ปวดเข่า ( 1 ) โรคข้อเข่านักวิ่ง
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คนส่วนใหญ่จะเข้าใจผิดเรื่องการปวดเข่ากับการวิ่ง มักจะคิดว่าถ้าวิ่งแล้วโอกาสปวดเข่าจะสูงขึ้น หลีกเลี่ยงไม่ได้ จริงๆแล้วอาการปวดเข่าในคนที่วิ่งสามารถหลีกเลี่ยงได้ และถ้ามีอาการปวดเข่าแล้วก็สามารถแก้ไขได้ไม่ยาก ถ้ารักษาและแก้ไขถูกวิธี ทั้งยังไม่จำเป็นต้องเลิกวิ่ง แล้วหันไปออกกำลังกายด้วยวิธีอื่น
ข้อเข่าจะมีหน้าที่พิเศษ จะเคลื่ินไหวในแนวเดียวคืองอเข่าและเหยียดเข่าเท่านั้น แนวอื่นก็คงขยับได้เล็กน้อย ไม่เหมือนข้ออื่นๆที่ต้องมีการหมุนตัว ( เช่นหัวใหล่และสะโพก ) การทำงานก็จะมีกล้ามเนื้อและเอ็นพังผืดอีกมากมาเกี่ยวข้องด้วย กระดูกอ่อนที่รับน้ำหนักหรือรับการเคลื่อนไหวก็มีการซ่อมแซมตัวเองอยู่ตลอดเวลา ดังนั้นถ้าเราฝึกกล้ามเนื้อและเอ็นพังผืดที่เกี่ยวข้องให้แข็งแรง และระมัดระวังไม่ให้ข้อเข่าต้องรับน้ำหนักมากๆ หรือมีการเคลื่อนไหวที่ผิดปกติไปจากเดิมมากๆ ก็จะสามารถลดการบาดเจ็บที่เกิดขึ้นกับข้อเข่าได้
อาการปวดเข่าที่พบบ่อยได้แก่
โรคข้อเ่ข่านักวิ่ง - Runner’s Knee (Chondromalacia of the patella )
เป็นการบาดเจ็บที่ผิวกระดูกอ่อนของกระดูกสะบ้า เกิดจากการที่กระดูกสะบ้ามีรูปทรงไม่ปกติหรือวิ่งมากไปไม่ถูกเทคนิค ทำให้การลื่นไหลของกระดูกสะบ้า ระหว่างที่มีการเหยียดและงอเข่าไม่สดวก เมื่อวิ่งมากๆจะทำให้แรงเค้นเกิดขึ้นมารวมกันอยู่ที่ผิวกระดูกอ่อน เมื่อมากขึ้นเรื่อย ๆ จำมีการทำลายกระดูกอ่อนผิวข้อของกระดูกสะบ้า ยิ่งถ้างอเข่ามาก ๆ จะเกิดแรงอัดที่กระดูกสะบ้ามากทำให้ผิวกระดูกอ่อนถูกทำลายมากขึ้นไปอีก ดังนั้นการวิ่งที่งอเข่ามาก ๆ เช่นการวิ่งขึ้นหรือลงที่สูง หรือที่ลาดเอียง ชัน จึงทำให้เกิดโรคงอเข่านักวิ่งได้ง่าย สำหรับอีกสาเหตุหนึ่งที่ทำให้มีการทำลายของผิวกระดูกอ่อนที่พบได้บ่อย ๆ ก็คือ กล้ามเนื้อต้นขาไม่แข็งแรง ทำให้ไม่มีตัวที่จะดึงรั้งกระดูกสะบ้าไว้เมื่อมีการเคลื่อนไหว ผิวกระดูกอ่อนของกระดูกสะบ้า จะไปถูไถกับกระดูกของข้อเข่า ทำให้มีการทำลายกระดูกผิวข้อได้
อาการของโรค คือ ปวด เจ็บ ใต้ลูกสะบ้า จะมีอาการเกิดขึ้นหรือเพิ่มมากขึ้นเมื่อวิ่งระยะทางมากขึ้น หรือเห็นได้ชัดเมื่อวิ่งขึ้นที่ลาดเอียง หรือวิ่งขึ้นที่สูง อาการที่เกิดขึ้นนี้อาจเกิดหลังจากหยุดวิ่งทันทีหรือภายหลังจากนั้น ในรายที่เป็นมาก ๆ เมื่อนั่งงอเข่าจะเหยียดเข่าไม่ค่อยออกเนื่องจากเจ็บปวด
การบาดเจ็บแบบนี้รักษาไม่ยากแต่ต้องมีความอดทนหน่อย ขั้นแรกก็ตามสูตรนะครับ หยุดพัก ประคบเย็น พักให้มีการเคลื่อนไหวให้น้อยที่สุด ถ้าทำได้ก็นอนยกเข่าสูง อาจทานยาแก้ปวดตามที่แพทย์สั่ง
พออาการเริ่มดีขึ้นก็เริ่มออกกำลังกล้ามเนื้อต้นขาเพื่อให้กล้ามเนื้อแข็งแรงขึ้น เพื่อให้เกิดแรงเค้นที่กระดูกสะบ้าน้อยที่สุด อาจทำให้ไม่เกิดการบาดเจ็บในการวิ่งต่อๆไป การที่กระดูกสะบ้าเคลื่อนที่ผิดทิศทางเกิดจากกล้ามเนื้อต้นขาไม่สมดุล ส่วนใหญ่แล้วจะเกิดกล้ามเนื้อต้นขาด้านหลัง ( Hamstrings ) จะแข็งแรงกว่ากล้ามเนื้อต้นขาด้านหน้า ( Quadriceps ) หรือเกิดจากเท้ามีการบิดตัวเข้าหรือออกในจังหวะที่เท้ากระทบพื้น ทำให้เข่าไม่มีความมั่นคง อาจต้องหาซื้อรองเท้าที่เหมาะสมถ้ามีปัญหาการบิดตัวของเท้า ถ้าจำเป็นก็ปรึกษาหมอกระดูกหรือผู้เชี่ยวชาญแนะนำการแก้ไข
ส่วนมากจะเกิดจากการฝึกซ้อมที่หนักเกินไป อาจต้องลดระยะทางลงก่อน ลดการฝึกความเร็วและการวิ่งขึ้นทางลาด ( Hills ) ส่วนเรื่องของเท้าต้องระวังการวิ่งตามชายหาด ตามบริเวณที่ต้องเลี้ยวมุมแคบบ่อยๆ หรือวิ่งในพื้นที่ไม่เรียบ เช่นถนนที่เป็นหลังเต่าจะมีความลาดเอียงทำให้เกิดการบาดเจ็บได้
การออกกำลังกล้ามเนื้อต้นขาขอเล่าต่อตอนหน้านะครับ
นพ. ธีรวัฒน์ กุลทนันท์ หนังสือบาดเจ็บจากการวิ่ง ( คนนี้เป็นเพื่อนจอมป่วนครับ อิอิ )
Knee Pain โดย Josh Clark จากhttp://www.coolrunning.com/engine/2/2_5/194.shtml
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