,运动员 |
| 16 | Performance as they were formerly known. | 他们以前所知道的表演 |
| 17 | It's now EXOS and the Andrews Institute. | 现为EXOS和安德鲁斯研究所. |
| 18 | And in | 并进 |
| 19 | working with the firefighters, we measured them doing real firefighting tasks, for example, | 与消防员合作,我们测量他们 做真正的消防任务,例如, |
| 20 | breaching a door, piking open an elevator to get people out, chopping holes in roofs | 打开电梯把人救出来 挖屋顶的洞 |
| 21 | of buildings. | 建筑物。 |
| 22 | We spent over half a million dollars documenting the stresses on the spine | 我们花了50多万美元 记录了脊椎的压力 |
| 23 | and the hips, et cetera. | 还有臀部之类的 |
| 24 | And we did various training studies as well and we found how | 我们做了各种训练研究 我们发现 |
| 25 | important it was for the transference of what you do in the training room to get it | 很重要的是你在训练室的功劳 |
| 26 | out onto the fire ground. | 在火场上。 |
| 27 | And poor coaching causes a lot of trouble. | 而糟糕的辅导也会带来很多麻烦. |
| 28 | It isn't just a matter | 不只是问题 |
| 29 | of doing the exercise and thinking you're going to be a more competent firefighter with | 认为你会成为一个更胜任的消防员 |
| 30 | less risk of injury out there. | 伤害的风险降低。 |
| 31 | Competent coaching matters. | 胜任的辅导很重要。 |
| 32 | The way that we quantified movement | 我们量化运动的方式 |
| 33 | and all of the tools that are commercially available to measure movement, it turned out | 以及所有商业上可用于衡量移动情况的工具 |
| 34 | you had to pretty much mimic the speeds and loads that these men and women utilize on | 你不得不模仿这些男人和女人利用的速度和负荷 |
| 35 | the job to be able to predict those who would and would not do well physically. | 能够预测那些在身体上会做和不会做好事的人。 |
| 36 | Anyway, | 总之 |
| 37 | that was just a little bit of an intro to our work here in Pensacola. | 那只是我们彭萨科拉工作的介绍 |
| 38 | Well, that's the | 嗯,这是 |
| 39 | evening. | 边 |
| 40 | The basic supposition is there's no such thing as nonspecific back pain. | 基本假设是,不存在不具体的背痛. |
| 41 | It's | 这是 |
| 42 | not in people's heads. | 不是在人们的头上。 |
| 43 | Pain is not normal. | 疼痛是不正常的。 |
| 44 | There is a cause. | 有一个原因。 |
| 45 | So I'll talk a little bit | 所以我来谈谈 |
| 46 | {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}关于一些神话 {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}如何去除疼痛触发器 {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}然后建立无痛的 | |
| 47 | foundation. | 基础。 |
| 48 | I'll start with this quote from the very famous Czech neurologist, Dr. Carol | 我从捷克著名神经学家卡罗尔博士的引文开始 |
| 49 | Lovett. | 爱人. |
| 50 | The first task for the physician or the clinician is to show the patient the | 医生或临床医生的第一项任务是向病人说明 |
| 51 | cause of their pain. | 他们的痛苦 |
| 52 | Well, typically, not always, but typically the patient gets 10 | 通常,不是总是, 但通常病人得到10 |
| 53 | or 15 minutes with the medic who has no chance to probe and provoke the pain mechanism so | 或15分钟 与医生 谁没有机会 探测和触发疼痛机制 |
| 54 | they understand it and reach a precise diagnosis. | 他们理解了 并得出了准确的诊断 |
| 55 | So they're left giving the patient an analgesic, | 他们给病人留了止痛药 |
| 56 | a piece of paper with some exercises that have just as much a chance of hurting their | 一张纸上写着一些练习 可能伤害他们 |
| 57 | back as it does of helping. | 就像帮助别人一样 |
| 58 | Or worse yet, they tell the person, we don't know your | 或者更糟的是,他们告诉人,我们不知道你的 |
| 59 | pain. | 伤痛。 |
| 60 | It must be in your head. | 肯定在你脑子里 |
| 61 | Have you ever heard of anyone who has nonspecific head | 你听说过有人 有非特定的头 |
| 62 | pain or nonspecific leg pain? | 脚痛还是脚痛? |
| 63 | Why do we put up with this nonspecific back pain? | 为什么我们要忍受这种不具体的背痛? |
| 64 | Degenerative | 变性 |
| 65 | disc disease, there's no such thing. | 盘病,无此病也. |
| 66 | Could you imagine going to your mother-in-law who's | 你能想象去你岳母那里吗? |
| 67 | got a few years under her belt and a wrinkle or two on her face and saying, hi mom, I see | 她的腰带下面有几年 脸上有一两条皱纹 |
| 68 | you've got degenerative face disease? | 你有变性的面部疾病? |
| 69 | What an awful, terrible thing to say. | 说这话太可怕了 |
| 70 | If you want | 如果你想的话 |
| 71 | to give someone a psychosocial disorder, tell them they have a disease. | 给人心理障碍 告诉他们他们有病 |
| 72 | There's no such | 没有 |
| 73 | thing as a disc disease. | 作为盘状疾病。 |
| 74 | They're getting a little bit older. | 他们越来越老了 |
| 75 | So here is a picture of | 所以这是一张图片 |
| 76 | a poor soul who was declared by the radiologist, who never saw them, but they looked at the | 一个可怜的人 被放射科医生宣称 从未见过他们 |
| 77 | picture and they said, you've got degenerative disc disease. | 图片和他们说, 你有变性的盘病。 |
| 78 | And the patient came to see | 病人来看 |
| 79 | me and said, oh, I've got a disease. | 我并说,哦,我有病。 |
| 80 | I'm only going to get worse. | 我只会变得更糟。 |
| 81 | And I said, no, sir, actually | 我说,没有,先生,其实 |
| 82 | you're going to grow out of that. | 你会长出来。 |
| 83 | And that is not a disease. | 这不是一种疾病。 |
| 84 | That is a fracture called | 这叫骨折 |
| 85 | a Schmorl's node and around that is a pocket of edema, which is an inflammatory process | a Schmorl的节点和周围是水肿的口袋,这是一个煽动性的过程 |
| 86 | and that hurts. | 这很痛 |
| 87 | The disc is now a bit flat. | 盘子现在有点平了 |
| 88 | There's a little bit of a bulge there, et | 那边有点暴动,等等 |
| 89 | cetera. | 诸如此类。 |
| 90 | But with provocative testing, we learned very quickly that they had no pain if the | 但是通过挑衅性的测试 我们很快得知 如果 |
| 91 | spine was in a neutral stack position. | 脊椎处于中性堆放位置。 |
| 92 | But when they flexed or extended the spine, it | 但是当他们伸展或伸展脊椎时 |
| 93 | triggered pain. | 引发了痛苦。 |
| 94 | So how simple it was to teach them to bend over with a hip hinge rather | 教他们用臀部弯曲 有多简单? |
| 95 | than bending their spine, which no one showed them. | 他们的脊椎是弯曲的,没有人给他们看。 |
| 96 | So instead of having degenerative disc | 所以,不是有退化的盘子 |
| 97 | disease, they got a diagnosis of you have your pain triggered by flexion intolerance. | 疾病,他们得到一个诊断 你的痛苦触发了 弹性不容忍。 |
| 98 | Now they have a rather precise guide of what not to do and what to do. | 现在,他们有一个相当精确的指南 如何不做和做什么。 |
| 99 | Well, where does | 嗯,这是哪里 |
| 100 | our science come from to have a foundation for some of these crass opinions that I have? | 我们的科学来源于 有基础 这些荒谬的观点,我有吗? |
| 101 | We have four pillars of evidence. | 我们有四根支柱的证据。 |
| 102 | I'll just go through them one at a time. | 我会一次一次地检查一次 |
| 103 | So we have | 所以我们有 |
| 104 | an in vitro laboratory. | 一个体外试验室。 |
| 105 | Don't forget to turn that back on again when you leave. | 别忘了离开后再打开它 |
| 106 | We have | 我们有 |
| 107 | an in vitro laboratory. | 一个体外试验室。 |
| 108 | Sorry. | 对不起 |
| 109 | Didn't mean to interrupt. | 无意打断 |
| 110 | We have an in vitro laboratory | 我们有一个体外试验室 |
| 111 | where we take real spines. | 我们把真正的脊椎。 |
| 112 | I hope you've all signed your organ donor cards on your driver's | 希望你们都签了器官捐献卡 |
| 113 | licenses. | 执照 |
| 114 | And we create the injuries so we have a one to one match. | 我们制造伤害 所以我们有一个对一匹配。 |
| 115 | We know very precisely | 我们很清楚 |
| 116 | what causes herniated disc or disc bulge or an end plate fracture or torn ligaments or | 是什么导致盘片或盘片膨胀 或端盘骨折或韧带撕裂 |
| 117 | whatever it is. | 无论它是什么。 |
| 118 | Then we do CT scans, x-rays, and we do micro dissections so we know exactly | 然后我们做CT扫描,X光, 我们做微分解,这样我们才知道 |
| 119 | once again what those specific loads did and how they are evidenced on various images. | 这些具体的载荷如何在各种图像中再次证明。 |
| 120 | Then we have an in vivo lab where we take real live people. | 然后我们有一个维沃实验室,我们在那里 带真正的活人。 |
| 121 | Some of these pictures are | 其中一些照片是 |
| 122 | historic now. | 这是历史性的 |
| 123 | And we use techniques to measure the stress concentration inside their bodies. | 我们用技术测量他们体内的压力浓度。 |
| 124 | For example, there was a study done on elliptical trainers. | 例如,对椭圆训练员进行了一项研究。 |
| 125 | And if you follow the reaction of | 如果你跟随反应 |
| 126 | people to working on an elliptical trainer, some will say, you know, that helps my back. | 人们在做椭圆形的训练, 有些人会说,你知道,这帮助了我的背。 |
| 127 | And then the next person says, oh, that really makes my back feel sick. | 然后下一个人说, 哦,这真的让我的背感到恶心。 |
| 128 | And what are the | 还有什么 |
| 129 | variables that cause the tipping point? | 导致临界点的变量 ? |
| 130 | As it turns out, one of the more dominant ones | 事实表明, 其中一个更主导 |
| 131 | is hip mobility. | 是臀部移动。 |
| 132 | So if you have a lot of hip mobility, the elliptical trainer is very gluteal | 所以,如果你有很多的臀部移动, 椭圆训练员是非常夸张的 |
| 133 | centric. | 以心为体. |
| 134 | It really works the gluteal muscles much more than, say, going for a walk. | 它真的工作过重的肌肉 比,比如说,去散步。 |
| 135 | You | 你们 |
| 136 | may have a need to do that. | 也许有必要这样做。 |
| 137 | But if you have mobile hips, the hips move and it really doesn't | 但是如果你有移动的臀部, 臀部移动,它真的没有 |
| 138 | stress the spine. | 脊椎应力. |
| 139 | But if you have tighter hips, the restrictions in the hips go right | 但是,如果你有更紧的臀部, 臀部的限制是正确的 |
| 140 | into the spine. | 进入脊椎。 |
| 141 | And the spine starts to move, causing cumulative stress and is linked to | 脊椎开始运动,引起累积性压力,并与 |
| 142 | pain. | 伤痛。 |
| 143 | But there's one of your great gold medalists from the Olympics, a world-class strongman | 但奥运会的金牌得主之一 世界一流的强者 |
| 144 | competitor. | 竞者. |
| 145 | She won the world IPF. | 她赢得了世界IPF. |
| 146 | Anyway, these are some of the patients that come. | 总之,这些是一些病人。 |
| 147 | And then we build a virtual spine. | 然后我们造一个虚拟的脊椎。 |
| 148 | So we might start with images such as MRs or CTs, and | 所以我们可以从MR或CT等图像开始, |
| 149 | we serially stack those to create that person's spine. | 我们连续堆放这些来创造那个人的脊椎。 |
| 150 | So there's a spine of one of my graduate | 所以,有一个脊椎 我的毕业生 |
| 151 | students. | 学生。 |
| 152 | And we're measuring spine motion so that we drive the virtual spine, which | 我们正在测量脊椎运动 这样我们就可以驱动虚拟脊椎 |
| 153 | allows us to measure the stresses in the discs and the ligaments, the passive tissues. | 可以测量盘子和韧带中的应力 以及被动组织 |
| 154 | And | 还有 |
| 155 | then as with their brain, they activate their muscles. | 然后和他们的大脑一样 激活他们的肌肉 |
| 156 | We sense those patterns and drive | 我们感应到这些模式并驱动 |
| 157 | their virtual muscles. | 他们的虚拟肌肉。 |
| 158 | Then we're able to create a stress map and see where the stress | 然后我们就能绘制出压力图 看看压力在哪里 |
| 159 | concentrations are. | 浓度是。 |
| 160 | And then we measure spine stability. | 然后我们测量脊椎的稳定性。 |
| 161 | So some of you have heard of core | 你们中有些人听说过核心 |
| 162 | stability, but there's very few institutions in the world that actually measure it. | 稳定,但世界上很少有机构 实际衡量它。 |
| 163 | So | 这么说 |
| 164 | how do all these hand waivers know what is spine stability, what is a stabilization exercise | 如何让所有的人知道什么是脊椎稳定,什么是稳定工作 |
| 165 | and that kind of thing? | 那种东西呢? |
| 166 | The next level of evidence is the clinic. | 下一层证据是诊所。 |
| 167 | So we get very disabled | 所以我们变得非常残疾 |
| 168 | {\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}然后衡量他们 | |
| 169 | way of creating these very athletic patterns, either with or without back injury. | 创造这些运动模式的方法 无论是背部受伤还是没有受伤 |
| 170 | I'll use | 我会用 |
| 171 | this quite famous quote from Vince Lombardi, every man is a volume if you know how to | 文斯·伦巴第的一句名言 每个男人都是一本书 如果你懂的话 |
| 172 | read them. | 读一下 |
| 173 | Back pain forms syndromes. | 背痛形成综合征. |
| 174 | Things cluster together. | 事情集中在一起。 |
| 175 | So when you see one sign | 所以当你看到一个标志 |
| 176 | in a patient, if you know what the other ones are that form a cluster, you get wise and | 在病人中,如果你知道什么是其他的 构成一个集群,你得到智慧, |
| 177 | can converge on a diagnosis much more quickly. | 可以更快地形成诊断 |
| 178 | It may very well be that they have a social | 很可能他们有社交能力 |
| 179 | issue. | 问题。 |
| 180 | I had a patient not too long ago and I was trying to understand why she wasn't | 不久之前我有个病人 我想了解她为什么没来 |
| 181 | going out and doing her walks, which were part of the prescription. | 出去散步,这是处方的一部分。 |
| 182 | And then after a | 礛 |
| 183 | while she told me, I can't do that. | 她告诉我的时候 我不能这么做 |
| 184 | It's too dangerous for me to go out at night. | 我晚上出去太危险了 |
| 185 | And | 还有 |
| 186 | if I didn't know that, I wouldn't understand the impediment of why she wasn't doing her | 如果我不知道,我不明白 她为什么不做她。 |
| 187 | exercises. | 练习。 |
| 188 | So these are things that when you find out and read them off a patient, you | 所以这些东西,当你发现 和读出病人,你 |
| 189 | become so much more effective. | 变得更为有效。 |
| 190 | The final bit in the evidence is then, now it's time to | 最后一点证据是,现在是时候 |
| 191 | put our money where our mouth is. | 把我们的钱放在嘴边 |
| 192 | Let's field test it. | 我们实地测试一下 |
| 193 | So I told you the story with the | 所以,我告诉你的故事与 |
| 194 | firefighters here in Pensacola. | 彭萨科拉的消防员 |
| 195 | We work with various police forces, the military, numerous | 我们与各种警察部队,军队,无数 |
| 196 | sports teams and different occupational groups to see if the interventions actually work | 运动队和不同职业群体,看干预措施是否实际有效 |
| 197 | or not. | 或无. |
| 198 | Well, this is the back of the book that Ken mentioned. | 这是肯提到的书的背面 |
| 199 | So we're just going to | 所以,我们只是要去 |
| 200 | read through a few chapters now. | 读了几章 |
| 201 | These are just samples. | 这些只是样本 |
| 202 | But here's a common question | 但有一个共同的问题 |
| 203 | that I'll get from patients. | 我会从病人那里得到。 |
| 204 | Oh, my mother had back pain. | 哦,我妈妈有背痛。 |
| 205 | I've got it. | 已讫. |
| 206 | I've got degenerative | 我有堕落症 |
| 207 | disc disease. | 盘病. |
| 208 | Is it only going to get worse? | 它只会变得更糟吗? |
| 209 | And I said, well, if it's a discogenic category | 我说,嗯,如果这是一个 异性恋类别 |
| 210 | of back pain and you're 30 years old, you won't retire with this. | 背痛,你30岁, 你不会退休 与这个。 |
| 211 | In fact, you will | 事实上,你会 |
| 212 | grow out of this type of pain. | 从这种痛苦中成长。 |
| 213 | Some docs say, oh, if you've got back pain, go to Pilates | 有些医生说,哦,如果你有背痛, 去彼拉多 |
| 214 | class. | 课。 |
| 215 | Well, the fact of the matter is that some of those exercises have just as much | 事实是,有些练习也一样 |
| 216 | chance of replicating your back pain as it does of curing it. | 可能复制你的背痛 就像治疗它一样 |
| 217 | It's a crap shoot. | 这是一个狗屎拍摄。 |
| 218 | So it's | 所以这是 |
| 219 | much more scientific than that. | 比这科学多了 |
| 220 | You've got to be quite precise on the exercises that | 你必须非常精确的练习 |
| 221 | you're prescribing and making sure they're not mimicking their specific pain trigger | 你开处方,确保他们不会模仿 自己特定的疼痛触发器 |
| 222 | and they're actually building the foundation that they need that they're currently deficit | 他们实际上正在建立基础 他们需要他们 是目前赤字 |
| 223 | in. | 进去 |
| 224 | There are some institutes that say, send us your MRI and we'll decide whether we're | 有些研究所说, 给我们你的核磁共振, 我们会决定我们是不是 |
| 225 | going to operate on you. | 要去手术你。 |
| 226 | Well, it doesn't work that way. | 嗯,它不工作 这样。 |
| 227 | I believe that no radiologist | 我相信没有放射科医生 |
| 228 | with back pain or with a back pain patient should write a radiology report. | 背部疼痛或背部疼痛患者应当撰写放射报告. |
| 229 | Now, I have | 现在,我有 |
| 230 | no issue with cancer patients and they're trying to find a tumor and that kind of thing. | 癌症患者没有问题 他们试图找到肿瘤之类的东西。 |
| 231 | That's good usage of MRI. | 磁共振的用法不错 |
| 232 | But with a back pain patient, when the radiologist looks at | 但有一个背痛病人, 当放射科医生看 |
| 233 | the anatomy and starts to report on the anatomy, it has nothing really to do with whether or | 解剖学和开始报告解剖学, 这与是否或 |
| 234 | not that is the cause of the person's back pain. | 这并不是造成人背痛的原因 |
| 235 | When an injury to the back first occurs, | 当背部受伤时 |
| 236 | you may or may not see it on the MRI, but the function of that joint changes and in | 您可以在核磁共振上看到,也可能看不到,但联合核磁共振的功能会有所改变。 |
| 237 | two or three years, a little bit of arthritis will start to grow around the facet joints | 两三年后 关节炎就会在侧关节上发作 |
| 238 | and they may remark on that and that is the unstable phase. | 他们可能会说,这是不稳定的阶段。 |
| 239 | There's micro movements at | 有微移动在 |
| 240 | the joint that are triggering pain. | 导致疼痛的关节 |
| 241 | But in another 10 years or so, the good news is, | 但是再过10年左右 好消息是... |
| 242 | all of that has gristled and stiffened out. | 所有这一切 已经闪烁和僵化出来。 |
| 243 | The pain is gone, but the MRI looks horrible. | 痛苦已经消失,但核磁共振看起来很可怕。 |
| 244 | Would you operate on that joint or would you operate on the one above now that is responsible | 你会在那个关节上操作 还是你现在负责的上面那个 |
| 245 | for all the motion when that original injured one has now gristled up? | 当最初受伤的一举一动的时候, 是否也出现了? |
| 246 | So these are myths | 这些是神话 |
| 247 | that result in a bit of heartache, I'm afraid. | 恐怕这会导致心痛 |
| 248 | Okay, well let's move on now. | 好吧,现在我们继续前进。 |
| 249 | We'll skip | 我们跳过 |
| 250 | a few chapters. | 几个章节。 |
| 251 | If the medical system is not set up to provide a precise diagnosis to the | 如果医疗系统没有为患者提供准确的诊断 |
| 252 | patient because of the political reason is, they don't have three hours. | 因为政治原因 他们没有三个小时 |
| 253 | It takes me | 这需要我 |
| 254 | three, if I do a very thorough assessment of the back, I spend three hours to go through | 三,如果我对背面做一个非常彻底的评估, 我花了三个小时去通过 |
| 255 | the mechanics, the neurology, the social situation, the history. | 力学 神经学 社会状况 历史 |
| 256 | If you want a precise diagnosis, | 如果你想要一个精确的诊断, |
| 257 | that's the reality of it. | 这就是现实 |
| 258 | So can I guide a patient to do a self-assessment? | 所以,我可以引导一个病人进行自我评估吗? |
| 259 | So let's | 所以,让我们 |
| 260 | consider that idea for just a moment. | 考虑一下这个想法 |
| 261 | Now there are many tissue-based differential diagnoses. | 现在有许多基于组织的差异诊断。 |
| 262 | The pain might be coming from a disc, a sacroiliac joint, a facet. | 疼痛可能来自一个盘子,一个神圣的关节,一个面部. |
| 263 | We can get close to the tissues | 我们可以接近组织 |
| 264 | after that level of assessment, but you never will, nor will it matter to you to know what | 评估之后,你永远也不会知道,你知道什么不重要。 |
| 265 | the precise bio-anatomical pain trigger is. | 精确的生物解剖疼痛触发器是。 |
| 266 | However, if you could understand which motions, | 但是,如果你能理解 哪些动议, |
| 267 | postures, and loads make your pain increase and which ones take your pain away, that would | 姿势和负载 让你的疼痛增加 而哪一种让你的疼痛消失 |
| 268 | be the most valuable thing you could know. | 成为最有价值的东西 你可以知道。 |
| 269 | So there are what docs call red flags, things | 因此,有一些文献称红旗,事物 |
| 270 | that are sinister and nasty and aren't good to have. | 这是邪恶和肮脏的 和不好有。 |
| 271 | Always start this process by seeing | 总是从查看开始此进程 |
| 272 | your clinician to get cleared to make sure you don't have one of these things. | 你的临床医生会帮你清场 确保你没有这种东西 |
| 273 | But I'm | 不过,我 |
| 274 | going to add one, or actually a couple more, but focus on this bottom one. | 准备再加一个,或者说再加几个, 但专注于这个底部。 |
| 275 | If you cannot | 如果你做不到的话 |
| 276 | find a motion, a posture, or a load that takes your pain away or makes it worse, you don't | 找到一个运动,一个姿势, 或一个负载 让你的痛苦消失,或使它更糟,你不 |
| 277 | have mechanical back pain. | 有机械背痛。 |
| 278 | You want to go back to your clinician now, and we've found | 你现在想回诊所去 我们发现 |
| 279 | numerous tumors, infections, and nasty things because the person didn't respond to those. | 无数的肿瘤,感染, 和恶心的东西 因为人没有回应这些。 |
| 280 | But if you have mechanical back pain, you will be able to find a motion, a posture, | 但是如果你有机械背痛, 你会找到一个运动,一个姿势, |
| 281 | or a load that makes you worse, and you must avoid those to desensitize and ones that | 或使你更糟糕的负载, 你必须避免那些去敏感 和那些 |
| 282 | you can tolerate, and you should build on as part of your therapy. | 你可以容忍 并且你应该继续做你的治疗 |
| 283 | So let's start with | 所以,让我们开始 |
| 284 | a supposition. | 一个假设。 |
| 285 | Exercise reduces pain. | 锻炼可以减轻疼痛. |
| 286 | Just a supposition. | 只是一个假设。 |
| 287 | Well, I'm going to show you | 好吧,我要告诉你 |
| 288 | a mechanism in just a minute that repeated spine flexion. | 一分钟内就有一个机制 来重复脊椎伸缩 |
| 289 | That means bending your spine | 就是弯腰 |
| 290 | over and over and over again, sitting at the computer for eight hours, doing this with | 一遍又一遍,坐在电脑上八个小时, |
| 291 | your cell phone, under a certain amount of load will create a little bit of a breach | 你的手机,在一定的负荷下 会产生一点突破 |
| 292 | or a delamination in the collagen fibers of the disc. | 或者在圆盘的圆柱形纤维中进行乳化 |
| 293 | See, the disc of your spine is not | 你看,你的脊椎圆盘不是 |
| 294 | a ball and socket joint. | 一个球和插座关节。 |
| 295 | It's not made to work like a shoulder or a hip and through the range | 不像肩部、臀部和射程 |
| 296 | of motion back and forth. | 前后运动。 |
| 297 | But if you stop that flexion under load mechanism, the hydraulic | 但是如果你在负载装置下停止了弹性 液压装置 |
| 298 | pressure is reduced. | 压力降低。 |
| 299 | So you folks are Floridians, so I'm going to use an orange seed example. | 你们是佛罗里迪亚人 所以我要用一个橙色种子的例子 |
| 300 | If I had an orange seed and I was going to pinch it between my finger and thumb, and | 如果我有一个橙色的种子, 我要把它夹在我的手指和拇指之间, |
| 301 | I biased the pressure on this one side, the orange seed would go out that way every single | 我偏偏了这边的压力 橘子种子会从这里出去 |
| 302 | time. | 时间。 |
| 303 | But if I drove the thrust line right down the middle, it would hold it steady. | 但如果我把推力线推到中间 它会稳住的 |
| 304 | So if I flex forward over and over and over again, hydraulically I create an effort and | 所以,如果我反复地向前摆动, 在液压上,我创造了一个努力, |
| 305 | it will work the nucleus posteriorly. | 它将在后期发挥核心的作用。 |
| 306 | I'll show you what I mean in just a moment. | 我马上告诉你我的意思 |
| 307 | But | 不过 |
| 308 | once again, if I was to use my hips and move from the hips, that hydraulic pressure would | 再说一次,如果我用臀部 从臀部移动, 液压会 |
| 309 | be negated. | 被否定。 |
| 310 | We can prove to you that that quite often will cause the bulge to shrink | 我们可以向你们证明,这往往会导致暴增的收缩 |
| 311 | and the open fissure, I'll explain that, gristles and you end up reducing the pain. | 和开放裂缝,我会解释, 克里斯特尔和你最终减轻疼痛。 |
| 312 | So in each | 所以,在每一个 |
| 313 | one of these, there are three elements. | 其中之一,有三个要素。 |
| 314 | We will assess, interpret your history, purposefully | 我们会评估,解释你的历史,有目的地 |
| 315 | provoke the pain so we understand the mechanism. | 激起痛苦,让我们理解机制。 |
| 316 | Do the opposite to take the pain away. | 做相反的消除疼痛。 |
| 317 | Now | 现在 |
| 318 | we're doubly confident that we understand the mechanism and then we don't prescribe | 我们倍感自信地相信 我们理解这个机制 然后我们不规定 |
| 319 | exercise. | 运动。 |
| 320 | The first thing is remove the cause. | 第一义是除因. |
| 321 | Allow the pain trigger to desensitize. | 允许疼痛触发器去敏化. |
| 322 | Build | 构建 |
| 323 | a person that is now receptive to exercise and then build a program that isn't Pilates | 一个现在可以接受锻炼的人 然后建立一个不是彼拉多的程序 |
| 324 | or yoga or anything else. | 或瑜伽或其他东西。 |
| 325 | It contains elements of what they need to build a pain free foundation. | 它包含了他们建立无痛基础所需要的内容. |
| 326 | So let me give you an example now. | 现在让我举个例子。 |
| 327 | Let's see if we can find your pain trigger and in back | 看看能不能在后面找到你的疼痛触发器 |
| 328 | mechanic, of course I've written clinical textbooks for clinicians that are big thick | 机械师,我当然写过临床教科书 给那些很厚的临床医生 |
| 329 | things and you wouldn't want to read it. | 事情,你也不会想读它。 |
| 330 | But for the lay person, can we at least get it | 但对于不专业的人,我们至少可以得到它 |
| 331 | down to, yes, flexion causes your pain or extension or here's a compressive load. | 至,是的,柔性会导致你的痛苦或延伸 或者这里是一个压缩负载。 |
| 332 | Just | 刚刚 |
| 333 | go up on your toes and do that. | 爬上你的脚趾 并做到这一点。 |
| 334 | And if that created a pain trigger, aha, a little bit | 如果这造成了痛苦触发点, 啊哈,一点点 |
| 335 | of compression causes your back pain. | 压缩会导致你的背痛 |
| 336 | So if we were to start this way, have the patient | 所以,如果我们开始这样, 请病人 |
| 337 | or yourself sit on a stool. | 或者你自己坐在凳子上, |
| 338 | Grab the side of the stool and pull upwards, which compresses | 抓住凳子的侧面 向上拉 压缩 |
| 339 | the back. | 后面那个 |
| 340 | Most people will say, yeah, that doesn't cause pain. | 大多数人会说,是的, 这不会造成痛苦。 |
| 341 | A few people will say | 有几个人会说 |
| 342 | it will. | 它会。 |
| 343 | And then we say slouch down and repeat. | 然后我们说滑倒和重复。 |
| 344 | And some will say, or if they say that increases | 有些人会说,或者说,如果他们说增加, |
| 345 | my pain, you've just identified that bending forward and flexing the spine is a pain trigger. | 我的痛苦,你刚刚确认了 弯曲向前和挥动脊椎是一个疼痛触发器。 |
| 346 | Now observe the neck. | 现在观察颈部。 |
| 347 | The posture of the neck determines the tension of the cord and the | 颈部的姿势决定了绳索和颈部的张力 |
| 348 | lum根于lum脊. | |
| 349 | Some people who have cord tension when you say, now flex | 有人有绳子紧张 当你说,现在灵活 |
| 350 | your neck, oh, my right toe just went on fire. | 你的脖子 我的右脚趾刚着火了 |
| 351 | My right toe just went on fire and yet when | 我的右脚趾刚着火了 什么时候 |
| 352 | I lift my head up, my pain went away. | 我抬起头来,我的痛苦消失了。 |
| 353 | So we've just proved that it's the tension or we have | 所以,我们刚刚证明 这是紧张的或者我们有 |
| 354 | the opposite where that takes the pain away on the person and that causes the pain. | 反之,那会消除 人的疼痛,并造成痛苦。 |
| 355 | That | 那个 |
| 356 | is called a neural underhook. | 叫做神经内脏 |
| 357 | There's the offense. | 违者有之. |
| 358 | It might be a little bit of arthritic | 可能有点动脉 |
| 359 | bone. | 骨头。 |
| 360 | It might be a bulging disc. | 这可能是个膨胀的盘子。 |
| 361 | But when they look down, it pulls the nerve root off | 但是当他们往下看时,它会拉掉神经根 |
| 362 | the pain, whatever it is. | 痛苦,无论是什么。 |
| 363 | And then when they look up, it drops their head down. | 然后当他们抬头看时,就会掉头. |
| 364 | And you | 还有你 |
| 365 | can see this usually a mile away. | 通常能在一英里外看到这个 |
| 366 | If a seven foot tall NBA player comes in, you can see | 如果一个高7英尺的NBA球员进来,你可以看到 |
| 367 | it. | 这个 |
| 368 | They're walking like this. | 他们这样走路 |
| 369 | And they've been told they're a | 他们被告知他们是 |
| 370 | psychosocial nutcase walking around like this. | 心理神经病像这样走来走去 |
| 371 | And you'll see it in their eyes. | 你会在他们眼里看到 |
| 372 | I'll do something | 我会做点什么 |
| 373 | clandestine to get them to look up and you can see it. | 秘密让他们抬头看 你可以看到它。 |
| 374 | Oh, that hurts, doc. | 哦,这很痛,医生。 |
| 375 | That hurts | 疼吗? |
| 376 | in my toe or down my leg. | 脚趾或脚下。 |
| 377 | It's just the doc didn't understand that they had an underhook | 只是医生不知道 他们有潜伏 |
| 378 | on that particular nerve root. | 特别的神经根。 |
| 379 | So I'm going to run a little movie. | 所以,我要运行一个小电影。 |
| 380 | There's many of these | 有很多这样的 |
| 381 | models that are made from our documentation of these. | 我们用这些文献制作的模型。 |
| 382 | So if you bend forward under a certain | 所以,如果你弯曲 在一个特定的 |
| 383 | amount of load, like say you've been really sloppy at the gym doing deadlifts or power | 像说,你在健身房里很草率地 做电梯或电力 |
| 384 | cleans or something where you're under load and you've kept bending your spine forward | 干净的什么的,你负重的地方 你一直弯腰向前 |
| 385 | over and over. | 一次又一次 |
| 386 | The nuclear gel in the middle of the nucleus, these collagen fibers that | 核糖体中间的核凝胶 这些焦糖纤维 |
| 387 | form the disc are adhered together with a ground substance. | 组成圆盘与地面物质结合。 |
| 388 | You keep moving and they | 你继续走,他们 |
| 389 | soften and with the pressure of whatever the load was that you were picking up, they will | 软化和压力 无论是什么负担 你正在捡,他们会 |
| 390 | delaminate and the gel will come out the back. | 消火,凝胶会从后面出来 |
| 391 | Now just watch. | 现在只是看着。 |
| 392 | I'm going to run this movie | 我要主持这部电影 |
| 393 | and watch. | 看着 |
| 394 | See how I bent forward? | 你看我怎么弯腰的? |
| 395 | Do you see the gel come out the back? | 你看到后面的凝胶了吗? |
| 396 | That's the | 就是这样 |
| 397 | nerve root. | 神经根. |
| 398 | Now this time I'm going to drive the force straight down. | 这次我要直接把部队赶下来 |
| 399 | Did you see how it | 你看见了吗? |
| 400 | didn't come out? | 没出来? |
| 401 | So if you're flexed forward, it pushes the gel out the back like the orange | 所以,如果你向前摆动, 它推出凝胶的背像橙色 |
| 402 | seed going one way. | 种子从一边走 |
| 403 | But if you keep upright and you bend over through the hips, in other | 但是如果你保持直立 弯腰穿过臀部,其他 |
| 404 | words you behave like a weight lifter, zero hydraulic pressure. | 你的行为就像举重机 零液压 |
| 405 | Do you want me to play | 你想让我玩吗? |
| 406 | that again? | 再说一遍? |
| 407 | Watch. | 看着 |
| 408 | 初以 squeeze塞而向前弯. | |
| 409 | This is | 这是 |
| 410 | exactly there. | 就是这样 |
| 411 | Now that can happen sitting at the computer too long. | 坐在电脑上可能太久了 |
| 412 | Now I'm going to | 现在我要去 |
| 413 | squeeze it and drive the thrust line straight down but not allow it to flex. | 挤压并驱动推力线直下但不允许其弹性. |
| 414 | The disc squishes | 盘子 |
| 415 | a bit but the gel does not come out through the fissure. | 但凝胶不会从裂缝里出来 |
| 416 | Over time if you stop doing that, | 随着时间的推移,如果你停止这样做, |
| 417 | that fissure will gristle and it will harden up. | 裂缝会变硬 |
| 418 | And now you're bulletproof once again. | 现在你又防弹了 |
| 419 | The gel won't come out anymore. | 凝胶不会出来了。 |
| 420 | Well here's another kind of a pain trigger. | 这里还有另一种痛苦触发器 |
| 421 | Just observe | 只要观察 |
| 422 | me for a second. | 我一秒钟。 |
| 423 | Now would I do this to an old eighty-five year old osteoporotic person? | 现在我要这样对待一个85岁的骨质疏松者吗? |
| 424 | No I wouldn't. | 不,我不会。 |
| 425 | But for the average person this is a one and a half times body weight. | 但对于普通人来说 这是体重的1.5倍 |
| 426 | I'll just go up on my heels and boom. | 我就骑上我的脚跟,砰砰。 |
| 427 | Now I might say, oh yep, my right toe just went | 现在我可以说,哦,对了,我的右脚趾刚刚走 |
| 428 | on fire. | 着火了 |
| 429 | Or that triggered back pain. | 或引发背痛. |
| 430 | Now push your fingers out. | 现在把手指伸出来 |
| 431 | Watch. | 看着 |
| 432 | See what I did? | 看到了吗? |
| 433 | I turned on my abdominal wall which acts as a bit of a brace. | 我打开了我的腹壁, 它有点像牙套。 |
| 434 | And then we repeat. | 然后我们重复一遍。 |
| 435 | Oh Doc | 哦,医生 |
| 436 | you're magical. | 你简直是魔力 |
| 437 | You just took my pain away. | 你把我的痛苦带走了 |
| 438 | No I didn't. | 我没有 |
| 439 | You had a little micro movement | 你有点小动作 |
| 440 | or you couldn't tolerate the... Well let's just assume now it's a micro movement. | 或者你无法容忍... 现在假设这是个小动作 |
| 441 | We | 我们 |
| 442 | put a girdle around it and we engineered out the micro movement. | 绕着它,我们设计了微型运动。 |
| 443 | It made you better. | 这让你变得更好。 |
| 444 | Or | 或者说 |
| 445 | you might say, you know what? | 你可能会说,你知道吗? |
| 446 | That hurt. | 这伤害。 |
| 447 | That made it even worse. | 这更糟糕了 |
| 448 | That means you can't tolerate | 这意味着你不能容忍 |
| 449 | the compressive cost of doing a brace. | 做支架的压缩成本 |
| 450 | Let's try something else. | 让我们试试别的东西。 |
| 451 | Externally rotate. | 对外旋转. |
| 452 | Looks | 外观 |
| 453 | like most of you are old enough to remember the good old days of hitchhiking. | 就像你们大多数人都老了一样 记得过去搭便车的美好时光 |
| 454 | Now watch. | 现在看。 |
| 455 | I'm going to pull down into... That's a shrug. | 我要拉下来... 师曰缩. |
| 456 | I'm going to anti-shrug. | 我要去抗血压。 |
| 457 | Let my belly go. | 让我的肚子走。 |
| 458 | Now try it. | 试试看 |
| 459 | Oh yeah, that's the secret sauce. | 哦,是的,这是秘密酱汁。 |
| 460 | So do you see how we'll create the pain and | 所以,你看我们如何创造痛苦和 |
| 461 | then play with different strategies to see what works for you. | 然后用不同的策略看什么对你有用 |
| 462 | And what works for you | 为你着想 |
| 463 | will hurt you. | 会伤害你 |
| 464 | Do you follow? | 你明白吗? |
| 465 | So we guide you through converging on what will work for | 所以,我们引导你 通过凝聚什么将工作 |
| 466 | you. | 你们 |
| 467 | So you identify your pain trigger. | 所以,你识别你的疼痛触发器。 |
| 468 | We take you through a series of these and then | 我们带你通过一系列的这些,然后 |
| 469 | you identify what takes your pain away. | 找出什么让你的痛苦消失。 |
| 470 | Now some of you won't feel confident doing this | 现在你们中有些人不会有信心这么做了 |
| 471 | with yourself. | 与你自己。 (笑声) |
| 472 | Great. | 不错 |
| 473 | Take it to your clinician, your physio, your gyro or your trainer or | 把它交给你的临床医生,你的理疗师,你的陀螺仪或者你的教练 |
| 474 | whoever and they will be able to coach you through it. | 不管是谁和他们能指导你通过它。 |
| 475 | So the next stage, now you've | 所以下一个阶段,现在你已经 |
| 476 | understood very precisely the motions, the postures and the loads that cause your pain | 完全理解造成你痛苦的动作、姿势和负载 |
| 477 | and which take them away. | 并把他们带走。 |
| 478 | So how do you then proceed? | 那么,你接下来怎么办? |
| 479 | Well, you may discover that a certain | 好吧,你可能会发现 某个 |
| 480 | amount of abdominal bracing may help or it may hurt. | 腹部结扎量可能有所帮助或可能受伤。 |
| 481 | But if it helps, you learn to tune | 但是,如果有帮助, 你学会调谐 |
| 482 | it now. | 现在 |
| 483 | Not too much and not too little. | 少则少则少. |
| 484 | It's tuning. | 是调音. |
| 485 | And we would take you through a series | 我们会带你通过一系列 |
| 486 | of drills there. | 钻孔。 |
| 487 | And then we get into the movement tools. | 然后我们进入移动工具。 |
| 488 | Well, some people might say, | 有人可能会说, |
| 489 | you know, the last time I had an acute attack was I was bending over and brushing my teeth. | 上次我发作时 我弯腰刷牙 |
| 490 | Aha. | 对啊 |
| 491 | Let's teach a hip hinge. | 让我们教一个臀部链。 |
| 492 | Put your hands on your thighs. | 把你的手放在你的大腿上。 |
| 493 | Just observe. | 只是观察。 |
| 494 | Slide your hands | 手滑动 |
| 495 | down. | 下来 |
| 496 | Now grab your knees hard and now you're not going to lift with your back. | 现在抓住你的膝盖 用力,现在你不会 抬起你的背。 |
| 497 | You grab | 你抓起来 |
| 498 | your knees hard. | 膝盖用力 |
| 499 | Watch. | 看着 |
| 500 | This is a shrug. | 这是一团糟。 |
| 501 | There's an anti-shrug. | 有抗hr者. |
| 502 | Now I tune my back. | 现在我调背 |
| 503 | There's | 还有 |
| 504 | a flex spine, an extended spine. | 一个柔软的脊椎, 一个延伸的脊椎。 |
| 505 | Find the position that just took your pain away. | 找到刚才让你痛苦消失的位置 |
| 506 | Anti-shrug. | 抗痰. |
| 507 | Now this is the magic. | 这就是魔力 |
| 508 | Don't lift with your back. | 背不举. |
| 509 | Pull your hips through. | 把臀部拉过去 |
| 510 | You stiffened | 你硬起来了 |
| 511 | your back into no pain and now you pull your hips through. | 背部没有疼痛,现在你把臀部通过。 |
| 512 | Everyone get that? | 大家都明白了吗? |
| 513 | Good. | 不错 |
| 514 | Stand | 站起来 |
| 515 | up. | 起来 |
| 516 | So this is a Simon Says thing. | 这是西蒙说的 |
| 517 | Let me coach you through this. | 让我来指导你通过这个。 |
| 518 | Folks, please, I need | 伙计们,请,我需要 |
| 519 | your attention. | 请注意 |
| 520 | We've got to get through this. | 我们得熬过去 |
| 521 | Watch. | 看着 |
| 522 | I want you to sniff a bit of air to | 我要你闻一下空气 |
| 523 | stiffen. | 坚固。 |
| 524 | Just watch. | 只是看着。 |
| 525 | Just do that. | 做到这一点。 |
| 526 | Nice. | 不错 |
| 527 | Put your hands on the front of your thighs. | 手执大腿前. |
| 528 | Slide | 幻灯片 |
| 529 | them down and every good American knows how to play shortstop. | 他们倒下,每个优秀的美国人 都知道如何打游击手。 |
| 530 | Go play shortstop. | 去玩游击手。 |
| 531 | Now | 现在 |
| 532 | don't have your hands like that on your knees. | 别把你的手放在膝盖上 |
| 533 | Around your knees. | 绕膝而行. |
| 534 | Now carry as much weight | 现在带着同样多的重量 |
| 535 | down your arms as you can. | 尽量放下你的手臂 |
| 536 | Now some of you are falling back on your heels. | 现在你们中有些人又回到了脚跟上。 |
| 537 | Watch. | 看着 |
| 538 | Leaning | 倾斜 |
| 539 | tower. | 塔楼 |
| 540 | Lean tower forward on your ankles. | 仰塔向前脚踝. |
| 541 | Nice. | 不错 |
| 542 | Boy, you're beautiful. | 小子,你真漂亮,你长得真美 |
| 543 | Now your knees | 现在跪下 |
| 544 | should be over the balls of your toes. | 应该是在你的脚趾的球。 |
| 545 | Some of you need to pull your knees back. | 你们中有些人得把膝盖往后拉 |
| 546 | Beautiful. | 美丽 |
| 547 | Now anti-shrug. | 现在反嘘声。 |
| 548 | Push down and pull your hips through. | 向下推把臀部通过. |
| 549 | There you go. | 给你。 |
| 550 | So those of you who've | 所以你们中的那些 |
| 551 | had the experience of brushing your teeth and someone putting a knife into your back, | 有刷牙的经验 有人把刀插进你的背上 |
| 552 | you can learn to engineer that out as a pain trigger. | 你可以学会把这个设计成痛苦触发器 |
| 553 | Some of you have heard, oh, I threw | 你们有些人听说过,哦,我扔 |
| 554 | my back out picking up a pencil or sneezing. | 我的后背拿起铅笔或打喷嚏。 |
| 555 | If you sneeze like this, phew, I'll say good, | 如果你像这样打喷嚏 我会说好的 |
| 556 | you deserved your pain. | 你罪有应得 |
| 557 | Now it wasn't a nasty thing to say, but it shocks the person to | 现在这不是一个讨厌的事情说, 但它震撼人到 |
| 558 | know they were in control. | 知道他们控制了一切 |
| 559 | Instead, next time, if you've had that kind of a pain trigger, | 相反,下一次,如果你有 那种痛苦触发器, |
| 560 | sneeze upwards. | 向上打喷嚏. |
| 561 | And now you've decreased that hydraulic effort post early. | 现在你提前减少了液压功率 |
| 562 | If that was your | 如果这是你的 |
| 563 | pain trigger. | 痛苦触发。 |
| 564 | Have a seat. | 请坐 |
| 565 | So now isn't that interesting? | 所以现在不是很有趣吗? |
| 566 | Folks, I just showed you the | 各位,我刚刚给你们看了 |
| 567 | hip hinge. | 臀关节 |
| 568 | And what did you do? | 你们做了什么? |
| 569 | Most of you just collapsed into your chair. | 你们大多数都掉到椅子上了 |
| 570 | All you then | 全部给你 |
| 571 | had to do was to do what I just showed you. | 只能做我刚才告诉你的事 |
| 572 | So now that is the spine hygiene. | 现在这就是脊椎卫生。 |
| 573 | I've given | 我给了 |
| 574 | you a movement tool. | 你是一个运动工具。 |
| 575 | I've now shown you how to get on and off the toilet, in and out of | 我现在教你怎么上下厕所 进出厕所 |
| 576 | your chair, how to brush your teeth. | 你的椅子,怎么刷牙。 |
| 577 | You get what I'm saying? | 你懂我的意思吗? |
| 578 | Morph that into your daily | 把那个塞进你的日报 |
| 579 | patterns. | 规律。 |
| 580 | And anyway, so that's what spine hygiene is customized for you. | 总之,这就是脊椎卫生为你定制的。 |
| 581 | Everyone when | 各位,当 |
| 582 | they come in, I'll say, do you mind taking your shoes off? | 他们进来了,我说,你介意脱鞋吗? |
| 583 | I couldn't care less. | 我一点也不在乎 |
| 584 | I really | и痷 |
| 585 | just wanted to see them move. | 只是想看到他们移动。 |
| 586 | So when I see them move and I determine that bending forward | 所以当我看到它们移动,我决定向前弯曲 |
| 587 | causes their pain, do you see that my therapy won't have a chance nor will anyone else's | 让他们痛苦,你有没有看到我的治疗 不会有机会,任何人也不会 |
| 588 | until you teach them to tie their shoe by avoiding that pain trigger. | 直到你教他们通过避免疼痛触发来系鞋带 |
| 589 | Put your foot | 把脚放下 |
| 590 | up. | 起来 |
| 591 | Take your hips to the target. | 把你的臀部到目标。 |
| 592 | See what the secret was? | 看到什么秘密了吗? |
| 593 | Take your hips down to the | 把你的臀部 下来 |
| 594 | target and now you avoided picking the scab, sensitizing your back pain. | 目标,现在你避免挑疮, 引起你的背痛。 |
| 595 | You put a dollar | 你放了一块钱 |
| 596 | in the bank instead of stealing one out. | 在银行而不是偷一个出来。 |
| 597 | Then we move on to work technique. | 然后我们转向工作技巧。 |
| 598 | This is called | 这叫做 |
| 599 | the archer's bow. | 弓箭手的弓箭手。 |
| 600 | Consider in archery, you push on the bow, you pull on the arrow. | 在箭术中考虑,你推弓,拉箭. |
| 601 | To | 改为 |
| 602 | lift that block, you push on this support, you pull on the block and you've just de-loaded | 抬起那个挡板,你推着这个支撑,拉着这个挡板,你刚卸下子弹 |
| 603 | and taken out that pain trigger. | 并拿出了疼痛触发器。 |
| 604 | So those are just some examples. | 这些只是一些例子。 |
| 605 | Well now let's move | 好了,现在我们走 |
| 606 | on to the third element and create a foundation for pain-free movement. | 在第三个要素上,为无痛运动打下基础。 |
| 607 | We didn't invent any | 我们没有发明 |
| 608 | of these exercises. | 这些练习。 |
| 609 | What we did was evaluate and assess many different spine stabilization | 我们所做的是评价和评估许多不同的脊椎稳定 |
| 610 | exercises and we had to choose the ones that were the very best at sparing your spine of | 我们不得不选择最能避免你脊椎 |
| 611 | load while guaranteeing spine stability. | 负载,同时保证脊椎稳定. |
| 612 | What it turned out to be was three exercises for | 原来是三次练习 |
| 613 | the front, the sides and the back. | 前面,边和后面 |
| 614 | The very best for the front was this modified curl-up. | 对正面来说最好的就是这个经过修改的卷曲。 |
| 615 | Do not flatten your back to the floor like you've been taught in Pilates class. | 不要像在彼拉多课上教过的那样把背扁到地板上 |
| 616 | That | 那个 |
| 617 | stresses the back. | 背部有压力 |
| 618 | Instead preserve the natural curve, put your hands palms down under your | 而不是保持自然曲线 把手掌放下 |
| 619 | back and support the curve. | 返回并支持曲线。 |
| 620 | Now some of you will have sore shoulders or a torn-up rotator | 现在,你们中有些人的肩膀会很疼, 或有一个撕裂的旋转器 |
| 621 | cuff. | 手铐 |
| 622 | Well you better put that hand on your tummy and fold the towel in half or be creative. | 你最好把你的手放在肚子上 把毛巾折成两半 或者有创意 |
| 623 | Put something under your low back and then you lift your head and neck half an inch. | 把东西放在你的低背 然后抬起你的头和脖子半英寸。 |
| 624 | That's all, half an inch and hold that for ten seconds. | 仅此而已,半英寸,拿着10秒 |
| 625 | Avoid this. | 避免这个。 |
| 626 | For the sides, the | 对于双方, |
| 627 | family of side bridge exercises turned out to be the best. | 侧桥的家族运动是最棒的 |
| 628 | It challenges quadratus lumborum, | 它挑战四重奏, |
| 629 | latissimus dorsi, the oblique wall, exactly what you need for the side guy-wire system. | 斜墙,你需要的就是侧面的电线系统 |
| 630 | Some of you, that's too aggressive. | 你们中有些人太冲动了 |
| 631 | You may have to start just leaning up against a wall, | 你可能要开始靠在墙上 |
| 632 | stiffening and breathing as she's demonstrating there. | 当她在那里展示时,会加强呼吸 |
| 633 | For the back, it turned out to be what | 对背部来说,结果是什么 |
| 634 | we call the bird dog family of exercises. | 我们称鸟狗家族为演习。 |
| 635 | It may just start with simply lifting one hand, | 它可能只是从举起一只手开始, |
| 636 | but before you start, posture your spine to obtain the neutral curves. | 但在你开始前, 保持脊椎以获得中性曲线。 |
| 637 | That is the least | 这是最小的 |
| 638 | stressed position that your back can be in. | 你背部的位置很突出 |
| 639 | You're preparing it to receive load and then | 你正在准备接收货物 然后 |
| 640 | start out stretching one arm and as you graduate one leg, but eventually you'll get to the full | 开始伸展一只手臂, 当你毕业了一条腿, 但最终你会得到满 |
| 641 | bird dog holding opposite arm and opposite leg for about ten seconds and then you sweep the floor. | 鸟狗握着对臂和对腿约10秒,然后扫地. |
| 642 | Why? | 为什么? |
| 643 | When we measured with near-infrared spectroscopy, we measured that the muscles | 当我们用近红外光谱测量, 我们测量肌肉 |
| 644 | go into oxygen depletion because the muscle contraction clamps down on the capillary bed. | 进入氧气耗竭,因为肌肉收缩 夹在毛细床。 |
| 645 | If you want to give yourself muscle cramps together with your back pain, hold it for 20 | 如果你想把自己的肌肉抽筋 加上背部疼痛, 拿着20 |
| 646 | seconds. | 秒数。 |
| 647 | That's why the science showed a ten-second hold, sweep the floor just to allow blood | 所以科学才有十秒的把握 扫地让血流成河 |
| 648 | perfusion and do it again. | 输血再喷一次 |
| 649 | All of these things sound so simple, but it's not rocket science, | 所有这些事情听起来都很简单 但这不是火箭科学 |
| 650 | but a lot of rocket science went into converging down to such simplicity. | 但很多火箭科学都趋于一致 |
| 651 | Well, | 那个 |
| 652 | some of you will have had knee replacement, hip replacement, do it on a chair. | 换膝盖 换臀部 换椅子 |
| 653 | So, | 这么说 |
| 654 | you work with what a patient has. | 你的工作与病人有什么。 |
| 655 | Anyway, you're starting to get the idea. | 无论如何,你开始得到这个想法。 |
| 656 | Now, | 现在, |
| 657 | you have to walk to have a healthy back. | 你要走路才能有一个健康的背部。 |
| 658 | There is a muscle, a primary spine stabilizer called | 有一个肌肉, 一个主要的脊椎稳定器叫 |
| 659 | a quadratus lumborum that works up either side of your spine. | 你脊椎两侧的四棱柱 |
| 660 | People say, well, what's the big | 人们说,什么是大 |
| 661 | deal with core stability? | 处理核心稳定性? |
| 662 | Well, I'll prove to you, you can't walk if you don't have core stability. | 好吧,我会证明给你,你不能走 如果你没有核心稳定。 |
| 663 | If you go to the Children's Neurological Hospital, you'll find some little kid who has a paralyzed | 如果你去儿童神经科医院, 你会发现一些小孩 谁瘫痪 |
| 664 | quadratus lumborum, one muscle on the side, the core. | 四面体 侧面有一个肌肉 核心 |
| 665 | They can't walk. | 他们不能走。 |
| 666 | They walk like this. | 他们这样走路 |
| 667 | When | 何时 |
| 668 | they get stance on this and then swing with this leg, they're fine, but when they stand on this leg, | 他们站在这个位置,然后用这个腿挥舞, 他们很好,但当他们站在这个腿上, |
| 669 | the pelvic platform falls away. | 骨盆平台掉下来了 |
| 670 | So, they walk like this because they're unable to act. | 因此,他们这样走路是因为他们无法行动. |
| 671 | That's how | 就是这样 |
| 672 | important that lateral core control is. | 重要的是,横向核心控制是。 |
| 673 | Now, does deadlifting fix that? | 现在,死尸 修复了吗? |
| 674 | Does Olympic lifting fix | 奥林匹克运动会的升降会吗? |
| 675 | that? | 那个? |
| 676 | No, every single one of those exercises are done with two feet on the ground. | 不,这些演习每一次都要在地面上两脚进行。 |
| 677 | The only time | 唯一的时间 |
| 678 | you challenge that frontal plane core stability is walking. | 你挑战的是正面平面的稳定性 |
| 679 | It's non-negotiable. | 不可商议. |
| 680 | When you get | 当你得到 |
| 681 | that, you can do a suitcase carry. | 那,你可以做一个手提箱。 |
| 682 | Carry a kettlebell or do a farmer's walk. | 带水壶铃或做农夫散步. |
| 683 | This isn't | 这不是 |
| 684 | heavy load stuff. | 负重的东西。 |
| 685 | It's very light, but here's some more science for you. | 光线很轻,但还有科学给你 |
| 686 | If you just go for | 如果你刚刚去 |
| 687 | one walk a day, good. | 一天走一次,不错。 |
| 688 | You deserve your pain. | 你应得的痛苦。 |
| 689 | The healthiest thing you can do is interval train it. | 你能做的最健康的事就是训练它 |
| 690 | If you want to make your back sore, go for a big long walk every day. | 如果你想弄痛你的背, 每天去大长途散步。 |
| 691 | You'd be far wiser to interval | 你会更明智的间隔 |
| 692 | train it in small, short, tolerable intervals. | 以小,短,可容忍的间隔训练它. |
| 693 | The more tender the back, we will have some | 越温柔的背部,我们会有一些 |
| 694 | patience. | 耐心点 |
| 695 | Every 20 minutes, you get out of the chair and you walk five steps. | 每20分钟,你下车 椅子,你走五步。 |
| 696 | That's where they | 他们就在那儿 |
| 697 | will start, but for most people, it would be much wiser. | 但对大多数人来说,这更明智 |
| 698 | Do a 20-minute walk for breakfast, lunch, | 做一个20分钟的步行 早餐,午餐, |
| 699 | and dinner. | 还有晚餐 |
| 700 | Far more healthful. | 更健康一点 |
| 701 | Now, you've accumulated an hour's good walking. | 现在,你累积了一个小时的好走路。 |
| 702 | Now, if you | 现在,如果你 |
| 703 | walk like this, you would be so much better if you could swing your arms about the shoulders, | 像这样走,你会好得多 如果你可以摆动你的手臂 关于肩膀, |
| 704 | and it's a bit more of a military walk. | 更像是军事步行 |
| 705 | Now, it doesn't have to be totally soldier-like, | 现在,它不必完全像士兵一样, |
| 706 | but there's a reason why you walk swinging your arms about the shoulders. | 但有一个原因,你走动 你的手臂围绕肩膀。 |
| 707 | Back pain makes your | 背痛让你 |
| 708 | back loose and freezes your shoulders when you're in pain, but if you can liberate your shoulders, | 背部松开,在疼痛时会冻住肩膀 但如果你能解放肩膀 |
| 709 | you store and recover elastic energy. | 你存储和回收弹性能量。 |
| 710 | When I walk like this, I get a natural stretch across | 当我走这样,我自然地伸展 |
| 711 | this right upper quarter and across the glute and down the leg on the other side. | 右上角 横跨大肚 另一边的腿 |
| 712 | Swinging the arms | 挥动手臂 |
| 713 | about the shoulders fails to get this, so do you see why corrective walking matters? | 肩膀没有这个,所以你明白为什么 矫正走路很重要吗? |
| 714 | It matters | 这很重要 |
| 715 | the way you walk. | 你走路的样子 |
| 716 | Get rid of the sandals, put on a good pair of walking shoes, walk faster for 20 | 把凉鞋脱了,穿上一双好鞋,走得快一点 |
| 717 | minutes three times a day. | 每天3分钟 |
| 718 | So not that, but that. | 所以不是那样,而是那样。 |
| 719 | Well, we're into the last little stage now. | 好了,我们现在进入最后一个阶段。 |
| 720 | It's | 这是 |
| 721 | time to fine-tune the machine. | 是时候对机器进行微调了 |
| 722 | Add a little bit more pulling power. | 再加点拉力 |
| 723 | So the TRX pulls is a magnificent | 因此,TRX的拉动是伟大的 |
| 724 | exercise. | 运动。 |
| 725 | There's zero shear load on the back. | 背面有零剪载荷. |
| 726 | The feet are on the floor. | 脚在地上. |
| 727 | Do you realize that | 笵盾 |
| 728 | this is compression on the back, and this is shear load? | 这是背后的压缩,这是剪切负荷? |
| 729 | Shear load causes pain triggers in | 切开负载引起疼痛 |
| 730 | lot of people, but when I do a push-up, there's no, I won't do a push-up, or a pull, there's no | 很多人,但当我做一个俯卧撑, 没有,我不会做俯卧撑, 或拉,没有 |
| 731 | shear load working my back. | 剪掉我的背部 |
| 732 | It's very tolerable for a lot of people, but if I bend forward and | 这对很多人来说都是可以容忍的 但如果我向前弯 |
| 733 | picked up a load, that's, do you see that's a cantilevered beam that is causing a shear load | 捡起一个负载,这就是,你看, 这是一个罐头束 导致一个剪载 |
| 734 | through the back. | 穿过后面 |
| 735 | So you can build a lot of strength if you know how to create what's called, | 如果你知道如何创造所谓的力量, |
| 736 | from an engineering point of view, a three-point bend on the back. | 从工程学的角度来说,背面有一个三点弯曲. |
| 737 | Well, there is, I'm joining a | 嗯,有,我加入一个 |
| 738 | lot of you with retiring and getting a little bit of a Q-tip myself on the top here. | 你们中很多人退休了 自己在顶端也得到了点Q点 |
| 739 | I'm much more | 我更厉害 |
| 740 | interested in the stenosis types of older spine pain triggers. | 对老年脊椎疼痛引发的性激素类型感兴趣. |
| 741 | Here is a patient who came to see | 有个病人来看我 |
| 742 | me, and within four minutes, he was upright like that. | 我,四分钟内,他就那样直立 |
| 743 | What did I do? | 我做了什麽? |
| 744 | A little bit of a thoracic | 一点点的胸肌 |
| 745 | spine stretch. | 脊椎伸缩。 |
| 746 | Now, we could start and go down on the knees, and you push two pounds through each | 现在,我们可以开始并跪下, 你推两磅通过每个 |
| 747 | hand, through each elbow into my supporting leg, and then don't push down on them, just the patient | 手,穿过每一肘进入我的支撑腿, 然后不要推下去,只是病人 |
| 748 | pushes two pounds for 10 seconds. | 推两斤十秒. |
| 749 | At 10 seconds, they release, and the elbows come forward a little | 10秒后,它们就释放了 肘部稍稍向前 |
| 750 | bit. | 位数。 |
| 751 | In other words, it looks like this. | 换句话说,它看起来像这样。 |
| 752 | You push down. | 你推下来。 |
| 753 | After 10 seconds, you relax, and the elbows | 10秒后,你放松,还有肘部 |
| 754 | come forward. | 站出来。 |
| 755 | Oh, you just got a little bit of a lift. | 哦,你刚刚得到 一点点的电梯。 |
| 756 | Well, you know, I'm not there all the time. | 嗯,你知道,我不 在那里所有的时间。 |
| 757 | You teach them how to do it on a chair. | 你教他们如何在椅子上做到这一点。 |
| 758 | So they push for 10 seconds with their elbows, and then | 所以他们用手肘推10秒 然后 |
| 759 | after 10 seconds, they pull their buttocks back towards their heels. | 10秒后,他们把屁股拉回脚跟 |
| 760 | Do you see the difference? | 你看到区别了吗? |
| 761 | They've pulled them, and now they do another cycle for 10 seconds. | 他们拉了它们 现在它们又做了10秒的循环 |
| 762 | Well, he didn't have knees to do | 他没有膝盖 |
| 763 | that. | 那个 |
| 764 | So instead, I did it standing. | 所以,我做了它站着。 |
| 765 | There's my arm under his elbows. | 他的肘下还有我的手臂 |
| 766 | He pushed down into me for 10 | 他推倒了我10岁 |
| 767 | seconds. | 秒数。 |
| 768 | He relaxed. | 他放松了下来。 |
| 769 | I lifted his elbows a little bit more. | 我抬起他的肘部多一点。 |
| 770 | Do you see how he's now higher? | 你看到他现在有多高了吗? |
| 771 | Three | 三个 |
| 772 | cycles of that, and now he's standing like that. | 周而复始,现在他就这样站着 |
| 773 | So there's just an example. | 故略举一例. |
| 774 | Is it going to work | 有用吗? |
| 775 | for all of you? | 为了你们所有人? |
| 776 | No, of course not. | 不,当然不是。 |
| 777 | It'll work for some of you. | 这会为你们中的一些人工作。 |
| 778 | So I'm just giving example after | 所以,我只是举个例子 |
| 779 | example that we've cataloged, and just because you've seen it here, it may or may not work for | 举例来说,我们已经编了目录, 仅仅因为你在这里看到它, 它可能或可能不工作 |
| 780 | you. | 你们 |
| 781 | But obviously, with the breadth of our work, we're finding different techniques. | 但显然,随着我们工作的广度,我们发现了不同的技术. |
| 782 | Well, now it's | 嗯,现在它 |
| 783 | time. | 时间。 |
| 784 | Remember I said it's time to go to the field and make sure it works. | 记得我说过该去野外了 确保它有效 |
| 785 | So we then do what we | 所以,我们做我们 |
| 786 | call the park bench decompression. | 呼叫公园长椅减压 |
| 787 | He could only walk three or four minutes before those back | 他只能走三四分钟才能回来 |
| 788 | symptoms started and the pains down his legs. | 症状开始 脚下疼痛。 |
| 789 | So we said, go walk in a park with a park bench. | 所以我们说,去公园散步 与公园长椅。 |
| 790 | If | 若为 |
| 791 | the pain starts every four minutes, you stop at three. | 痛苦每四分钟开始一次 你就停在三点 |
| 792 | Don't pick the scab and don't cause pain. | 不拣疮而不引起痛. |
| 793 | But go over to the back of the park bench, put your hands on the back of the bench, lean up over | 但是去公园的后座 把你的手放在后座上 向上倾斜 |
| 794 | the bench and just remember the little anti shrug I was showing you. | 记住我给你看的抗血压 |
| 795 | And I'll watch my hips. | 我会注意我的臀部。 |
| 796 | I'm | и琌 |
| 797 | going to let my hips drift towards the park bench. | 让我的臀部向公园长凳漂移 |
| 798 | Stay there for 30 seconds. | 呆在那里30秒钟。 |
| 799 | And he stood up. | 他站起来。 |
| 800 | He | |
| 801 | says, Doc, yeah, my symptoms are gone. | 说 医生 是的 我的症状消失了 |
| 802 | Great. | 不错 |
| 803 | Go walk another three minutes. | 再走三分钟 |
| 804 | Come back and | 回来 |
| 805 | recycle it. | 把它循环起来 |
| 806 | Now for the first time, instead of only walking three minutes and then having to give | 现在,这是第一次, 而不是仅仅步行三分钟 然后不得不给 |
| 807 | up cumulatively, cumulatively, he walked 15 pain free. | 累积起来,累积起来, 他走了15个疼痛。 |
| 808 | So you're starting to get this idea of | 所以,你开始得到这个想法 |
| 809 | cumulative training for success, short, little exposures, gain success that way. | 累积训练成功,短暂,很少接触,以这种方式获得成功. |
| 810 | And slowly that | 慢慢来 |
| 811 | envelope, instead of breaking the pain in four minutes, it's now eight minutes and 10. | 信封,而不是在四分钟内打破疼痛, 现在8分钟10。 |
| 812 | Look, our | 听着,我们 |
| 813 | job is to keep what we have as long as we can. | 工作就是尽我们所能 保持我们所拥有的一切 |
| 814 | Right? | 对吧? |
| 815 | We don't want any more. | 我们不想要了。 |
| 816 | Just don't take | 只是别拿 |
| 817 | any more away. | 越远越好 |
| 818 | So there's a few thoughts. | 故有数念. |
| 819 | Well, I thought I'd finish with something I heard back | 好吧,我想我会结束 的东西,我听到回 |
| 820 | in the cells. | 在牢房里。 |
| 821 | So I know there's a few docs in here. | 我知道这里有一些医生。 |
| 822 | Every clinician will tell you that they have | 每个临床医生都会告诉你 |
| 823 | patients who come to them and say the last time, well, we're now abstinent. | 病人来他们 说最后一次, 好了,我们现在节欲。 |
| 824 | We haven't had sex for | 我们还没做爱呢 |
| 825 | half a year because the last time we did, we knackered our back so badly that we're now fearful. | 半年了,因为上次我们做了, 我们抽了我们的背 如此严重,我们现在害怕。 |
| 826 | I | 一、导 言 |
| 827 | think I know what image just went through your mind. | 我想我知道是什么 图像刚刚进入你的脑海。 |
| 828 | Nonetheless, our research program for the | 尽管如此,我们的研究方案 |
| 829 | last 32 years, we were never interested in little questions. | 过去32年,我们从未对小问题感兴趣。 |
| 830 | We always went to the clinical community | 我们总是去临床社区 |
| 831 | and said, what's the biggest problem that you need the solution to? | 并说,什么是最大的问题 你需要解决? |
| 832 | And it came around that it was | 它绕过来,它是 |
| 833 | we looked at that one. | 我们看了那个 |
| 834 | There are no clinical guidelines that exist to guide clinicians now | 现在还没有指导临床医生的临床指南 |
| 835 | to tell patients how not to knacker their back doing heaven's sex. | 告诉病人 如何不打背 做天堂的性。 |
| 836 | So we said, let's do it. | 所以我们说,让我们做到这一点。 |
| 837 | It | 这个 |
| 838 | took us a very brave student of mine, one of my graduate students. | 带我们一个非常勇敢的学生 我的研究生之一。 |
| 839 | Well, you can laugh, but I'm | 你可以笑,不过我... |
| 840 | being very serious now. | 现在很严肃 |
| 841 | Her name's Natalie Sidorkiewicz, and she has created the first | 她的名字是娜塔莉·西多基维奇 她创造了第一个 |
| 842 | atlas that you can now, we give it out to physicians. | 现在,我们把地图交给医生。 |
| 843 | So when that patient comes and says, | 所以,当病人来说, |
| 844 | we're so fearful, we're now abstinent, the clinician now measures their pain trigger in | 我们是如此害怕,我们现在节欲, 临床医生现在测量他们的疼痛触发器 |
| 845 | terms of offending motions, postures, and loads, and shows them on the chart what not to do and | 攻击性运动、姿态和负载的术语,并在图表中显示不这样做和不这样做 |
| 846 | what to do. | 怎么办? |
| 847 | This was the most successful media launch campaign in the history of the university. | 这是大学历史上最成功的媒体发起运动. |
| 848 | We made the economist broke back mounting sex and backache. | 我们让经济学家打破了不断上升的性与背痛。 |
| 849 | We were on the front page of Costa | 我们在科斯塔的头版 |
| 850 | Rica, Italy, France, China. | 哥斯达黎加、意大利、法国、中国。 |
| 851 | We touched 1.4 billion people in the readership of that. | 我们接触了14亿的读者。 |
| 852 | We didn't make | 我们没有做 |
| 853 | the front page in the US. | 美国的头版 |
| 854 | Well, you can say, ah, you live in an awfully interesting country. | 嗯,你可以说,啊, 你生活在一个非常有趣的国家。 |
| 855 | There's no university in your country that would be allowed to do this research. | 贵国没有大学可以做这种研究。 |
| 856 | They'd | 他们 |
| 857 | be shut down. | 关闭。 |
| 858 | So now the Kinsey Institute, which is the repository in Indiana of sexual health | 现在的金赛研究所 是印第安纳州性健康中心 |
| 859 | science, who can't do this research here in the US. | 科学,谁不能做这个研究 在美国。 |
| 860 | We've partnered with them, and if you want | 我们和他们合作过 如果你想 |
| 861 | to volunteer, no, I'm only kidding. | 不 我只是在开玩笑 |
| 862 | Anyway, I'll just wrap this up by saying some of you have been | 总之,我最后会说 你们中有些人是 |
| 863 | dismissed. | 开除 |
| 864 | You have back pain, oh, it's because you're getting older, it's in your head, or you've | 你背痛,哦,这是 因为你越来越老, 它在你头上,或者你已经 |
| 865 | got, look it, back pain has a reason. | 听着 背痛是有原因的 |
| 866 | Get a diagnosis, and if you can't, I'll take questions | 得到诊断,如果你不能, 我会接受问题 |
| 867 | at the end, sorry. | 在结尾,对不起。 |
| 868 | But get a precise diagnosis so that you will know exactly what to do and not do. | 但得到一个精确的诊断, 这样你就会知道 到底做什么而不是做什么。 |
| 869 | Then you can wind down your pain trigger sensitivity and build a pain-free foundation. | 之后可以将痛感降低引发敏感度,建立无痛基础. |
| 870 | Now you've been | 现在你已经 |
| 871 | empowered. | 授权。 |
| 872 | Good clinicians show the patient how to cure themselves. | 好临床医生教病人如何自我治疗. |
| 873 | Good clinicians and coaches | 好医生和教练 |
| 874 | don't create movement fear and avoidance and tell them they have a disease when they do not. | 不要制造运动恐惧和避免, 告诉他们他们有疾病 当他们没有。 |
| 875 | They | 他们 |
| 876 | create movement confidence and competence, and that was the great gift that we learned from the | 创造运动的信心和能力,这是我们从 |
| 877 | Pensacola Firefighters. | 彭萨科拉消防员. |
| 878 | There is a time for surgery, but I can now also give you a statistic because | 有时间做手术 但我现在也可以给你一个统计 因为... |
| 879 | we follow up with every single patient that ever has come to our clinic. | 我们跟踪每一个来过诊所的病人 |
| 880 | There are those who've | 有的人谁 |
| 881 | been told, well, you've tried physio, chiro, we've sent you to the pain clinic, you've seen the | 听说你试了理疗 奇洛 我们送你去止痛诊所 |
| 882 | only thing left for you is surgery. | 只剩下手术了 |
| 883 | Of the 95% of those, we get them to avoid surgery, and the first | 在95%的手术中, 我们让他们避免手术, 而第一个 |
| 884 | thing we start is this. | 我们开始的是这个 |
| 885 | We perform virtual surgery. | 我们做虚拟手术 |
| 886 | Virtual surgery is this. | 虚拟手术就是这个 |
| 887 | I'm very dramatic and I | 我非常戏剧化 |
| 888 | go up to them. | 去他们那里。 |
| 889 | I'll touch them on the shoulder and say, there, I bestow upon you surgery. | 我会在肩膀上抚摸他们,然后说,在那里,我给你做手术。 |
| 890 | Now, | 现在, |
| 891 | some people will say, I have to go to the gym every day and go spin on the elliptical machine | 有人会说,我必须每天去健身房 然后在椭圆形机器上旋转 |
| 892 | for 20 minutes because if I don't, I'll get so stressed and I'll murder my husband, or whatever | 20分钟,因为如果我不这样做, 我会变得如此紧张 我会杀了我的丈夫,或什么的 |
| 893 | it happens to be. | 碰巧是这样 |
| 894 | They're addicted, and I'll say, but if you had surgery, it's forced rest. | 他们上瘾了,我会说, 但是如果你有手术, 这是强迫休息。 |
| 895 | For the | 对于 |
| 896 | first time, you've stopped the pain triggers on your back. | 第一次 你停止了背部的疼痛触发 |
| 897 | There you go. | 给你。 |
| 898 | You've had virtual | 你有虚拟 |
| 899 | surgery. | 手术。 |
| 900 | Tomorrow, you're going to behave like a post-surgical patient, and you're going to do | 明天,你会表现得像个手术后病人 |
| 901 | just a little bit as you would. | 只是一点点,你会。 |
| 902 | Slowly, you will build it up, and lo and behold, you will beat | 慢慢地,你会建立起来, 看着,你会打败 |
| 903 | your back pain. | 你的背部疼痛。 |
| 904 | Try it. | 试试 |
| 905 | It will work in 95% of you. | 百分之九十五的人会成功 |
| 906 | Well, Ken, Dr. Ford, thank you, sir. | 肯,福特医生,谢谢你 |
| 907 | I get the | и笵 |
| 908 | diversity of the audience, and I appreciate the experience that's in here as well. | 观众的多样性,我欣赏这里的经验。 |
| 909 | I hope there | 我希望有这样 |
| 910 | was a little bit of something in that talk for each of you, and I thank you very much for the | 演讲里有些东西,你们每个人,我非常感谢你们 |
| 911 | honor of speaking. | 很荣幸发言。 |
| 912 | Okay, well, I guess our mics are ready and waiting, so you can fire away. | 好吧,我想我们的麦克风已经准备好了 等待,所以你可以开火了。 |
| 913 | Michelle, | 米歇尔, |
| 914 | I guess there's a question there. | 我想有一个问题。 |
| 915 | Do you have a recommendation as to the best type of mattress | 你对最好的床垫有建议吗? |
| 916 | to sleep on? | 睡觉? |
| 917 | Well, I'll tell you what the science says, because no, I don't have a recommendation | 好吧,我告诉你科学怎么说 因为我没有建议 |
| 918 | for you, but let me tell you what the science shows. | 对你来说,但让我告诉你 科学显示。 |
| 919 | Basically, they subcategorize people into | 基本上,他们把人细分为 |
| 920 | what's called a square and a triangle. | 这叫方形和三角形 |
| 921 | Now, looking at you, can we talk about you? | 现在,看看你,我们能谈谈你吗? |
| 922 | Yeah, | 对 |
| 923 | you're more of a triangle, so you're a woman with curves. | 你更像三角形 所以你是个有曲线的女人 |
| 924 | You've got high shoulders, and so, | 你肩高过头,所以, |
| 925 | typically speaking, if you're on a very firm mattress because you're curvy, the parts that | 通常来说,如果你在很坚固的床垫上 因为你是弯曲的,那些部分 |
| 926 | support it are going to slink into the mattress, and it will deviate you. | 支持它会进入床垫, 它会偏离你。 |
| 927 | So, you might be wiser to | 所以,你也许更明智 |
| 928 | get a somewhat firm mattress, but have a pretty healthy pillow top on top. | 得到一个有点坚固的床垫, 但有一个相当健康的枕头顶上。 |
| 929 | Now, having said that, | 现在,既然这么说, |
| 930 | I would tell you I would not go for one of those memory foam types of beds. | 我会告诉你,我不会去 那种记忆泡沫类型的床。 |
| 931 | Here's why. | 这是为什么。 |
| 932 | When you | 当你 |
| 933 | sink into the foam, that's it for the rest of the night. | 沉入泡沫, 就是这样的余夜。 |
| 934 | You would have to wake up and work to climb | 你得醒来去爬山 |
| 935 | up out of the depression. | 从抑郁症。 |
| 936 | Do you follow what I mean? | 你明白我的意思吗? |
| 937 | So, the memory foams tend to work better | 因此,记忆泡沫 往往工作更好 |
| 938 | for the squares, the ones that just go and they lay there, and that's it. | 对于广场,那些只是去 他们躺在那里,就是这样。 |
| 939 | They're not going to move. | 他们不会移动。 |
| 940 | But anyway, there is what the science would show. | 但总之 科学会显示什么 |
| 941 | But having said that, go to the mattress store | 但是说完,去床垫店 |
| 942 | and forget the world. | 并忘记世界。 |
| 943 | Don't worry about the salesmen. | 别担心推销员 |
| 944 | Tell them to go away, | 叫他们走开 |
| 945 | and you lay in that bed for an hour, and then you will know. | 你躺在床上一个小时, 然后你就会知道。 |
| 946 | So, you know, there's a little | 所以,你知道,有一点 |
| 947 | bit of science with a modicum of just a bit of horse sense. | 有点科学,有点马感 |
| 948 | Yeah. | 对 |
| 949 | Sir, yeah, we'll let the mic | 先生,是的,我们会让麦克风 |
| 950 | come over. | 过来 |
| 951 | Thank you for visiting Pensacola. | 谢谢你来宾萨科拉 |
| 952 | The mineral manganese is essential for | 矿物锰对 |
| 953 | healthy tendon ligaments, cartilage, and disc. | 健壮的韧带 软骨和圆盘 |
| 954 | And a lot of us think the American diet is anti-nerve, | 我们很多人认为美国饮食是反神经的 |
| 955 | anti-blood vessel, and maybe even anti- tendon, ligament, cartilage, and disc strength or | 反血液容器,甚至包括反阴道、韧带、软骨和盘状体力 |
| 956 | just constitution. | 只是宪法。 |
| 957 | Do you recommend at all supplementing with gelatin or manganese to | 您是否建议用胶原或锰进行补充 |
| 958 | strengthen the disc with your patients? | 给病人加固圆盘? |
| 959 | Well, the answer to that is A, I don't know. | 嗯,答案是A, 我不知道。 |
| 960 | It's out of my | 这出自于我 |
| 961 | wheelhouse, so I really can't answer that. | 轮房,所以我真的无法回答。 |
| 962 | I stay within my wheelhouse of expertise, | 我留在我的专门知识之家, |
| 963 | but it's a good question. | 但这是一个很好的问题。 |
| 964 | Sherry, you want to? | 雪莉,你想吗? |
| 965 | And I happen to know Sherry, and I don't know, | 我碰巧认识雪莉 我不知道 |
| 966 | oh, he did have to go anyway. | 哦,他确实必须去。 |
| 967 | Sherry and her husband John, John's at the Naval Academy, | 雪莉和她的丈夫约翰 约翰在海军学院 |
| 968 | and I've been there for the last couple of days, and you've been fantastic hosts as well, so | 我过去几天都在那里 你们也是很棒的主持人 |
| 969 | thanks so much. | 谢谢 |
| 970 | Does acupuncture have any role in your world? | 针灸在你的世界里有什么作用吗? |
| 971 | In my world? | 在我的世界里吗? |
| 972 | No, I am not | 不,我没有 |
| 973 | qualified or I have zero skill in that, but I'll say something that is a bit more of a broader | 但我会说一些更宽泛的话 |
| 974 | answer if I may. | 请回答 |
| 975 | My world is diagnosing the mechanical cause, getting rid of that mechanical | 我的世界正在诊断机械的原因 摆脱机械 |
| 976 | cause, and then building the best performance and tuning the machine. | 然后建立最好的性能 和调制机器。 |
| 977 | I can think of several | 我可以想到几个 |
| 978 | of your great Olympians in this country who I've seen as patients, and in the end I've done all I | 你伟大的奥林匹亚人在这个国家 我见过的病人, 最后我做了所有我 |
| 979 | can. | 能够。 |
| 980 | I've got rid of their pain. | 我摆脱了他们的痛苦。 |
| 981 | They're back to training heavy. | 他们又开始重训练了 |
| 982 | They're doing well, except they've | 他们做的很好,除了他们 |
| 983 | got one little snag, and I can think of one in particular, one of your great Olympians, | 我特别想到一个 你伟大的奥林匹亚人 |
| 984 | and in their QL there was just a little snag, and I did not have the manual skill to get rid of it, | 在他们的QL中,只有一点点障碍, 我没有手动技能去摆脱它, |
| 985 | but I do have my go-to gurus in what I call manual medicine, and they might be dry needlers or | 但我确实有我的Gurus 在我的所谓的手动药, 他们可能是干需要者或 |
| 986 | acupuncturists or whatever, and three sessions with that person, and they made me look like | 催眠师什么的 和那个人的三次会面 他们让我看起来像 |
| 987 | a superstar. | 超级巨星 |
| 988 | That was the last little final piece of the puzzle. | 这是最后一块拼图 |
| 989 | I'm going to say one other thing | 我还想说一件事 |
| 990 | as well. | 临Τ |
| 991 | You may see on the infomercials these guys that are selling a little TENS machine or | 你可能看到这些在卖小TENS机器的家伙的缩写 |
| 992 | something like that. | 类似的东西。 |
| 993 | Well, there's one on the infomercials where I was asked to do an investigation | 嗯,有一张在缩影 在那里,我被要求做一个调查 |
| 994 | for the report to your FDA to get it approved as a medical device. | 报告给你的FDA 以获得批准 作为医疗设备。 |
| 995 | Is this thing for real? | 这是真的吗? |
| 996 | What I learned there was from the consulting physician, it works better when you put it over | 我从心理医生那里学到的, 你放进去后效果会更好 |
| 997 | acupuncture points. | 针灸点. |
| 998 | Now, I have zero expertise on that. | 现在,我对此没有专门知识。 |
| 999 | I don't understand it, but that's all | 我不明白,但仅此而已 |
| 1000 | I can tell you. | 我可以告诉你。 |
| 1001 | Again, to stay within the integrity of the science, that's all I can | 再说一遍 保持科学的完整性 我只能这样 |
| 1002 | really say. | 真的说。 |
| 1003 | I don't know if that answers your question, but I'll leave it like that. | 我不知道这是否回答了你的问题, 但我会这样离开它。 |
| 1004 | Could we go here, Sherry, with this, and then I see you, so maybe second Michelle, please. | 我们可以在这里,雪莉,用这个, 然后我看到你, 所以也许第二米歇尔,请。 |
| 1005 | Thank you very much. | 谢谢 |
| 1006 | How about inversion tables? | 倒置表怎么样? |
| 1007 | Well, again, I've measured inversion tables, which will elongate your spine and decompress | 再说一遍,我测过反演表 这会延长你的脊椎和减压 |
| 1008 | the disc pressure to some degree. | 磁盘压力在某种程度上。 |
| 1009 | When you stand up, all of that decompression is gone within 15 | 当你站起来时,所有的减压 都在15内消失 |
| 1010 | minutes. | 几分钟 |
| 1011 | Does it help some people? | 有帮助吗? |
| 1012 | I can tell you that it's hurt some people. | 我可以告诉你,它伤害了一些人。 |
| 1013 | What I would do if a patient asked me that, I would say, look, let's go try it. | 如果一个病人问我 我会怎么做,我会说,你看,让我们去试试。 |
| 1014 | Do you feel | 你觉得 |
| 1015 | better or worse? | 还是更糟? |
| 1016 | Now, some might say, oh yeah, I feel better. | 现在,有些人可能会说, 哦,是的,我感觉好多了。 |
| 1017 | No, I make it worse. | 不,我让它更糟。 |
| 1018 | Good. | 不错 |
| 1019 | I'm going | и璶ǐ |
| 1020 | to restore the natural curves of your back first. | 首先恢复你背部的自然曲线。 |
| 1021 | I'm going to put a little lumbar pad under your | 我要在你下面贴个小垫子 |
| 1022 | low back. | 低头 |
| 1023 | Maybe you have a lot of curve, maybe you have big buttocks. | 也许你有很多曲线,也许你有大屁股。 |
| 1024 | I don't know, but we're | 我不知道,但我们 |
| 1025 | going to shape it a little bit to de-stress as much as we can. | 将它塑造成一点点 来尽可能地解除压力。 |
| 1026 | Then we're going to try it. | 那就试试看 |
| 1027 | Then I'm going to put them on a table, and then I'm going to try a little decompression, | 然后把它们放在桌子上,然后我尝试一些减压, |
| 1028 | traction on them, and I'll play with the amount. | 牵引力在他们身上, 我会玩的金额。 |
| 1029 | I'll play with the angle. | 我来玩这个角度。 |
| 1030 | For example, | 举例来说, |
| 1031 | if you have a femoral nerve root coming from L1, 2, and 3 that's a bit irritated, when you bend the | 如果你有来自L1、2和3的股骨神经 有点刺激 当你弯曲 |
| 1032 | knee, it pulls on the femoral root and causes the pain. | 膝盖,它拉 股骨根并引起疼痛。 |
| 1033 | Do you see if you hung upside down and bent | 你看,如果你颠倒,弯曲 |
| 1034 | your knees, that would cause you to get worse. | 你的膝盖,那会让你更坏。 |
| 1035 | It depends on what the offending pain mechanism is. | 这取决于什么是发作的疼痛机制。 |
| 1036 | It gives some people headaches. | 这让人头痛 |
| 1037 | Anyway, do you see where I'm headed with this? | 总之,你看见我要去的地方吗? |
| 1038 | It's like every | 这就像每个 |
| 1039 | single thing you're going to ask me, the answer is always, it depends. | 你要问我的一件事 答案是永远,这要看情况 |
| 1040 | Understand your pain mechanism | 理解你的疼痛机制 |
| 1041 | and pull out the best clinical tool you can find to address it. | 拿出你能找到的最好的临床工具 |
| 1042 | How's that for a... | 这对一个... |
| 1043 | I'm not trying | 我没有尝试 |
| 1044 | to avoid your question at all, but I have to stay, again, within the integrity of the science. | 避免你的问题, 但我必须,再次, 保持科学的完整性。 |
| 1045 | Thank you. | 谢谢 |
| 1046 | Very enjoyable. | 极乐. |
| 1047 | When you talked about your body repairing some of its | 当你谈论你的身体修复一些它 |
| 1048 | gel or liquid, those kinds of things, is that a permanent fix? | 凝胶或液体,这些种类的东西, 这是一个永久固定? |
| 1049 | If you continue to | 如果你继续 |
| 1050 | do your proper mechanics, or if you slip out of it and fall back into your old sloppy ways, | 做你的正常的机械, 或者如果你溜出它 回到你老的草率方式, |
| 1051 | you're going to go back into hurting your body. | 你会回到伤害你的身体。 |
| 1052 | Is it something that you can repair forever, | 这是你能永远修理的东西吗? |
| 1053 | what I'm asking? | 我在问什么? |
| 1054 | Is it going to repair itself and be that way forever or every time you do it wrong? | 它会永远修补自己吗? 还是每次你做错了? |
| 1055 | I understand the question. | 我理解这个问题。 |
| 1056 | The answer is yes and no. | 答案是肯定和否定。 |
| 1057 | Generally speaking, well, look, I've got | 一般来说,嗯,你看,我有 |
| 1058 | 在NBA,NFL,战斗UFC, | |
| 1059 | so yes, we can manage it to subclinical levels. | 所以是的,我们可以管理它 到亚临床水平。 |
| 1060 | No problem for some of them. | 他们中的一些人没有问题。 |
| 1061 | If they | 如果他们 |
| 1062 | get out of position, yes, it will come back. | 离开位置,是的,它会回来。 |
| 1063 | Now, some people, it seals very quickly and starts to | 现在,有些人,它封印非常快,开始 |
| 1064 | gristle, and it's better if you're older. | 葛丽丝,老一点会更好 |
| 1065 | But if you're younger with a more viscous gel, it's a | 但是,如果你年轻 与更粘胶,这是一个 |
| 1066 | little harder to seal. | 更难封印。 |
| 1067 | It's going to take a bit more time, but eventually it will. | 这需要多一点时间,但最终会的。 |
| 1068 | So there's a | 所以有一个 |
| 1069 | little bit of an answer. | 一点点的答案。 |
| 1070 | The older you are, the faster it will seal, generally speaking. | 一般来说,你越老,会越快封住 |
| 1071 | Does that | 难道 |
| 1072 | help you? | 帮你? |
| 1073 | Oh, there's a great advantage to be getting a little older. | 哦,有一个很大的优势 越来越老一点。 |
| 1074 | You're going to grow | 你会长大的 |
| 1075 | out of that back pain. | 从背部疼痛。 |
| 1076 | Thank you for coming. | 谢谢你能来 |
| 1077 | There's been a lot of television internet | 有很多电视网 |
| 1078 | advertising in the U.S. this year about stand-up desks. | 今年在美国的广告 关于站台。 |
| 1079 | Yes. | 对 |
| 1080 | I have two questions. | 我有个问题 |
| 1081 | Are they | 难道他们 |
| 1082 | beneficial? | 有用吗? |
| 1083 | Secondary, I happen to sit at a computer at a desk quite a lot, and I'm | 副手,我碰巧坐在电脑 在一个桌子上很多,我 |
| 1084 | tall like you are. | 和你一样高 |
| 1085 | Is there something I should be doing specifically because of | 我是不是应该做点什么 因为... |
| 1086 | height and size? | 身高和体型? |
| 1087 | Okay, well, there's two questions there. | 好吧,这里有两个问题 |
| 1088 | What about stand-up sit-down desks? | 站起来坐着的桌子呢? |
| 1089 | Well, | 那个 |
| 1090 | here's the funny thing that we measured, and again, forgive me for folks, but it depends. | 这是有趣的事情,我们衡量, 再次,原谅我的人,但它取决于。 |
| 1091 | Now, here's something very interesting. | 现在,这是非常有趣的。 |
| 1092 | Does everyone know what lordosis is? | 大家都知道什么是龙卷风吗? |
| 1093 | Lordosis is the | 领主是 |
| 1094 | low back. | 低头 |
| 1095 | Now, when we measure people with a lot of lordosis, they stand in what's called elastic | 现在,当我们测量人 与很多的尊崇, 他们站在所谓的弹性 |
| 1096 | stress. | 压力 |
| 1097 | Now, let me define, first of all, elastic equilibrium. | 首先,让我来定义弹性平衡。 |
| 1098 | It's a mechanical concept. | 这是一个机械的概念。 |
| 1099 | If I could | 如果可以的话 |
| 1100 | get anesthetized and fall into a swimming pool, my joints would go to elastic equilibrium. | 麻醉后掉进游泳池 我的关节会达到弹性平衡 |
| 1101 | So, | 这么说 |
| 1102 | if that's elastic equilibrium for my elbow, if I extend, I get flexor stress. | 如果这是弹性平衡 我的肘,如果我延伸, 我得到弹性压力。 |
| 1103 | If I flex, | 如果我摇摆, |
| 1104 | I get extensor stress. | 我得到扩展压力。 |
| 1105 | So, do you see how that's my elastic equilibrium? | 所以,你看到我的弹性平衡吗? |
| 1106 | Now, people with a lot of | 现在,人们有很多 |
| 1107 | lordosis stand in elastic extension when we measure it. | 当我们测量时,劳洛斯西斯是弹性延伸的。 |
| 1108 | So, when they sit down, they unstress | 所以,当他们坐下, 他们松绑 |
| 1109 | their spine. | 他们的脊椎。 |
| 1110 | If a person has a flat back, when they sit down, they get more stress because they | 如果一个人有一个平背, 当他们坐下, 他们得到更大的压力,因为他们 |
| 1111 | go even more flat. | 更平坦一点 |
| 1112 | Do you guys see the argument? | 你们看到争论了吗? |
| 1113 | So, the scientific principle is based on elastic | 因此,科学原理是基于弹性 |
| 1114 | equilibrium, which is based on your anatomy. | 平衡,这是基于你的解剖学。 |
| 1115 | So, do you see how, again, it depends. | 所以,你看,如何,再次,它取决于。 |
| 1116 | And the first | 第一个 |
| 1117 | thing I would look at is where your elastic equilibrium point is. | 我想看的是 你的弹性平衡点在哪里 |
| 1118 | But that's what the | 但这就是 |
| 1119 | scientific mechanistic research shows. | 科学机械学研究显示. |
| 1120 | But the practical shows is that if you stand a lot, | 但实际表现是,如果你站了很多, |
| 1121 | your relief from standing should be sit awhile. | 暂时不要站着了 |
| 1122 | If you sit a lot, your relief position is to stand | 如果你经常坐着,你的救济位置就是站着 |
| 1123 | for awhile. | 有一段时间。 |
| 1124 | So, you don't stand all day, and you don't sit all day. | 故曰:不日而立,不日而坐. |
| 1125 | And that was the beauty of the | 这是美丽的 |
| 1126 | sit-stand station. | 坐着站着 |
| 1127 | It's easy to adjust. | 方便调伏. |
| 1128 | So, when you get tired of one, go to the other. | 所以,当你厌倦了一个,去另一个。 |
| 1129 | That's the | 就是这样 |
| 1130 | more simplistic route with the science on top of it. | 更简单化的路线 科学在上面。 |
| 1131 | However, if you sit a lot, and I've noticed you | 不过,如果你经常坐着,我注意到你 |
| 1132 | a little bit in your posture, and I've been doing a little bit of an assessment for the last hour on | 在你的姿势上,我做了一点点 评估的最后一小时 |
| 1133 | you. | 你们 |
| 1134 | Why don't you try this? | 你为什么不试试这个? |
| 1135 | Make a fist and put it across your back like that. | 竖起拳头,像那样放在你的背上. |
| 1136 | Now, relax and lean | 现在,放松和倾斜 |
| 1137 | back. | 回来 |
| 1138 | Scoot your pelvis to the back of the seat pan a little bit more, and put your hand there. | 把骨盆放回座位后面 再多一点,把手放那里 |
| 1139 | Now, you've got a sore shoulder, right? | 现在,你有一个疼痛的肩膀,对不对? |
| 1140 | Right sore shoulder? | 右肩痛吗? |
| 1141 | Yeah. | 对 |
| 1142 | Try it with your other arm. | 用另一只手臂试试 |
| 1143 | That | 那个 |
| 1144 | better shoulder, is it? | 肩膀好一点,是吗? |
| 1145 | Slightly better? | 有点好? |
| 1146 | Yeah, you got a rotator cuff on the right. | 是啊,你有一个旋转器袖子 在右边。 |
| 1147 | I can see it, | 我看得出来 |
| 1148 | right? | 对吧? |
| 1149 | Anyway, watch. | 无论如何,看。 |
| 1150 | When you put that behind your back, did that make your back feel more | 当你把它放在背后,做 让你的背感觉更多 |
| 1151 | comfortable? | 舒服吗? |
| 1152 | So, when you're sitting at your computer, get a lumbar pad and put it in there. | 所以,当你坐在你的电脑上, 得到一个凸轮垫并把它放在那里。 |
| 1153 | Now, you've taken away the stress that accumulates to cause pain. | 现在,你已经消除了压力 累积造成疼痛。 |
| 1154 | Okay, so there's an assessment | 好吧,所以有一个评估 |
| 1155 | right away that I can see in you. | 我马上就能看见你 |
| 1156 | Okay? | 好吗? |
| 1157 | One last question. | 最后一个问题 |
| 1158 | Right here, yeah. | 在这里,是的。 |
| 1159 | I have a question. | 我有个问题 |
| 1160 | I was always wondering, is it good to crack your back? | 我总是在想,打碎你的背好吗? |
| 1161 | And for me, it feels good. | 对我来说,感觉很好 |
| 1162 | And I know that's | 我知道这是 |
| 1163 | a- I don't know. | - 我不知道 - 说不定 |
| 1164 | Yeah, again, I don't know for you if it's a good thing, but I'll tell you one thing. | 是啊,再说一遍,我不知道这是不是好事 但我会告诉你一件事 |
| 1165 | When a patient sits down in front of me, and they are self-manipulating, so they'll sit there | 当病人坐在我面前, 他们自制,所以他们会坐在那里 |
| 1166 | in front of me, telling me about their back pain, and they grab their neck and- and then they sit | 在我的面前,告诉我他们的背痛, 他们抓住他们的脖子,然后,他们坐下 |
| 1167 | there and- that usually is an indicator that they are over-manipulating, and they have reversed | 这通常是一个指标 他们过度操纵, 他们已经逆转 |
| 1168 | neurological perceptions. | 神经认知。 |
| 1169 | And what I mean by that is, if I took a joint and I bent it, | 我的意思是,如果我拿一个关节,我弯了它, |
| 1170 | that's called jiu-jitsu. | 这叫秋津 |
| 1171 | Most people don't like that, you submit. | 大多数人不喜欢,你顺从。 |
| 1172 | Some people love stretching the | 有些人喜欢伸展 |
| 1173 | range. | 范围。 |
| 1174 | And because your body has stretch receptors, and the more normal response is to say, | 因为你的身体有伸展受体, 并且更正常的反应是说, |
| 1175 | that's a stretch- I don't like it. | 这很长... 我不喜欢 |
| 1176 | The stretch receptors is to take you back to equilibrium. | 伸展受体是带你回到平衡。 |
| 1177 | So you see some people get reversed perceptions, and they keep stretching, getting a 20-minute | 所以,你看到一些人 得到反向的认识, 他们不断伸展, 得到20分钟 |
| 1178 | spell of analgesia from the stretch receptor reflex, not realizing that that's the original | 从拉伸受体反射得到的止痛药的咒语 并没有意识到那是原药 |
| 1179 | pain trigger, and they keep picking this gap so it feels good for 20 minutes. | 疼痛触发器,他们不停地挑这个缺口 这样它感觉好20分钟。 |
| 1180 | Stop it. | 别说了 |
| 1181 | Every time | 每次都这样 |
| 1182 | you feel like stretching, go lay on a table, lay down. | 你想伸展 躺在桌子上 躺下 |
| 1183 | Do you see what I mean? | 明白我的意思了吗? |
| 1184 | So again, it depends | 再说一遍,要看 |
| 1185 | on where your neurology set point is right now, and whether you're in that reverse perception. | 以及你是否处于相反的认知中 |
| 1186 | So | 这么说 |
| 1187 | it doesn't really answer your question, I know. | 它没有真正回答你的问题,我知道。 |
| 1188 | I don't know. | 师曰. |
| 1189 | But I bet if I could work with you | 但我敢打赌,如果我可以和你一起工作 |
| 1190 | for a little bit, we'd converge a bit more on the answer. | 稍稍地,我们会在答案上更趋一致。 |
| 1191 | Anyway, we're getting a time call. | 无论如何,我们得到了一个时间通知。 |
| 1192 | Thank our speaker. Thank our speaker. Thank our speaker. Thank our speaker. Thank our speaker. | 感谢我们的演讲者。 感谢我们的演讲者。 感谢我们的演讲者。 感谢我们的演讲者。 感谢我们的演讲者。 |
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