Publication:

柔道運動員前十字韌帶傷害機轉之探討

中文摘要

本研究之研究對象為17位國立體育學院七十七學年度至八十九學年度入學之柔道專長選手，且曾發生前十字韌帶斷裂傷害，經專科醫師診斷，確認為前十字韌帶斷裂者。以質的研究方式與深度晤談及內容分析，利用參與觀察、半結構性訪問、回溯法深入訪談等方式，深入訓練場所，觀察訓練情形，談論日常生活管理，回溯訪談有關運動傷害的情形。在自然的情境中，探討教練與選手有關訓練、生活、運動傷害的情境，從中引出影響發生前十字韌帶的因素，探討眾多造成前十字韌帶傷害發生的原因，藉以找出防範的措施，來進行前十字韌帶傷害的預防相關事宜。在本研究範圍所有資料與研究限制內所獲得之結果，經歸納分析後獲致下列結論：

一、前十字韌帶傷害之發生狀況，一為外力直接撞擊膝關節；二為傷者本身膝關節過度扭轉。

二、消極性防禦是影響傷害發生的因素之一，造成消極性防禦原因是因為不會或不熟練防禦攻擊動作。

三、動作技巧錯誤是影響前十字韌帶斷裂重要因素，除傷者本身動作技巧錯誤引發危險狀況外，對手動作技巧錯誤作用力在膝關節上可能會造成前十字韌帶傷害。

四、護身倒法的動作不正確，因倒地姿勢不佳會導致力量直接衝擊膝關節，或喪失避免外力影響之保護機制，容易造成前十字韌帶傷害。

五、前十字韌帶傷害很少僅由單一危險因素所致，而是數個危險因素交互作用下，交織形成危險狀況，因而引發傷者本身反應或對手外力的改變，造成傷者膝關節外翻、脛骨部受大力撞擊壓迫造成脛骨相對股骨後縮、膝關節過度扭轉等狀況，導致前十字韌帶過度伸展而斷裂。

六、訓練時數增加時傷害發生人數也隨之增加。但是無直接證據顯示，訓練時數與傷害發生數有直接相關，但確實會對運動員造成生理或心理上的負擔，會導致訓練效果降低。

七、研究對象之得意技傷害發生比率，以單下支撐地之技術動作最高。原因是攻擊時只有一條腿支撐身體重量，容易失去平衡，也因此容易被反摔。因此施展單下肢支撐的技術時，應特別要求破勢動作，並應維持身體平衡，加強對腿部的防護。

八、造成傷者本身攻擊失敗，引發對手反摔的原因：身體狀況不佳、動作技巧錯誤、對手力量干擾。

Abstract

Seventeen Judo athletes who had suffered a tear of anterior cruciate ligament injury from the National College Physical Education and Sports between the year of 1988 to 2000 participated in the study.　Qualitative study, depth personal interviews, content analysis, field observation, semi-structure interviews were used for the collection of information of the study.　 It was hope that through the in depth analysis of the mechanism of injury, prevention against the ACL injury can be sought.

Within the limitations and delimitation of the study, the following resultswere found:

1.The mechanism of the ACL injury for Judo athletes included a direct impact on the knee, and a twist of the knee during exercise.

2.The passive defend was a factor of causing injury.　The athlete who defended passively did not know how to react during an attack by the opponent.

3.The poor technique was another factor of causing injury.　Due to the poor technique, the athlete would generate undue stress or overload on the knee joint, therefore, causing ACL injury.

4.Poor Ukemi skills resulted in poor landing skill that caused overload to the knee.

5.ACL injury rarely induced by single factor.　It may take several factors to occur concurrently to cause an ACL injury.　Those factors included:1) counter movement by the injured athlete against an attack, 2) change of direction of movement by the opponent that cause knee to hyperextension and valgus and internal rotation force, 3) direct impact on the femur that cause anterior shift of the tibia.

6.There was a positive correction between the injury rate and the amount of training load.　However, the causes of ACL injury can not be positively proven with the increase of training load.

7.Most of the injuries occurred when the athletes used single leg to support their body weight during attack move.　This would put too much stress on the knee.　Therefore, it was suggested that when using single leg skill to attack,

the kuzushi movements should be properly used and keep body balance to reduce undue stress on the supporting leg.

8.Poor physical conditioning and return too early from the previous injury were also contributing factors to cause ACL injury.