Deconstruction of "Z-Health Performance Solutions"

[Mike T Nelson]

Thanks! Glad to be here.

Keats (and others) what holes do you believe are in the system and we will discus.

Mike N

[Jon Newman]

Hi Mike,

Keats has already posed some questions (concerns really.) For example, see post #2

On a side note, what do you think about the marketing tactics?

[Mike T Nelson]

In relations to the second comment, the theory is that the neuro-postural control system is arranged in the hierarchy (most of the time)


1) visual system
2) vestibular system
3) proprioceptive system

This is a conceptual paradigm and explains that posture is controlled and regulated by several systems.
In regards to the visual, the I Phase testing (level 2) is testing the eye muscles themselves and the coresponding reflex, so it is not directly related to vision (there are more vision test in level 3).


The movement of the body should follow the eye position. So as you move your eyes up (for example) you increase extensor activity (this is very slight in most people). As you move your eyes down, you increase flexor activity.

Try a movement of your choice (arm back circles done slowly maybe) and then snap your eyes into different positions. In some different eye positions, for most (not all) people the movement difficulty will increase in certain positions. The movement is the same but the only difference is eye position.

Vestibular is based on similar ideas.

For example, in my case I tested positive on the eye test (down position) and on the vestibular test (head tilted right). I had a gait assessment done at the start, then the tests, and then I tried a Z Health drill (ironically the same one I had done many times before) this time with my eyes down and my head tilted to the right. My gait immediately cleaned up (gained full arm extension on my left side and my head aligned straight also as my thoracic lengthen quite a bit, although it felt like there was much LESS tension). Movement felt much better and my gait speed increased . Now I now this is all anecdotal, and does not fly with the scientific method, but it was still amazing to me. This was the third time I had been tested and each time just added a head and/or eye position made an amazing difference.

One study quoted below and I was only able to get the abstract so far.

Let me know what questions you have. It is a little harder to start with the system at the second level, but post any questions you have. I don't believe there is tons of literature for every aspect of the system (maybe there is, but I am finding new stuff all the time); but the theory seems to be (you be the judge) quite sound.

Thanks
Mike N

Head-body righting reflex from the supine position and preparatory eye movements

Authors: Diana Troiani; Aldo Ferraresi; Ermanno Manni
DOI: 10.1080/00016480510036448
Publication Frequency: 12 issues per year
Published in: Acta Oto-Laryngologica, Volume 125, Issue 5 May 2005 , pages 499 - 502
Subject: Otorhinolaryngology;
Number of References: 14
Formats available: HTML (English) : PDF (English)

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Abstract

Conclusion Saccular and utricular maculae can provide information on the supine static position, considering that both have pronounced curved structures with hair cells having a variety of polarization vectors that enable them to sense an inverted position and thus direct the righting reflex.

Objective The vestibular system is essential for the structuring of motor behaviour, senses linear and angular acceleration and has a strong influence on posture and balance at rest, during locomotion and in head-body righting reflexes.

Material and methods Using guinea pigs in the supine position with a symmetrical head and trunk position, the ocular position was analysed to ascertain whether any ocular movement that occurred would adopt a spatial deviation indicative of the subsequent head and body righting. The characteristics of the righting reflex (direction, latency, duration and velocity) were analysed in guinea pigs from position signals obtained from search coils implanted in the eye, head and pelvis. The animals were kept in a supine position for a few seconds or even minutes with the eyes in a stable primary position and the head and body symmetrical and immobile.

Results The righting reflex took place either immediately or after a slow deviation of the eyes. In both cases the righting sequence (eyes, head, body) was stereotyped and consistent. The direction of head and body righting was along the longitudinal axis of the animal and was either clockwise or anticlockwise and the direction of righting was related to the direction of the eye deviation. The ocular deviation and the direction of deviation that initiated and determined the direction of the righting reflex could be explained by possible otolithic activation.

Keywords: Balance; body stabilization; gravito-inertial receptors; postural vertical

[Mike T Nelson]

In regards to marketing tactics I don't have a whole lot to say since I am not a marketer (although I try my best). I do think that every thing they say in the marketing is true. The first time I heard it, my first response (and my response for quite awhile) was that it was bull crap. It sounded too good to be true and there was no way it would work.

I knew some guys that started doing it and they kept reporting PRs (personal records) in the gym and stated that they never felt better.

so I plunked down the cash and bought the R Phase DVD/manual. Even doing most of the movements with out precision (wrong), I got a fair amount of benefit from it.

Dr Cobb was here last June for some 1:1 sessions and I signed up myself, my sister and one client that I was working with at the time. He got my left hamstring to fire (based on a manual muscle test--yes I know there are people that cheat on those all the time, but I have since reproduced it many times on others) by having me do elbow circles. Sounds nuts, but then you realize that the elbow is related to the opposite hamstring due to the gait pattern. It was amazing and I stayed and watched gait assessments the next day and was blown away by the changes in only 1 hour in the people that came in; so I drank the Kool Aid and was off to training that Fall. I spent tons of time trying to poke holes in the R Phase theory (level 1) and what I found was that it all seemed to work like he said about 80% of the time. It was not the same response each time, but going through the system I was able to help about 80% of the people I saw. By "help" I mean better gait, increased ROM, increased muscle strength (via the arthrokinetic reflex) and decreased pain.

Mike N

[nari]

Interesting about the eye movement bit.
I have known quite a few PTs who incorporated eye movements (this was years ago, in the 1980s) with ROM movements, particularly with the cervical spine.
They didn't know why, but it improved pain and range which lasted after co-ordinated eye movement ceased. Previously the ROM movments had not improved without eye movements.
?

Nari

[Crazy Pole]

Hi Mike and welcome to Soma Simple.

Being in White Bear Lake, I know you aren't too terribly far from 35W (I attended the U). I hope you and your family are safe.

Thank you for sharing your personal anecdotes. You mentioned the successes that you have had as a patient/subject in the system. I am wondering what sort of symptoms you had, if any?

Also, being a trainer, I also wonder what your caseload is like in terms of primary complaints/goals. Are they mostly pain patients, or athletes hoping to gain a competitive edge?

Thank you for your time and I look forward to your contributions,
Wes

[bernard]

You're welcome Mike.
Sorry if I'm a bit provocative but I found the same advices and techniques in my old books for less than 20$.

And more, since they explain why it works...

Moshe FELDENKRAIS; Awareness Through Movement

Thomas HANNA; Somatics

[Jon Newman]

I won't nitpick the marketing as it would be boring but I think it's deceptive if not overtly wrong but that is a common occurrence in marketing.

I found no substantial discussion of theory. Do they provide something in the course work that you can share with us?

[Bas Asselbergs]

Hi Mike. Thanks for coming here to help us understand the ideas/claims of Z-Health.

I have to admit, unless there are some good answers to the following questions, all we seem to have here, is a concept built on anecdotal results, with meager scientific theoretical support. In fact, only theoretical support, by the looks of it.

Simple questions:
How do you know that "The muscles that control eye movements can actually become imbalanced" ? And how does nystagmus and other eye-muscle dysfunction fit in this?

Second: How do you know this "(...)if these imbalances/weaknesses exist, they affect how the body moves and what happens on the myofascial level." ? How is the effect on the "myofascia" measured? How is the body movement evaluated? And since people are so inconsiderate to be fiercely independent in their (own habitual) movement patterns, how do you establish "normal" in order to assess "abnormal"?


Third: And how do you know this?: "This means your eyes can set you up for structural imbalances and injuries without you even knowing it." How has this been measured?

I assume that the above quotes (thanks Keats) are representative of the whole Z-Health concept.

[Jason Silvernail]

As with any system of evaluation and treatment, for this to be considered a credible approach, it must have...
- an explanation of it's evaluation and treatment that makes sense given the known facts of human physiology - often referred to as "a deep model"
- evaluation methods that are plausible for use in the clinic, and that may be studied for inter and intra-rater reliability, validity, and relevance to the complaint
- treatment methods that might plausibly address the underlying cause of the complaint, as revealed by evaluation methods.

Seen in this light, is Z-Health credible in terms not just of it's marketing, but in terms of it's claims regarding the origin and resolution of the complaints it purports to treat?

[Keats Snideman]

Thanks! Glad to be here.

Keats (and others) what holes do you believe are in the system and we will discus.

Mike N

Mike, I'm so glad you are here to add to this discussion since you have much more actual information on the system than I do.

They (this community) were about to bite my head off at first since they thought I was some troll sent my Dr. Cobb to market the sytem. :mg:

Regarding holes in the system:

1) it seems difficult to achieve the results Dr. Cobb does consistently unless you have him around.

2) The system is based on the Nervous System supposedly but no real exploration into neural anatomy and testing (i.e. Neurodynamics) seems to be taught. I mention this because I've tried some of the isolated (R-Phase) joint movements with people (in the neck for example) and only made them worse. In hindsite, I believe these people had too much "neural tension" in their brachial plexus and the isolated movements only added more tension (strain) to the already tensed nerves. I've had more success with mobilizing movements now by adding in Neurodynamic testing to see how sensitive the nervous sytem is to begin with. Using slider/tensioner techniques as advocated by David Butler and others has worked much better than some of the ultra-strict Z-health drills. The slider techniques in particular add more "slack" to strained nervous tissue; something that does not seem to happen with any of the isolated Z-health drills. Putting some slack in the system reminds me of some of Feldenkrais' work (who Dr. Cobb quotes I believe) that I've done in the past. I've had more success with high-tension nervous systems (including my own) using a Feldenkrais approach rather than the Z-Health approach; of course this is my own anecdotal evidence.

I could go on with the last point on nervous system stuff but that's a good start to get this discussion rolling. Great to have you here Mike!

[Mike T Nelson]

Hi Mike and welcome to Soma Simple.

Being in White Bear Lake, I know you aren't too terribly far from 35W (I attended the U). I hope you and your family are safe.

Thank you for sharing your personal anecdotes. You mentioned the successes that you have had as a patient/subject in the system. I am wondering what sort of symptoms you had, if any?

Also, being a trainer, I also wonder what your caseload is like in terms of primary complaints/goals. Are they mostly pain patients, or athletes hoping to gain a competitive edge?

Thank you for your time and I look forward to your contributions,
Wes

Wow, looks like I opened a can of worms! I appreciate all the comments.

Yes, I am fine and thanks to everyone for their concern. I do drive that way to class all the time, but I am currently off from class until Sept.

My story is probably longer than anyone cares to hear, but here is the short version
Started lifting weights in college since at 6'3" and 155 lbs I could turn sideways and dissappear. I had no idea what I was doing, but added some strength and size over time and eventually many years later and after learning as much as I could I got up to 237 lbs at the same height (but body fat was around 18% by skin fold caliper)

In the process, I had several injuries--completely dislocated right shoulder from broomball, pulled both hip flexors and groin at the same time (don't EVER do that), seperated left shoulder, sprained ankles, sprained wrists, aches pains, low back pain one year ago that it was incredibly painful to bend over in the AM to wash my face, etc. I also like to do mtn biking, kiteboarding, wakeboarding, snowboarding, etc so I tend to subject my body to outside high force things too for fun.

Add to this I had open heart surgery at age 4.5 (ASD with complete thoracotomy), lazy eye (amblyopia) as a kid which created a huge head tilt for awhile, glases since 4th grade (now fixed with PRK surgey), scoliosis, torticolis, and a car accident about 5 years ago.

A year ago I was a mess, posture was horrible, joint pain, low back pain was horrible, neck pain, took me an hour of foam roller work, dynamic drills, etc before I could even lift in the gym. At that point I did the Z Health system cert (drank the Kool Aid) and relearned my lifts in the gym and did lots of Z work. Today I feel better than I have ever felt, my deadlift is up 40 lbs (TSC competion in Sept and I will hit 405 lbs raw then, so that would be a 60 lb increase), etc.

Yes, I know this is a case study of one with lots of other variables and none of the issues I had are really huge things; but no other system I found took into consideration everything and the impact on the nervous system. At one point I hired one of the top trainers in the US to help me out and it did not help at all (made it worse actually).

Enough about me.

I work as a trainer and my main goal for all my athletes is performance enhancement. I don't want to be known as a pain specialist (nothing wrong with that, it is just not my main interest) BUT all the people I see are already banged up so I need to get them out of pain first. Most are shoulder pain, neck/upper trap pain, hip pain etc. Even just some simple motions like lunges/squats cause them pain. Already I am getting referrals from other trainers that are not able to help them.

Mike N

[Mike T Nelson]

You're welcome Mike.
Sorry if I'm a bit provocative but I found the same advices and techniques in my old books for less than 20$.

And more, since they explain why it works...

Moshe FELDENKRAIS; Awareness Through Movement

Thomas HANNA; Somatics

Thanks for the post.

I am sure this information is out there, no question about it. From my standpoint, I am not a neuroscience person as my main background or field of study (although I am learning more and more all the time). I've taken some advanced classes on neuroscience and the physiology of pain, but my current PhD work is in Exercise Phys (Metabolic Inflexibility). Also, I am also a "results guy" Athletes (I refer to everyone as an athlete since they use their body to make a living) hire me to get them results as fast as possible in a safe manner. If I can learn something in 4 days and go home to use it on Mon to help my athletes, that is worth quite a bit to me. I am sure I would be able to figure it out in time perhaps, but that time is also lost income and doing my athletes a dis-service. I expect myself to be the best that I can possibly be and if I can learn a system to play around with and test in a few days, I will do it. I have taken many other courses and most have virtually no practical aspect to them. I agree that understanding is everything and I am working to deepen my understanding all the time, but my first goal is to get them results. Is Z Health the ONLY way to do that? Of course not, but I feel it is very effective.

Not sure if this helps or not
Mike N

[Mike T Nelson]

Second: How do you know this "(...)if these imbalances/weaknesses exist, they affect how the body moves and what happens on the myofascial level." ? How is the effect on the "myofascia" measured? How is the body movement evaluated? And since people are so inconsiderate to be fiercely independent in their (own habitual) movement patterns, how do you establish "normal" in order to assess "abnormal"?


Third: And how do you know this?: "This means your eyes can set you up for structural imbalances and injuries without you even knowing it." How has this been measured?

I assume that the above quotes (thanks Keats) are representative of the whole Z-Health concept.

I am cramped for time, so I will answer the second question first and the other one (which is a good question) soon.

The theory is that the body works in the following hierachy (as mentioned before) 1) visual (eye muscle movements) 2) vestibular 3) proprioception

The general test done first is to have the athelete stand and watch how much they sway--Romberg's test (normally it is very small). Next have them close their eyes (cut visual info). Normally they are fine.

If they pass, the next test is a Sharpened Romberg's test (where the eyes are closed).

Next the Postural Reactions to Eye Position is checked. If clear (no issue), vestibular is checked (Postural Neck Reflex Test). If that is clear THEN neuromyofascial winding is checked. If there is a visual or vetibular test that is positive, there is no point to checking for winding since the body would just wind itself off the visual or vestibular input. Neuromyofascial winding is checked by a Fukuda Stepping Test (with head in neutral, rt and left positions).

Normal and abnormal is measured by a gait analysis. We are not looking for small things, just something a 5 year old could spot (left foot turns out at the hip, forward head posture, etc). A Z drill is done and then the gait assessment is repeated and any change is noted. Since the Z drills act on the nervous system (they are active not passive drills), if the gait is better--yahoo! If not, try another drill. If their gait is worse, that is not a good drill for them. Instead of gait you can measure ROM or do a muscle test also; but gait is the best since it is an autonomous motion (assuming you get them to do their normal gait, which isn't too hard to do, normally just having them walk faster will do it).

Let me know if that helps. Gotta run, but I will answer more soon.
Mike

[Mike T Nelson]

Mike, I'm so glad you are here to add to this discussion since you have much more actual information on the system than I do.

They (this community) were about to bite my head off at first since they thought I was some troll sent my Dr. Cobb to market the sytem. :mg:

Regarding holes in the system:

1) it seems difficult to achieve the results Dr. Cobb does consistently unless you have him around.

2) The system is based on the Nervous System supposedly but no real exploration into neural anatomy and testing (i.e. Neurodynamics) seems to be taught. I mention this because I've tried some of the isolated (R-Phase) joint movements with people (in the neck for example) and only made them worse. In hindsite, I believe these people had too much "neural tension" in their brachial plexus and the isolated movements only added more tension (strain) to the already tensed nerves. I've had more success with mobilizing movements now by adding in Neurodynamic testing to see how sensitive the nervous sytem is to begin with. Using slider/tensioner techniques as advocated by David Butler and others has worked much better than some of the ultra-strict Z-health drills. The slider techniques in particular add more "slack" to strained nervous tissue; something that does not seem to happen with any of the isolated Z-health drills. Putting some slack in the system reminds me of some of Feldenkrais' work (who Dr. Cobb quotes I believe) that I've done in the past. I've had more success with high-tension nervous systems (including my own) using a Feldenkrais approach rather than the Z-Health approach; of course this is my own anecdotal evidence.

I could go on with the last point on nervous system stuff but that's a good start to get this discussion rolling. Great to have you here Mike!

Thanks Keats! The quick answer is that you must be sure when you are doing a Z Health drill that you are NOT adding tension to the body, as you have pointed out, it will not be effective. It also has to be done with high precision. In my experience, working directly on the neck/cervical area on a first visit is tricky since you will normally see tension levels go UP (not what we are after).

However, as you know the body is a big X with regard to force transfer, so working on the feet, hips and wrists will (in most people) affect neck tension. I just worked on an athlete today that got pain in neck extension of a 4 (1-10 scale). I worked on his feet/ankles, index finger (old injury), and left hip. His gait was much better and he could move his head into the same position with no pain. Shoulder ROM increased about 45 degrees in both arms also.

Also, as I mentioned above, some Z drills even done correctly can make the body WORSE. This is rare, but that is the point of having a gait assessment and then a re-assessment. Everyone is different and without a re-assessment you are just guessing at what that person needs at that time. The body/nervous sys is not that simple that when I do X I ALWAYS get Y (and you know that).

Dr. Cobb is amazing, but I don't feel you need to be him to get results. I was getting about an 80% response from clients I saw only using R Phase. I Phase should add about another 10-15% to that number (time will tell). Is Dr. Cobb getting better results? I am sure that he is, but I will get better also as I get more experience and learn more also.

Take care
Mike N