识别并纠正肌肉失衡与受伤风险

如果你要对自己或你指导的人进行不对称性检测，需要注意的事项是不一样的。

The testing considerations, if you're gonna test yourself or someone you're working with for asymmetries, they are different.

你首先要弄清楚的是，在我们说的三大类不对称中——形态、肌肉大小、质量或功能——你到底想测哪一种？

The very first thing you need to figure out is of our big three types of asymmetries, morphology, again, that's muscle size, quality, or functionality, which one are you even testing for?

你可能会很惊讶。

You'll be stunned.

但很多时候，当从业者和人们谈论不对称时，他们把这三者都当成一回事。

But a lot of the times when we hear practitioners and people talk about asymmetries, they treat all three of those as the same thing.

就像我在实验室做的研究，还有我举过的其他例子，这三者其实差别很大。

And as I've described with the study we did in my lab and plenty of other examples I've given, they are very distinct.

它们传递的信息完全是两回事。

They're telling you different things entirely.

所以第一步，先问问自己：我到底想测什么？

And so first ask yourself the question, what am I trying to test?

接下来，还要考虑年龄、性别这些因素，不过目前来看，这两者本身并不是导致不对称的主要原因。

Then from there, we have factors like age, sex, which right now don't appear either one of those to be major drivers internally of asymmetry.

但你总是会考虑所有能想到的因素，对吧？

But you always consider every factor you can, right?

我们还有训练经验这个因素。

We have experience level.

我之前已经举过好几个例子了。

I've given you multiple examples of this already.

高水平运动员更可能出现幅度更大、更严重的不对称，而没受过训练的人，或者没做过这种测试的人，表现会完全不同。

Highly trained athletes are going to have more likely, more magnitude, more serious asymmetries where an untrained person or someone maybe not even trained in that exact test will perform differently.

你做的测试是在正常活动范围内的吗？

Are you doing a test over your normal range of motion?

你做的测试是按正常速度进行的吗？

Are you doing a test at your normal speed?

你应该明白我的意思了。

You see what I'm getting at.

一旦你偏离了自己平时的习惯，结果就会不一样。

If you start walking away from anything that's not normal for you, we're gonna see something different.

其实有一些非常有意思的研究，比如让一位训练有素的卧推选手在50%最大单次重量下做测试，你会发现他们在肩部、胸部和腹部的肌肉激活上根本看不出任何不对称。

There's actually been some really cool studies that have looked at things like test a highly trained bench presser at 50% of their one rep max, and you won't see any asymmetries in their ability to activate the muscles in their shoulder, chest, and abdomen, and things like that.

但一旦把重量提到90%，接近他们的极限，不对称就立刻暴增，完全失控了。

But then you slap them with 90%, so almost their maximum, and the asymmetry start flying off the chart.

像这种简单的例子，对吧？

And so simple things like that, right?

现在这个领域里，关于不对称和平衡的测试，大多都只在自重或轻负荷下进行。

So much of this field of asymmetry and balance does everything at body weight or at light loads.

可一旦你加重、加快速度，或者做到力竭，结果可能就完全不一样了。

But when you do it heavy, when you do it fast, when you do it to fatigue, those can completely change your findings.

那我们所说的因变量到底是什么？

So what is our, what we call dependent variable?

我们是在观察肌肉激活情况吗？

Are we looking at muscle activation?

还是在看活动范围？

Are we looking at range of motion?

我们是在观察单个肌群，还是多个肌群，或者整个动作模式？

Are we looking at a single muscle group or a group or a movement pattern?

这些因素你都得考虑进去。

All of this should be something you're considering.

但你不可能把所有这些都做到位。

Now you will not have the ability to do all of it.

所以我建议你，挑出一两个或三个跟你最相关、最贴合你实际情况的方面，建立一套规范的评估方法。

So what I would beg of you is, you know, pick one or two or three things that are most relevant to you in your context and come up with good standardized systems.

不过你心里得清楚，我看到的只是部分情况。

But then just keep in the back of your brain, I'm not seeing the full picture here.

那么话说回来，我们在三大领域里最好的做法是什么？

So that said, what are kind of our best practices for our three big areas?

我们先从第一个开始，也就是形态学。

We'll start off with the first one, morphology.

我保证这是最后一次提醒你，形态学指的是肌肉的大小和形状。

I promise this is the last time I'll remind you, but morphology is muscle size and shape.

在这方面，这一直被轻视，而且是有道理的。

This has traditionally been pooh poohed in this space, and for good reason.

如果你只看一个人肌肉的大小，根本无从了解它的运作方式。

Or if you look at just the size of someone's muscle, you don't have any idea how it operates.

你不知道它是如何收缩的。

You don't know how it contracts.

你不知道它的活动范围是多少。

You don't know its range of motion.

你不知道它什么时候会疲劳，甚至对它的功能一无所知。

You don't know how it gets tired or you don't know anything about how it functions.

但在现实场景中，我们更关心的是功能性。

And most of the time in real world settings, we're worried about functionality.

不过好处是，它更容易标准化。

But the nice part about it is it's way easier to standardize.

你的肌肉大小，几乎总是保持不变的。

Your muscle size will almost always be your muscle size.

我之前讲功能的时候提到过，左右两侧的外观、规模和力量可能完全不同，能做的测试多得数不清。

When I was describing functionality earlier and I told you it can look, it can be totally different on the right side and left side and scale and force, there's infinite tests there.

但肌肉形态就只有一种标准。

Muscle morphology has like one.

所以我没必要操心今天是不是对的日子、负荷对不对、百分比是多少、用什么设备，还有那些乱七八糟的变量。

So I don't have to make sure that I'm doing the right day and the right load and the percentage and what technology and all those other variables.

对咱们来说，这反而成了一个更稳定的指标。

So it's actually for us come to be way more stable of a metric.

它比其他方法容易标准化多了。

It's way less difficult to standardize rather.

而且，借助这些图像，我们还能同时评估肌肉的质量。

And it enables us in the same time to look at quality because we have images.

你在家里做这个其实很简单，就用一把普通的卷尺就行。

So the way that you can do this at home, this is a basic tape measure.

关键是得特别留意你量的是身体哪个部位，尤其是你要用的定位点。

Just make sure you're really careful with the part of the body that you're looking at, and especially the landmark you're using.

你可以用很多方法，但最好选一个固定的位置。

Bunch of ways you can do it, but just pick a standardized place.

如果你能接触到的话，更推荐用双能X光吸收法扫描。

More likely that if you have access to it, you can use something like a DEXA scan.

DEXA的好处是价格便宜，负担得起。

What's nice about a DEXA, pretty cheap, pretty affordable.

现在这类设备越来越普及，不用处方也能做了。

They're getting more available so people can do them without a prescription.

它通常能提供你左右腿的对比数据。

And they'll give you generally things like your right leg versus your left leg.

不过它不会细分到每块肌肉，这确实是个局限。

So they don't give you muscle by muscle, which, you know, is is kind of a limitation there.

这个局限不小，但总比完全没有数据强。

It's a pretty big limitation, but it could be better than nothing.

如果你真要拍影像，更可能用的是超声波或核磁共振。

Really more likely if you're gonna take imaging here, you're gonna use an ultrasound or an MRI.

这些设备以前一直非常贵，但现在价格正在下降，也越来越现实了。

Now those have always been really, really expensive, but that is coming down and is becoming more realistic.

接下来，我们可以开始讨论组织质量的第二类指标了，对吧？

From there, we can now start talking about our second category of tissue quality, right?

我之前跟你们说过，这还是个新兴领域。

I told you before, this is an emerging area.

我会重点讲脂肪浸润，但也要记住，结缔组织和肌肉本身也有不少令人兴奋的研究进展。

I'm gonna discuss fat infiltration the most, but keep in mind, there's some really cool stuff going on with just the connective tissue, the muscle itself.

我这里说的脂肪浸润，是指肌肉细胞内部的脂肪，不是你体内的整体脂肪。

And the fat infiltration I'm talking about here is the fat inside the muscle cell, not your body fat.

这种脂肪，DEXA扫描是检测不出来的。

This is not something a DEXA scan can pick up.

之所以重要，是因为最近人们才开始发现，神经健康和组织质量之间存在关联。

Why this matters is only recently have people started to identify that there's a connection between your neural health and the quality.

而且这些因素很可能会影响运动表现。

And that those are likely performance limitations.

如果我们发现你的肌细胞里有很多脂肪，通常上游的神经通路也会存在某种限制。

If we find a bunch of fat inside your muscle cells, very often there's some restriction also in the upstream neurological pathway.

即使没有这种限制，肌细胞里的脂肪也几乎总会削弱肌肉的性能。

And even if there isn't, that fat in the muscle cell almost always compromises performance of that muscle cell.

这不一定是因为你不够努力。

It may not be the fact that you're not trying as hard.

也不一定是因为肌肉本身不够大。

It may not be the fact that the muscle isn't as large.

但如果本该由肌动蛋白和肌球蛋白这些收缩组织占据的位置被脂肪填满了，那这部分肌肉的体积就不是由健康有力的收缩组织构成的。

But if a bunch of fat is in the place of the muscle where it's supposed to have myosin and actin and the part of the muscle that contracts, that size is not made up by good, strong contractile tissue.

取而代之的是脂肪，而脂肪是无法收缩的。

It's made up of fat, which means it can't contract.

所以，你在这块肌肉或肌肉某部分的性能下降，正是因为那里堆积了脂肪。

And so your performance drop in that muscle or part of the muscle is because the fat that got built up there.

肌肉里的脂肪含量，并不完全取决于你的整体体脂水平。

The amount of fat in your muscle is not necessarily driven by your body composition.

事实上，我们现在发现的一个更有趣的情况是，这往往源于过去的伤病。

In fact, I think one of the more interesting places we're seeing this now is it is oftentimes a result of a previous injury.

当然，一般来说，体脂率高的人，组织里的脂肪也往往更多。

Again, it is true generally if you have more body fat, oftentimes this comes with more fat in your tissue.

但这两者完全可以是独立的。

But those can be completely independent.

我给你举个典型的例子。

I'll give you a great example.

我有个朋友叫道格·拉尔森，他最近做了个扫描，发现髋部一块小肌肉的右侧比左侧小了将近45%。

A friend of mine, Doug Larson, he recently got a scan done and he found that one of the small muscles in his hip was about 45% smaller on his right side than his left side.

他们检查脂肪含量时发现，右侧那块肌肉里有大约25%是脂肪。

And when they looked at the amount of fat, the fat on the right side, about 25% of that muscle was fat.

而左侧的脂肪含量不到5%。

On the left side, it was less than 5%.

我一听就笑了，因为马上想起来，他也记得，大概十年前，他有一次在柔道或摔跤训练时脱了臼。

And I smiled immediately because I remembered, and he knew immediately that about ten years ago, he dislocated his hip, I think during judo or wrestling practice.

他现在髋部其实没什么疼痛或不适，但他渐渐意识到，偶尔会有些异常感觉。

Now, he doesn't have a much hip pain or problems, but he started to realize, Oh, man, occasionally I get a, b, and c going on.

看到这种情况，我们一点都不意外，这明显是旧伤的后遗症。

And it was no surprise at all for us to see we've got a previous injury.

他一直设法绕开这个问题。

He had worked around it.

他把关节周围的其他肌肉都练得很强壮。

He had strengthened all the other muscles around that joint.

所以那些肌肉变得特别有力，替那块受伤的肌肉分担了负担。

So they were hyper strong and picking up the slack.

但那块肌肉本身并没有真正恢复好。

But that muscle actually hadn't properly reattached.

它还是部分撕裂的状态。

It was still partially torn.

因此，神经根本没法有效激活它。

So it was not getting neural activation.

这肌肉十年来一直没被激活，也没锻炼过。

It was not getting turned on, not being exercised for a decade.

结果就开始堆积脂肪，体积也缩小了。

So it started to fill up with fat and it shrank.

这正是我想说的典型例子。

So that is a classic example of what I'm talking about.

十年前的那次受伤，表面上看已经完全康复了，但实际上却暴露出严重的功能异常。

An injury ten years ago that was on the surface completely rehabilitated was actually giving us clues of some pretty major dysfunction.

我们在无数职业运动员身上都见过非常类似的情况，所以我们现在正在全力为很多人做基础扫描，哪怕他们目前还很健康。

We have seen a very, very similar thing with countless professional athletes, Which is why one thing we're doing right now is going bonkers getting a bunch of baseline scans of people, even when they're healthy.

这样我们才能在康复过程中及时发现类似的问题。

So we can start to see and look out for anything like this in the rehabilitation process.

这种现象，或者说我们通常讲的脂肪浸润，非常重要。

So this quality or as again, we'll typically refer to this as fat infiltration is important.

另外，这里还有一些值得关注的点，比如筋膜长度——如果有肌肉生理学家在场的话，还有肌肉的形态，以及一个叫‘羽状角’的参数。

Other things while we're here that are interesting are things like the fascial length, if you Any muscle physiologists out there, the geometry, and then something called penation angle.

记住，你身体里有骨头，肌肉就是靠拉动这些骨头来运动的。

So remember, you've got bones on your body and your muscle moves those bones.

但肌肉和骨头之间的连接角度非常关键。

But the orientation of the muscle to the bone is meaningful.

打个比方，假设你面前有一根笔直的骨头。

Meaning this, let's imagine you have a bone laying straight in front of you.

旁边连着一堆肌肉，都附着在这根骨头上。

And you have a bunch of muscles that connect to that bone lying next to it.

如果这些肌肉和骨头平行排列，紧贴着骨头，那它们收缩时，几乎推不动骨头。

If the muscles run parallel to the bone, right next to it, when they contract, that's gonna barely move the bone.

但如果肌肉是垂直于骨头的，就像一个T字形，直接扎进骨头里。

However, if the muscles were run perpendicular, so the muscles go right into the bone making a T.

这时候一收缩，骨头就会被带动得完全不同。

Now when it contracts, it's gonna move the bone very differently.

这个角度，如果是T字形，那就是90度。

That angle, in this case, if it's a T, that angle is 90 degrees.

如果是平行的，那就是零度。

If it's parallel, that's zero degrees.

这个角度叫作羽状角，决定了你是偏向速度还是力量。

That angle called the Penetian angle determines if you're optimized for velocity or strength.

你往一个方向越偏，另一个方向就越弱。

The more you go in one direction, the least you get at the other.

我们通常都能看到这种情况。

And so we classically see this.

有些肌肉和骨头呈直线排列，有些则垂直于骨头排列。

We see some muscles that are oriented in line with the bone, and then we see some that are oriented perpendicular to the bone.

这通常意味着它们在追求力量，或者追求速度。

And again, it generally means they're hedging for force or they're hedging for velocity.

现在我们发现，脂肪浸润、身体不对称等因素都会改变或干扰这个羽状角。

What we're seeing a lot now is this penation angle can be altered or disturbed by things like fat infiltration, by things like asymmetries.

只要把羽状角调整回正常范围，我们就能根据需求提升力量或速度。

And so we can gain force or speed depending what we're looking for by just kind of getting these penation angles back to a normative state.

我知道刚才讲肌肉生理学讲得有点深了，但我一点都不后悔。

I know I went a little deep in my muscle physiology there, but I will not apologize.

这正是我热爱的领域。

That is my passion.

你选择留下来，完全是自愿的。

You are here at your own accord.

在我们的对话里，稍微忍一忍肌肉生理学的内容吧。

You can suffer through some muscle physiology in our conversation.

好，我们回到正题。

Okay, back to business here.

这个话题挺有挑战性的，对吧？

This is a tough one, right?

目前要评估肌肉质量，便宜又容易获得的方法并不多。

You don't have a lot of low cost or widely available ways to look at muscle quality.

成像技术的成本正在下降。

Imaging is coming down.

我知道现在甚至有一些手持超声设备，价格正变得越来越亲民。

I know that there are even some handheld ultrasound devices that are becoming more and more affordable.

这真的太棒了。

This has been really cool.

它让我们能在现场做研究，而不必非得跑去医院。

It's allowed us to do research on the field instead of having to go to a hospital.

你完全可以把这些设备带到足球场、球场或者任何运动场地去用。

You could actually literally take these on a football fields or pitches or courts or whatever.

但它们还是挺贵的，几千美元起步，有的甚至更贵。

But they're still very expensive, several thousand dollars, if not more.

过去，我们通常靠肌肉活检来评估这种情况。

Traditionally, the way we would look at this is actually via like a muscle biopsy.

对大多数人来说，如果没有活检的条件，超声或者核磁共振算是比较现实的选择。

For most people, since you don't have access to a biopsy is potentially an ultrasound, which is again somewhat reasonable or that MRI device.

我们现在用的是一个叫 Optima Muscle 的项目，可以通过 Springboks 扫描来做，我以前在这档节目里提过好多次了，这是一次四十五分钟的核磁共振扫描。

What we're doing now is with our program called Optima Muscle, you can use the Springboks scan, which I've talked about many times in this show in the past, but it's a forty five minute MRI scan.

你几乎在美国任何地方都能做这个检查。

You can do it almost anywhere in The US.

事实上，他们在全球多个地方都设有站点。

In fact, they have multiple sites over the world.

你躺进扫描仪里，它就能生成你身体140块肌肉的三维模型。

You sit in this scan and it makes a three d model of 140 muscles on your body.

这样一来，你就能清楚地看到各种不对称的情况。

So you can start to see all those asymmetries.

回到你的身体形态问题，我之前说过，最好的方式就是核磁共振。

Going back to your morphology, I told you the best way is MRI.

我们就是这么做的。

This is how we do it.

再说一遍，这里有利益冲突。

Again, conflicts of interest.

我和这家公司有财务关联，我本人也经常使用这项服务。

I have financial ties to this company, I use it all the time.

但这正是我平时在做的。

But this is exactly what I do.

这些信息你怎么看，信或不信，都由你决定。

So take that information for what you will or what you won't.

不过这个扫描其实挺简单的。

But that scan is pretty easy.

你躺在机器里就行。

You lay in the machine.

我能把全部一百四十块肌肉都数字化出来。

I get all hundred and forty muscles digitized.

我可以观察左右不对称的地方。

I can look at asymmetries.

我还能看肌肉的大小。

I can look at size.

脂肪浸润、更多细节，都能看得一清二楚。

I can look at that fat infiltration and more and more and more.

所有结果都会根据年龄、性别，甚至运动项目和场上位置进行标准化处理。

All the results come back normalized for age, sex, and even sport, as well as sport position.

我记得没错的话，他们已经扫描了大多数NFL球员、很大比例的NBA球员，还有不少英超球员。

I remember correctly, they've scanned most of the NFL players, a huge percentage of NBA players, lots of English Premier League players.

所以我们既能从精英运动员的角度，也能从普通人群的角度来分析这些数据。

And so we can look at these from the perspective of high performance or general population.

接下来，我们要转向第三个也是最后一个类别——功能性表现。

From there, we're gonna transition to our third and final category, and that's functionality.

这个领域没有边界，可以无限拓展。

This is an unlimited field.

能做的测试多得数不清。

There are an unlimited number of tests.

功能性测试可以是任何一种，比如坐位体前屈、柔韧性测试，或者你偏好的其他项目。

So functionality wise could be anything from a sit and reach test, a flexibility test, anyone that you prefer.

你也可以用一种叫测角仪的设备。

You could use something called a goniometer.

这是一个小装置，特别便宜，大概二十五美元左右，能测量任何关节的屈伸角度，对吧？

It's a little device, really cheap, probably $25 And you can measure the degree of flexion or extension of any joint, right?

这些设备到处都是。

They're all over the place.

它们能告诉你基本的活动能力和柔韧性。

Those things would tell you basic mobility or flexibility.

还有很多动作评估方法。

There are plenty of movement screens.

最经典的一种叫FMS，也就是功能性动作筛查。

Probably the most classic one is called the FMS or a functional movement screen.

这方法已经存在很久了。

It's been around for a really long time.

被广泛应用于各个领域。

It's used all over the place.

关于它的研究也很多。

There's been plenty of research on it.

有些内容还不错。

Some of it is good.

有些内容显示效果并不理想。

Some of it's showing it's not so great.

但在我看来，它能展示全身的基本动作模式。

But to me, it shows you basic movement patterns across the body.

FMS这类评估的好处在于，它不是孤立地针对某块肌肉。

What's nice about something like an FMS, it's not muscle isolating.

它主要是想让你了解动作模式中的对称性。

It's trying to give you an indication of symmetry with movement patterns.

想象一下做这样的动作。

Imagine doing something like this.

你四肢着地，把左臂向前伸出，同时把右腿向后伸。

You're on all fours and you reach your left arm out in front of you and you put your right leg behind you.

这样只有右手和左膝接触地面。

So that the only thing on the ground is your right hand and left knee.

然后反过来做一遍。

And then you do it the opposite.

这时候你要看的是，你往一边做时会不会失去平衡，另一边呢？

And what you're looking for there is did you fall when you're on one side versus the other?

还有像深蹲这样的动作，也可以试试。

Similar things of do an overhead squat.

你的膝盖在一边下蹲得更深，另一边却不行吗？

And do you go further down on one side of your knee versus the other side?

所以，我们现在关注的是整体动作的功能性，而不是某个肌肉的单独力量、活动范围，或者激活能力。

So again, we're trying to look at now functionality from a whole body movement rather than a muscle specific strength or muscle specific range of motion or ability to activate that muscle.

你也可以用测力台这类设备。

You can also use things like a force plate.

我之前已经提到过它们了。

I described those earlier.

这些是超高精度的秤，能精确到小数点后很多位，能提供大量值得留意的数据。

But these are ultra sensitive scales that go many digits past zero and that can give you tons of variables to pay attention to.

我刚开始做这行的时候，这些东西一台要三万五千美元。

When I first started, those things were like $35,000 each.

现在你花几百美元就能买到了。

And now you can get ahold of them for a couple of $100.

我和他们没有合作关系，但我用过Vald，就是V-A-L-D这个牌子。

I don't have any relationship, but I have used Vald, v a l d.

他们生产了大量这类设备。

They make a ton of these.

他们还做测握力的设备。

They make them for your grip strength.

也有测腿部、上肢，还有各种不同功能的型号。

They make them for your legs and your upper body and all kinds of different ways.

这些设备现在更贴近普通消费者了。

So these are a little bit more consumer friendly.

如果你去一家靠谱的力量训练或运动表现中心，他们很可能有Vald或者类似的品牌。

If you're at a good strength conditioning or performance facility, they've probably got bald or somebody else.

你也可以使用更大的设备，叫做等速测力仪。

You can also use bigger machines called isokinetic dynamometers.

这类设备更常见于科研环境。

Things probably more likely to be in a research setting.

你可以通过肌电图，也就是EMG，来观察肌肉激活情况。

You can look at muscle activation via what's called EMG.

在肌肉上贴几个小电极，就能知道你到底用了多大力。

Little electrodes placed on your muscle that tells you how much you activated them or not.

你可以像Titleist运动表现研究所的格雷格·罗斯那样，用摄像机来分析动作。

You could look at motion like Greg Rose does at Titleist Performance Institute with cameras.

这叫动作捕捉。

This is called motion capture.

我们会在你各个关节上贴上小标记点，然后拍下你做动作的过程，这样就能精确看到你是怎么发力、什么时候发力，以及活动范围等等。

So we put little dots on all of your joints and then film you doing your thing, and then we can look at exactly how you're producing force and when you're producing it and the range of motion and all those things.

在非运动场景，甚至运动员研究中，常用的测试包括Y平衡测试和星形跳跃测试。

Really common ones for non sport situations or honestly even used in athlete research are things like the y balance test or the star excursion.

你会看到它被写成 S E B T。

You'll see this as s e b t.

这是一些小的平衡测试，比如你单脚站立，假设左脚着地，就把右脚尽量往前伸，轻轻点地。

These are little balance tests where you balance on one leg and you let's say you're standing on your left leg, you reach your right foot out in front of you as far as you can and tap the ground.

然后把右脚往后伸，再点一下地。

And then you reach that right leg behind you and tap the ground.

接着往右侧、左侧伸，再用右脚站稳，左脚朝外伸展。

And then you reach it to your right side and your left side and you do it with your right leg on the ground and your left leg pointing.

你关注的不只是它们之间那几厘米的差距，或者其他任何数字。

And you're looking at more than these four centimeter differences between them or whatever the case may be.

你明白我的意思了吧？

You get the point here, right?

你可以列出一大堆低成本甚至零成本的，中等成本的测试方法。

So you could get an endless list of low cost or no cost, moderate cost.

我还把一些高精度的研究设备也列进来了，比如等速测力仪、动作捕捉系统、测力台，以及中间各种档次的工具。

And then I've even again included some research quality stuff from isokinetic dynamometers to motion capture and force plates and everywhere in between.

所以不管你想怎么了解功能方面的情况，你都能在这里找到答案。

So you can get your question answered here however you would like functionality.

不管你是做形态、质量还是功能测试，最重要的是怎么解读这些数据。

What's most important regardless of what tests you're doing for morphology, quality, or functionality is the interpretation.

朋友们，这才是最难的地方。

And friends, this is the tricky part.

那么，什么时候这些不对称性才需要关注？什么时候又不必在意呢？

So when do these asymmetries matter And when do they not?

接下来我们深入探讨这一点。

Let's dive into that next.

正如我一开始所说，我认为最好从两个核心方面来审视这个问题：运动表现和受伤风险。

As I stated at the outset, I think it's best to frame this entire question in two pillars, performance and injury risk.

就运动表现而言，关键问题是：这种不对称性是在拖累我的表现，还是在帮助我？

Performance wise, the question is ultimately this, is this asymmetry hurting my performance or aiding it?

而从受伤风险的角度来看，那就很明显了。

And then from an injury perspective, pretty obvious.

它是增加了、降低了，还是根本无法提供关于我受伤风险的有用信息？

Is it increasing, reducing, or not having any meaningful insight into my injury risk?

但我们必须搞清楚这一点。

We need to understand this though.

受伤是无数因素共同作用的结果。

Injuries are a result of countless variables.

不对称只是这些众多因素中的一个而已。

Asymmetry is only one of those many, many, many variables.

所以在看这些研究的时候，我们可能会觉得它们不够出色，从而有点苛责。

So while we look at the research here, it might be easy for us to give it a little bit of a hard time because it's not incredible.

你不会看到任何研究说：天啊，这点不对称就一定会导致受伤。

You're not gonna see any study that says, Oh my gosh, this small asymmetry promises injury.

但那样就太不现实了，因为就像我说的，训练、营养、补水、睡眠、既往受伤史、年龄——这么多因素都会影响非接触性损伤的发生。

But that'd be unrealistic because as I've stated, your training, your nutrition, your hydration, your sleep, your previous injury history, your age, so many things go into non contact injuries.

单靠不对称这一项，根本不可能解释所有的风险。

There's no way an asymmetry alone could describe all of that risk.

所以我想先明确一点，一开始就讲清楚。

So I wanna make sure I stated that at the outset here.

那我们现在就开始逐条来看吧。

So let's start going through it though.

关于肌肉大小和肌肉质量的不对称，我们到底知道些什么？

What do we know about asymmetries in muscle size and muscle quality?

现阶段，我会把这两者归为两类：运动表现和受伤风险。

I'm gonna lump those two together for now in those two categories, performance and injury risk.

如果你发现确实存在肌肉大小的不对称，第一个该问自己的问题是：这真的存在吗？

Well, the first question you wanna ask yourself, if you identify a legitimate muscle size asymmetry is, is it even real?

我举个经典例子，比如你的斜方肌。

The classic example I'll give here is take your trap muscles.

就是脖子后面、脖子和肩胛骨之间的那块肌肉。

Those muscles kind of behind your neck, between your neck and your shoulder blade.

这种情况其实非常常见。

We'll see this really commonly.

事实上，你看看我，很可能就能发现一个。

In fact, if you look at me, you'll probably notice one.

你可能会发现，比如我的右斜方肌比左斜方肌小得多。

And you might see things like, wow, my right trap is way smaller than my left trap.

于是你去Instagram、TikTok或者YouTube上看，就会有人建议：多做右边的耸肩或提铃训练。

So then if you go to Instagram or TikTok or YouTube rather, you'll see, wow, do more trap raises or shoulder shrugs on my right side.

但你就算把右边练到脱皮，效果可能也微乎其微。

Well, you could do that to your blue in the face and it probably won't do any different.

因为在这种情况下，肌肉本身并没有真的更大。

Because in this case, they're not actually bigger.

它们看起来不一样，是因为别的地方受伤了。

They look different because something else is injured.

换句话说，如果你现在透过屏幕看我，假设我的双肩本来是完全平行的。

So in other words, if you were to look at me on camera right now, those of you watching, and let's assume my shoulders were perfectly straight parallel to each other.

如果我脖子受了伤，下意识地把左肩抬高一点来保护它，那左斜方肌就会显得明显更发达。

If I had an injury, say my neck, and I shrugged my left shoulder a little bit to protect against that injury, that would make my left trap look significantly bigger.

不是的。

It's not.

我只是耸了耸肩。

I'm just shrugging my shoulder.

你看到的肌肉不对称，很可能只是姿势问题或身体在保护受伤部位。

So what you may be seeing with muscle asymmetries is actually just postural differences, injury protection.

所以在你花八周时间专门给身体一侧加20%训练量之前，先确认一下是不是真的存在结构差异。

So before you go doing an eight week block where you put 20% more volume on one side of your body, make sure you actually have a morphological difference.

还有另一点要注意，尤其是当人练得特别瘦的时候，你会看到明显的不对称，比如背阔肌和腹肌。

Another thing we have to pay attention to, and you'll see this when people get really lean, you'll see huge asymmetries, especially in things like your lat muscles and your abs.

腹肌是最明显的例子。

Abs are the easiest one.

几乎没人能拥有完全对称的六块腹肌。

Almost nobody has a perfectly symmetrical six pack.

这很正常。

That's normal.

记住，你的骨骼本来就不是完全对称的。

Remember, your bones aren't perfectly symmetrical.

所以你的肌肉在身体上的起止点，距离也不会完全一样。

So the way that your muscles start and stop on your body won't be the same distance.

它们的形状也不会相同。

They won't have the same shape.

它们看起来不同，纯粹是因为你无法控制的解剖结构差异。

They will look different simply because of anatomical structural things that you got no control over.

因此，在判断我们是否真的有问题时，首先要确认一点：我们看到的不是姿势差异。

So our first stop on this journey in terms of interpreting whether or not we actually have a problem is making sure that we're not one, just seeing differences in posture.

其次，要确认这并不是单纯由解剖结构导致的。

And then two, making sure it's not just anatomically driven.

我们从普通人群和衰老相关的研究中，也学到了不少关于形态和不对称性以及它们何时重要的知识。

Other stuff that we've learned from probably has come more from general population and aging related research in terms of morphology and asymmetries and when they matter.

我就统称它们为普通人群吧。

I'll just call the general population.

这些人通常要么久坐不动，要么最多就是偶尔活动一下。

These are typically people who are either sedentary or maybe recreationally active at best.

我们经常会看到下肢肌肉质量的不对称。

And we'll see things like lower limb muscle mass asymmetries.

一旦差距超过百分之三点五，受伤的风险就会明显上升。

When they exceed three and a half percent, the injury rate starts to really climb.

我前面提到的一篇论文就发现，这种情况会让受伤风险增加高达百分之三十五。

And specifically, one of the papers I mentioned at the very beginning here was one found that that increased your risk of injury by up to thirty five percent.

这其实非常符合常理。

And this actually makes a ton of intuitive sense.

如果一块肌肉比它对应的另一块大很多，几乎肯定会造成动作异常。

If you have a muscle that is larger than the other complementary muscle, this is almost surely gonna result in movement dysfunction.

因为动作是靠技巧控制的，光是肌肉大小不一样，问题没那么大。

Because movement is skill driven, that isn't necessarily as problematic as the whole muscle itself being larger.

因为技巧上的问题，我很快就能调整过来。

Because I can correct a skill really quickly.

但要是某块肌肉明显比另一块大或小，那就说明可能出了严重问题。

But a muscle itself being much bigger or smaller than the other one means something significant is potentially going on.

对吧？

Right?

这里还有另一个类似的情况。

Another kind of a similar story here.

有一项研究发现，女性的不对称性每增加百分之一，受伤风险就会上升高达百分之八十三。

One paper found an increase in asymmetry by one percent, increased injury risk up to eighty three percent in women.

所以你能明白其中的关键了。

So you can see the point there.

你也不用太纠结于百分之八十三还是百分之三十五这样的具体数字。

And I wouldn't get too bogged down in like eighty percent injury risk, thirty five percent injury risk.

重点是，这些小小的不对称——百分之一、百分之三——都会在日后造成显著的、临床上有意义的影响。

The point of it is here, these small asymmetries, one percent, three percent, are making a meaningful and what we'd call a clinically meaningful difference down the line.

还记得我一开始说的百分之十吗？

Remember at the beginning when I said ten percent?

这里有一些相当有力的证据表明，就肌肉大小而言，除非有明确原因，否则即使肌肉之间只有百分之三点五的差异，尤其是下肢肌肉，也可能值得去纠正，而不是放任不管。

Well, here's some pretty compelling evidence that when it comes to muscle size, unless you have a reason for it, and even then we might argue that three and a half percent difference in size between like muscles, especially in lower body, that might be something you wanna consider correcting and not just leaving along.

在阅读大量抗衰老研究论文时，最让我印象深刻的是肌肉的大小、脂肪浸润和结缔组织的质量。

From the aging research, the biggest thing that stuck out to me in reading a lot of those papers was the size, the fat infiltration, and the connective tissue quality.

这些指标能预测所谓的功能表现。

That stuff can predict what are called functional outcomes.

换句话说，只要你是五十岁以上，我一看你肌肉里的脂肪含量，就能预测你的平衡能力。

In other words, I can look at how much fat is in your muscle if you're over the age of 50, and I can predict your balance.

我能预测你的步行速度。

I can predict your walking speed.

我能预测你的柔韧性和力量。

I can predict your flexibility and your strength.

这已经是第三、第四次，甚至可能是第五次了，这些方面目前正受到大量科学研究的关注，因为研究人员想搞清楚：衰老的肌肉到底发生了什么变化？

For the third or fourth or maybe fifth time now, these areas are getting a lot of scientific attention right now because they're trying to help us figure out, well, what is actually happening with aging muscle?

而这些指标能直接解释并预测你如何行走、如何活动，这让我觉得特别值得关注。

And the fact that that component can explain and directly predict how you walk, how you move throughout the world, to me is very compelling to pay attention to.

所以我们还得承认，形态和质量的堆叠方式跟功能性完全不一样。

We also have to acknowledge then that that morphology, that quality stacks very differently than functionality.

就像我刚才说的，但我特别想再强调一下这一点：我其实可以提出一个很有说服力的观点，至少在我自己看来是这样。因为功能性这东西太依赖具体情境了，所以我反而觉得，关注形态可能更靠谱。

And as I said, but I really wanna reiterate this point, I could actually make a compelling case, and I have so in my own brain at least, because of the functionality stuff is so wildly context dependent, I actually think morphology might be a better place to pay attention to.

对吧？

Right?

不过我刚才也提到过，数学模型不一样，标准化也很难做。不管是快肌还是慢肌，是力量型还是耐力型，再加上你们做的测试项目不同，这就让标准化变得特别困难。

But I was going back earlier, I was saying the math is different and the standardization, and if it's fast or slow or strong and what tests you're doing, it makes it so hard to standardize.

这几乎不太现实。

It's almost impractical.

所以我刚才坦诚地跟大家说了我们一直在做的事，现在揭晓我们背后的秘密。

And so I've told you just candidly what we've been doing, and here you go, here's our behind the scenes secret.

我们其实更多地转向了形态学分析，因为我清楚它没法反映肌肉的功能，但因为它更容易标准化。毕竟，糟糕的数据比没有数据更糟糕。

We've actually turned so much more to the morphology because I know it doesn't tell us about how the muscle functions, but because it's just so much easier to standardize, bad data is worse than no data.

所以我们至少得确保拿到高质量的数据，哪怕这些数据有局限性，我们就用这些肌肉大小和质量的影像资料。

And so we have turned to at least getting quality data even though it's being limited and using that muscle size and quality imaging stuff.

正因为这样，当我看到肌肉形态、对称性或者质量上的不对称时，我的判断阈值会大幅降低。

Because of that, when I see a muscle morphology or symmetry or quality asymmetry, my threshold fraction goes much lower.

我刚才提到过，有证据表明3.5%这个数值偏低。

I shared a second ago, there's some evidence that three and a half percent is low.

如果我看到你力量上有3.5%的差异，我完全不在意。

If I see a three and a half percent difference in your strength, I don't care at all.

但从肌肉体积的角度来看，这可能就有影响了。

But from a muscle size perspective, might matter.

还有一项非常棒的研究结果出来，我想跟大家分享一下。

There's also been a really cool study that came out that I wanted to share.

这项研究刚发表不久，我记得大概是去年二月。

This was just out actually, I think in February of last year.

这是一篇关于上肢不对称性的综合综述和荟萃分析，当时就引起了我的注意。

It was a comprehensive review and meta analysis looking at upper body asymmetry, and that caught my attention.

正如我之前提到的，目前这里做的研究大多集中在下肢。

As I mentioned, most of the stuff being done here is on the lower body.

但这项研究分析了将近90项研究。

But it looked at almost 90 studies.

有意思的是，我会把这篇论文放出来，应该是开放获取的，你们可以下载这个图表自己看看。

And what's cool about it is, and I'll put this paper up, I think it's open access, and so you can download this chart and look at it yourself.

真正吸引我的是，他们按关节和动作类型分析了大量测试数据，给出了身体各部位不对称程度的详细图表。

But what was really interesting about it is they looked at a bunch of different tests by joints and by movements, and it gave amazing charts about the level of asymmetry in different parts of the body.

让我特别注意的是，像肩膀这样的部位，左右两侧力量相差15%到20%非常普遍。

And what stood out to me is in general, places like the shoulder, it is really common to have a 15 to 20% difference in strength between your, say your right shoulder and your left shoulder.

健身和动作专家应该能立刻认出这些术语。

And anatomy nerds and movement nerds will recognize the terminology.

但这项研究涵盖了从内旋到外旋的所有动作。

But this included everything from internal to external rotation.

还包括内收、外展、屈曲、伸展，以及肩膀的多种运动模式。

It looked at adduction and abduction and flexion and extension and lots of different movement patterns in the shoulders.

综合所有研究数据，15%到20%的不对称现象确实很常见。

And all the studies combined, really common, fifteen to twenty percent asymmetries.

但当你看其他部位，比如肘部和手腕时，不对称的比例就大幅下降到通常只有5%左右。

But when you looked at other parts like the elbow and the wrist, those came crashing down to typically more like 5%.

所以如果你真的想深入研究这个问题，不管是肩部或肘部有困扰，或者你从事相关领域的工作，我建议你留心一下：也许肩部的干预阈值可以设得高一点。

And so if you're gonna really dive hard in this area, if you're either struggling with a shoulder or elbow issue, or you're working in these areas, I think it'd be prudent for you to pay attention and say, okay, maybe my threshold for action in the shoulder is higher.

如果差距在10%或以下，我可能就忽略它了。

Maybe if it is 10% or lower, I let it go.

但如果是肘部，哪怕只有10%或更低的差距，我也不会忽视。

But if it's 10% or lower in the elbow, I don't let it go.

因为这种差异更有意义。

Because that's more meaningful.

因为你的右肘和左肘几乎完全对称，才是正常情况。

Because it's normal to be actually almost perfectly identical between your right elbow and your left elbow.

手腕、前臂和手指的两侧应该非常接近对称，但肩膀可能本来就不该那么对称。

Your wrist, your forearm, your fingers should be really close to symmetrical, but it may just be something like our shoulders aren't meant to be that symmetrical.

所以我会说，这种程度的差异才更符合所谓的‘正常’。

And so I would maybe call that more quote unquote normal.

我还能说很多，这方面的研究论文太多了，但我特别想提醒一下那些深耕这个领域的人。

I could go on, lots of papers in this area, but I wanna highlight that for people that are really in these fields.

不过我也再强调一次，如果你想搞清楚什么时候该在意、什么时候可以忽略，最好还是一个关节一个关节、一个动作一个动作地去分析。

But also let you know again, if you're trying to interpret this context of when does this matter, when does this not matter, you probably need to go joint by joint and movement by movement.

如果觉得这要求太高、根本做不到，那也没关系。

If that is completely unrealistic over your head, that's totally fine.

在这一部分的最后，我会给你一个极简的要点清单，我觉得每个人离开这里后都能用得上。

At the end of this section, I'm gonna give you kind of my very short bullet list that I think is something that all of us could use going out of here.

但我还是想把这些内容放进来，给那些特别在意的人——不管是从事这个行业的，还是正被伤病困扰，或者想达到最佳表现的人。

But I wanted to throw this in for the people that really do care a lot about this, whether you're practicing this field or you're really struggling to get past an injury, or you're trying to perform at your absolute best.

你们里面有些完美主义者，就是想把每个细节都抠明白。

Some of you A types out there just want every little nitty gritty thing.

所以我没打算跳过这些内容，也不想轻描淡写地带过去。

And so I didn't wanna gloss that over and skip that out.

我还想从伤病风险的角度来聊聊这个问题。

I also wanna talk about this in terms of injury risk.

你会看到不同的答案，取决于你关注的是运动员群体还是非运动员群体，我会快速讲讲这两方面。

You're gonna see a little bit different answers, whether you're looking at athlete groups or non athletes, and I wanna hit both pretty quickly.

我先聊聊我们常说的基于动作的分类。

The first thing I wanna talk about are what we call movement based things.

在准备这次内容时，我一直在想一个经典误区：推和拉的区别。

So one thing that I've actually was thinking about a lot in preparing for the show was the classic stigma of pushing versus pulling.

当你把东西推离身体时，比如俯卧撑或卧推，我们称之为推的动作；深蹲、腿举也属于这一类。

Whenever you're pushing something away from your body, like a pushup or a bench press, we call those pushing exercises, a squat, a leg press.

拉的动作通常是指你把器械拉向身体，或者让器械靠近你。

Pulling exercises generally mean you're coming closer to the implement or you're bringing that implement closer to you.

比如俯身划船。

These are bent rows.

比如二头肌弯举。

These are biceps curls.

比如罗马尼亚硬拉、引体向上，或者类似的动作。

These are Romanian deadlifts or pull up or anything like that.

很多时候，像我这样的人只做推类动作，只练镜子里能看到的肌肉，结果就容易出现前侧损伤。

Oftentimes because of people like me, who did all pressing and we only worked on the muscles we can see in the mirror, we end up with these anterior injuries.

所以肩膀常常会不自觉地往前缩。

So the shoulders oftentimes roll forward.

我们之所以容易肩部受伤，是因为前后肌群不平衡。

We get shoulder injuries because we're not symmetrical front to back.

那些镜子里看不到的拉力肌群，就是我们说的后链肌群。

That pulling side, those muscles you can't see in the mirror are what are called our posterior chain.

前面叫前侧，后面叫后侧。

So anterior is front, posterior is the back.

在健身房里，经验丰富的教练经常会说：至少要保持一比一的推拉比例。

Oftentimes you'll hear in the weight room, good coaches, good trainers will say things like, At minimum, we're doing a one to one push to pull ratio.

但更多时候，他们会建议二比一。

But a lot of the times you'll hear two to one.

也就是说，每做一次推的动作，就要做两次拉的动作。

And this is two pulling for everyone pressing.

这个数字其实没什么科学依据。

There's no real evidence for that number.

但我个人觉得它作为训练指导挺有用的。

But I actually like it as a coaching tool.

这其实涉及到‘实际如此’和‘应当如此’之间的区别。

This is if difference friends between what we call an is and an ought.

‘实际如此’指的是真实的数据。

The is is the data.

根本没有数据表明你必须保持二比一的拉推比例。

There's really no data saying you should have a two to one pull to press ratio.

但根据我的经验，大多数人如果时间不够或累了，往往会跳过拉力训练，却一定不会错过卧推——不管是男性还是女性，都会优先保证下肢的推类动作完成。

But what I think you ought to do based on my experience, based on the fact that most people tend to skip the pulling exercises if they're short on time or tired, and they tend to make sure they get those bench presses in, at least, you know, the males and and the females tend to get their lower body pressing stuff in.

所以我觉得，用二比一这个规则作为训练提示，能帮大家至少多重视一下拉力训练。事实上，我这辈子都没听说过谁因为拉力练太多，反而伤了肩膀或膝盖。

I think as a two to one rule, it's a good coaching tactic to get people to make sure they at least overemphasize the pulling side and far In fact, I don't know if I've ever in my life heard of somebody who developed such a demand for pulling exercises that they cause a shoulder or knee injury because they did too much pulling.

出问题的几乎都是推类动作太多。

It's almost always a pressing issue.

所以在这个部分，我们正在尝试解读身体的不对称性。

So at the same time here, we're in the section where we're trying to interpret asymmetries.

不应该认为人在推举动作中的力量或耐力，必须和拉的动作完全一致。

It is not appropriate to think people should be equally strong or have equal endurance during pressing movements as they have with pulling movements.

这种误解太常见了。

We see this confused often.

即使真的存在不平衡，也完全不是问题。

And if they do have an imbalance, that is not a problem at all.

事实上，这几乎完全可以用四肢的长度差异来解释。

In fact, you can explain this almost exclusively by their limb lengths.

维特鲁威人说，你的臂展——从指尖到指尖——应该和身高相等。

The Vitruvian man says your width span, so your fingertip to your fingertip is identical to your height.

这才是真正的对称标准。

That's what perfect symmetry is.

所以那个古意大利人画的圆圈能完美贴合，就是这个道理。

That's why that circle around that old Italian guy works perfectly.

我现在是负二，意思是我的手臂比身高短了两英寸。

Now I am a negative two, which means my arms are actually two inches shorter than I am tall.

这让我在推举动作上占了很大优势。

This gives me a very large advantage when I press.

因为我不用把重量举得特别远。

Cause I don't have to bench press and move the weight very, very far.

当我完全伸展时，比那些身体比例完美的人少做了两英寸的功。

Because when I'm fully extended, that's two inches less work than it is for you if you're perfectly balanced.

所以在推举类动作上，我相对于自己来说已经很强了。

So I am really good relative to my own self at pressing exercises.

我深蹲的水平远高于硬拉。

I'm a far better squatter than I am a dead lifter.

我腿举的重量能比任何罗马尼亚硬拉或拉的动作多很多。

I can leg press way more than I can any kind of RDL or pulling activity.

我卧推的能力远超过引体向上。

I can bench press far better than I can do pull ups.

你明白我的意思了。

You get the idea.

如果你的四肢长度不一样，而且是正偏差的话。

If you have different limb lengths and you are a plus.

实际上，我觉得NBA或WNBA球员的臂展普遍比身高多出六到十英寸。

In fact, I think the average NBA person, NBA or WNBA, is somewhere between six to ten inches plus.

我知道有些经典例子，比如NBA里七英尺高的球员，臂展能达到八英尺半。

I know there's classic examples of people that are like seven feet tall in the NBA that have eight and a half feet wingspans.

人们就是这么形容的。

That that's how you refer to it.

乔恩·琼斯，史上最出色的格斗运动员之一，之所以难被击败，部分原因就是他的臂展比对手长了好几英寸，甚至好几英尺。

Jon Jones, one of the best combat sport athletes of all time, in part was extremely difficult to beat because his reach was inches, if not feet longer than any of his opponents.

这对拉拽类动作来说是个巨大的优势。

It is a huge advantage for pulling.

为什么呢？

Why?

如果我胳膊长八英寸，做硬拉时臀部根本不用降那么低，因为手根本够不到杠铃。

If I had eight inches longer arms and I went to do a deadlift, my butt doesn't have to go nearly as low down because my hand couldn't reach the bar.

现在呢，我得蹲得特别低，简直像要贴到地上，才能碰到杠铃。

As it stands now, I gotta go all the way down like I'm squatting all the way on the ground literally to reach the bar.

这样硬拉起来特别吃力。

That makes it really hard to deadlift.

不仅要多花很多力气，姿势还特别别扭。

I've gotta do a lot more work and a really bad mechanical position.

大腿长短、小腿长短，还有大腿、小腿和躯干的比例都很关键。

Long femurs, short femurs, your femur to shank to waist ratio.

事实上，你经常能观察到这一点。

In fact, you'll see this.

优秀的长跑选手通常躯干很短，骨盆位置特别高。

Good distance runners have really short torsos and their hips are really high.

有个老说法你常听到：一个身高五英尺八英寸的长跑选手，站在六英尺二英寸左右的迈克尔·菲尔普斯旁边，看起来简直像大人和小孩站一块儿。

In fact, the old joke that you'll see a lot is you can see a good distance runner who's maybe five foot eight inches tall, And you stand him next to Michael Phelps, who is six foot two or probably something like that.

他们俩穿的牛仔裤腰围可能都是三十二英寸。

And they probably both wear thirty two inch jeans.

这位跑者的四肢比例比他的身高应该有的要长。

The runner has longer limb lengths than he should for his height.

优秀的游泳选手腿相对较短，但躯干很长。

Good swimmers have way lower shorter legs, but long torsos.

所以你单看外表根本看不出区别。

And so you can't tell the difference.

如果从生物力学的角度来看，这种情况其实很常见，人们经常会做些有趣的小测试。

If you look at this from like the biomechanical world, you see this all again, oftentimes people will do fun things.

比如让两个人并排坐在椅子上，拍张照片，你会发现他们的头顶几乎在同一个高度。

Like they'll have two people sit down on a chair next to each other, and you can take a picture of them, or you can see that their heads are at the exact same level.

等他们站起来，一个人却比另一个人高出八英寸，原因就是四肢长度不同。

And then they stand up and one person is eight inches taller than the other person because limb lengths are different.

我讲这么多，其实想说的是，这些身体比例会直接影响你推和拉动作之间的平衡。

What I'm getting at with all this stuff is these will determine your balance between your pressing and pulling.

这种不对称并不是我们需要关注的功能性问题。

That's not a functional asymmetry that we care about.

这几乎完全是由于其他因素造成的。

That is almost again exclusively driven.

当然，训练会影响它，但主要还是由你的肢体长度和杠杆结构决定的。

Well, obviously it can be driven by your training, but it is highly driven by your limb length and your levers.

这种不对称不需要过度纠正或刻意调整。

And that is not a type of asymmetry that we should be over correcting and coaching.

所以我们对这个就放任不管。

So we leave that one alone.

而那些更可以通过动作模式来改善的，比如功能性动作筛查。

Others that are more actionable in terms of movement pattern are things like the functional movement screen.

就像我之前说的，关于它的研究证据并不特别有力。

The research on it, as I said before, is not incredibly compelling.

但如果你清楚它的局限性，我觉得它其实还是有帮助的。

But if you understand the limitations, I think it actually is helpful.

关于这个，已经有不少研究了。

There have been plenty of studies on it.

有的说它能预测受伤风险。

Some say it does predict injury.

有的说它并不能。

Some say it does not.

如果你在动作筛查中表现不佳。

If you perform poorly on a movement screen.

所以，你可以把它看作是五到六个，或者八个动作，我们不是要练到最大力量。

So again, think of this as five or six or eight exercises you do, and we're not doing this to maximal strength.

也不是要练到最大耐力。

We're not doing this to maximal endurance.

我们关注的是你动作的质量。

We're looking at the quality of your movement.

你左脚跨过绳子的方式，和右脚跨过绳子的方式，是一样的吗？

Is the way you step forward over a rope the same on your left side as the way you step forward over your right side?

这里没有速度的因素。

There's no speed component.

也没有疲劳的成分。

There's no fatigue.

更没有力量或爆发力的要求。

There's no force or strength component to it.

所以我们才称它为——quote unquote，运动质量。

That's why we're calling this, you know, quote unquote quality.

我提过好几次FMS，但其实还有很多其他的动作筛查方法。

I've mentioned the FMS several times, but there's a bunch of these movement screens.

FMS的研究数据是最充分的。

FMS certainly has the most research behind it.

如果你表现得很差，比如按评分标准得了D或更低，那你的受伤风险确实会高很多，原因就在于动作质量不好。

If you perform really poorly, like if you were to imagine getting a letter grade and you got a d or lower, you're very likely or much more likely to have an injury because of movement quality.

但如果你本来就是B，哪怕提升到A，受伤风险其实也不会有明显变化。

But if you're at a b and you go from a B to an A, you actually really shouldn't anticipate any change in your injury risk.

如果你没怎么训练过，身体左右两边的协调性可能不太好。

If you are untrained, you probably don't have great symmetry.

如果你训练有素，这些测试对你来说其实挺简单的，毕竟都是基本的人体动作，你作为运动员或者动作控制能力强，很容易就能调整弥补。

If you're highly trained, you probably do better on these tests because they're pretty easy human movements and you're an athlete or you're really skilled and you can compensate.

所以当你把研究放在实际背景下看，而不是光看一篇篇孤立的论文，或者丢给AI去过滤，反而会觉得合情合理。

So when you kind of just give the research some context and you don't just read it abstract by abstract or put it into an AI filter, and actually makes intuitive sense.

像这类情况，我们一般的原则是：如果你得分是C或者更低，我们姑且先定义一下什么叫C吧。

So for things like that, the general rule we have is if you score a C or lower, making up what a C would be, right?

但只要你处在中下水平，就值得去关注和改善一下。

But just like if you're in the middle to lower part of it, you should probably address that.

如果你分数更高，那我就不太担心了。

If you're above it, I'm not worried about it.

为什么呢？

Why?

因为这些测试没在负重下做，也没要求速度，再加上我们之前说的那些局限性。

Cause it wasn't done at load, it wasn't done fast, and all the other limitations we talked about.

所以我们应该把这些看作是筛查工具。

So we should think of these as screens.

这不就是叫筛查嘛，对吧？

That's what it's called, right?

这确实是个筛查。

It's a screen.

它不是最终的诊断手段，而是用来发现严重动作问题的筛查。

It's not an end all diagnostic, it is a screen for really bad movement.

如果发现有问题，就应该纠正，因为你很可能在增加受伤或功能障碍的风险。

And if that happens, you should correct it because you are probably increasing your chance of injury or dysfunction somehow.

本期节目由大卫赞助。

Today's episode is sponsored by David.

大卫做的蛋白棒，我以前从没吃过这样的。

David makes protein bars unlike any I have ever encountered.

每根含有28克蛋白质，只有150卡路里，而且零糖。

They have an amazing 28 grams of protein, only 150 calories, and zero grams of sugar.

没错。

That's right.

28克蛋白质，其中75%的热量都来自蛋白质。

28 grams of protein and 75% of its calories come from that protein.

这比市面上第二高的蛋白棒还要高出50%。

This is 50% higher than the next closest protein bar.

说实话，这是我这辈子吃过最好吃的蛋白棒，完全没得比。

Honestly, it's the best tasting bar I've ever had in my life by a mile.

他们最新推出的David Bronze蛋白棒，味道也特别棒。

And their newest bar, the David Bronze bar tastes incredible as well.

我经常提到，为了维持肌肉健康、促进恢复和保持瘦体重，建议每天每磅体重摄入一克蛋白质。

While I often talk about the importance of getting one gram of protein per pound of body weight for things like muscle health and recovery and the promotion of lean body mass and sanctity.

但对大多数人来说，真正做到每天每磅体重摄入一克蛋白质其实很难。

The reality of that is for most people getting that one gram of protein per pound of body weight is really challenging.

不过，David让这件事变得很简单。

However, David makes that easy.

他们的蛋白棒味道特别棒。

Their bars taste incredible.

金条含有28克蛋白质，热量是150大卡。

The gold bar is packed with 28 grams of protein, which is 150 calories.

铜条也含有20克蛋白质，同样是150大卡。

And the bronze bar has 20 grams of protein also, which is 150 calories.

我几乎每天都吃，出门旅行时背包里总会带上两三个。

I eat one almost every single day and always have two or three with me in my backpack when I'm traveling.

我说的‘总是’，真的是字面意思的总是。

And I like literally mean always.

听起来可能有点奇怪，但我经常拿它当甜点吃。

It probably sounds funny, but I eat them as dessert all the time.

你试过之后，就完全明白我在说什么了。

When you try them, you'll know exactly what I mean.

如果你有兴趣试试，可以去 davidprotein.com/perform。

If you're interested in trying these bars for yourself, you can go to davidprotein.com/perform.

再强调一遍，网址是 davidprotein.com/perform。

Again, that's davidprotein.com/perform.

接下来，我们来看最后一个功能类别。

This then leaves us with our final category of functionality.

那么，关于整体的不对称功能或表现与受伤风险之间的关系，我们到底了解多少？

So what do we know about the relationship between overall asymmetrical function or performance and injury risk?

现在我们打开一个大难题了，朋友们，因为相关研究实在太多了。

And now we've got a can of worms to unpack friends, because there's an enormous amount.

我会尽量概括一下研究的整体情况，不深入任何一个具体领域。

So I'd like to try to do my best to summarize the landscape of the research and not go into any specific area into extreme detail.

先打个底，这里要分清楚技能和力量的区别。

To get us started, remember, there's a difference here between skill and force.

所以大部分研究大致可以归为两大类。

And so most of the research is brought into kind of two big categories.

第一类，我称之为力量与施力。

The first is what I'll call strength and force.

通常你看到的这些测试都是腿伸展测试。

Typically, the tests you're gonna see here are leg extension tests.

就是你坐在健身房的器械上，尽可能多地向前抬起你的腿。

You know, you're sitting in the machine at the gym, and you're lifting your leg out in front of you as heavy as you can.

握力测试就是你拿一个握力器，用尽全力去捏。

Grip strength is you literally take an implement and squeeze as hard as you can.

另一大类是我所说的爆发力或功能性跳跃测试。

The other major category are what I'll call power or functional jumping tests.

比如单腿跳、深蹲跳这类动作。

These are often things like a single leg hop, a counter movement jump, something like that.

明白吗？

Okay?

所以，这些指标主要就是通过这两种方式来测量的。

So that's the main two ways these things have been tested.

我仔细研究了这些资料后，大致发现了以下几点。

After pouring through this stuff, here's what I basically found.

如果你关注运动员，这个领域里十项研究中有八项，尤其是质量最高的那些，都发现力量或爆发力的不对称程度与受伤风险呈正相关。

If you're looking at athletes, eight of the 10 studies in this area, the ones that were done the highest quality, found positive associations between the amount of asymmetry in either strength or power and injury risk.

不对称越明显，受伤的可能性就越高。

So more asymmetry, more likely to be hurt or more likely to get hurt.

这本身就说明了很多问题。

That should tell you something.

更直接的是，有六项研究专门分析了单腿跳跃。

Even more directly, there were six studies that looked at unilateral jumping.

就是一次只用一条腿跳。

This is jumping on one leg at a time.

在这六项研究中，有五项发现单腿跳跃的差异与受伤之间存在明显关联。

In the six studies that looked at that metric and looked at injury, five of those six found a positive association.

对我来说，这非常具有实操意义。

So to me, this is very actionable.

我强烈建议你让每个人，包括你自己，做单腿跳跃测试，看看两侧的差异有多大。

I would strongly encourage having your individuals or yourself jump on one leg doing some kind of unilateral jumping test and looking at the amount of asymmetry.

关于具体的可操作标准，我们稍后再讲。

And we'll go over the actionable magnitude later.

但这一点看起来非常明确。

But that one seemed to be pretty clear.

单腿跳跃能力不对称越明显的人，下肢受伤的可能性就越高。

Those that have the more asymmetry in their ability to jump on one leg are more likely to eventually get hurt in their lower body.

明白了。

Okay.

我们不关心上肢的损伤，这跟它没什么关系。

We don't care about upper body injuries, it's not really related.

除非他们专门训练过单腿跳跃。

Unless they are specifically trained in unilateral jumping.

当你深入研究时，就会发现，这其实挺有道理的。

And again, this is when when you get in the research, you're like, oh, that actually makes sense.

你看那些只用右腿跳的篮球运动员，她们的两侧差异通常会更明显。

If you look at a basketball player who only jumps on her right leg, she's probably gonna have a more asymmetrical thing.

但如果你看的是从事对称性运动的运动员，他们的左右腿跳跃能力不应该出现明显的差异。

But if you're looking at a player who's in a symmetrical sport, we shouldn't be seeing huge asymmetries in the right left leg with jumping.

当我们把注意力转向非运动员群体时，这里几乎所有的现象都可以归结为衰老。

When we turn our attention to non athletic populations, almost everything we're gonna see here is what we'll call aging.

每项研究对衰老的定义都不太一样，但通常指的是50岁以上，有时甚至是60岁以上的人群。

Every study defines aging a little bit differently, but oftentimes you're looking at 50 years old plus, sometimes 60.

但我认为这其实很有帮助。

But I think it's really helpful.

并不是说这些因素在40岁的人身上就不重要。

It's not that these things don't matter in 40 year olds.

我们只是通常不会对非运动员或者不到60岁的人做研究。

We just typically don't do research in people that are either not athletes or not 60.

中年人往往被忽视了。

The middle aged people just get kind of left out to dry.

这不只是在不对称性研究中如此，而是整个科学领域普遍存在的现象。

That's not just for asymmetry research, that's just science in general.

不过这是另一个话题了，咱们以后再说。

But topic for another day, as we say.

那我们今天学到了什么？

What have we learned here?

有一项很有说服力的研究发现，有60%——没错，就是百分之六十——跌倒的老年人，其下肢力量左右差异超过百分之十。

There was a really compelling study that found sixty percent, again, six zero percent of older adults who fall had an asymmetry of more than ten percent in lower body power.

在我看来，这个发现非常实用。

To me, that's extremely actionable.

当我们发现某人有这种情况时，就意味着他有六成概率会跌倒。

We start to see this in individuals, sixty percent of these people are gonna have a fall.

你去搜一下跌倒的后果，尤其是60岁或65岁以后的，结果可不乐观。

You can Google the consequences of falling, especially after the age of 60 or 65, and it's bad news.

所以我们必须尽一切努力避免这种情况发生。

So we wanna avoid that at all costs.

话虽如此，这个领域里研究最多、最充分的，还是手部握力不对称与衰老相关指标之间的关系。

Okay, with that being said, by far the most research in this entire field is the relationship between hand grip asymmetry strength and aging related variables.