关节过度活动？是的，你可以进行力量训练（以下是安全训练的方法）

大家好。

Hello, my friends.

欢迎回到《与医生同行更美好》的新一期节目。

Welcome back to another episode of Better with Doctor.

我是斯蒂芬妮。

Stephanie.

没错，我是你们的主持人，医生。

It's me, your host, Doctor.

Stephanie Estima。

Stephanie Estima.

今天只有你和我，我们将应大家的要求来聊聊关节过度活动的问题。

And today is just you and me, and we are gonna be talking about hypermobility by popular demand.

很多人写信、联系我说，能不能讲讲关节过度活动，因为这是我的困扰。

So many of you have wrote in, reached out, and said, can you please talk about hypermobility because that is my issue.

如果你能把大拇指碰到前臂，或者伸直手肘时手肘能向后弯，或者别人曾戏称你是“双关节”像表演杂耍一样，那这期节目就是为你准备的。

If you can touch your thumb to your forearm or if when you lock out your elbows, they bend backwards, or you've ever been called double jointed like it was a party trick, this episode is for you.

或者你是个教练，有个客户能像折叠椅一样对折，但穿袜子时却会扭到背，这期节目也适合你，因为我们会讨论关节过度活动到底是什么，为什么多拉伸或放松可能是你听过的最糟糕的建议，以及为什么增肌对这个人群来说不是可选项。

Or maybe you're a coach, and you have a client who can fold in half like a lawn chair, but somehow tweaks their back by putting on their socks, this episode is also for you because we are gonna talk about what hypermobility actually is, why just stretching more or taking it easy might be the worst advice that you have ever gotten, and why building muscle is not optional for this population.

实际上，增肌是基础，我们今天要讨论的是如果你关节过度活动，该如何训练。

It is actually foundational, and what we're gonna talk about today is how to train if you're hypermobile.

我们会讨论营养策略和恢复。

We're gonna talk about nutrition strategies and recovery.

所以如果你觉得自己天生柔韧性好，或者上辈子是舞者或体操运动员，也许你现在是瑜伽爱好者，而且你的关节会咔咔响、弹响、移位，或者感觉非常松。

So if you think that you're naturally flexible or maybe you in a past life, you were a dancer or a gymnast, maybe you're currently a yogi, and maybe your joints, they click, they pop, they shift, or they feel really loose.

或者即使你反复受伤，疼痛似乎在身体各处游走，而且疼痛原因不明，柔韧性是健身中最被误解的特质之一，我们其实一直被教导要赞美柔韧性。

Or even if you've had recurring injuries that seem to move around your body and you have pain that doesn't really make sense, flexibility is one of the most misunderstood traits in fitness, and we've actually been taught to celebrate flexibility.

就像更多活动度、更多拉伸、更大活动范围。

It's like more mobility, more stretching, more range of motion.

但对这个人群来说，问题不是太紧。

But for this population, the problem is not that you are too tight.

你的问题是太松了。

Your problem is that you are too loose.

所以对你来说，答案不是拉伸或者柔韧性训练。

So in your case, the answer is not gonna be stretching or mobility.

而是要增加肌肉量，这样才能真正提高稳定性。

It's going to be building more muscle so that you can actually impart more stability.

我觉得我们不应该再把胶原蛋白仅仅当成美容补品了，因为健康地变老、优雅地变老，不只是看外表。

I think we need to stop talking about collagen simply as a beauty supplement because healthy aging and aging like a boss isn't just about how you look.

更重要的是你的身体还能做什么。

It's about what your body can still do.

大多数女性一听到胶原蛋白，首先想到的就是皮肤，比如减少皱纹、提升弹性、看起来更年轻。

And when most women hear the word collagen, they think about skin, like fewer wrinkles and better elasticity and looking younger.

当然，胶原蛋白确实对皮肤有好处。

And, yes, sure, collagen can absolutely support your skin.

但这只是其中一部分。

That's only part of the story.

胶原蛋白是全身的结构蛋白，包括关节、肌腱、韧带和骨骼。

Collagen is a structural protein throughout your entire body, including your joints, your tendons, your ligaments, and your bones.

所以随着年龄增长，胶原蛋白不应该只是关于我们外表的话题。

So as we get older, collagen shouldn't just be a conversation about how we look.

它应该关乎我们如何活动、如何感受，以及我们在余生中能保持多强壮。

It should be a conversation about how we move, how we feel, and how strong we remain for the remainder of our lives.

这就是AlgaeCal胶原蛋白与普通美容胶原蛋白补充剂的区别。

And that's what makes AlgaeCal collagen different from a typical beauty collagen supplement.

它不只是依赖一种普通的胶原蛋白来源，而是结合了四种经过临床研究的专业胶原蛋白，分别是Verisol、FortiGel、UC2和FortiBone。

Instead of just relying on one generic collagen source, it combines four specialized clinically studied collagen, and the four are Verisol, FortiGel, UC two, and FortiBone.

这些组合得到了25项人体临床研究的支持，其中包括18项双盲安慰剂对照试验。

These together are backed by 25 human clinical studies, including 18 double blind placebo controlled trials.

AlgaeCal把所有这些都融合在一个配方里。

AlgaeCal brings all of those together in one formula.

所以，你既能支持看得见的部分，比如皮肤、头发和指甲，当然，也能支持让你保持活力的部分，比如关节和骨骼。

So you're supporting things that you can see, like your skin, your hair, and your nails, sure, while also supporting the things that keep you active, like your joints and your bones.

因为看起来好固然很棒，但能在生活中持续活动、锻炼、旅行，做你热爱的事情，那才是真正的优雅老去。

Because looking good is great, but being able to keep moving and exercising and traveling and doing the things that you love over the course of your life, that is aging like a boss.

AlgaeCal没有味道，很容易溶解在你早上的咖啡或冰沙里。

AlgaeCal is flavorless and dissolves easily into your morning coffee or your smoothie.

如果你想试试，AlgaeCal胶原蛋白给我的听众提供首次购买10%的折扣。

If you wanna try it, AlgaeCal collagen is offering my listeners 10% off their first purchase.

请访问dr.stephanieestima.com/algaecal。

Head over to dr.stephanieestima.com/algaecal.

就是drstephanieestima.com/algaecal。

That's drstephanieestima.com/algaecal.

好好享用吧。

Enjoy.

那我们开始吧，先定义一下什么是关节过度活动。

So let's start by defining what is hypermobility.

好吗？

Okay?

简单来说，关节过度活动就是关节的活动范围超出了通常认为的正常范围。

So simply, hypermobility are joints that move beyond what's typically considered a normal range of motion.

所以这可能发生在一个关节，也可能发生在很多关节。

So this can be in one joint, or it can be many.

所以这就是贝顿评分作为常见筛查工具的用武之地。

So this is where the Beighton score comes in as the common screening tool.

它是一个九分制的量表。

So it's a nine point scale.

它检查你的拇指、小指、肘部、膝盖，以及你能向前弯腰多远。

It looks at your thumbs, your pinkies, your elbows, your knees, how far you can forward fold.

它本身不是诊断工具，但经常被用作筛查工具。

And it doesn't it's not a diagnostic tool on its own, but it is often used as a screening tool.

而且关节过度活动症有三个等级。

And there are three tiers of hypermobility.

第一个就是单纯的关节过度活动。

So the first is just joint hypermobility.

也就是说你的关节很灵活，但没有任何症状。

So you have flexible joints, and there's no symptoms.

所以很多舞者、体操运动员和瑜伽练习者在这个阶段生活得很舒适。

So many dancers, many gymnasts, many yogis live here very comfortably.

这个等级的第二层是过度活动谱系障碍，简称HSD。

The second point on that tier is hypermobility spectrum disorder or HSD.

这就是我们刚才说的关节灵活，但同时还伴有症状。

So this is the flexible joints that we just talked about, but it's also symptoms.

包括疼痛、关节不稳定、经常扭伤和疲劳。

It's also pain and instability and frequent tweaks and fatigue.

然后这个等级的第三层是过度活动型埃勒斯-当洛斯综合征，简称hEDS。

And then the third part on that scale is hypermobile Ehlers Danlos Syndrome or hEDS.

这是一种遗传性结缔组织疾病，关节过度活动只是它更广泛临床表现中的一个特征。

This is a genetic connective tissue condition with hypermobility as one feature among broader clinical picture.

所以患者可能会出现皮肤问题、胃肠道问题、心血管问题，有些情况下还有自主神经功能障碍。

So you're going to have skin issues, GI issues, cardiovascular issues, dysautonomia in some cases.

要说明的是，这并非诊断标准。

So to be clear, this is not a diagnostic scale.

如果你怀疑自己得了hEDS，那你需要和熟悉结缔组织疾病的遗传学家或风湿病专家谈谈。

If you suspect hEDS specifically, this is a conversation that you need to have with a geneticist or a rheumatologist familiar with connective tissue disorders.

我不希望你只从这期播客获取所有信息。

I don't want you getting all of your information just from this podcast.

但我想传达的核心观点是，关节过度活动是一个谱系，而过度活动本身并不是问题所在。

But the core idea that I'm trying to get across is that hypermobility exists on a spectrum, and the hypermobility itself is not actually the problem.

问题在于它带来的不稳定性。

The problem is the instability that it confers.

所以，你的柔韧性本身并不危险，但在没有控制的情况下进行大幅度活动，才是容易出问题的地方。

So your flexibility unto itself is not dangerous, but rather moving through a huge range of motion without any control is where things often go sideways.

简单总结一下，关节过度活动就是指关节的活动范围超出了正常范围。

So hypermobility, just to summarize, simply means that a joint is moving beyond what is considered a normal range of motion.

这可能有几个原因。

So this can happen for a couple reasons.

你的骨骼形状允许这样。

The shape of your bones allow it.

这是其中一个原因。

That's one thing.

韧带更有弹性。

The ligaments are more elastic.

这是大多数人联想到关节过度活动时会想到的。

That's what most people will associate with hypermobility.

你的结缔组织整体上更柔韧，或者这些因素的综合作用。

Your connective tissue as a whole is more compliant or a combination of all of those things.

而且女性比男性更容易出现关节过度活动，因为雌激素会影响我们的结缔组织。

And women in particular are much more likely than men to have hypermobility because of how estrogen affects our connective tissue.

雌激素，我之前稍微提过，它会增加所谓的韧带松弛度。

So estrogen, I've talked about this a little bit before, but it increases something called ligament laxity.

这会让我们的韧带变得有点松垮。

So this just makes our ligaments a bit more loosey goosey.

这通常就是为什么女性一般比男性更柔韧，也是为什么女性比男性更容易出现关节不稳定的原因。

And it's usually it's why generally women are more flexible than men, and it's also why women experience more joint instability compared to our male counterparts.

大家都对那种深度的瑜伽姿势赞叹不已，但没人提到这位女士的肩膀老是半脱位。

Everybody ooze and ahs over the, you know, the deep held yoga pose, but nobody's talking about this woman's shoulder that keeps, you know, subluxing.

所以大家都喜欢深蹲，但没人提到那些经常酸痛的髋关节。

So everyone loves the deep squat, but no one talks about the hips that are constantly aching.

所以我们真的要考虑，不一定只赞美柔韧性。

So we wanna really be thinking about not necessarily celebrating only the flexibility.

我们还得赞美并朝着稳定性努力，因为正是稳定性让你保持正常功能。

We have to celebrate and move towards stability because it's the stability piece that keeps you functioning.

那我们来具体分析一下，一个人怎么会变得过度灵活。

So let's actually break down how somebody can be hypermobile.

说到稳定性，大多数人想到的是肌肉。

When we think about stability, most people think about muscles.

当然，肌肉是其中的一部分，但我想给你介绍被动和主动稳定器。

And, of course, muscles are a part of the picture, but I wanna introduce you to passive and active stabilizers.

明白吗？

Okay?

被动稳定器就是那些你无法收缩的东西。

So passive stabilizers are things that you cannot contract.

你对它们没有自主控制能力。

You have no voluntary control over them.

这些结构是不需要费力就能提供稳定性的。

These are the structures that create stability without effort.

你对它们没有任何有意识的控制。

They don't you don't have any conscious access to them.

这些包括韧带、骨骼、关节囊、软骨和筋膜。

So these are things like your ligaments, your bones, your joint capsules, your cartilage, and your fascia.

它们的作用是提供静态稳定性。

Their job is to provide static stability.

它们在静止时把骨头固定在一起，不需要开关。

So they hold the bones together at rest without needing to turn on or off.

所以在过度活动的身体里，这些被动结构通常更易伸展。

So in hypermobile bodies, these passive structures are often more extensible.

所以这通常是由结缔组织引起的。

So this is usually connective tissue mediated.

所以胶原蛋白的结构和比例可能会起作用。

So the collagen structure and the ratios can play a role.

不过我要说的是，确切的机制并不完全清楚，而且它们也不完全受……我是说，个体差异也很大。

Although I will say that the exact mechanism is not exactly known, and they aren't fully under I mean, there's so much individual variability as well.

所以被动结构在控制关节运动方面作用很小。

So passive structures have very little say in controlling a joint through movement.

它们更像是……更像是护栏。

They're more like the they're more like the guardrails.

就像，它们更像是支撑帐篷的绳子。

Like, they're more like the ropes holding up a tent.

或者如果你把它们想象成护栏，就像，你不是路上的车。

Or if you think about them as guardrails, like, it's you're not the car on the road.

你是高速公路旁边的护栏，确保你不会，嗯，不会冲出高速公路。

You're the guardrails on the side of the highway to make sure that you don't like, you don't drive off the highway.

在这些类别里，我想简单提一下骨骼。

So within those categories, I don't I wanna touch just briefly on bones.

我们的骨骼是不能收缩的。

So we we can't contract our bones.

骨骼非常非常重要。

Bones are very, very important.

骨骼之所以会动，完全是因为肌肉和肌腱在带动它们。

The only reason why bones move is because we have the muscles and tendons that are moving them.

但你的骨骼结构也可能导致关节过度活动。

But your bony structure can also contribute to hypermobility.

比如，想想你的髋关节，一个深的髋臼。

So for example, think about your hip, a deep hip socket.

所以，在髋臼关节里，如果你的髋臼很深，那会提供巨大的稳定性。

So if you have a so in the acetabular joint, if you have a very deep hip socket, that is going to provide a tremendous amount of stability.

而浅的髋臼提供的稳定性就少得多。

A shallow socket is gonna provide a lot less.

所以你的骨骼形状也会影响你是否容易过度活动。

So your bone shape also contributes to whether or not you have a tendency towards hypermobility.

还有韧带，大家一提到过度活动就会想到它，它的作用是在关节活动到极限时提供限制。

And the ligaments, which is what everybody thinks about when we think about hypermobility, their job is to provide that restraint at the end ranges.

就像我之前说的高速公路上的护栏，或者像安全带一样。

So it's like the guardrails on the highway that I was saying, or they're like seat belts.

它们不是用来开车的。

They're not supposed to drive the car.

它们是用来防止灾难的。

They're supposed to stop disaster.

但如果你的韧带太松，用专业术语来说，我们称之为顺应性。

But if your ligaments are too loosey goosey or in nerd speak, we would call that compliance.

如果你的韧带太顺应，它们就无法保护关节，防止关节活动过度。

If your ligaments are too compliant, they cannot protect the joints from moving too much.

就像一条旧橡皮筋，或者你小时候玩过的弹簧玩具，拉长了就回不去了，差不多就是那种感觉。

So just like, you know, an old elastic band, if you've ever had a slinky toy when you were younger and it stretched out, it's kind of like that.

而且我自己都不知道，真的很好笑。

And I don't even know like, I have the it's so funny.

我刚说到弹簧玩具，脑子里就自动响起它的广告曲了。

Like, as I'm saying slinky, I literally have the jingle of it in my head.

这旋律一直在我脑子里挥之不去。

It has been living rent free.

你们还记得这个吗？

Have you guys remember this?

你们还记得那个走下楼梯的画面吗？

Do you guys remember the walks downstairs?

一个孤独的弹簧，成对出现，发出那种弹簧的声音。

A loner in pairs that makes the slinky sound.

一个弹簧。

A spring.

一个弹簧。

A spring.

真是个神奇的东西。

A marvelous thing.

大家都知道那是弹簧玩具。

Everyone knows it's slinky.

天哪。

Oh my god.

那个，我也不知道我是从哪儿想起这个的，但就是想到了。

That, like, I don't know where I found that in my mind mansion, but there we go.

那些营销天才让这个广告曲在我脑子里住了三十年。

The marketing geniuses have had that jingle living in my head for the last thirty years.

但我想说的是，如果你有一个拉长了的弹簧玩具，它就不会那样独自或歪歪扭扭地走下去。

But what I was saying was if you have, like, a stretched out slinky, it doesn't go down alone or impaired.

你知道，它下楼梯的方式就不一样了。

You know, it doesn't go down the stairs in the same way.

它就像一根拉长了的旧橡皮筋。

It's sort of like an old stretched out elastic band.

对吧？

K?

所以这些就是你的被动稳定器。

So those are your passive stabilizers.

而主动稳定器，是通过运动来动态产生稳定性的结构。

Your active stabilizers, these are structures that create stability dynamically through movement.

所以，如果你不能收缩筋膜，不能收缩结缔组织，不能收缩韧带。

So if you can't contract your fascia, you can't contract your connective tissue, you can't contract your ligaments.

相反，主动稳定器是可以收缩的。

On the contrary, active stabilizers, you can contract.

对吧？

K?

所以想想你的肌肉、肌腱、整个神经肌肉系统、神经系统、本体感觉，比如关节位置感、运动控制，还有反射性稳定。

So think of your muscles, your tendons, the neuromuscular system as a whole, your nervous system, proprioception, like your joint position sense, your motor control, and your reflexive stabilization.

它们的作用就是提供动态稳定性。

Their job is to provide dynamic stability.

所以这就是在关节运动时控制关节，尤其是在接近活动范围末端的时候。

So that is controlling joints as they are moving, especially near the end range.

所以当被动结构松弛、更柔韧时，这个系统就得做更多的工作。

And so that system has to do more work when the passive structures are lax, when they're more compliant.

对于我那些关节过度灵活的姐妹们来说，好消息是你们对这些结构其实有更多的自主控制能力。

And the good news for my hypermobile girlies is that you actually have more voluntary control over these structures.

肌肉是最明显的例子。

So muscle is the obvious one.

它们显然能产生力量。

They obviously generate force.

它们控制运动。

They control movement.

它们是移动骨骼的结构。

They are the structures that move your bone.

肌腱，当然，可以说是肌肉的两端。

Tendons, of course, are the bookends, if you will, of muscle.

它们把肌肉固定在骨头上。

They tether the muscle to the bone.

它们还传递力量，并且对关节的稳定性贡献很大。

They also transmit force, and they significantly contribute to joint stiffness.

还有一个系统，我觉得很多人没怎么提到，就是你的神经系统。

And the other system that I don't think a lot of people talk about is your nervous system.

你的神经系统一直在监测你的关节位置、速度、负荷和威胁，然后协调肌肉对这些做出反应。

Your nervous system is constantly monitoring your joint position, your speed, your load, the threat, and then coordinating the muscular responses to it.

所以你的大脑，真的，每时每刻都在运行稳定算法，一秒都不停。

So your brain is, like, literally constantly running the stabilization algorithm every single second of your life.

对于我那些关节过度活动的女性朋友们，你们通常有我们说的，专业术语叫本体感觉缺陷，意思就是关节过度活动的人往往关节位置感较差，可能不能准确感觉到关节在空间中的移动，尤其是在接近活动范围末端的时候。

And for my hypermobile women, you typically have what we would call, again, nerd speak proprioceptive deficits, which just means that people with joint hypermobility often have a reduced, joint position sense that they may not accurately feel when when a joint is moving in space, especially near the end range.

这就是为什么，你知道，很多女性会说，我不知道。

And this is why the you know, a lot of women will say, I don't know.

我总是扭到脚踝，或者肩膀老是脱臼。

I keep rolling my ankle or I keep dislocating my shoulder.

我老是扭到膝盖。

I keep tweaking my knee.

这种模式反反复复，因为你根本感觉不到自己快到极限了。

Like, that pattern goes on and on and on because those you can't actually feel when you're getting to that end range.

你不一定会感到疼痛，或者没有任何预警，直到已经超出了正常范围。

You don't necessarily feel pain or there's no warning until something has already gone past where it should have.

而且，在极限位置，没有那种内在的GPS或警报系统，不像韧带张力正常的人那样。

And there isn't any, like, internal GPS or internal alarm system at the end range in the way that there is for someone with typical ligament ligamentous tone, we'll say.

这也是很多关节过度活动症的女性感到疼痛的原因之一。

So this is also a reason why a lot of women with hypermobility have pain.

因为如果你的被动稳定器很弱，你的主动稳定器——也就是肌肉、肌腱——你的神经系统就得加倍努力。

Because if your passive stabilizers are weak, your active stabilizers, so the muscle, the tendon, your nervous system has to work a lot harder.

所以如果你的韧带比一般人更松弛，你的肌肉就得承担更多，就像字面意思那样，真的。

So if your ligaments are more compliant than the average person, your muscles now have to pick up the slack, like, you know, pun intended, like, literally.

你的神经系统必须更积极地监控，这会消耗更多能量。

Your nervous system has to monitor much more aggressively, which, you know, gobbles up more energy.

你的肌腱得承受更大的负荷。

Your tendons have to tolerate more load.

所以下游的一切都得更努力地工作。

And so everything downstream has to work harder.

所以对女性来说，这是我想让你记住的一个关键点：如果你有过度活动症，力量训练就不再是可有可无的，而是主要的治疗策略，特别是如果你有症状性的过度活动症。

So for a woman, and this is, like, a key point that I want you to get, if you are someone with hypermobility, strength training then becomes less of a nice to have to more of a primary treatment strategy, especially if you have symptomatic hypermobility.

比如，如果你老是受伤，你的主动稳定系统就是预防受伤的第一道防线，因为你不能只依赖被动系统。

Like, if you keep getting injured, your active stabilization system is the first line intervention to preventing injury because you can't rely on your passive system alone.

如果你正在经历围绝经期或中年阶段，你可能已经注意到精力、恢复能力，甚至那种难以解释的潜在疲劳感的变化。

If you're navigating perimenopause or midlife, you've probably noticed shifts in your energy, your recovery, and even that underlying fatigue that can be hard to explain.

最近我特别关注的一种化合物是亚精胺。

One compound I've really been focused on lately is spermidine.

随着年龄增长，我们体内亚精胺的自然生成量会下降，这很重要，因为亚精胺能激活一种叫做自噬的机制，也就是你身体的细胞更新过程，还有线粒体自噬，这有助于清除受损、老旧、缓慢的线粒体，并支持健康的能量生成。

As we age, our natural production of spermidine declines, and that matters because spermidine activates something called autophagy, which is your body's cellular renewal process, and also mitophagy, which also helps clear out damaged, old, slow mitochondria, and it helps to support healthy energy production.

既然你的线粒体负责为身体里的每一个细胞提供能量，这就会直接影响你的感受，也就是你的精力、恢复力和活力。

And since your mitochondria are responsible for powering every single cell in your body, this is going to directly impact how you feel, so your energy, your resilience, and your vitality.

我很喜欢并一直在用牛津健康寿命（Oxford Healthspan）的Primadine，因为它提供的是源自食物的多胺矩阵，也就是说你摄入的多胺是天然形态的，同时还有其他多胺与之协同作用。

I love and use primadine from Oxford Healthspan because it delivers a food derived polyamine matrix, meaning that you're getting spermidine in its natural form alongside other polyamines that work synergistically with it.

它很简单，是一种基础性的方式，帮助你在衰老过程中支持认知功能、细胞健康以及持续的能量水平。

It's simple, and it's a foundational way for you to support your cognitive function, your cellular health, and sustained energy as you age.

如果你想试试，可以去牛津健康寿命官网，网址是oxfordhealthspan.com/doctorstephanie。

If you wanna try it, head over to Oxford Healthban dot com forward /doctorstephanie.

那就是我的名字。

That's my name.

输入优惠码 doctor Stephanie，订单可享八折优惠。

And use code doctor Stephanie to get 20% off your order.

网址是 oxfordhealthspan.com/doctorstephanie，结账时填写 doctor Stephanie 即可。

That's oxfordhealthspan.com/doctorstephanie, and use doctor Stephanie at checkout.

我关注 OneSkin 这款产品已经有一段时间了，所以当他们说要寄新款 OS-one 丰润面霜给我试用时，我简直高兴坏了。

I have been obsessed with OneSkin for a while now, so I jumped with joy when they said they were sending me their new OS-one face rich cream to try out.

它确实完全满足了我肌肤的需求。

And it has been exactly what my skin has been craving.

你知道，到了四十多岁，或者五十多岁，如果你幸运的话，这个阶段你的皮肤就开始发生变化了。

Now, you know, in your forties, maybe your fifties, if you're lucky, this is the decade that your skin starts changing on you.

皮肤变得更干。

It gets drier.

不再那么有弹性了。

It stops bouncing back.

化妆开始变得奇怪，你开始怀疑自己是不是做错了什么。

Makeup starts sitting weird, and you start wondering what you're doing wrong.

我是说，至少我自己就是这样。

I mean, I know at least I was doing that.

但这并不是你一个人的问题。

But this isn't a unique problem.

其实皮肤表层下面正在发生一些变化。

There's something actually shifting underneath the surface.

你的皮肤正在流失胶原蛋白。

Your skin is losing the collagen.

它正在失去让皮肤保持紧致和水润的弹性蛋白和透明质酸。

It's losing the elastin and the hyaluronic acid that keep it firm and hydrated in the first place.

这个过程被OneSkin的两位女性创始人和长寿科学家称为“密度转变”。

This is a process that two female founders and longevity scientists at OneSkin are calling the density shift.

这款新的丰润面霜正是他们为应对这一时刻而研发的。

Now this new rich cream is what they developed for exactly that moment.

它采用了你早已喜爱的同款肽技术。

So it's the same peptide technology that you already love.

它能清除所有衰老细胞，而且现在的配方比任何普通面霜都更深入。

It's getting rid of all the senescent cells, but now it's been formulated to go deeper than any normal cream.

并且经证明，它确实能促进皮肤自身胶原蛋白、弹性蛋白和透明质酸的生成。

And it's proven to actually build up your skin's own collagen and elastin and hyaluronic acid.

所以，随着时间的推移，你的皮肤会看起来更紧致、更水润，而且明显更光滑。

So your skin is now gonna look more firmer, more hydrated, and visibly smoother over time.

这正是你的皮肤所需要的深层补水滋养。

It's the kind of deep replenishing hydration that your skin needs.

它很滋养。

It's nourishing.

它持久，能保持一整天，而且不会感觉太厚重或太油腻。

It's long lasting, and it holds all day without feeling too heavy or too greasy.

我现在每天晚上都用这款丰润面霜，已经用了两周，我可以马上告诉你，第二天早上我的皮肤更水润、更保湿了。

Now I have been using the RICH CREAM now at night, every night for two weeks, and I can tell you right away that my skin is dewier and hydrated the next morning.

对我来说最重要的是，我的妆容不再卡粉了。

And the most important thing for me is that my makeup is not taking anymore.

我的皮肤之前有点开裂，T区特别干。

My skin was, like, cracking and getting all dry sort of in my t zone.

我原以为是粉底的问题，但其实是皮肤本身的问题。

I had assumed that it was the foundation, but it was actually my skin.

基于十多年的皮肤长寿研究，OneSkin正在帮助你在衰老过程中保持最健康的皮肤。

Born from over ten years of skin longevity research, OneSkin is helping you unlock your healthiest skin now as you age.

限时优惠，使用优惠码better，在oneskin.co/better购买他们的新款OS-one丰润面霜，可享受15%的折扣。

For a limited time, try their new OS-one face rich cream with 15% off using code better at oneskin.co forward slash better.

在 oneskin.co 下单可以享受 15% 的折扣，结账时使用优惠码 better。

And that's 15% off at oneskin.co, and use code better at checkout.

购买后，他们会问你从哪里了解到他们的。

After you purchase, they are gonna ask you where you heard about them.

拜托拜托，求求你了，请告诉他们你是在我这里发现他们的。

Please, pretty please with a cherry on top, please tell them that you found them through me.

那我们就开始吧，稍微深入一点。

So let's get into let's get a little nerdy.

跟我聊聊专业的东西，我们来谈谈为什么会这样。

Let's speak nerdy to me, and we're gonna talk about why that is.

好吗？

Okay?

首先，当你拥有更多的肌肉和更好的控制力时，所谓的关节对位会得到提升。

So the first thing is when you have more muscle and more control, you are going to have an increase in what's called joint centration.

这其实就是用专业术语来说，就是关节的对齐。

And that's just, again, nerd speak for essentially alignment of the joint.

如果关节周围的肌肉强壮，就能帮助关节保持在关节窝的中心位置，而不是滑向那些末端范围，在那里被动结构——比如你那些已经松弛的结构——在承担所有工作。

If you have strong muscles around a joint, it helps to keep the joint centered in the socket instead of drifting towards those end ranges where passive structures, in your case that are already lax, are doing all the work.

所以这是原因之一。

So that's one reason.

另一个原因是，当我们增加肌肉量时，你会发展出更多的代偿能力来弥补本体感觉的下降。

Another reason is when we develop more muscle, you are going to develop more compensation for reduced proprioception.

不过我们别太深入那些专业术语了，但肌肉内部有一种叫做肌梭的结构。

So without kind of going too far off into nerd land here, but there are structures inside the muscle called muscle spindles.

还有高尔基腱器官，也就是GTO，它们嵌入在肌腱或肌腹中，也参与位置感知。

There's also the GTOs, the Golgi tendon organs, which also they're embedded either within the tendon or the muscle belly, and they also contribute to position sense.

所以如果我说，比如，闭上眼睛，然后——我现在就闭上眼睛，给那些在YouTube上观看的人。

So if I were to say to you, like, close your eyes, and then, like, I'm closing my eyes now for those of you that are watching on YouTube.

好。

Okay.

所以如果我说闭上眼睛，让你的肘部弯曲成90度角，我并不是靠视觉系统来完成这个动作的。

So if I say close your eyes and make a 90 degree angle with your elbow, like, I'm not using my visual system to do that.

我是在用我的本体感觉。

I'm using my proprioception.

所以我的关节位置感在告诉我的大脑。

So my joint position space is telling my brain.

如果我打开眼睛检查一下，是的，我大概在90度。

And if I open and I check, yeah, I'm about at 90 degrees.

所以我们有高尔基腱器官、肌梭，这些都有助于位置感。

So we have the GTOs, those Golgi tendon organs, muscle spindles, those contribute to position sense.

它们告诉你的大脑你在哪里，当肌肉在运动的时候。

They tell your brain where you are as the as the muscle is moving.

当你进行力量训练，特别是当你注重节奏和控制时，这会改善你大脑对关节位置的感知。

And when you are strength training, especially when you are utilizing tempo and control, that is going to improve your brain's map of where the joint is.

所以这实际上是在大脑中重新建立一些你从韧带那里得不到的内部反馈。

So it's literally building back in the brain some of that missing internal feedback that you're not getting from your ligaments.

当你增加肌肉量时，你也会减少对韧带末端活动范围的依赖。

When you are building more muscle, you are also gonna reduce the reliance on the ligamentous end range.

所以，一个状态良好的肌肉能够减速，也就是放慢速度，停下来，在关节达到其结构性活动范围极限之前控制动作。

So a well conditioned muscle can decelerate, so slow down, come to a stop, and control movement before the joint reaches its structural end range.

这有助于保护关节囊和韧带，避免它们反复被过度拉伸。

And that is going to help protect the joint capsule and the ligaments from repetitive overstretching.

因为记住，你的韧带实际上不会向大脑发送信号，告诉大脑：嘿。

Because remember, your ligaments are literally not firing up to the brain and telling your brain, hey.

这太过分了，所以你需要你的肌肉来接管并完成这个任务。

This is too much, so you need your muscles to take over and do that.

然后我要提到的另一件事是，当你正确锻炼肌肉时，对吧？

And then the other thing I'll mention is that when you develop your muscles right?

所以，当你发展神经肌肉系统并建立强壮的肌肉时，你会随着时间的推移提高你的负荷承受能力。

So when you develop the neuromuscular system and building strong muscles, you are going to improve your load tolerance over time.

我这么说的意思是，结缔组织，也就是你的肌腱，以及程度较小的韧带，会适应渐进式的机械负荷，但它们的适应速度比肌肉慢得多。

So what I mean by that is connective tissue, so your tendons and to a lesser degree, your ligaments adapt to progressive mechanical loading through like, and they do it much slower than muscle does.

但是，通过数月持续、适当剂量的渐进式超负荷力量训练，可以增强组织的韧性。

But consistently dosed appropriate progressive overload through strength training over months and months and months supports more tissue resilience.

所以我个人的理念是，对于关节过度活动的女性，其实对于所有关节过度活动的人来说都一样，但我在跟你们这些关节过度活动的姐妹们说，你们的灵活性和稳定性不是两码事。

So my personal philosophy here with hypermobile women I mean, just hypermobility in general, but I'm talking to you, my hypermobile girlies, is that your mobility and stability are not separate categories.

对于关节过度活动的身体来说，力量训练就是灵活性训练。

For a hypermobile body specifically, strength is the mobility program.

明白吗？

Okay?

所以如果你关节过度活动，你的力量训练就是你的灵活性训练。

So if you are hypermobile, your strength training is your mobility program.

明白吗？

Okay?

你不能只选一个，放弃另一个。

You don't get to opt out of one and lean on the other.

你必须做力量训练。

You have to strength train.

我这么说的时候，通常大家会有些害怕。

So often when I say that, usually, there's some fear that comes up.

很多关节过度活动的女性会告诉我，她们害怕举重，因为有人跟她们说她们很脆弱，或者她们担心会受伤。

A lot of hypermobile women are will tell me that they are scared of lifting heavy because they've been told that they're fragile or they're they're worried about getting injured.

这种恐惧是真实存在的。

And that is a real fear.

但我想帮你重新看待这个问题，并且温柔地指出，你的脆弱其实来自于松弛关节周围缺乏锻炼的组织，而不是举重本身。

But I wanna reframe this for you and gently and lovingly point out that your fragility comes from undertrained tissue around the lax joints, not from the lifting itself.

比如说，你需要调整举重的方式，我们待会儿会聊到这一点。

Like, you have to modify how you lift, and we're gonna talk a little bit about that.

但力量训练，你必须积极且坚定地追求力量训练、肌肉增长和力量，因为你没有其他系统可以依赖。

But strength you must actively and aggressively chase strength training and muscle hypertrophy and strength because you don't have any other systems to rely on.

所以，如果你正在积极且坚定地追求肌肉力量——你应该这样做——那么你就不应该在全范围活动度下训练。

So first thing that you're gonna do if you are actively and aggressively pursuing muscle strength, which you should be, is you are not gonna train in a full range of motion.

明白吗？

Okay?

通常的标准力量训练建议会说，为了肌腱和关节健康，要训练全范围活动度，这确实没错。

So for standard strength training advice often says, you know, train full ROM for tendon and for joint health, and that's true.

但这个默认建议对像我这样关节过度活动的人来说，需要加个星号或者打个折扣。

But that default advice needs a bit of a asterisk or a caveat for my hypermobile bodies.

问题不在于活动范围这个概念本身。

The issue isn't the concept of range of motion.

关键在于我们说的是谁的活动范围终点。

It's whose end range of motion are we talking about.

因为我的完整活动范围和你的完整活动范围差别很大。

Because my full range of motion and your full range of motion are very different.

通常，关节过度活动的女性，其关节的完整活动范围往往已经超出了结构上能支撑的范围。

Usually, a hypermobile woman, her full range of motion in a hypermobile joint often means that a range that's already beyond what is structurally supported.

所以，在负重下反复训练到那个极限范围，实际上会加剧韧带松弛，并刺激那些已经不堪重负的被动结构。

So training all the way into that end range under load repeatedly can actually reinforce the ligamentous laxity and irritate those already stressed out passive structures.

所以，更好的思路和框架是，在可控的范围内训练，而不是追求最大范围。

So the better way to think about this and the better framing here is to train in a controlled range, not maximum range.

明白吗？

Okay?

我再说一遍，因为这真的很重要，然后我会解释什么是可控范围。

So I'll say that again because it's really important, then I'll define what controlled range is.

我希望你在可控范围内训练，而不是你的最大范围。

I want you to train in the controlled range, not your maximum range.

可控范围是指你能主动减速、停下来的那个范围。

So controlled range is where the person can actively decelerate, come to a stop.

你能主动稳定住，并且能发力。

You can actively stabilize and produce force.

你不是靠重力或惯性一下子甩进去或者倒进去的。

You're not just flipping into it or flopping into it, you know, via gravity or momentum.

所以对于关节过度活动的人来说，量化一下，可能就是你可用的被动范围的80%左右。

So to quantify that for someone who's hypermobile, that might be mean, like, 80% of your available passive range.

所以你不会达到你活动范围的100%。

So you're not going to a 100% of your range of motion.

你会达到大约80%，最多90%的可用被动活动范围。

You're going to, like, 80, maybe maximally 90% of your available passive range of motion.

所以实际应用的时候，比如你在考虑做深蹲或者弓步蹲，你要控制到骨盆保持中立的位置。

So a practical application of that, when you are thinking about squatting, let's say, or lunges, you are going to control to a depth where the pelvis stays neutral.

然后你可以停顿，再平滑地反转那个动作轨迹。

The and you can pause and then reverse that that movement line smoothly.

你不一定要蹲到屁股贴地。

You're not necessarily ass to the grass.

也不一定要蹲到最低点。

You're not necessarily rock bottom.

通常在那个位置控制就会失效，即使对不是过度活动的人也一样。

That's often where control breaks down, even for people who are not home hypermobile.

所以对于过头动作，比如你做过头推举，你要避免在负重下把肘关节锁死到过伸的位置。

So maybe with overhead work, like if you are, you know, doing an overhead press, let's say, you're gonna avoid locking your elbows into hyperextension under load.

你要保持肘部有一个主动的轻微弯曲。

You're gonna keep, like, an active slight bend in the elbow.

对于肩部训练，这是很多女性受伤的地方，你要控制好末端范围，比如那些拉伸负重的位置。

For shoulder work, and this is where a lot of women get injured, you're gonna con you're gonna control that end range, like those stretch loaded positions.

比如说，像非常深的三头肌下压，或者极端的过头活动范围，直到你建立起控制力。

So for example, like, very deep tricep dips, let's say, or extreme overhead ranges until your control is established.

这并不意味着关节过度活动的人应该永远避免深范围，或者所有末端范围训练都不好，但你必须先建立可控的活动范围。

So this doesn't mean that hypermobile people should avoid deep range forever or that all end range work is bad, but you have to establish controlled range of motion first.

所以先要控制住，主动负重，然后你可以慢慢进入末端范围训练。

So controlled, actively loaded, and then you can slowly move into end range training.

一旦通过中间范围建立了控制，这最终可能是合适的，甚至是有益的。

That can eventually be appropriate and even beneficial once control through that midrange is established.

但对你来说，这个顺序真的非常重要。

But the sequence the sequencing for you really, really matters.

你必须先建立控制，然后逐渐在负重下重新获得活动范围。

You have to establish the control first and then gradually reclaim range under load.

所以理想情况下，你应该在脊椎按摩师或物理治疗师的指导下进行，他们要有处理关节过度活动的经验。

So, ideally, you do this with a chiropractor or a physical therapist who has some experience in hypermobility.

你也可以自己尝试，但要知道你的本体感觉有点偏差。

You can also play with it yourself, but just know that your own position sense is a little bit off.

所以，达到你认为的全范围运动的大约80%是非常重要的。

So going to, like, 80% of what you think full range of motion, is is really important.

我还想再做一个区分。

And I I do wanna make one more distinction.

被动拉伸，比如保持静态拉伸来增加活动范围，对于有症状的关节过度活动的人来说，通常优先级较低，甚至可能适得其反。

Passive stretching, so, like, holding a static stretch to increase range is generally, like, a lower priority or even counterproductive for someone with symptomatic hypermobile joints.

因为它强调的是那些已经过于松弛的被动结构。

Because it emphasizes the passive structures that are already too accommodating.

它们已经太容易拉伸了。

They're already too compliant.

主动活动度训练，也就是通过肌肉力量而不是重力或外力推动来进入活动范围，通常是更好的方式。

Active mobility work, meaning moving into a range using muscular effort rather than gravity or an external push is generally the better way.

你是不是很烦恼，随着年龄增长，肌肉流失、脂肪增加？

Are you frustrated with losing muscle and gaining fat as you get older?

告诉你吧，这其实不全是你的错。

Well, let me tell you, it is partially not your fault.

随着年龄增长，你身体里的酶产量自然会下降，这样一来，分解食物中蛋白质就变得更困难，长肌肉也就更难了。

Your body's enzyme production naturally declines with age, making it harder to break down protein from the food that you're eating and therefore harder to build muscle.

不过还是有希望的。

But there's hope.

BiOptimizers 的 Masszymes 含有强效的消化酶配方，能大大促进蛋白质消化，让氨基酸吸收率惊人地提升1200%。

Masszymes from BiOptimizers contains a potent digestive enzyme formula, and it supercharges your protein digestion, increasing the amino acid absorption by an incredible 1200%.

没错。

Yes.

这意味着你能从蛋白质中获取更多营养。

That means that you are gonna get more from your protein.

所以每一餐都能提供更多增肌营养，你还会恢复得更快，酸痛更少，训练效果也更好。

So that's more muscle building nutrition from every meal, and you're gonna experience faster recovery and less soreness and better workout results.

算我一个，女士们。

Sign me up, ladies.

好吗？

Okay?

Mastzymes 不只是给运动员用的。

Mastzymes isn't just for athletes.

它可以帮助任何因年龄增长而肌肉流失或体重增加的人，通过优化消化和蛋白质吸收来改善状况。

It can help anyone struggling with age related muscle loss and weight gain by optimizing your digestion and your protein absorption.

Mastzymes 支持维持瘦肌肉和减脂。

Mastzymes supports lean muscle maintenance and fat loss.

我希望你去 bioptimizers.com/better，并在结账时使用代码 better，以获得订单 15% 的折扣。

I want you to head over to bioptimizers.com/better and use code better at checkout to get 15% off your order.

网址是 bioptimizers.com/better，记得在结账时使用 better 这个代码。

That's bioptimizers.com/better, and make sure that you use better at checkout.

那我们再多聊聊训练吧。

So let's talk a little bit more about training.

接下来就是你的实际清单了。

So here is gonna be your actual checklist.

好吗？

Okay?

所以如果你在记笔记，现在就是记笔记的时候了。

So if you're taking notes, this is the time this is the time to take some notes.

你每周要进行两到四次力量训练。

You're gonna strength train two to four times a week.

你要优先选择复合闭链动作，一般来说，比如深蹲、推举、划船或髋部铰链这类动作，身体接触点更多，反馈也更多。

You're gonna prioritize compound closed chain movements, generally where, like, for example, a squat or a press or a row or a hinge where the body has more contact points and more feedback.

明白吗？

K?

你还要放慢动作节奏。

You're also gonna slow down your tempo.

所以每次训练时，你要使用一种叫做控制离心的方法。

So whenever you're training, you are going to utilize something called a controlled eccentric.

离心就是动作中肌肉拉长的部分。

So eccentric is the lengthening portion of the movement.

我希望你能给自己设定一个三到四秒的下降过程。

I would love if you would queue yourself to do, a three or four second lowering.

比如说，你在做二头弯举。

So let's say you're doing, a bicep curl.

这是向心阶段。

This is the concentric.

如果你在听的话，我现在就是在展示我的肘部弯曲。

So if you're listening, I'm just showing my elbow flexing.

然后离心阶段就是我的手臂慢慢伸直。

And then the eccentric is my arm strengthening strengthening out.

但如果我在练离心，那么下降阶段就要持续三到四秒。

But my eccentric, if I'm training the eccentrics, is gonna be three to four seconds in that lowering phase.

这能帮你建立你非常需要的神经肌肉控制。

That is going to help build that neuromuscular control that you desperately need.

明白吗？

K?

另外我要说的是，在你的训练计划中加入等长收缩训练是非常明智的。

The other thing I'll say is it will be very wise for you to add in isometrics into your training program.