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THOMAS Rehab Labs | 질환별 운동, 신경기반 기능 회복

@wellness_thomas

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🧑‍🔬 @gachon_university ER (운동재활학과) 22
💆‍♂️ @wellness.to.home 전담 강사 - 방문PT문의
운동생리학 기반 Holistic medical
⚡️🧠 neurological wellness
PT, 손상재활, 퍼포먼스 향상

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📄 발목 가쪽 & 고위 인대 손상 (Instability)
1. 전방 끌림 검사 (Anterior Drawer Test)
타겟 구조물: 전거비인대 (ATFL, 앞목말종아리인대)
움직임 조합: Plantarflexion(저굴) 상태에서 전방 유도
더 깊은 원리: ATFL은 발목이 밑으로 내려갔을 때(저굴) 가장 팽팽해지며 목말뼈가 앞으로 빠지는 것을 막아줍니다. 이 상태에서 뒤꿈치를 앞으로 당기면, 끊어진 인대 때문에 뼈가 가로막는 것 없이 앞으로 툭 밀려 나옵니다.

2. 목말뼈 경사 검사 (Talar Tilt Test)
타겟 구조물: 종비인대 (CFL, 뒤꿈치종아리인대) 및 삼각인대 (Deltoid Ligament)
움직임 조합: Plantarflexion + Inversion: ATFL 집중 스트레스
Neutral(90도) + Inversion: CFL 집중 스트레스
Neutral/Dorsiflexion + Eversion: 안쪽 삼각인대 복합체 스트레스
더 깊은 원리: 발목 각도에 따라 팽팽해지는 인대가 다릅니다. 발목을 90도로 세우면 CFL이 수직이 되어 내번(Inversion)을 막아주는데, 이때 과도하게 꺾이면 CFL 손상입니다. 바깥으로 꺾을 때(Eversion) 덜컹거리면 안쪽 삼각인대 손상입니다.

3. 클라이거 검사 (Kleiger Test)
타겟 구조물: 원위 경비인대 결합 (Syndesmosis, 고위 발목 인대) 및 삼각인대
움직임 조합: Dorsiflexion + External Rotation (외회전)
더 깊은 원리: 발끝을 들면(Dorsi) 목말뼈의 넓은 앞부분이 관절 사이에 꽉 끼게 됩니다. 이 상태에서 발을 바깥으로 돌리면(ER) 목말뼈가 회전하면서 정강뼈와 종아리뼈 사이를 양옆으로 벌리는 벌리개(Wedge) 역할을 하여 결합조직 통증을 유발합니다.

댓글로 이어 나가겠습니다😆

#reels #healthy #운동 #운동스타그램 #wellness by @wellness_thomas

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3 months ago

다리가 저릴 때, 치료사들이 무조건 해보는 필수 검사 6가지
"뼈(관절)가 범인일까? 줄(신경)이 범인일까?"
원리만 알면 10배 더 쉬워지는 체형/재활 공부 🔍
⬛ : 신경을 빨래줄처럼 최대로 늘려라!
💡 Slump Test (슬럼프 테스트)
어떻게 하나요? 양손을 뒤로 하고 ➡️ 구부정하게 척추를 굽히고 ➡️ 목까지 숙인 뒤(C-Flexion) ➡️ 무릎을 펴고 발목을 당깁니다(Dorsiflexion).
왜 이렇게 검사하나요? (원리)
우리 몸의 신경은 머리부터 발끝까지 하나로 연결된 '긴 빨래줄'과 같습니다. 이 자세는 그 빨래줄을 양끝에서 최대로 잡아당겨 팽팽하게 만드는 동작이에요.
이럴 때 양성!
이때 다리가 저릿한 신경학적 증상이 나오면, 허리 디스크(HNP)나 신경 뿌리가 주변 조직에 들러붙은 '신경근 유착', '척추 충돌'을 의미합니다.

⬛ : 각도에 숨겨진 비밀
💡 SLR (하지직거장 검사) & 건측 SLR
왜 각도가 중요할까요? (원리)
다리를 들어 올릴 때, 0~70도까지는 허리 신경(L5, S1)과 궁둥신경(좌골신경)이 본격적으로 당겨지는 구간입니다. 이때 허벅지·종아리가 저리다면 디스크나 신경근 염증이 확실해요.
70도 넘어서 아프다면?
70~90도 구간에서는 신경이 이미 다 늘어난 상태라 더 당겨지지 않아요. 그런데도 이 각도에서 골반 주변이 아프다면, 범인은 신경이 아니라 천장관절(SI Joint) 자체의 문제입니다.
반대쪽(건측) 다리를 들었는데 아픈 쪽이 저리다면?
디스크가 신경 뿌리 안쪽(Axillary형)을 심하게 누르고 있어서, 반대쪽을 당겨도 아픈 쪽 신경까지 끌려 내려가며 자극받는 위험한 신호입니다!

⬛ : 목을 숙였는데 다리가 왜 구부러질까?
💡 커니그(Kernig) & 브루진스키(Brudzinski) 징후
왜 이렇게 검사하나요? (원리)
뇌와 척수를 싸고 있는 막(뇌척수막)에 염증이 생기면 극도로 예민해집니다. 고개를 앞으로 숙이는 동작(C-Flexion)만으로도 척수막이 머리 쪽으로 강하게 당겨지죠.
몸의 본능적인 방어 작용
뇌막염 환자는 목을 강제로 숙였을 때, 자기도 모르게 무릎을 굽히는 반사 반응(브루진스키 양성)을 보입니다. 다리를 구부려 아래쪽 신경을 느슨하게 만들어야 척수막에 가해지는 팽팽한 기계적 장력(Tension)과 통증이 줄어들기 때문입니다.
돌출된 추간판(디스크)이나 뼈가 신경을 침범했을 때도 목을 숙이면 장력이 커져 통증이 심해집니다.
⬛ : 확실하게 확인 사살하기
💡 Bowstring Test (활시위 검사)
왜 오금을 누르고 목을 숙일까요? (원리)
SLR 검사 도중 다리가 아파서 멈춘 지점에서 무릎을 살짝 구부리면 근육(햄스트링)의 긴장은 풀립니다. 이때 오금 한가운데를 지나가는 궁둥신경(좌골신경)만 콕 집어 손가락으로 누르는 것이죠.
진짜 '신경 통증' 유효타 확인법
오금을 눌러 통증을 유발한 상태에서, 발목을 당기거나(Dorsiflexion) 고개까지 숙였을 때(C-Flexion) 통증이 확 심해진다면? 관절이나 근육은 가만히 고정된 채 오직 신경줄만 더 팽팽해진 상태이므로, "이건 100% 확실한 신경 뿌리(Nerve root) 압박이다"라고 확진할 수 있습니다.(의사의 진단을 반드시 권고!)
⬛ : 뼈와 관절의 문제라면 이것!
💡 FABER & FADDIR (골반 관절 검사)
왜 다리를 꼬고 비틀까요? (원리)
앞서 본 검사들이 신경줄을 '밀고 당기는' 테스트였다면, FABER(양반다리 자세)와 FADDIR(다리를 모아 안으로 비트는 자세)은 신경을 건드리지 않고 골반 관절면에 직접적인 스트레스(회전력과 압박)를 주는 검사입니다.
결론!
이 자세를 취했을 때 골반 뒤쪽이나 앞쪽에 찝히는 통증이 나타난다면, 신경통이 아니라 천장관절(SI Joint)이나 엉덩관절(고관절) 자체의 염증 및 충돌 증후군을 뜻합니다.
✍️
#reels #운동 #운동스타그램 #healthy #wellness by @wellness_thomas

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3 months ago

@laget_om_ka 존경하는 경아선생님 따라잡기!
근데 선생님 전 몇년을 더 운동해야 선생님처럼 아름다운 움직임을 할 수 있을까요?
#reels #운동 #workout #헬스 #gym by @wellness_thomas

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16

8 months ago

허벅지 씨름, 다리를 모으는 게 무조건 유리할까? 🤔

저는 항상 다리를 모으는 쪽이 더 쉽게 느껴졌는데요.

그런데 단순히 “내전근이 더 강해서”라고 설명하기는 어렵습니다.

고관절의 위치에 따라
근육의 힘선과 모멘트암이 달라지고,
같은 힘을 내더라도 만들어지는 토크가 달라질 수 있기 때문입니다.

이 원리는 실제 운동에서도 마찬가지입니다.

같은 스쿼트, 런지, 필라테스라도
사람마다 필요한 움직임은 다를 수 있습니다.

그래서 웰니스투홈은
운동부터 정하기보다 현재 몸의 움직임을 먼저 확인합니다.

내 몸에 필요한 운동을 찾는 것,
움직임을 확인하는 것에서부터 시작합니다.

📌 자세한 내용은 블로그에서 확인해주세요😉 by @wellness_thomas

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4 days ago

손흥민 선수의 70m 원더골, 발에서는 무슨 일이 일어났을까요?🦶

스프린트에서는 다리 근육이 강한 것만으로는 충분하지 않습니다.

발은
착지 → 충격 흡수
↓
체중 수용 → 아치 변형
↓
Supination → 발 강성화
↓
Windlass → 추진
의 과정을 아주 짧은 시간 안에 반복합니다.

그리고 고관절에서 만들어진 힘은
무릎 → 발목 → 발 → 지면으로 연결됩니다.

중요한 건 힘을 크게 만들어 내는 것과 더불어 그 힘을 지면까지 효율적으로 전달하는 것 입니다.

착지할 때는 유연하게, 추진할 때는 단단하게 바뀌어야 합니다.

이 유연성 → 강성 전환이 스포츠 움직임에서 발이 중요한 이유입니다.

내 발과 움직임은 어떻게 사용되고 있을까요?

📌더 자세한 내용은 웰니스투홈 블로그에 있습니다. by @wellness_thomas

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17 days ago

웰투홈 많이 이용부탁드립니다 걸어다니는 배너
#reels #운동 #운동스타그램 #pt #wellness taken in 잠실 by @wellness_thomas

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15

20 days ago

팔이 안 올라간다고 무조건 세게 늘려야 할까요?

오십견은 어깨 관절을 둘러싼 관절낭이 뻣뻣해지면서 통증과 움직임 제한이 나타나는 상태입니다.

따라서 무작정 강하게 스트레칭하기보다
현재 움직일 수 있는 범위에서 천천히 움직이는 것이 중요합니다.

① 월슬라이드
벽에 머리와 발을 가볍게 대고
가능한 범위까지 천천히 W를 유지하면서 팔을 올렸다 내립니다.
→ 통증이 심해지는 범위까지 올리지 않기

② 케이블 풀다운 리트렉션
앉은 자세에서 케이블을 잡고
어깨를 끌어내린 상태로 팔을 뒤로 당기며 견갑골의 움직임을 느껴줍니다.
→ 어깨를 으쓱하지 않기

③ 레인보우
옆으로 누워 위쪽 무릎을 고정하고
팔로 크게 원을 그리며 흉추의 회전을 함께 만들어줍니다.

→ 반복할수록 가능한 범위에서 손이 조금 더 멀리 넘어가도록 진행합니다.

⚠️ 중요한 점
같은 오십견이라도 통증과 가동범위는 사람마다 다릅니다.
따라서 운동의 종류와 강도도 현재 상태에 맞게 조절해야 합니다. by @wellness_thomas

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20

a month ago

우리들의 재활운동 스터디 서로가 서로를 죽이는중 중둔근 뿌셔질뻔했다
#reels #운동 #운동스타그램 #healthy #wellness by @wellness_thomas

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18

a month ago

우리들의 해부학 스터디📚

회원님께 더 좋은 움직임을 알려드리기 위해,
저희는 주말마다 함께 공부합니다.

운동은 동작만 따라 하는 것이 아니라,
몸을 이해하는 것에서 시작된다고 생각합니다.

해부학은 한 번 봤다고 끝나는 공부가 아니라,
주기적으로 다시 보고,
계속 연결해야 하는 학문이니까요.

이번 스터디는 뉴만 키네시올로지를 함께 읽으며
기본을 다시 하나씩 정리하는 시간입니다.

앞으로도 멈추지않고,
회원님들의 더 건강한 움직임을 위해
꾸준히 공부하겠습니다🤍 by @wellness_thomas

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2 months ago

파킨슨병 재활, '교차 운동'에 숨겨진 신경학적 비밀 🧠

1️⃣ 기저핵-시상-피질 운동 루프 활성화
파킨슨병의 핵심은 흑질의 도파민 부족입니다.
하지만 오른팔과 왼다리를 뻗는 등 높은 수준의 신체 조절을 요구하는 '교차 운동'은 뇌를 강하게 자극합니다.
대뇌피질 ➔ 기저핵 ➔ 시상 ➔ 대뇌피질로 이어지는 운동 루프가 활성화되며, 동작을 완성하기 위해 뇌는 남아있는 도파민을 적극적으로 방출합니다.
(수용체 민감도가 상승해 적은 도파민으로도 효율적인 통제가 가능해집니다!) ⚙️

2️⃣ 좌우뇌의 교차 소통 (Interhemispheric Communication)
신체의 중앙선(Midline)을 넘어가는 움직임은 좌뇌와 우뇌를 잇는 뇌량(Corpus Callosum)의 정보 교환을 극대화합니다. ⚡
무의식적인 움직임 ❌
의식적이고 목표 지향적인 움직임 ⭕
전두엽과 운동 피질에 가해지는 이 '건강한 인지적 부하'는 보상 기전을 자극해 도파민 분비 시스템의 스위치를 켭니다.

3️⃣ 뇌 신경망의 비료, BDNF & GDNF 폭발 💥
전신 협응이 필요한 복잡한 움직임은 뇌유래신경영양인자(BDNF) 등의 수치를 급격히 높입니다.
이 단백질들은 도파민 세포를 새로 만들어내진 못해도, 기존 신경세포가 사멸하는 것을 막는 신경 보호(Neuroprotection) 작용을 합니다. 동시에 뇌 시냅스 연결을 튼튼하게 재배선합니다. 🌱

재활 운동의 진짜 가치 💡
교차 운동 시퀀스는 단순한 근골격계 강화를 넘어선 "뇌의 시상과 기저핵을 깨워 한정된 도파민을 가장 효율적으로 쓰게 만드는 중추신경계 리모델링 작업"입니다.

기전을 알고 적용하는 재활, 결과의 깊이가 다릅니다.

대뇌피질부터 기저핵까지 뇌의 신경망을 다시 연결하려면 철저한 '계획'과 '평가'가 필요하죠. 제가 매 세션 이 <파킨슨 재활 & 교차운동 평가표>를 지참하는 이유입니다.
환자분이 제 구두 지시(Cueing)에 얼마나 반응하는지, 신체 좌우 협응 타이밍과 자가 통제력은 얼마나 개선되었는지 0~5점 척도로 세분화하여 추적합니다. 이렇게 데이터가 쌓이면 환자분의 뇌가 실제로 어떻게 긍정적으로 변화하고 있는지 눈으로 직접 확인할 수 있죠. 📊
단순한 근골격계 운동을 넘어, 뇌의 시상과 기저핵을 깨워 한정된 도파민을 가장 효율적으로 쓰게 만드는 과정.
제대로 된 평가가, 제대로 된 재활을 만듭니다. 🙏
#reels #rehab #운동 #운동스타그램 #wellness by @wellness_thomas

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5

2 months ago

🚨 단순히 "허리 펴고 등으로 당기세요"라는 큐잉에 머물러 계신가요?
바벨로우는 광배근 하나만을 타격하는 단순 고립 운동이 아닙니다. 인체를 하나의 거대한 네트워크로 연결하는 '근막경선(Anatomy Trains)'과 '중추신경계(CNS)'가 만들어내는 완벽한 신경-구조 오케스트라입니다.
운동생리학과 구조적 생체역학 관점에서 바벨로우의 '진짜 가치'를 해부해 드립니다. 🧠⚙️

🧬 1. 척추의 완벽한 지지대 : 표면후방선 (SBL)
바벨을 쥐고 힙 힌지를 세팅하는 순간, 발바닥(Plantar fascia)부터 햄스트링, 척추기립근을 지나 머리(두상근막)까지 이어지는 SBL이 중력에 저항하는 강력한 텐트를 칩니다. 이 전신 텐션이 척추의 완벽한 중립을 만듭니다.

⚡ 2. 폭발적인 힘의 엑스(X)자 전달 : 후방기능선 (BFL)
광배근에서 흉요근막(TL Fascia)을 지나 반대쪽 대둔근으로 이어지는 거대한 크로스 체인! 상체와 반대쪽 하체가 대각선으로 협응하며 실질적인 당기기(Pull) 파워와 추진력을 뿜어냅니다.

🔗 3. 견갑의 정밀한 통제 : 후방 팔선 (Posterior Arm Lines)
표면후방팔선(승모근-삼각근)이 전체적인 당기기 궤적과 악력을 통제한다면, 심부후방팔선(능형근-회전근개-삼두근)은 견갑골을 후인(Retraction)시키며 상완-견갑 리듬의 정밀도를 완성합니다.

🌀 4. 척추 전단력 방어 : 나선선 (Spiral Line)
고중량을 다룰 때 몸통이 비틀리지 않는 이유는? 전거근, 복사근, 장경인대를 나선형으로 감싸는 구조가 강력한 회전 저항(Anti-Rotation) 브레이크를 걸어주기 때문입니다.

🔑 [Master Key] 복강내압(IAP)과 중추신경계의 동기화
이 모든 근막의 연결은 '호흡'으로 비로소 완성됩니다. IAP를 통해 흉요근막을 단단하게 팽창시키면, 우리의 뇌는 "척추가 완벽히 안전하다"고 판단합니다. 그 순간 근신경 동기화(Motor Unit Sync)가 극대화되며 평소보다 훨씬 높은 수준의 폭발적인 근력을 낼 수 있도록 락다운(Lock-down)을 해제합니다.
결론적으로 바벨로우는 근육을 넘어 뇌와 전신 근막의 초고속 데이터 전송을 훈련하는 마스터피스입니다.

단일 근육의 기시/정지에만 갇혀 있지 마세요. 오늘 바벨로우 루틴에서는 무게를 올리기 전, 발바닥의 접지부터 호흡의 압력, 전신 후면 사슬의 '연결(Connection)'부터 느껴보시길 바랍니다.
이 연결을 통제하는 순간, 여러분의 퍼포먼스는 차원이 달라집니다. 📈

#reels #운동 #healthy #운동스타그램 #wellness by @wellness_thomas

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19

2 months ago

바벨로우와 근막경선 그리고 근육의 연결성이 좋을시 신경과 호흡생리학적 이점

#healthy #운동 #운동스타그램 #wellness #gym taken in 잠실 by @wellness_thomas

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4

2 months ago