Showing posts with label neurology. Show all posts
Showing posts with label neurology. Show all posts
Friday, May 7, 2010
Muscle Cramps in Calves when Running in Vibram FiveFingers: what is it, what causes it and what can be done about it?
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Runners Cramp - Calves cramping - it's AWFUL. In talking with folks who run in VFF's it seems that one usual side effect initially at least is that, when picking up the pace in VFF's (perhaps especially up hill), calves may start to cramp up. Guaranteed, if we keep going with this run, once that cramp starts, the calf or calves will turn to unyielding, painful rock. What can be surprising is how quickly into a run this seize up can happen. What the heck is going on, and what might help stop it from happening.
There could be lots going on, so i'm not trying to be comprehensive and exhaustive - not sure that's possible. The goal of this post is to look at pain generally, muscle cramps in particular and what's hypothesised about causes, introduce a newer model not seen in web discussions of cramp, and propose a refinement for that model. Finally, some practical suggestions of getting out of that cramp while heading to barefoot running freedom.
Pain is a signal for Change
Based on work in pain, and as summarized in work by David Butler like the plain language Explain 
Pain
, pain is a signal for change; pain does not necessarily, however, equal injury, and the site of pain is not always the source of pain; treating the site of pain therefore can be a losing proposition.
I've used the analogy of a car oil gauge regularly reading low. One solution is to top up the oil in the engine so that the gauge reads the right level. That level will only last short term and needs to be repeated regularly - and in the interim, what related problems might be developing from such regular loses?
Another solution is to do a diagnostic to find out what else might be going on - like a leak in the engine block where actually a bolt may simply need to be tightened (or an entire gasket in the block replaced - can you tell i'm having flashbacks of stripping the head of an engine in the middle of the bush on an old carola. never mind; i digress). The point is, getting away from site = source often leads to better results.
In the car analogy, finding a more fundamental issue, performing a wee tweak and testing if that tweak will work means that the oil level stays where it's supposed to be for as long as it's supposed to be there. Both approaches are a kind of solution; the benefits on the system and the wallet are better in the latter case.
What's a Cramp in the Calves Anyway?
So taking the above pain thesis into account, what does this mean for the calves rock effect?
What's a Cramp? A cramp is an involuntary and intense contraction of a muscle. What causes a cramp is a subject of much discussion, and poorly understood. A quick check on the web doesn't get at too much about why this contraction occurs.
WHy a cramp? The usual checks: electrolytes, hydration, low carbs, tight muscles to begin with are offered up not as reasons, but of things somehow thought to be related to cramping. Here's an examplary summary of that kind. In this model, the thesis seems to go, the muscles don't have the chemical materials needed to fire in that working limb properly so they effectively rigor mortis up. This rationale for cramp has been more or less tossed out as demonstrated here in 04, and as summarised in this recent BMJ review article. First, on dehydration:
Here's another view of cramps by Luke Hoffman that could be written for VFF runners:
The above describes what might be called "voluntary contraction" - not quite the same as involuntary. If we take the above council about voluntary cramps to bear, however, what should be the case is once a cramp starts, we should stretch it out, and wait for the fatigue to pass from that contraction, and recover, and really stop doing what we were doing - running on the forefoot. Consequently, Pose & VFF runners who run on the forefoot should be cramping all the time. And if we believe work in barefoot running, this is rather how we're designed to run. So, hmm, maybe not.
None of these explanations therefore is complete it seems, to explain cramping we see in the calves that comes on unexpectedly, as lots of well fed, well hydrtated, well electolyted people who stretch still get cramps, and these weird cramps in VFF's in particular.
So why does this cramp only happen *some* of the time - especially if all the typical niceities of cramp avoidance are observed? For me, for instance, it happened first when i started practicing actually bringing the heel of the foot down more (extending the calf) when running, rather than staying up on the forefoot. So, maybe it's not (entirely) about the calves?
Altered Neuromuscular Control. In the research one of the explanations around cramp is: maybe the muscle is just not strong enough to do what is being asked of it, for the duration it's being asked to operate at this level - hence fatiguing - and it's that fatigue that is setting up EAMC: exercise-associated muscle cramping. This hypothesis, also known as "altered neuromuscular control" was first proposed in 1996, so that's how new this stuff is. A key part of this model is that the neuromuscular control issue is located in the SPINE, not at the site of the issue - the site is paying for what's going on at the source.
So in the Pain as Signal to Change perspective, cramps are painful; they are a signal to change. The altered neuromuscular control model suggests, stretch it out and recover. Related work suggests, improve strength/stamina to reduce fatigue and reduce this muscle cramp response. Both have in common that fatigue is causing neural level loss of appropriate control.
Wildly Hypothesising? What's going on when this particular response occurs well before one would think a muscle used to running for miles and miles starts to go all crampy?
In
work pionered by LeDoux in the nineties
, he showed that the brain processes emotional responses like fear/threat without the conscious brain being involved. It happens fast, at a low level, without cognitive involvement and has immediate chemical consequences in the system (nice review of this and related work here by Ohman, 2005). In other words, perhaps there's some other *thing* happening in the sensory-motor exerperience that is saying "not good" and the result is this fatigue-like chemical messaging system that sets off early light cramp signals - that if ignored will just get louder until one is forced to change patterns.
In Z-Health, Eric Cobb translates this fear response into the nervous system's job to perceive threat or no threat: if there's a perception of threat, the system starts to shut down (example in arthrokinetic reflex). What might be the threat ocuring in VFF ocaisional calve cramping? The system may be literally putting on the breaks to what it perceives as a threatening to it's well being practice.
It's easy to see that if the nervous system perceives that the task - going at a particular speed in a particular way - is causing part of the system to be over-taxed, it's going to respond to that as a threat or non-optimal situation, and if it takes pain to get change, well, whatever it takes.
Personal Experience. Taking a Z-Health approach to this experience, i think i've learned to become more alert to any pain signal my bod sends up in an athletic effort. So in this case, if and when these cramps begin, they usually start with a very mild "uh oh" twinge of "about to turn to rock if you don't respond."
There are two simple things that z-health suggests for rehabbing a movement with the cue of "never move into pain:"
Guided by the Nose: run to pace inhalation. Another technique i've been using and coaching to help head off cramps and adapt to barefooting generally is to explore gaiting running speed with ability to stay breathing in through one's nose. If running at a clip where i have to mouth breath, i slow it down (i find if i hit that level, it's pretty hard to get it back to nose inhaling). This approach is just one way at least some of the time to practice running reps quality rather than overdriving the other parts of the system.
Deeper Tune Up: Starting from the Source
So we've seen one theory in the research is around muscular fatigue inducing EAMC; getting stronger in those areas where muscles cramped seemed to help. In one study. That's great. Another possibility - that can lead to faster fatigue - is if there's some kind of issue in one's movement that is causing perhaps other muscles to compensate for other weaknesses, and causing fatigue/pain/signaling in the calves faster that should happen for that group. So while a solution may be to do extra strength work, maybe a faster solution may actually be to look at one's movement as a whole.
In other words, the calves may be plenty strong IF everything else is firing up appropriately, but they may be being asked to super compenate for other stuff, that if those other movement issues were addressed, wouldn't cause the problem.
There's value therefore in (a) having a movement assessment and (b) practicing dynamic joint mobility and sensory-motor work to ensure great movement, and ability to maintain great, clean movement.
Summary: Avoiding Running Cramps in VFF's
Based on the latest research, EAMC cramps are about temporary loss of clear neuromuscular control. The best model so far to explain this effect is fatigue. A known way to work out a cramp is to lengthen the muscle. There may however be other approaches that just haven't been researched that also seem to work. The hypothesis here is that these approaches are dealing with neurological signaling, too, taking advantage of the sensory-motor system.
Some pragmatic responses therefore if cramp occurs are:
During a Run: Assuming one is not dehydrated, de-electrolyted, or have squirrels biting their calves while running,
And before That
Consider a movement assessment to check for what Gray Cook calls "weak links" so as not to build strength on top of dysfunction.
Let me know what works for you.
Citations
Tweet Follow @begin2dig
Runners Cramp - Calves cramping - it's AWFUL. In talking with folks who run in VFF's it seems that one usual side effect initially at least is that, when picking up the pace in VFF's (perhaps especially up hill), calves may start to cramp up. Guaranteed, if we keep going with this run, once that cramp starts, the calf or calves will turn to unyielding, painful rock. What can be surprising is how quickly into a run this seize up can happen. What the heck is going on, and what might help stop it from happening.
There could be lots going on, so i'm not trying to be comprehensive and exhaustive - not sure that's possible. The goal of this post is to look at pain generally, muscle cramps in particular and what's hypothesised about causes, introduce a newer model not seen in web discussions of cramp, and propose a refinement for that model. Finally, some practical suggestions of getting out of that cramp while heading to barefoot running freedom.
Pain is a signal for Change
Based on work in pain, and as summarized in work by David Butler like the plain language Explain Pain, pain is a signal for change; pain does not necessarily, however, equal injury, and the site of pain is not always the source of pain; treating the site of pain therefore can be a losing proposition.I've used the analogy of a car oil gauge regularly reading low. One solution is to top up the oil in the engine so that the gauge reads the right level. That level will only last short term and needs to be repeated regularly - and in the interim, what related problems might be developing from such regular loses?
Another solution is to do a diagnostic to find out what else might be going on - like a leak in the engine block where actually a bolt may simply need to be tightened (or an entire gasket in the block replaced - can you tell i'm having flashbacks of stripping the head of an engine in the middle of the bush on an old carola. never mind; i digress). The point is, getting away from site = source often leads to better results.
In the car analogy, finding a more fundamental issue, performing a wee tweak and testing if that tweak will work means that the oil level stays where it's supposed to be for as long as it's supposed to be there. Both approaches are a kind of solution; the benefits on the system and the wallet are better in the latter case.
What's a Cramp in the Calves Anyway?
What's a Cramp? A cramp is an involuntary and intense contraction of a muscle. What causes a cramp is a subject of much discussion, and poorly understood. A quick check on the web doesn't get at too much about why this contraction occurs.
WHy a cramp? The usual checks: electrolytes, hydration, low carbs, tight muscles to begin with are offered up not as reasons, but of things somehow thought to be related to cramping. Here's an examplary summary of that kind. In this model, the thesis seems to go, the muscles don't have the chemical materials needed to fire in that working limb properly so they effectively rigor mortis up. This rationale for cramp has been more or less tossed out as demonstrated here in 04, and as summarised in this recent BMJ review article. First, on dehydration:
A careful review of the literature did not identify a single published scientific study showing that athletes with acute EAMC are more dehydrated that control athletes (athletes of the same gender, competing in the same race with similar race finishing times). In contrast, there is evidence from four prospective cohort studies showing that dehydration is not associated with EAMC.And on electrolytes (and dehydration):
In summary, dehydration and electrolyte depletion are often considered together (and recently together with muscle fatigue) as the ‘‘triad’’ causing EAMC. The key components of this hypothesis (fig 1) are that electrolyte (mainly sodium) depletion through excessive sweat sodium loss together with dehydration causes EAMC. However, results from prospective cohort studies consistently show that athletes suffering from acute EAMC are not dehydrated, neither do they have disturbances in serum osmolality or serum electrolyte (notably sodium) concentrations. Furthermore, sweat sodium concentrations measured during exercise in 23 reported cases with a past history of EAMC are not higher than those reported in many other studies. Both electrolyte depletion and dehydration are systemic abnormalities, and therefore would result in systemic symptoms, as has been observed in other clinical conditions. However, in EAMC, the symptoms classically are local and are confined to the working muscle groups. Thus, the available evidence to date does not support the hypotheses that electrolyte depletion or dehydration cause EAMC — therefore an alternate hypothesis for the aetiology of EAMC has to be considered.And here's another typical "it's because you didn't stretch right" response - but you'll note the article doesn't raelly say *why* stretching prior to running does or does not do anything for cramp reduction. Indeed, when it comes to running and stretching, the current scene seems to suggest that a stretching program - not necessarily something done prior to running, but just putting this into one's routine - helps running mechanics. That's different. And has nothing to do with a pre-run routine to reduce cramps; as we'll see, stretching is used to respond to a cramp; not prep for one.
Here's another view of cramps by Luke Hoffman that could be written for VFF runners:
According to current theory in the sports science literature (as of 1997), skeletal muscle cramps during exercise probably happen when muscles that are shortened (for example, a calf muscle when your toe is pointed) are repeatedly stimulated. This can happen if your foot is extended, toe pointed, and you keep extending it further. You can actively do this by, for example, running on your toes or doing lots of toe-raises without going down to extend the muscle. What appears to happen is that the muscle gets fatigued, and it doesn't relax well. There is a reflex arc -- made up of the muscle, the nerves carrying signals to the central nervous system (CNS) and the nerves carrying signals from the CNS back to the muscle -- that keeps carrying contraction signals from and to the muscle. This appears to lead to a sustained contraction in the muscle, also known as a cramp.
Stretching (in this case, grabbing your toe and stretching the calf) is about the only thing that breaks this reflex arc signal and stops the cramp when it comes to exercise-induced cases. But the muscle is still fatigued, and the cramp process is easy to re-trigger until the muscle rests for a while. The fatigue-cramp process seems to happen most often in muscles that cross two joints, such as the calf muscle (which crosses the knee and ankle), since the muscle is easy to shorten and continue contracting.
The above describes what might be called "voluntary contraction" - not quite the same as involuntary. If we take the above council about voluntary cramps to bear, however, what should be the case is once a cramp starts, we should stretch it out, and wait for the fatigue to pass from that contraction, and recover, and really stop doing what we were doing - running on the forefoot. Consequently, Pose & VFF runners who run on the forefoot should be cramping all the time. And if we believe work in barefoot running, this is rather how we're designed to run. So, hmm, maybe not.
None of these explanations therefore is complete it seems, to explain cramping we see in the calves that comes on unexpectedly, as lots of well fed, well hydrtated, well electolyted people who stretch still get cramps, and these weird cramps in VFF's in particular.
So why does this cramp only happen *some* of the time - especially if all the typical niceities of cramp avoidance are observed? For me, for instance, it happened first when i started practicing actually bringing the heel of the foot down more (extending the calf) when running, rather than staying up on the forefoot. So, maybe it's not (entirely) about the calves?
Altered Neuromuscular Control. In the research one of the explanations around cramp is: maybe the muscle is just not strong enough to do what is being asked of it, for the duration it's being asked to operate at this level - hence fatiguing - and it's that fatigue that is setting up EAMC: exercise-associated muscle cramping. This hypothesis, also known as "altered neuromuscular control" was first proposed in 1996, so that's how new this stuff is. A key part of this model is that the neuromuscular control issue is located in the SPINE, not at the site of the issue - the site is paying for what's going on at the source.
There is a growing body of evidence to suggest that the mechanism for muscle cramping has a neuromuscular basis. Firstly, as has been discussed, voluntary muscle contraction or stimulation of the motor nerve can reliably cause muscle cramping. Secondly, there is evidence from experimental work in human subjects that stimulation of the 1a afferents through electrical stimulation or using the tendon tap (activating the 1a afferents) can induce cramping. Thirdly, it has repeatedly been shown that the most effective treatment for cramping induced in this manner is muscle stretching.
[WHY stretching?] An increase in tension in the Golgi tendon organ during stretching, which will result in increased afferent reflex inhibitory input to the a-motor neuron, is a plausible mechanism to explain why stretching is an effective treatment of cramping. [see Bertolasi and Co., '93]
[...]
There are other possible mechanisms that could alter neuromuscular control at the spinal cord level, and therefore may contribute to the development of EAMC. The first of these is the possibility that muscle injury or muscle damage, resulting from fatiguing exercise, could cause a reflex ‘‘spasm’’, and thereby result in a sustained involuntary contraction. The second possibility is that increased or decreased signals from other peripheral receptors (such as chemically sensitive intramuscular afferents, pressure receptors or pain receptors) could elicit a response from the central nervous system that can alter neuromuscular control of the muscles. These other mechanisms have not been investigated in athletes with EAMC, but would be important to explore in the future.
So in the Pain as Signal to Change perspective, cramps are painful; they are a signal to change. The altered neuromuscular control model suggests, stretch it out and recover. Related work suggests, improve strength/stamina to reduce fatigue and reduce this muscle cramp response. Both have in common that fatigue is causing neural level loss of appropriate control. Wildly Hypothesising? What's going on when this particular response occurs well before one would think a muscle used to running for miles and miles starts to go all crampy?
In
work pionered by LeDoux in the nineties, he showed that the brain processes emotional responses like fear/threat without the conscious brain being involved. It happens fast, at a low level, without cognitive involvement and has immediate chemical consequences in the system (nice review of this and related work here by Ohman, 2005). In other words, perhaps there's some other *thing* happening in the sensory-motor exerperience that is saying "not good" and the result is this fatigue-like chemical messaging system that sets off early light cramp signals - that if ignored will just get louder until one is forced to change patterns. In Z-Health, Eric Cobb translates this fear response into the nervous system's job to perceive threat or no threat: if there's a perception of threat, the system starts to shut down (example in arthrokinetic reflex). What might be the threat ocuring in VFF ocaisional calve cramping? The system may be literally putting on the breaks to what it perceives as a threatening to it's well being practice.
It's easy to see that if the nervous system perceives that the task - going at a particular speed in a particular way - is causing part of the system to be over-taxed, it's going to respond to that as a threat or non-optimal situation, and if it takes pain to get change, well, whatever it takes.
Personal Experience. Taking a Z-Health approach to this experience, i think i've learned to become more alert to any pain signal my bod sends up in an athletic effort. So in this case, if and when these cramps begin, they usually start with a very mild "uh oh" twinge of "about to turn to rock if you don't respond."
There are two simple things that z-health suggests for rehabbing a movement with the cue of "never move into pain:"
- reduce the range of motion
- reduce the load
Guided by the Nose: run to pace inhalation. Another technique i've been using and coaching to help head off cramps and adapt to barefooting generally is to explore gaiting running speed with ability to stay breathing in through one's nose. If running at a clip where i have to mouth breath, i slow it down (i find if i hit that level, it's pretty hard to get it back to nose inhaling). This approach is just one way at least some of the time to practice running reps quality rather than overdriving the other parts of the system.
Deeper Tune Up: Starting from the Source
So we've seen one theory in the research is around muscular fatigue inducing EAMC; getting stronger in those areas where muscles cramped seemed to help. In one study. That's great. Another possibility - that can lead to faster fatigue - is if there's some kind of issue in one's movement that is causing perhaps other muscles to compensate for other weaknesses, and causing fatigue/pain/signaling in the calves faster that should happen for that group. So while a solution may be to do extra strength work, maybe a faster solution may actually be to look at one's movement as a whole.
In other words, the calves may be plenty strong IF everything else is firing up appropriately, but they may be being asked to super compenate for other stuff, that if those other movement issues were addressed, wouldn't cause the problem.
There's value therefore in (a) having a movement assessment and (b) practicing dynamic joint mobility and sensory-motor work to ensure great movement, and ability to maintain great, clean movement.
Summary: Avoiding Running Cramps in VFF's
Based on the latest research, EAMC cramps are about temporary loss of clear neuromuscular control. The best model so far to explain this effect is fatigue. A known way to work out a cramp is to lengthen the muscle. There may however be other approaches that just haven't been researched that also seem to work. The hypothesis here is that these approaches are dealing with neurological signaling, too, taking advantage of the sensory-motor system.
Some pragmatic responses therefore if cramp occurs are:
During a Run: Assuming one is not dehydrated, de-electrolyted, or have squirrels biting their calves while running,
- As soon as a cramp (pain) starts, change something - gait, speed, whatever; if that doesn't work, stop what you're doing.
- consider rather than (just) stretching, doing mobility/sensory-motor work.
And before That
Consider a movement assessment to check for what Gray Cook calls "weak links" so as not to build strength on top of dysfunction.
Let me know what works for you.
Citations
Schwellnus, M. (2008). Cause of Exercise Associated Muscle Cramps (EAMC) -- altered neuromuscular control, dehydration or electrolyte depletion? British Journal of Sports Medicine, 43 (6), 401-408 DOI: 10.1136/bjsm.2008.050401
OHMAN, A. (2005). The role of the amygdala in human fear: Automatic detection of threat Psychoneuroendocrinology, 30 (10), 953-958 DOI: 10.1016/j.psyneuen.2005.03.019
Bertolasi L, De Grandis D, Bongiovanni LG, Zanette GP, & Gasperini M (1993). The influence of muscular lengthening on cramps. Annals of neurology, 33 (2), 176-80 PMID: 8434879
Wagner, T. (2009). Strengthening and Neuromuscular Reeducation of the Gluteus Maximus in a Triathlete With Exercise-Associated Cramping of the Hamstrings Journal of Orthopaedic and Sports Physical Therapy DOI: 10.2519/jospt.2010.3110
Caplan N, Rogers R, Parr MK, & Hayes PR (2009). The effect of proprioceptive neuromuscular facilitation and static stretch training on running mechanics. Journal of strength and conditioning research / National Strength & Conditioning Association, 23 (4), 1175-80 PMID: 19528850
Schwellnus, M. (2004). Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping (EAMC) in distance runners British Journal of Sports Medicine, 38 (4), 488-492 DOI: 10.1136/bjsm.2003.007021
Schwellnus MP (2007). Muscle cramping in the marathon : aetiology and risk factors. Sports medicine (Auckland, N.Z.), 37 (4-5), 364-7 PMID: 17465609Related Sources
Schwellnus, M. (2008). Cause of Exercise Associated Muscle Cramps (EAMC) -- altered neuromuscular control, dehydration or electrolyte depletion? British Journal of Sports Medicine, 43 (6), 401-408 DOI: 10.1136/bjsm.2008.050401
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Tuesday, September 8, 2009
What is Z-Health b2d Article index: what is it, reviews and more
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The following index lists a suite of articles i've written about aspects of Z-Health.
I'd like to preface these articles with the following overview i gave in an interview with Chris Highcock from Conditioning Research Nov 09.
Chris asked "I have read a lot about Z Health over the last few years and it is often presented almost as a miracle panacea. I bought the basic Neural Warm Up Level 1 DVD and it just seemed to be a bunch of mobility drills. Must admit to a bit of cynicism. What am I missing?"
Here's the reply:
Some folks have told me, ok, enough where to i start? I don't need to read more. So
If you'd like to dive right in, don't want to read further, just want to get going, here are a few recommendations for getting into Z-health practice.
b2d R-phase DVD Overview. Includes coverage of what's in the R-Phase and Neural Warm Up 1 dvd's along with concepts in Z in genera.
I-Phase. The follow on package is i-phase/neural warm up 2 (level 2 package). This takes the drills learned in R-phase neutral stance (standing tall) and starts putting them into more challenging, loaded, and real life postures that can also be readily adapted for sport or life specific work. There are more vision drills included as well. Vision training is talked about in more detail in the S-phase overview.
b2d What's I-Phase and Why I-Phase?. I-Phase is the second stage of the Z-Health template. It's where you can get all sports specific with the application of the drills, and where it goes from postures in neutral stance to crazy pattern stuff.
When to move from R-phase to I-Phase: b2d guidance. It may be sooner than you think, and that's great!
Going Full Athlete
S-Phase: The Complete(r) Athlete: And for folks who are keen to take their vision, speed, coordination performance for life and for athletics further, there's S-Phase
S-Phase is the learn how to get super fast - which involves not only the body but the visual and balance systems as well. This is an awesome and inspiring DVD where concepts like bone rhythmn are letter ball catching are taught. As well as how to get up and GO from being on your back really fast.
Here's the b2d S-Phase, Complete Athlete Vol 1 DVD review.
Atheltes are strongly advised to have R/I under their belts before moving to the S-Phase drills.
Getting The Full Monty: R, I, S together.
If all this sounds like a profoundly good idea, z of course puts together all the above disks into a box set of dvd's and manuals.
Putting Z Together, one on one
R, I, S Workshop. If you already think z-health sounds intriguing, and you'd like to check out with some hands on
guidance, beyond the DVD's, and learn more about the neurological approaches, applications and self-assessments, then the Elite Performance Workshop is a great way to go. This is a 3 day workshop that goes through the core principles of R,I and S, with practical exploration of the drills associated in each along with how to tune proprioceptive, visual and vestibular performance (overview of workshop here)
The workshop is also a great way to see if you're thinking about certifying as a z-health coach, to get a flavour for the program. If you do decide you want to certify, the cool thing is, your registration for the workshop can be applied directly to those courses, so you're getting a kind of double value from the workshop to the cert.
Course Support -Prep More; Save More - The Essentials of Elite Performance DVD mini course
This 2010 dvd is perhaps the best way to get an overview of Z-Health. It provides all the drills and assessments from the Elite Performance Workshop, so there's immediate take-away value for practical use either personally or for working with clients AND the cost of the DVD in its entirety will be applied to the workshop if you register for a workshop within 30 days of purchasing the DVD.
The workshop provides hands on and discussion oportunities to check and tune your own performance, but the DVD gives you an ongoing reference to map after the course to the material covered, and before the course to prep up any questions, so you can get even more from the onsite experience. Of course you don't have to do the workshop, but my guess is you'll want to before you're finished the first disk. And like all z-health's material, it's 100% satisfaction guarenteed.
Certifications. Then there's the biggie: certification itself. If like me, you're seeing this, going "i just want to get certified," you get the level 1 package included in your registration. It's a 6-day course (can be done over 2 weekends)
b2d Review of R-Phase certification
Where science meets application for efficient, immeidately applicable performance enhancement.
Here's also a wee report about successes around pain with just the first z-health cert, R-phase: Moving Clients out of Pain: Z-Health R-Phase in Practice
Trainers/Assessments And finally, if you'd like to connect with a z-health trainer to tune your personal performance here's a list. Now like anyone in anything, all trainers are human beings: the same rules apply for finding a great z trainer as they do for finding anyone you'd choose to work with you.
REQUEST: let 'em know mc at b2d recommended you
General Movement Related Considerations:
The Z-Health 9S model of the Athlete
Related Posts
I'd like to preface these articles with the following overview i gave in an interview with Chris Highcock from Conditioning Research Nov 09.
Chris asked "I have read a lot about Z Health over the last few years and it is often presented almost as a miracle panacea. I bought the basic Neural Warm Up Level 1 DVD and it just seemed to be a bunch of mobility drills. Must admit to a bit of cynicism. What am I missing?" Here's the reply:
I can kinda see how one might get that impression of “incredible results” because of where Z-health is focused. The framing of z-health is to get as fundamental as we can with what happens inside of us. The nervous system/brain connection is at the leading edge of this understanding, so z-health asks how does the nervous system work? Knowing that how can we work with that?
In brief the nervous system works fundamentally as a governor of our survival, detecting threat or no threat, threat or no threat. As soon as there’s a detection of threat, the body starts a response process to enhance survival. That may be releasing stressor hormones for fight or flight, or starting up an inflammation process for healing, or simply shutting down full power to a muscle or setting up a pain cry so bad we have to go all foetal. The goal of z-health is therefore threat modulation.
Now as to those mobility drills, it turns out that there are some great ways to talk with the nervous system via movement. We’re designed to move. We have joints in our bodies for a reason. So by moving the joints actively we are sending loads of all clear/no threat signals to the nervous system. As we move joints, we are also sending a very rich map of where we are in space to give the body increased options about how it can respond to a threat: the more joints perceived as richly mobile, the more responses to avoid an incident. The internet is sort of like this process: if an email message can’t get through via one route because it’s busy, another one is used. More options are better.
To make this practical, let me take evil shoes as an example [i'll add in a link here to where i've written about this in more detail -mc] . A quarter of the joints in our bodies are in our feet. When we wear shoes their range of motion is reduced tremendously because many shoes have very thick and very rigid soles: they may only slightly bend at the ball of the foot, and not really twist easily. As a consequence, messages that would be coming to the brain about where our foot is in space at any given time goes down. There’s just not as many points of information firing back to the brain to say where every little joint is moving. Consequently there is less information the brain can use to keep us out of trouble if it senses we’re stumbling. If the only joints its getting rich signals from are the ankles as opposed to the tarsals, metatarsals, falanges, what’s it going to do? There was a study out this summer that said no kind of sneaker mitigated the incidence of foot injuries in the context of the army’s training [link about study added -mc].
No kidding: all these high tech sneakers do the same things: cut off our optimal signalling.
The foot is one common example of what happens at every joint in our body. One of the challenges for many people is moving the bones in their upper spine back and forth or side to side. This means the back that should move in segments acts like a unit that’s not functioning optimally, so some other body part that is takes up the slack. Eventually pain will result. RSI, carpal tunnel syndrome, tennis elbow are all examples more times than not of movement related compensations, joints that aren’t moving through their range of motion.
A lot of pain is movement based. Fix the movement, open up the signalling around the joints, give the body more of its options, and a way to map out where we are and what we’re doing in space, well being is enhanced.
So z-health can seem pretty miraculous in the context of someone who’s had say a lot of manual therapy for a back problem, or has had what feels like chronically tight hip flexors, and they do a simple drill with a z-health person and suddenly they feel ok; they can move again; pain’s gone. Our nervous system – some of the fibres – is sending signals at 300mph, and responds immediately and exactly to what we’re doing. So yes change can be that fast. When we do it for ourselves, we’re triggering off thousands more nervous systems signals than when someone manipulates us, so we also really amp up our body’s ability to learn and hold that new pattern [example video added below -mc].
Some of it seems like magic or voodoo – with prescriptions on which way to look etc. Is there a simple principle behind it all that you could summarise?
Now as for that r-phase dvd seeming like a lot of mobility drills, what you find when getting together with a coach (even though this is all in the manual, sometimes it helps to be shown), is the precision of the movements is important. It’s sort of one of the things that’s distinct about z-health. Hitting the target is a big part of getting the benefit of this signalling. Moving the joints at different speeds comes into this process, too. And finally, R-phase is the movement fundamentals. It’s designed for folks to go into i-phase as soon as possible. I-phase gets out of r-phases neutral stance and into a more template approached to movement where we practice the drills in loaded positions, for example, in a lunge with both feet at 45 degrees, and the head titled – a la catching a ball while running. Again the focus is on precision of these core movements translated to more challenging, realistic planes of action. It’s why I call i-phase where we “train for the sprain” – prepping the bod for weird positions by practicing that mobility.
Threat modulation.Diving Into Z-Health: where to start with what kit?
Once you get that we’re wired for survival and that everything in us is geared to survival – to perceiving and responding to threat, then the voodoo goes out and the “obvious” science comes in.
The eye position stuff, by the way, is related to the nervous system again with respect to our visual systems. We talk about joint mobility and awareness of where we are in space. That’s proprioception. And it’s third in our way of perceiving the world. First is visual, second is vestibular, third is proprioceptive. So by finding out by assessment if someone may have an issue with looking in a particular direction, and working with that, problems that seem intractable just treated with movement can suddenly open up. Z-Health really tries to respect how we’re designed. As an engineer, that’s appealing.
Some folks have told me, ok, enough where to i start? I don't need to read more. So
If you'd like to dive right in, don't want to read further, just want to get going, here are a few recommendations for getting into Z-health practice.
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| R-Phase package |
R-Phase. The best best way to start to explore z-health is the r-phase/neural warm up 1 kit (level 1 package). The r-phase suite is the fundamental drills for the whole body. The neural warm up is a sub set of these drills that can be done every day, quickly. They also include vision work.
b2d R-phase DVD Overview. Includes coverage of what's in the R-Phase and Neural Warm Up 1 dvd's along with concepts in Z in genera.
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| I-Phase Package |
b2d What's I-Phase and Why I-Phase?. I-Phase is the second stage of the Z-Health template. It's where you can get all sports specific with the application of the drills, and where it goes from postures in neutral stance to crazy pattern stuff.
When to move from R-phase to I-Phase: b2d guidance. It may be sooner than you think, and that's great!
Going Full Athlete
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| SPhase DVD Course |
S-Phase is the learn how to get super fast - which involves not only the body but the visual and balance systems as well. This is an awesome and inspiring DVD where concepts like bone rhythmn are letter ball catching are taught. As well as how to get up and GO from being on your back really fast.
Here's the b2d S-Phase, Complete Athlete Vol 1 DVD review.
Atheltes are strongly advised to have R/I under their belts before moving to the S-Phase drills.
Getting The Full Monty: R, I, S together.
If all this sounds like a profoundly good idea, z of course puts together all the above disks into a box set of dvd's and manuals.
Putting Z Together, one on one
R, I, S Workshop. If you already think z-health sounds intriguing, and you'd like to check out with some hands on
guidance, beyond the DVD's, and learn more about the neurological approaches, applications and self-assessments, then the Elite Performance Workshop is a great way to go. This is a 3 day workshop that goes through the core principles of R,I and S, with practical exploration of the drills associated in each along with how to tune proprioceptive, visual and vestibular performance (overview of workshop here)The workshop is also a great way to see if you're thinking about certifying as a z-health coach, to get a flavour for the program. If you do decide you want to certify, the cool thing is, your registration for the workshop can be applied directly to those courses, so you're getting a kind of double value from the workshop to the cert.
Course Support -Prep More; Save More - The Essentials of Elite Performance DVD mini course
This 2010 dvd is perhaps the best way to get an overview of Z-Health. It provides all the drills and assessments from the Elite Performance Workshop, so there's immediate take-away value for practical use either personally or for working with clients AND the cost of the DVD in its entirety will be applied to the workshop if you register for a workshop within 30 days of purchasing the DVD.The workshop provides hands on and discussion oportunities to check and tune your own performance, but the DVD gives you an ongoing reference to map after the course to the material covered, and before the course to prep up any questions, so you can get even more from the onsite experience. Of course you don't have to do the workshop, but my guess is you'll want to before you're finished the first disk. And like all z-health's material, it's 100% satisfaction guarenteed.
Certifications. Then there's the biggie: certification itself. If like me, you're seeing this, going "i just want to get certified," you get the level 1 package included in your registration. It's a 6-day course (can be done over 2 weekends)
b2d Review of R-Phase certification
Where science meets application for efficient, immeidately applicable performance enhancement.
Here's also a wee report about successes around pain with just the first z-health cert, R-phase: Moving Clients out of Pain: Z-Health R-Phase in Practice
Trainers/Assessments And finally, if you'd like to connect with a z-health trainer to tune your personal performance here's a list. Now like anyone in anything, all trainers are human beings: the same rules apply for finding a great z trainer as they do for finding anyone you'd choose to work with you.
REQUEST: let 'em know mc at b2d recommended you
if any of this information at begin2dig contributes to your deciding to do a z-health workshop or cert, or even get a disk or two, please let the z-health office know when you sign up or purchase stuff. Here's why: z-health has a great continuing education program: a trainer can re-attend any cert they've taken for free, forever.
Ongoing Ed: if anyone takes a course and credits a current trainer with that encouratement/recommendation, that trainer gets credits - virtual dollars - towards a future z-health course. That's gold. So thank you for your kind consideration. I think you can tell i think this stuff is pretty wicked. Let's do more together.And now, really, back to the articles.
General Movement Related Considerations:
- Move or Die: Movement as Optimal Path to Health - and by the way what is Dynamic Joint Mobility Work.
- Why not Train Through Pain?
- Chronic Back Pain - what it may be and solutions
- What's a Mobility/Movement Assessment and Why Have One?
- Relationship of Z to other Movement Practice - like T'ai Chi, etc
- Sensory Motor connection: training on the other side of the Weight Room for training
- Should i do this next set? Fatigue testing
- One less rep: it's ok NOT to finish a set.
- Hormones: middle managers of state change in the body.
- Some differences between Active and Passive/Manual Care for Performance
- Turkish Get Up as Partial Movement Screen?
- Turkish Get UP: Role of the High Hip Bridge - gray cook
- Arthrokinetic reflex (demo): joint action affects muscle performance
- " How Many Reps of this Mobility Drill Should I Do?" A key concept in Z-Health is the SAID principle: specific adaptation to imposed demand, and its relationship to learning stuff to become optimally, athletically efficient.
- Going Lighter to Go Heavier: Threat Modulation in Lifting (skills first then load )
- the four elements of movement efficiency - in the path to the perfect rep and the kb front squat revisisted.
- over at nopain2.geekfit: free your feet!
- guest article at birtdayshoes.com Vibram FiveFingers and Z-Health: Move and Feel Even Better (than VFF's alone)
- Range of Motion example - youth and GS
- Threatened into Hypertrophy: Get Huge or Die
- Eye Health: How Fast can you switch focus?
- Eye Position and Strength - how one supports the other
- Eye position to support rowing stroke.
- How get strong if PART of a muscle isn't On?
R-phase & DVD Overview. Includes coverage of what's in the R-Phase and Neural Warm Up 1 dvd's along with concepts in Z in general
- An R,I, and S Z-Health Workshop Preview. Occasionally Z-Health puts on a three day workshop that includes R,I,S Phases. Wow. So what's in 'em and why would you want them, and who would want them?
- What's I-Phase and Why I-Phase?. I-Phase is the second stage of the Z-Health template. It's where you can get all sports specific with the application of the drills, and where it goes from postures in neutral stance to crazy pattern stuff.
- When Switch Up from R-Phase to I-Phase (and how)?
- S-Phase, Complete Athlete Vol 1 DVD review
S-Phase is the learn how to get super fast - which involves not only the body but the visual and balance systems as well. This is an awesome and inspiring DVD where concepts like bone rhythmn are letter ball catching are taught. As well as how to get up and GO from being on your back really fast.
- What the Heck is Sustenance - an overview of the 9S:Sustenance certification
The Z-Health approach to nutrition, well being and why no single factor solution will solve the obesity epidemic
- Essentials of Elite Performance Workshop: Hands on Z-Health in 3day Intensive workshop. (Applications of this workshop to sports performance)
The Z-Health 9S model of the Athlete
Aside: if you'd like to train with me (mc)
or do a workshop with me i'd be delighted
or do a workshop with me i'd be delighted
INDIVIDUAL: Please see the "coaching with dr. m.c." page
WORKSHOPS: I also run workshops on kettlebells, z-health, and/or general performance tuning (you will get faster - even if like me, you've thought your were slow).
Here's a nice discussion by Jez Davis (unsolicited even) on the highlights of one such workshop with Rannoch Donald of Simple Strength. And another by Chris Highcock of Conditioning Research.
If you'd like to host such a workshop, please email. Let's make it happen.
Related Posts
- foot mobility rules: articles on the vibram five fingers experience
- applying z-health to strength practice: the perfect rep quest series.
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