Deconstruction of "Z-Health Performance Solutions"

[Jason Silvernail]

Hello Mike.
You're not really answering any of these questions, simply regurgitating statements with no evidentiary support such as:

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

and

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.

These are almost nonsense statements in that they don't really convey any real understanding of the human body. Everything posted about this "system" sounds like Star Trek - throw a couple of big words out there it sounds convincing.
I can do this, too, see:
First we check eyes to examine the upper rectus for trigger spasms, if that's clear then we move toward the cingulate gyrus to look at ganglion transmission speed. We really only go as far as neurochemical plexus inhibition if it's needed, it usually isn't.

What's next, [insert scottish accent] "Captain, we can't get anymore power, the dilithium crystal's overheating!"
Please.

Do you even know what you're talking about here? You mentioned "checking vestibular"- how can the system be "checked" by the use of the postural neck reflex? What problems does this test supposedly reveal and how can they be addressed through "exercises"?
This is just one example.

Additionally, do your credentials in training or exercise qualify you to legally diagnose or treat any medical condition?

Well?

[Jon Newman]

Hi Mike,

I'm trying to find something of value to salvage from all the bunk.

Can you help us understand what neuromyofascial winding means? I entered it as a keyword in Google and got zippo.

My understanding (limited as it is) of the Fukada step test has nothing to do with neuromyofascial anything. Do you suppose this is an appropriate use of the test? If so, how do you know this?

[Bas Asselbergs]

Mike, thanks, but your answer is not really what I am looking for. I will start with this:
"neuromyofascial winding" What is this? I have read a few things in my years as PT and I have never seen this mentioned anywhere....

"left foot turns out at the hip, forward head posture"
How do you know that these are NOT "normal" for the person you look at? How do you know that the outturn of the hip is not associated with an angle variation of the acetabulum? Or that the head forward is simply how the person HAS to be?

And then, in the last paragraph, it seems as if there is some trend like: throw this at the person, if it doesn't work, throw something alse at them until it does.
This does not bode well for the accuracy and reliability of the tests....

Mike, I do not think I will actually get these and my first questions properly answered. I don't say you are to blame for that, but rather the lack of solid scientific underpinning for the "theory' upon which this approach is built.

[Diane]

some Z drills even done correctly can make the body WORSE

Why would anyone want to engage a system that could do this? Surely there has to be more reason behind a "system" that supposedly treats pain and dysfunction or lack of optimum function than just a personal success story (Mike's). Please bring some links to some science support. Please. Otherwise there might have to be revisit of some serious moderating of this so-far apparently anti-scientific thread. It still smells like spam to this nose.

[anoopbal]

wow.. it amazes me a Ph.d guy can write like what he just wrote.

Generally, Ph.D guys are just critical to the core and ask for refernces even for simple little statements. That's show they are trained to think. It is just unbelivably hard to get a conclusive statement from a good researcher.

Anoop

[Keats Snideman]

Why would anyone want to engage a system that could do this? Surely there has to be more reason behind a "system" that supposedly treats pain and dysfunction or lack of optimum function than just a personal success story (Mike's). Please bring some links to some science support. Please. Otherwise there might have to be revisit of some serious moderating of this so-far apparently anti-scientific thread. It still smells like spam to this nose.

Diane, this thread is definately not spam. Mike is a very credible individual who happens to be experiencing great success with the Z-Health System. While Mike is my friend and colleague, I obviously don't share the same enthusiasm for the system that he does.

That was the original reason for my posting on this forum. I was not satisfied with the explanations/theories that Dr. Cobb was giving for his results. Since so many Soma Simple members sound like they're quite versed in current science-based research on the nervous system, it seemed like a good place to bounce some ideas around.

I think this thread will yield some valuable discussion.

[Diane]

I think this thread will yield some valuable discussion.

I hope it starts soon.

[nari]

Anoop,

I was starting to think the same thing. A PhD student is interested in results but the 'why is it so' must come first, and foremost.

Results do not mean anything unless there is a hypothesis which must be shown to stand up to scrutiny.
I haven't found any sort of hypothesis in what Mike has written.

Can one question at least be answered:

What is the evidence for neuromyofascial (?) unwinding and winding???

Without strong references, it sounds like making a pastry for croissants.

Nari

[Barrett Dorko]

I'm with Diane. The "valuable discussion" may commence at any time. So far, I think the regulars here are doing exactly what I told Mike they would do; They're being "his friends."

This comes from a line in Achenbach's "Captured by Aliens" - In science if you don't work hard enough to prove yourself wrong, your friends will gleefully take up the slack.

As yet, I'm not really seeing much of a theory to be, uh, "friendly" with. Do you think Dr. Cobb himself might answer an invitation? Might he appreciate some new friends?

[toddhargrove]

Hello,

I thought I would jump in here and offer what I know about Z, which will help fill in some background and context for what Mike has offered. I’m not qualified to offer the detailed science that will answer some of the good questions people have asked, but I think some background would be helpful if this discussion is going to go anywhere. Obviously Dr. Cobb could do a far better job of this, but I know he’s a busy man and thought I might be able to help for the time being.

For a little background on myself, I am a rolfer in the Seattle area. I have learned a great deal lurking around this site for the last year and have done much of the recommended reading (Butler, Shacklock, etc.) I have also taken a first level Z certification course from Dr. Cobb, called R-phase.

Mike Nelson has just finished the second level, and I have no knowledge of that. But, I'm fairly sure that what he is discussing regarding the visual and vestibular testing is actually only a small part of Z. If Z was a meal, the visual and vestibular stuff would be like a vitamin supplement (possibly very important for a particular individual’s health), but the first level is the meat and potatoes. So I thought I would take a minute to explain my knowledge of the meat and potatoes so we can have a better context for the discussion.

I should also point out that what I’m saying here is mostly my interpretation of Z, and it might not be exactly how Dr. Cobb would explain or understand what he is doing. Anyway, here goes.

Z is a system of movement education based around dynamic joint mobility drills that seek to decrease pain and increase performance. Dr. Cobb has stated that his work is influenced by Feldenkrais, Alexander technique, somatics, and tai chi. In my mind, it is very similar to these techniques in that it is based on very gentle, subtle, precise and mindful movements. My impression is that one of the key differences between Z and these practices is that Z movements are done (at the outset) on an isolated joint by joint basis. This prevents compensation and ensures that each joint is encouraged to recover its normal coordination.

There are three or four Z drills for each major joint or set of joints in the body, e.g. , the jaw, neck, shoulders, scapula, thoracic spine, hips, ankles, feet, etc. To offer some examples, the neck drills involve lateral tilts, rotations, a/p translations, lateral translations, etc. The shoulder drills involve making small circles to the front/ back inside/out and top/bottom. There are numerous foot drills to mobilize the various joints in the foot and ankle.

Z places a great deal of emphasis on HOW the movements are done. Some of the main guidelines are as follows.

1. Use perfect form. This requires concentration and attention and keeps the client in the cognitive phase of motor learning.
2. Maintain a tall spine throughout the movement This helps develop awareness of and inhibit the startle reflex, as described by Hanna.
3. NEVER move into pain.
4. Keep balanced tension and relaxation throughout. This means that the only thing moving should be the joint at issue, and that all other joints should be as relaxed as possible. This helps develop coordinated and differentiated movement, and is very much of a challenge.

If you do all the drills in this fashion, you are basically working to recoordinate and mobilize each joint in the body while staying relaxed. Although I don’t have the science background to explain (on the deep model level that everyone here likes)why doing this would help with pain or increase performance, but I would assume that the efficacy of the above techniques could be explained by two primary mechanisms.

First, Z could reduce pain in a similar way to other manual therapies – by using novel movements to cause a proprioceptive barrage that will reduce nociception. Dr. Cobb states in one his seminars that this mechanism, is in his opinion, the basis for the vast majority of successful manual therapies.

Second, Z could reduce pain by simply improving movement patterns so that they are more efficient, use less energy, cause less wear and tear at joints, avoid nerve impingements, entrapments, etc. One of Dr. Cobb’s concepts is that movement is like a language and that Z is intended to develop “fluency.” Each isolated drill is like a letter, which when integrated with other movement can form words. I believe there may be some motor learning theory which supports the idea that integrated movement patterns are learned by chunking together smaller simpler patterns. Dr. Cobb believes that many people experience pain because they have only a “survival” vocabulary of movements. By improving your movement vocabulary you can better respond to the physical challenges of life. This sounds like a similar concept to Barrett’s idea of adaptive potential.

Another main principle of Z is that “a problem anywhere can cause pain anywhere else.” In other words the body works as whole, it is amazingly complex, and the site of pain is often not the site of the problem. So, by systematically improving the mobility and coordination of each joint in the body, you can expect that problems throughout the body may begin to resolve, often in very surprising and immediate ways. For example, shoulder pain might be cured by ankle drills.

This is only a very brief and broad outline of Z at the first level. I know that the second involves vestibular and visual testing as discussed by Mike as well as movement drills that are more integrated and sophisticated. Dr. Cobb also offers a course for manual therapists that recommends reading Explain Pain, Sensitive Nervous System and Clinical Neurodynamics. I understand that this course teaches some very gentle hands on techniques that involve skin stretching. So, I think Dr. Cobb could have an interesting conversation with the people on this Board.

Anyway, I hope this has been helpful and I would be happy to try and answer further questions.

[Diane]

Is proprioception the only sort of input he bases this on/thinks is relevant?

[Luke Rickards]

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

It seems obvious from this, and Bas alluded to it earlier, that the absolute first step in supporting this theory would be an epidemiological study to show that ALL people with BPPV, Meniere's, labrynthitis, vestibular neuritis, perilymph fistula, acoustic neuroma, nystagmus, all the types of strabismus (exotropia, hypertropia, esotropia), amblyopia, etc, etc, suffer from measurable, systemic postural 'dysfunction', pain, muscle weakness and poor co-ordination.

Until this is accomplished I don't see how the hypothesis, in its current from, can be taken seriously. From my experience with a few of these conditions I'd willing to bet it's a billion-to-one shot that such a correlation would be found.

What's left to discuss??

[Luke Rickards]

Todd,
I appreciate your use of the word "could" throughout your post. I think we should be seeing a bit more of that in relation to Z here.

[Barrett Dorko]

Todd says, "Dr. Cobb believes that many people experience pain because they have only a “survival” vocabulary of movements. By improving your movement vocabulary you can better respond to the physical challenges of life. This sounds like a similar concept to Barrett’s idea of adaptive potential."

Speaking for myself, I would say that the concepts aren't related in any way whatsoever. If you think so, please explain how.

[nari]

Another analogy which ties in with what Luke has stated, is this:
Some people can be stiff and uncoordinated without pain.
Some can be weak without pain.
Therefore the correlation between pain and weakness and/or stiffness is tenuous, to say the least, despite a massive industry based on the assumption of correlation.

Could is indeed a cautious word which could be said more often.

Thanks Todd

Nari