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Deconstruction of "Z-Health Performance Solutions"

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  • Diane
    replied
    Coutney, I'm glad you're here and seem willing to do some of the deeper neuro digging from your side, which is closer to this matter than from where I sit. Thank you.

    Jason has asked everything I had in mind in his post #94 succinctly. I look forward to your answers, or those of Cobb. Especially re: the toes.

    Keats, looks like you'll get a debate going after all - that is, if everyone reads Jason's post and answers the question as he posed it.
    The question continues to be - what is the explanation for the supposed results seen by using this system? Also, how is this system better than the million other treatment and movement therapies out there?
    Be sure to read his whole post carefully to avoid wasting time falling into answers that he has suggested do not in the least matter.

    Also Barrett's question as he posed it.
    I didn’t ask you what the patient was complaining of or displaying, I asked you what the origin of these things were, according to Dr. Cobb.

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  • Keats Snideman
    replied
    Nice to see this thread continuing...I do hope Dr. Cobb can join in so we can hear explantions from the creator of the system.

    Thanks again to those who are contributing; healthy debate and discussion can only help and deepen true understanding.

    Back to some earlier posts, I don't think we ever got an explantion of "neuromyofascial winding." I'd really like to know what this is. One of the problems between between healthcare disciplines is the different verbage that is used to explain various processes and phenomenon. It would be easier if everyone used the same words (science-based). On-line discussions of this sort become a true test of one's communication skills!

    Let's keep the communication going and see where we can get realizing that we're all probably more alike than different; and realize that there is NO personal attack on any individuals here, just their ideas and concepts.

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  • anoopbal
    replied
    He will join when and if he wants to - although personally, I rather hope he stays above the fray
    And why should he not? This is the great oppurtunity for him to show that his treatment is rooted in fundamental physiology and also great oppurtunity to market his product and get more clients.

    As you said personal anecodotes can be used as evidence, but what if all the treatment modalities out there are wholly based on personal succes stories? Are you goona spend 2000 dollars and try each one by one and see if you could fix your hammer toes?

    What do you suggest is a better option for anybody wanting to learn more?

    Anoop

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  • Barrett Dorko
    replied
    Well, it was short enough, but it wasn’t even close to the point.

    I didn’t ask you what the patient was complaining of or displaying, I asked you what the origin of these things were, according to Dr. Cobb. Perhaps you should take a look at the Five Questions thread for a definition and discussion of origin and its importance. Then you could try again, or not.

    “Above the fray”? I would think that Dr. Cobb would want to lend his support to his students speaking up for his method here. It would take all of ten minutes to throw some words onto the computer and hit “send.” Sort of the way John Barnes and Ron Hruska did.

    Oh wait, that never happened either.

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  • cneupert
    replied
    [quote=Barrett Dorko;36008]According to Dr. Cobb, what are the origins of the patient's/client's complaint when his method is appropriate?

    The client's complaints may include but are not limited to specific localized pain from musculoskeletal disorders, generalized pain, mechanical dysfuntion, functional limitations, neurologic disorders, or desire for enhanced performance. The "method" depends on the client's complaint - again, using the right tool to achieve the desired outcome. (short enough for you?)


    When do you suppose Dr. Cobb himself will join this discussion? Why wouldn't he?

    He has been out of town teaching, which means that he hasn't had time to join the discussion. He will join when and if he wants to - although personally, I rather hope he stays above the fray.

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  • Jason Silvernail
    replied
    Courtney-
    What is the question here then?
    Are you kidding?

    The question continues to be - what is the explanation for the supposed results seen by using this system? Also, how is this system better than the million other treatment and movement therapies out there?

    Answers about it being "applied neurophysiology" and giving responses based on mechanoreceptor activity and joint mobilization is well and good, but this doesn't make it any different than any other exercise or movement program. My walking to the refrigerator for a beer does all those things, too.

    Perhaps making the question more specific would help. Regarding your story of your hammer toes straightening or your sudden deadlift success - how did/does "Z" achieve this, do you think? Can you explain how this system accomplished these feats?

    I'm not calling your results into question, just asking for an explanation that works in the established framework of human physiology and that shows this system to be better than all the others. I mean, either of those two things you described, if they were explainable and repeatable, would do nothing short of revolutionize training and therapy. Think of all the wasted hammertoe correction surgeries just for example.

    Additionally, I like that the name has been shortened to just "Z". Is this kind of like when MC Hammer changed his name to just "Hammer"?

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  • Barrett Dorko
    replied
    According to Dr. Cobb, what are the origins of the patient's/client's complaint when his method is appropriate?

    I assume the answer will be short and to the point but probably shouldn't ask for that much. (I will admit that's mildly sarcastic but not hostile at all. It just expresses my desire for answers that don't include every possible mechanism)

    When do you suppose Dr. Cobb himself will join this discussion? Why wouldn't he?

    Thank you Courtney for not including another testimonial with your last post. That stuff can wear on you.

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  • cneupert
    replied
    Diane - What is the question here then? It seemed as if Keats was originally asking what Z was based on some experiences posted on a blog. There is no heavy marketing going on here. The only marketing is on the Z health website - which is for their business - I should hope there is some marketing on a business website! Some of the trainers have attempted to answer your questions based on their enthusiasm and real world experience with the system. Anecdotal evidence is still evidence - it is just not written up yet.

    As for neural glides - it is possible. As you mobilize a joint actively you are also stretching the skin and tissue around the joint which contain mechanoreceptors among other things. You are also initiating some muscular contraction to perform the movement, and the movement would also affect circulation and lymphatic drainage. Through myofascial connections, you are probably getting some neural gliding. Is this the sole reason for the results? Maybe, maybe not. It could also be pointed out that when you are performing a nerve glide, you are also stretching fascia and moblizing joints, so again, is the nerve glide the sole reason for the results? Maybe, maybe not. Does cognitive intention play a role? Probably. Intentional nerve glides are also in the toolbox within the Z health system - much of it based on the works by David Butler, the NOI group, etc. With the basic joint mobility exercises however - I doubt you are truly getting enough of a glide to effect the kind of change you are talking about. The movements are very subtle, and most of them are begun in positions of neural slack. You can also modify movements to decrease neural tension even further and still get the same result. Whether you are performing a nerve glide or stimulating mechanoreceptors through joint motion or other tools, you are always affecting the CNS. The question is whether the change you are getting is good in the long term. Z provides a framework where you can quickly ask and answer this question within a treatment session. The take home point is - there are a lot of really good treatment modalities including nerve glides, joint motion, myofascial release, cognitive therapy, strength and conditioning, nutrition etc etc, but it is imperative to determine which modality is needed when, and be able to reassess to see if what happened was what you actually intended.

    Hope that helps.

    Leave a comment:


  • Jason Silvernail
    replied
    Geoff-
    I've shown neither bias nor ignorance here. Unless you consider my (along with other posters here) devotion to science and scientific principles in medicine and therapy to be bias, in which case, guilty as charged.

    Your comparison of people with painful problems to operating an automobile is inaccurate. As I said before you don't know what you don't know. Hopefully if you (or any other fitness trainer) pretends to treat medical problems, you at least get a referral from a medical provider such as a physician or a physical therapist so you don't hurt anyone.
    This is probably not the thread to go further into this issue, though I lay the blame in no small measure on Mike Clark's program for encouraging this sort of thing. Back to Z-Health, I suppose.

    If I came on to a science-based training and conditioning board (such as NSCAs) claiming I got all sorts of people to deadlift PRs with a new system when no other trainer or coach could help, and I talked about this kind of stuff, they would tear me apart. And rightly so. They're scientists, too.

    Courtney-
    Regarding hostility, cynicism, and sarcasm - isn't that what the claims and explanations being made for this system require? People promoting this system had (and continue to have) plenty of opportunity to provide any sensible explanation for the results (which by the way have not been disputed)that they see. Before your post, there was nothing but a regurgitation of marketing material. What do you expect from your fellow scientists?

    Yes, we prefer journal articles to anecdotes - if you've earned a doctorate in your field, don't you, too? Journal articles aren't even required - just a sensible scientific explanation for what's being claimed. As of now, this thread is 2 full pages long, and your post (such as it is) is the first serious attempt to explain anything.
    It has been my experience that when people lament of cynicism and complain of hostility and personal attacks in the clear absence of such things, they really are just disappointed that others aren't as credulous as they are.
    Last edited by Jason Silvernail; 06-08-2007, 07:39 AM.

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  • Barrett Dorko
    replied
    I don't know about the rest of you, but I really appreciate this post.

    Leave a comment:


  • Diane
    replied
    Thank you for your input Courtney. Everyone here agrees on the nervous system being powerful and fast. In fact that's kinda what this board is about. Most of us have had experiences that support that contention. What's to say that this z approach is not just neural glide exercises either inadvertently 'rediscovered' or deliberately repackaged and called joint control exercises? In fact, I'd bet the farm that neural glide explanations can more than account for the apparent magical speedy results. It usually takes three days of practicing those, with solid pain education, to recover, not ten..

    Frankly, I am appalled and saddened by the overt hostility, cynicism, and sarcasm displayed by my colleagues on this thread. How about we all check our egos at the door and get back to the basics.
    ??? I beg to differ. This forum isn't used to a bunch of heavy marketing-type posting, is all. In fact we're sort of allergic to it. We tend to be a bit nerdy here actually.

    The main question seems to be what the heck is Z health, and what is it based on. Dr. Cobb is able to articulate this much better than I am, but I will do my best.. . .
    I don't know that that was really the question. It seems to be related to what the "answer" that everyone trained by Cobb is providing, however.

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  • cneupert
    replied
    Frankly, I am appalled and saddened by the overt hostility, cynicism, and sarcasm displayed by my colleagues on this thread. How about we all check our egos at the door and get back to the basics. The main question seems to be what the heck is Z health, and what is it based on. Dr. Cobb is able to articulate this much better than I am, but I will do my best.. . .

    Z-health is a comprehensive system based on applied neurophysiology. Because neurophys is such a broad and complex topic, it is way too much to completely cover here. There are multiple tools in the Z toolbox, but the most easily recognized is the joint mobility. Z seeks to restore optimal movement patterns by stimulating the nervous system using whichever tool is appropriate (joint mobility, visual/vestibular exercise, strength, manual therapy, etc), and the certifications teach you which tool to use when. The concepts behind Z are based in basic science that we all know and understand. The first is proprioception - the entire body is mapped into the nervous system. Anything you experience in the human body helps to shape this map. The idea behind the joint mobility exercise is that the precise retraining of volitional joint control stimulates mechanoreceptors in the joints to help reshape the proprioceptive map. (So far, so obvious) The arthrokinetic reflex is a major player, as the lack of joint mobility affects neural input to and from the musculature surrounding the immobile joint, thus affecting motor programming. Precise volitional control of joint motion improves proprioception, and the ability of the nervous system to achieve more efficient motor programming by preventing the arthrokinetic reflex. We could then begin to talk about formation of synaptic connections, dendritic pruning, so on and so forth, but I prefer to stick to simple stuff. We are just now beginning to understand how much visual and vestibular input can affect movement. (Remember the vestibulocollic, cervico-ocular, and cervicocollic reflexes?) The Z-health system also provides tools to assess and integrate the visual, vestibular, and proprioceptive systems into training or rehabilitation in a systematic and simple way. Other basic principles and reflexes also come into play such as the SAID principle and the startle reflex. These are important because anything the body perceives as a noxious stimulus can elicit the startle reflex which then shuts down movement and efficiency. This can also lead into a sympathetic hormone cascade - but that is a whole other topic. You also get exactly what you train for because of the SAID principle, and if you train imprecisely or inefficiently - you get imprecise and inefficient movement. The difference between Z and other joint mobility programs is in the precision of the movements and the skillful integration of these precise movements.

    Because Z is a relatively new system, there are no scientific studies in peer-reviewed journals yet . . . But the principles it is based on are well-studied and well known. In the end, the proof is in the pudding.

    It is apparent that you prefer journal articles to anecdotal evidence, but I have to give you 2 personal examples of the power of the nervous system brought to light by Z. 1. I've had hammer toes my whole life. My sister has them and my mom has them. No amount of exercise, manual joint mobilization or stretching has made a dent in my hammer toes in 30 years. Last month I had been doing a lot of joint mobility and noticed that the toes on my left had begun to straighten - weird. Then, one day, I combined some of the visual work with joint mobility, and lo and behold, the toes on my right foot had straightened out - in a total of 30 seconds! It doesn't make sense to the evidence-based practice trained therapist that I am - but it happened. Why? The nervous system rules.
    2. I weigh about 138 pounds. I haven't lifted anything heavy since 1998 when I hit a PR in the deadlift of 225lbs - I was a scholarship volleyball player and trained every day. Since then I have de-trained and have been working to rehab all the injuries I accumulated over the years. Last year I also dislocated my SC joint (dog walking injury) and haven't been able to do any heavy pushing or pulling since due to the instability. The heaviest thing I've routinely lifted over the last year was 12 kg. Last week, after a week of doing high quality mobility work combined with visual and vestibular work, I walked up to a bar and deadlifted it without warming up at all. It weighed 225 lbs!

    The point here is this: the nervous system is extremely powerful and fast. There is more that we don't know about it than we do. If a system is out there that has the ability to help us integrate multiple tools in the real world to make a change for the better - that is a great thing - even if we don't completely understand it. I hope that you will practice what you preach - keep an open mind and continue to investigate.

    Best Regards,
    Courtney Neupert, PT, DPT

    Leave a comment:


  • Barrett Dorko
    replied
    Symptoms of pain are reduced when the origins are reduced and/or when the tolerance of the person suffering is sufficiently increased. It's not a mystery. When movement helps, it's probable that the mechanical deformation responsible for the pain's origin has been addressed correctively. Again, no mystery.

    When do you suppose that those who push an incredible variety of movement therapies out there are going to figure this out? What's there to wonder about?

    I'm with Jon. Why wouldn't Dr. Cobb have "a flying chance" here? Are we supposed to give him some sort of special dispensation? Isn't he supposed to have a theory he can defend just like everyone else?

    Keats, you made no mistake asking about this method here, but you were mistaken if you assumed that we might come up with an explanation for the supposed effect of this work or that we would automatically imagine that Dr. Cobb's claims are reasonable or true. Perhaps you didn't expect this, I don't know.

    The guy who invented the method and who makes his living teaching it is supposed to do this. The fact that his students (read those who pay him) don't demand this is why the whole thing seems such a confused mess.

    These tasks are Dr. Cobb's responsibility.

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  • Diane
    replied
    What may have been more effective at the start of this thread is if I posted a video or an explanation of some particular Z-drill, and then posed my questions and objections to the drill such as: What sort of benefits/detriments could come from such a movement? How could this possibly help/worsen symptom X or Y? That way, we could have separated the movement from the system and really tried to distill it down to the most fundamental processes at work.
    I doubt that would have helped.

    Don't worry about the worms Keats, they'll go back into the can eventually.

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  • Jon Newman
    replied
    Hi Keats,

    Now if Dr. Cobb could join in it might add to the discussion but it doesn't sound like he'd stand a flying chance on this forum.
    Why do you say this? What sort of forum would he stand a flying chance on?

    Leave a comment:

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