膝蓋傷(髂脛束摩擦症候群)希望是有治的! Iliotibial Band Syndrome can be fixed

中文 / English

新加坡比賽前其實是 林德銘 最煎熬的一段時日. 一來, 他沒法練車, 擔心新加坡那兒的經銷商如此辛勞的為我們牽線安排, 會對他的表現很失望. 壓力極大. 二來, 我們將近四個月的巡醫, 完全都沒成效. 看過 中, 西, 復健科, 骨科 等的醫生及物理治療師, 更有出名的 "奧運隨隊"醫生, 每一位都說一樣的: 休息, 冰敷, 拉筋, 做些復健運動. 三來, 上網查更讓人心灰意冷. 中文, 英文網誌每個人的經驗都表示他的情況是無治的, 只能減少運動量, 也就是說他將來騎車只能 "消遙游". 我們當時真的見不到隧道盡頭的光.

上天簡直是在玩弄他.

出國當天, 他等飛機時打了通電話叫我上網看看在新加坡有沒有醫生可求. 之前我們就有出國就醫的主意, 也連絡過日本及澳洲的醫生, 但是一直還沒行動因為成本很高希望先試盡台灣管道後再考慮出國. 而且想想新加坡這麼小, 運動醫療知識也許與台灣類同, 所以沒有事先調查. 不過既然他問了, 我也就查查看. 多看看就算沒結果, 最少不會惡化吧!

之前在調查 林德銘 的狀況時, 有查到一個特殊的軟組織的醫療技術叫做 "Active Release Technique (A.R.T.)" 也許對他的傷勢會有效. 所以我就找了一個有A.R.T.認證的治療師, 東方人(網上有照片), 簡訊了他的聯絡資料給 Chris, 叫他自己打去預約. 幾分鐘後 Chris 打回來說第二天就可以去看診, 還說他是個 "醫生", 英國人! 我心理想, 新加坡人沒有英國腔阿? 原來我給他的電話是一個醫療中心, 從 Chris 的病情敘述中被轉到這個英國大夫. 我還很擔心他又會跟台灣醫生說一樣的, 而且可能沒有A.R.T., 不知道 Chris 會不會是去浪費時間的… 也許這也是冥冥中的安排吧!

第二天, Chris 去看Dr. David Wells. Dr. Wells 仔細從頭到腳的打量了 Chris 一番後, 竟然告訴 Chris: "你從一進門時我就可從你的動作看出你的骨架嚴重歪曲." 還說Chris是他見過所有職業選手內情形最糟糕的一位. 更訝異著 Chris竟然還能練到這個層次.

其實話說回來 Chris 的右側膝蓋傷已經是第三次浮現了. 青年時一次, 做幾天復健運動就好了. 一年前又一次, 兩個禮拜復健好了. 今年是第三次, 也是最嚴重的一次. Dr. Wells 說他膝蓋的軟組織的傷需要時間休息復原, 用了一些 A.R.T.來幫他治療, 加快復原. 但是最重要的是, 真正的根源如果不治療, 就算是軟組織完全復原後, 傷還是會一而再, 再而三的浮現, 而且會每下愈況. 於是 Dr. Wells 就替他從脖子, 脊椎, 臀部, 到大腿, 膝蓋, 以及腳 全面"整骨"一番… 治療他骨架歪曲的問題. 就好像有一次看 "CSC Becoming" 的影片, 他們車隊的醫生替選手一邊按摩一邊整骨調整一樣. 現在想想, 當 Pro Tour 的選手真好, 有人每天幫你維持top shape!. 咖拉咖拉的. Chris說 Dr. Wells所做的動作都很精準, 有一些很恐怖, 像有一項是將他的膝蓋向"後"彎! 如過動作不精準, 一定會受傷. 不過, 第一次治療完後就立即有一個 "暢通了" 的感覺. 這也是Dr 說他一直如此不柔軟的原因之一.

Dr. Wells 還說 Chris 的右腳雖然乍看不明顯, 但是走路時, 和騎車時明顯的有扁平足的症狀. 扁平足的人因為沒有腳背弧度的支撐, 每走一步路, 全身的體重會朝腳內側下壓, 腳版會往內八. 雖然 Chris 的扁平足不嚴重, 但這內八的動作牽動著他的Tibia bone (也就是小腿前方的那條長骨) 朝內旋轉, 亦連帶著將他的 Patella (膝蓋骨)往外側推動. Chris 的右膝Patella 外移是之前在 慈濟 照 X-Ray時就證實了. 也是他青年時候 加拿大國家代表隊教練 判定他當時受傷的原因. 成為一位單車選手的他因 Patella 長期外推, 加上過度使用才會造成膝蓋韌帶及軟骨的一些磨損與不適. Dr. Wells 說平板腳的原因是基因遺傳, 姿勢不正只會惡化, 不是起因, 而且基本上沒法把它變成完美的. 於是對這問題 Dr. Wells 製作了客制的鞋墊來提供 Chris 的腳適當的支撐. 來彌補他先天的不正! 穿上鞋墊後立即發現他每一次踩踏, 膝蓋, 腳 都直了. 所以照理講, 騎單車真的是最不傷的運動 - 如果沒有骨架彎曲或平板足的情況!!

治療後的當天, 也是 Chris 這麼多天以來第一次可以騎一小時高強度, 還可以站起來抽車 (在賽前有和Pro們出去練車, 不抽一下太丟臉了). 還有他每天都會做一個甩膝的動作去試試看膝蓋好了沒有, 第二次治療次後, 走了一整天(穿著鞋墊), 晚上測試時竟然不痛了! 雖然新加坡比賽在預期中第二圈就被主集團拋棄, 此新加坡一行看似沒有白跑一趟.

昨天的北大武比賽, Chris 也做了一次攻擊來測試膝蓋(也解解自己近來的悶). 還是沒痛. So far so good. 當然我們目前還是抱者觀望的心態. 不過感覺隧道盡頭可能有光線了. 希望 Dr. Wells 是正確的. 將來可能會一年回去一次微調. 有類同症狀的人們, 我們也建議找類似的治療, 不要舉喪, 這問題是有救的.

幾件值得提到的事:
之前我們也想下下策可能要用到膝蓋手術 (Scope). Dr. Wells 是熱愛運動, 騎車的人, 自己年輕時也受過膝蓋傷, 更雙膝接受 Scope 手術, 但是都沒治到本. 結果他自己決定學醫, 才找到他真正的毛病.

Dr. Wells 基本上不相信有所謂的 IT band syndrome. 他認為會這樣診斷的其實是診不出所以然才會如此下定.

還有, Chris 給Dr. Wells 看診了三次. 其中一次遇到 2004 年的 Mr. Universe 也去看診. (阿諾史瓦斯辛格 是1968年的 Mr. Universe.)

最後, 當 Dr. Wells 在診斷 Chris 的問題時, 時常是趴在地上細細的觀察 Chris 的腳!! 他專業的態度與台灣一些醫師截然不同. 之前還有醫生(也都是同系骨科的ㄜ)竟然連摸都不摸, 也不叫 Chris 走走看的就下診斷, 感覺上好似忙這愛現他們的英文能力. 我想, 有些醫生忘記了他們的診斷很有可能會影響一個人的一生. 也很明顯的缺乏從業的熱誠. 做家長的, 還是要鼓勵孩子追求自己的夢, 要不然當了醫生, 卻沒熱誠有何用呢?

中文 / English

Prior to Singapore race, it was probably the toughest period of time for Chris during his injury. First, our Fuji Singapore distributor had worked so hard hooking us up to such a high profile race with the Pros in Singapore. They also setup ESPN and magazine interviews for the team. Chris was under a lot of pressure to perform. Second, after seeking for medical advises from so many "authorities" in Taiwan, including physiotherapy, osteopaths, and sports Dr., on illio tibia band syndrome, non had offered him any breakthrough. Everyone said the same: rest, ice, stretch, and do some physiotherapy exercises. Third, all our online researches pointed to an even grimmer conclusion. Everyone's conclusion is to "reduce in training and intensity" which spelled an end to his competitive cycling career.

I think he is going through the make-or-break test of his life.

While they were waiting for the air plane in the airport, Chris called and asked me to research if there is anyone to see in Singapore for his conditions. We had considered seeking help outside of Taiwan, but since it would be costly,
we planed to exhaust our options in Taiwan first then proceed to Japan or Australia. Plus Singapore seems to be such a small place, their sports medicine is probably on par with Taiwan, so we didn't think seeking help in Singapore would be a viable plan. Anyhow, I did the search thinking it couldn't get any worse than this…

Through our previous research on IT Band syndrome, we had found a treatment technique called the "Active Release Technique (A.R.T)". This technique is good for repairing soft tissue damages. So I found an A.R.T. certified therapist, and text messaged Chris his phone number. Online, it showed an Asian Therapist, but 15 minutes later, Chris called back and told me he had made an appointment for the next day and the "Dr." is a British! It turns out that the number I gave Chris was actually for a medical clinic, and through Chris' description of his condition, he got routed to Dr. David Wells.

During Chris' first visit, Dr. Wells carefully studied Chris' anatomy and then told Chris that the alignment of his structure is completely off and it is especially bad on the right side. Dr. Wells also said Chris was the worst he has seen in elite athletes.

This right knee injury of Chris' was actually not his first time. When he was a junior racer, he had one episode and it took a few days of physio to recover. The second time was last year, and it took about 2 weeks to recover. This time is actually the 3rd time.. and the worst of all. Dr. Wells said his soft tissue damage in his right knee will heel in time, and did perform some A.R.T. to the tissues to help the recovery. The root cause, however, was his "flat-footness" of his right foot which caused his structure misalignment then in terms caused his knee injury. Dr. Wells did some really funky bone cracking literally from his head to his toe. Some for sure would have injured him severely if they were done wrong. For example, one of the treatment was "bending his knee backwards"!! Pretty scary stuff. I recall seeing CSC Pro riders getting massages and alignment maintenance everyday for recovery by their team doctor. It's such a luxury now that I think about it.

Dr. Wells said he can definitely tell Chris has the symptoms of a flat-footed person especially on his right leg just by the way he walks. When you are flat-footed, due to the lack of arch and support, each stride you take your body puts tremendous pressure to your inner foot, which rotates your Tibia bone inwards at the ankle end but pushes your patella out at the knee end. This causes patella tracking issues. When Chris was in Taiwan, an Osteopathic Dr. did diagnose his Patella being pushed out through the result of an X-Ray, but did not identify the root cause. A person in general is born with flat-footness, and the only way to cure it is to wear the right insole to give your feet the proper support. Dr. Wells also made a custom insole for Chris that he can and have to (!) wear in all his shoes and forever (!) - including his cycling shoes too. In theory, if you do not have misaligned structure, cycling really is a very low impact sports!

In another word, Dr. Wells does not believe there is such a illness called ITB Syndrome. He believes which ever Dr. concludes a patient with ITB Syndrome actually does not have any clue of the root cause, that's why they blame it to ITB Syndrome.

After his first treatment, Chris was able to ride in high intensity for over an hour and even stand up to sprint for the first time at the training ride with the Pros. Plus he passed a little knee-shaking test he does everyday since November which can tell him if his knee pain is gone. Magical? Perhaps. Coincidental? Perhaps not! Although he was expectedly dropped after the 2nd lap of the OCBD race due to lack of training (his goal was to make it to 1 lap!), this trip has brought him personal triumph. At the next race, Chris also tried an (though pathetic) attack, no pain. Triumph again. Obviously it may be too early to jump to any conclusion, but we sure are hopeful and believe that Dr. Wells may be correct. If so, we may visit him once a year for maintenance. For those who have similar condition, we highly recommend you to seek similar treatment and keep your chin up as the cure is out there.

中文 / English