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  • Is Z Health "zee answer"?

    I know this question has been brought up on the forum previously, but the following brought it back to light for me.

    One of my colleagues, whom I really respect for his involvment in youth sports and speed training, noted the following:

    "I recently met a Z Health practitioner who has helped several of my athletes with various pain and nerve related issues. I was somewhat skeptical at first, but when he resolved a serious chronic shin splint in one session, I began using him more frequently."

    Any new insights from forum members on the Z-Health approach to the "neuroscience" of pain?

  • #2
    Ken,

    Haha. I like the "zee' answer" line. I remember seeing another post on another forum saying: "vat is zis Z-Health?"

    Here's a quick answer which I hope does not ignite another huge controversy like last time.

    I've been to several Z certs and spent a good amount of time talking with Eric Cobb, the creator.

    In my view, Z is basically a large toolbox of mostly ectodermal techniques along with a systematic way to apply them. Some of the basic tools are: joint mobility drills to enhance body maps, cure sensory motor amnesia and reduce the threat value of movement; "threat inoculation" which is basically graded exposure or the SAID principle; skin stretching; neurodynamic techniques for nerve flossing; vestibular and vision training; neurodynamic techniques for nerve flossing; and many others. Everything is viewed through the lens of the CNS, with a major emphasis on the threat neuromatrix and the idea of the CNS being a central governor on performance. In other words, if you need more strength, flexibility, coordination or endurance, look to the CNS and not the body for the quickest, easiest and most powerful changes.

    I think most of the material is excellent and very in line with the ideas espoused here. (which makes it ironic that it got such a cold reception here.) However, there are some Z tools, particularly in regard to assessments, where Cobb goes beyond "science" into the realm of "art." For example, the use of range of motion or strength tests before and after a particular drill to determine whether the drill is of benefit. It looks a little AK. Personally I am very skeptical that these assessments are useful, but there are numerous aspects of the Z approach that are very sensible.

    In general, I think it's a great source of info and insight, but it costs a lot and there are non-trivial amounts of voodoo and marketing built into the way the info is delivered.

    I hope that is helpful, and I should say Ken, that I have enjoyed much of your commentary on this site.
    Todd Hargrove

    http://bettermovement.org

    Comment


    • #3
      Some quibbles, Todd.
      I think most of the material is excellent and very in line with the ideas espoused here. (which makes it ironic that it got such a cold reception here.) -Todd
      No, the outrageous claims without either randomized trial evidence or plausible explanatory mechanism is what got it a cold reception. Same as any other treatment.

      Some of the basic tools are: joint mobility drills to enhance body maps, cure sensory motor amnesia and reduce the threat value of movement; "threat inoculation" which is basically graded exposure or the SAID principle; skin stretching; neurodynamic techniques for nerve flossing; vestibular and vision training; neurodynamic techniques for nerve flossing; and many others.
      Somatics/Feldenkrais + Neurodynamics + ??

      For example, the use of range of motion or strength tests before and after a particular drill to determine whether the drill is of benefit. It looks a little AK.
      Actually the "test-retest" concept is what I have the least amount of trouble with. While it can be AK if done in that way, those sorts of clinical assessments are important to making clinical decisions IMO.

      It may be that Z Health is a totally reasonable treatment and examination method for performance enhancement and pain relief. However, the people we had here previously arguing for this system including a two very experienced conditioning coaches (Mike Nelson and Geoff Neupert) and a DPT (Courtney Neupert). None of the three, who said they were certified if I'm not mistaken, could provide a plausible rationale for this approach beyond vague references to vestibular or visual problems of some kind and saying the words "the nervous system" repeatedly.

      It may be that Z Health is all about body schemas in the brain, SAID principles, graded exposure, education for fear reduction and choreographed movements to reduce pain. But all we heard in that long thread by people supposedly schooled in this method was "jammed joints", "corresponding joints" which had lost mobility, the importance of "joint mobility drills", some kind of vestibular and visual diagnostic system, outrageous claims, and extremely expensive certification schemes. So forgive me if I judge Z Health by its website, seminar advertisements, and discussions with educated and experienced practitioners. The Z Health i've read about on their official material and that those folks represented here bears no resemblance to the description you provided.

      I'm willing to believe everyone else is just misrepresenting things, but I'd need to hear more. Your reputation is such that if you say there are worthwhile things there, I believe you. But I haven't seen them yet.
      Last edited by Jason Silvernail; 16-07-2011, 12:04 AM. Reason: add "test-retest"
      Jason Silvernail DPT, DSc, FAAOMPT
      Board-Certified in Orthopedic Physical Therapy
      Fellowship-Trained in Orthopedic Manual Therapy

      Certified Strength and Conditioning Specialist


      The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

      Comment


      • #4
        Todd,

        That was a great explanation what it is to you, but I wonder if that comes through with many trainers who arent yet "ectodermalized". Cobb can have the best intentions but when it comes through other Z-Health practitioners that I've met, it's a different story. It's still all meso...

        Comment


        • #5
          Jason,

          I can assure you I am not here to “neurowash” Z, I’m actually giving it an honest appraisal based on my experience.

          I will agree that Courtney and Mike did not make a very good presentation of Z. I’m not here to defend what they said or Z’s marketing, but I think the marketing is pretty clear that what they are selling is a nervous system based approach to fitness and performance.

          The home page of the website has a huge banner that says “Get out of pain, train the brain.” Two of the first FAQs are “why do you primarily target the nervous system" and “how do you target the nervous system?”

          The reading list for one of the certs would be almost the same as what would be recommended here - books by Doidge, Butler, Shacklock, Moseley, Lederman, and even some articles from Anoop and Barrett.

          I actually think Z is an interesting case in regard to your earlier post about keeping science and marketing separate. In the case of Z, the marketing distorts the science a little, which is a bad thing. But the marketing also brings in a lot of people who would never have otherwise been exposed to an ectodermal approach. And that’s a good thing. An ectodermal approach is not an easy sale to make, as many SS people know, but Cobb makes the sale very well. He uses some flash and voodoo to do it, and uses terms like "Jamed joints." This corrupts the message a little, but he is able to effectively challenge many mesodermal assumptions and get people thinking. To use Will’s excellent phrase, Z is “ectodermalizing” many trainers. A hundred a month? Many of them turn into neuro geeks and spread the word on the internet. Including me. I noticed two Z trainers, including Mike Nelson, who posted Paul’s recent FMS debunkery on Facebook and generated debate.

          If I had to sell education to trainers or PTs on an ectodermal approach, I would probably stick way closer to fully defensible material. And probably no one would show up! Its not an easy thing to change the world.
          Todd Hargrove

          http://bettermovement.org

          Comment


          • #6
            Will,

            My experience meeting people at Z certs is that they will often retain some bad meso ideas and maybe even learn some new bad ecto ideas. But there is progress in the right direction. Its not easy to learn a whole new paradigm.
            Todd Hargrove

            http://bettermovement.org

            Comment


            • #7
              Hi Todd!

              In my world, the possibility of any PT being able to resolve "a serious chronic shin splint in one session" will certainly generate a great deal of attention.

              Is there anything "new" that Z Health professionals might be doing relative to "shin spints," (MTSS) or might it be just choosing something from a toolbox of therapies that, in this case, worked right away?

              The description of "one session" relieving a chronic issue leads me to believe that the therapist must have hit upon something right away. From your experience, what might the therapist have tried, or is this really too general of a description to provide an appropriate answer?

              Comment


              • #8
                Hi Todd.
                I think the marketing is pretty clear that what they are selling is a nervous system based approach to fitness and performance. -Todd
                Well, I get that, but that statement alone is not enough for me. This is why, when pressed to explain any of the several claims and diagnostic schemes of ZHealth, it's proponents only answered "the nervous system." Apparently, that's the extent of their understanding. If that's the case I can't give it any credit. This seems to me like things that try to be "science-y" sounding. There's little beyond the most superficial lip service to science before diving headfirst into the outrageous claims, the implausible schemes, and the simplistic protocols.

                I get that you've pulled good things out of it, and I think that's important, and I really appreciate your mentioning you're not here to "neurowash" it. But at some point we have to believe that what the proponents are saying reflects their true understanding rather than thinking they really have some better deeper understanding they just aren't sharing with the unwashed masses.

                If the point of ZHealth is to sell the usual recycled concepts (good ones and not so good ones) in a way that has a lot of unnecessary complexity and to charge big certification bucks to do it, all while saying "The Nervous System" over and over, then I think ZHealth is a 100% success.
                If the goal is to actually bring understanding of scientific principles and provide a defensible scheme of evaluation and management to use as a template for understanding pain and fitness issues while being faithful to what we know is actually true about the human physiology, then I'd say its a failure.
                Jason Silvernail DPT, DSc, FAAOMPT
                Board-Certified in Orthopedic Physical Therapy
                Fellowship-Trained in Orthopedic Manual Therapy

                Certified Strength and Conditioning Specialist


                The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                Comment


                • #9
                  Jason,

                  I can understand that you are skeptical. Z certainly does not have perfect success in fully educating all of its students. But of course no teacher can make such a claim.

                  Almost every regular on this forum has related how difficult it is to “cross the chasm” and get people make a paradigm shift from meso to ecto. Barrett has expressed many times that many of his students completely don’t get it. (And Mike attended a class by Barrett only a few days prior to getting involved in the Z thread.) And for the students who do try to make the shift, they are bound to lose their footing during the transition and make some shaky statements along the way.

                  Further, I have talked with Mike frequently, and while I don’t agree with everything he says, he certainly has many valid ideas about the central nervous system that he learned at Z certs. I recall that one of his blog articles about using a Z based ecto approach to training athletes was cited with approval by Lorimer Moseley on his blog. Here’s the link: http://bodyinmind.com.au/brain-scien...t-elite-sport/

                  There is no easy way to just convince everyone to “cross the chasm.” The Z certs are just one of many potential imperfect strategies for getting a hard job done. This forum is another strategy. Barrett’s classes are another. Each has its weaknesses and strengths.
                  Last edited by toddhargrove; 19-07-2011, 04:10 AM.
                  Todd Hargrove

                  http://bettermovement.org

                  Comment


                  • #10
                    Z stuff seeems closer to chiro marketing schemes then SoS.

                    Comment


                    • #11
                      To paraphrase from my previous post, I think if Z Health actually brought understanding of scientific principles and provided a defensible scheme of evaluation and management to use as a template for understanding pain and fitness issues while being faithful to what we know is actually true about human physiology, that some people tragically misunderstood, then I could agree with you.

                      I'm unwilling to give Z a pass for vestibular visual diagnosis ideas, "jammed joints", "corresponding joints" and their absurdly overpriced credentialing scheme just because there are a few pearls of neuroscience in there.
                      As an example, Barrett's courses are rigorously scientific, very light on claims, encourage critical thinking, are unafraid of uncertainty, are very inexpensive, and have no certification process. If someone makes some unusual claims about neuroscience, ideomotion, or the origin of painful processes after Barrett's course, we can't really fault Barrett for that.

                      But if the teaching actually includes questionable aspects, we have to fault the actual teaching. And so I fault ZHealth for that. These claims and ideas aren't a result of the difficulty in crossing the chasm, the phenomenon of cognitive dissonance, and the foibles of human nature. They seem to be a reflection of what Z Health actually teaches. Huge difference.
                      Jason Silvernail DPT, DSc, FAAOMPT
                      Board-Certified in Orthopedic Physical Therapy
                      Fellowship-Trained in Orthopedic Manual Therapy

                      Certified Strength and Conditioning Specialist


                      The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                      Comment


                      • #12
                        Almost every regular on this forum has related how difficult it is to “cross the chasm” and get people make a paradigm shift from ecto to meso.
                        I think you mean "meso to ecto", Todd, no?
                        Diane
                        www.dermoneuromodulation.com
                        SensibleSolutionsPhysiotherapy
                        HumanAntiGravitySuit blog
                        Neurotonics PT Teamblog
                        Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                        Canadian Physiotherapy Association Pain Science Division Facebook page
                        @PainPhysiosCan
                        WCPT PhysiotherapyPainNetwork on Facebook
                        @WCPTPTPN
                        Neuroscience and Pain Science for Manual PTs Facebook page

                        @dfjpt
                        SomaSimple on Facebook
                        @somasimple

                        "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                        “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                        “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                        "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                        "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                        Comment


                        • #13
                          If you are involved in training for any length of time, you hear, and you realize, that breakthroughs usually occur from the field to the laboratory rather than the other way around. I think what we are talking about may be an example of this in a way. These people came up with some things that they found really effective through applying experience and trial and error. The problem seems to be they are trying to get others to believe they understand why these things are effective when they don't really know. The motivation for this appears to be, at least partly, commercialization.

                          I believe some of you are fans of this site but for those of you who are not you might enjoy watching the solo form being demonstrated. I think, or I am guessing, that some here will like it:

                          http://www.exuberantanimal.com/web/solo_form/index.html

                          Comment


                          • #14
                            I enjoyed it Randy. Just watching it made me feel a bit more limber. I do some of those things in my kitchen when I'm cooking or cleaning.

                            It reminded me a bit of Napoleon, some of whose moves I also do.

                            [YT]kr7djGY1fhA[/YT]
                            "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                            Comment


                            • #15
                              Randy,

                              I've sent your link on to a couple of people who I thought might find it beneficial. Thanks for the link.
                              "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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