Sunday, February 22, 2009

Address Movement; Address Pain: Z Health R phase Certification

In the Staley/Tsatsouline Strength Seminar, Pavel tells the joke of the weight room: "How many of you have had shoulder injuries? Anyone who hasn't raised their hand, can't." Tweaks, injuries, low back pain, gamy knees, all seem to be part of the athlete's oeuvre. Despite this, athletic coaches have shied away from tackling pain. Most certifications, from the CSCS to the CK-FMS, encourage coaches to refer pain to the appropriate specialist. So i was very surprised when i read the seeming emphasis on addressing pain as a core part of the Z health Certification.

The Blurb for the ZHealth RPhase certification includes, as rationale for seeking out this cert:
  1. You have chronic, nagging injuries that inhibit your own performance!
    (How can you hope to help others to optimal health if you aren’t there yourself?)
  2. You’re totally frustrated with ‘cutting-edge’ exercises and programs which yield minimal results in pain-relief or enhanced performance for both you and your clients!
    (Nothing’s worse than wasting time, money and effort learning a new set of protocols only to see pitiful, or even worse, NO results.)
  3. You’re tired of losing good clients because of injury, poor performance or loss of motivation!
I can think of no other certification i've seen that focuses on pain relief and learning about offering pain relief in a trainer/coach context. Isn't that where we, the humble trainers/coaches, are supposed to punt to the skilled therapist trained in working with pain as the main reason their clients come to see them?

The "punt" is exactly what we learned too in the CK-FMS: if in any of the three tests for pain or if in any of the 7 screens induce pain, punt - get thee to a medico, PT or other well educated practitioner of manual therapy. And that seemed right proper, too.

But as i practice more ZHealth (here's an overview of Z), have the opportunity to coach more people, and read more about brain plasticity and about the nervous system, i've started to understand better a very foundational principle of ZHealth discussed in the certification: address movement; address (an awful lot of ) pain. This understanding also seems to be what sets ZHealth apart from other more general joint mobility work: it's focus of joint mobility work as a path towards improved movement/function and consequent pain relief.

This is not to say that other systems of joint mobility do not enhance function and potentially reduce pain, albeit perhaps less directly/systematically. I am not aware, however, of other joint mobility approaches that look at movement so diagnostically and associates specific movement work with addressing movement issues. There is a well-considered mapping between poor movement and exercises to enhance performance by restoring or improving that movement along full range of motion in the way joints are supposed to move.

What comes out of this correlation between movement assessment and work to improve movement is that there is a strong correlation between poorer movement and a heck of a lot of tissue-based pain. Address the movement issue and the associated pain seems to be addressed as well. In having read now some of the sources that inform the Z approach, this connection just makes so much sense. We are SO interconnected: physiologically, chemically, psychologically.

So while it sounds on the one hand like Z pracitioners are dealing with PAIN right at the top of the charts, Z practice is about movement and the processing systems that come into play with movement: joints, muscles, and especially nervous system receptors - including those in vision and balance. That's cool. It's movement (and turtles) all the way down.

In ZHealth (hereafter referenced as simply "Z"), there are a few basics
  • never move into pain
  • anything can cause anything
  • the site of the pain may not be the source of the pain
  • poor movement is often the source of pain: address the movement, and address the pain.
Now some folks have had issues for instance with "never move into pain" - particularly around the issue of Foam Roller use (please see Mike T Nelson's identity setting post on why there are some issues with foam rollers). A little light reading in the nervous system, however, shows that nociceptive pain (generally, pain in tissue) is a complex set of neurological actions that triggers a consequent set of chemical reactions that sets off tons of stuff of other responses that all say "problem" and "protect." This protection may mean making an area more sensitive so that less stimulus causes more pain; or it may have the opposite effect such that more stimulus (inducing pain) is needed to get an effect. It would seem sensible, therefore, that far from wanting to trigger those kinds of responses, we'd want to find approaches that achieve what many call "release" without further inducing trauma. I just speculate here, based on what i'm able to parse from these texts. And also from what i've seen in practice.

I worked with a client recently who complained of knee issues - sufficient to keep her away from squatting and even swinging a kettlebell with joy. After an assessment, we worked intensely on getting elbow circles (a Z movement) working. I was happily taken aback at seeing her the next morning saying that the pain was gone. Just. Gone. I've heard other Z coaches say they've had similar results with knee issues, and i've heard Eric Cobb talk about how quickly the body can adapt - but to see it yourself - well, it's impressive.

What Z focus on movement also means with respect to pain is really to break the site is the source mentality. The neurological focus may raise the question, based on nervous/chemical/tissue responses, if someone's shoulder is sore, is adding more stimulus directly to that area necessarily the best approach from a nociceptive perspective? Might that just keep irritating an area potentially? Yes the limb will need to be worked - our bodies are also very much apparently use it or lose it organisms - but is that where we start? Z would say, (i belive), look at the overall movement. Now it says a whole lot more about taking someone's history and so on, but in terms of the Big Picture, if anything can cause anything, why think addressing the site (alone) is the best or only place to begin?

What Z practice is showing me (and i'm only speaking for myself here, at a very early level of Z work) is that it's harder to rationalize training people in sport (or any other endeavor involving movement) without knowing more about what's happening in our bodies holistically as we train. What is going on in the brain as we practice? what is going on in the nerves and muscle fibers as we learn particular habits of movement? How does this patterning relate to either the Perfect Rep in particular or more general well being and ongoing ability to perform?

Knowledge about the interconnectedness of all the systems in the body - muscle, bone, brain, nerves - is actually pretty new. From the research new ideas in just how plastic we are at repatterning - how adaptable - has only really been pouring out of research over the last 10-20 years, depending on area. Eric Cobb's work in Z seems to be right at the cutting edge of that research - i've written before about how that connection to bleeding edge neurological science informs Z and why i personally like it because of that grounding. I've talked about this as the Engineering of the Science behind Z- translating the findings of science into practical applications of Engineered technology. The advantage that Z has again in this translation process is the increasing number of Z certified pracitioners and their clients finding out how well this tekne works.

A key part of this tekne is helping the person move themselves better - this self-movement as opposed to being moved by another - is also grounded in leading edge science, neurology.

So while i don't say to clients "wow, i can heal your pain" - if someone says "i have this pain" or "there's a bit of a tweak here" i can say "let's see how you move." So far, because of this integrative approach of "anything can cause anything" i've been able to work with more people, and more kinds of people, more effectively - and often more quickly and happily, too.

If you've been thinking about doing a Z certification, please contact Kathy Mauck and Z directly (kathy@zhealth.net) and let her know mc suggested you connect to find out how to make this work for you. The cool thing about Z is that there are also real people on the other end of the web page/email/phone. They'll help you make accessing a z cert work for you.

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