Z-Health and the ABCs of Movement

“Make the impossible possible, the possible easy, the easy elegant…” – Moshe Feldenkrais, founder Feldenkrais method of somatic education

The Movement Alphabet

Watch someone walk, run, throw, swing, dance, sit down, shovel snow or pick up something off the ground–watch someone move in other words. Look closely. You’ll notice movement at very nearly each and every joint. From the toes to the ankles to the knees, hips, spine, shoulders, elbows, wrists, fingers and possibly the jaw you’ll likely see at least some degree of movement to the point that you may realize each and every joint plays a role in our larger movements.

If we think of these general movements as words, then movement at each individual joint is a letter of an alphabet. This alphabet is the very foundation of how we move. So the better our command and recognition of each letter, the smoother, the faster, the stronger our movement no matter what our event or activity.

Z-Health R-Phase: Learning the Alphabet

R-Phase is the foundation of Z-Health. The R stands for injury Rehabilitation, movement Restoration all via neural Re-education. We accomplish these goals in R-Phase by establishing (or re-establishing) a connection between the brain and all of our joints. Why? Because the majority of chronic pain issues are movement problems. (i.e. “It hurts when I reach over head/climb stairs/turn my head…” In other words pain is involved in movement.) It’s the disconnection of these components that often result in poor movement and thus pain. Or to use the alphabet/word analogy, it’s like we’re trying to spell a word but we don’t have all the letters we need, so our words are no good. Our alphabet is complete once we have precise perception and control at every speed of every joint in the body.

Master the Foundations to Become Excellent

Many top athletes are known for their dedication to practice. Michael Jordan was known to show up before practice and games to shoot free throws. No noise. No opponent. No distractions. Just him a ball and a basket. And he worked on mastering the very basic element of his sport, over and over and over… Kobe Bryant is said to have similar habits. Michael Irvin of the Dallas Cowboys was known for being the first on the practice field and the last to come off. Further, a little known fact about boxing champ “Sugar” Ray Leonard was that he used to practice his punches and footwork in super-slow motion so he could perfect his technique. In a recent New York Times article, former diving-champ-turned-coach Greg Louganis “insists his divers show proficiency in one fundamental before moving on to the next.” The article goes on to say:

“As a competitor, Louganis’s mechanics were so sound that China’s national coaches in the 1980s pored over film of his dives and tailored their programs to match his technical precision. Perhaps not surprisingly, the Chinese have dominated diving much as Louganis did.”

Do you see a trend here?

The best in the world are intensely dedicated to mastering the simplest details of their sport. Whether they know it or not, they are working toward Moshe Feldenkrais’ ideal to, “Make the impossible possible, the possible easy, the easy elegant…” It’s not some in-born “talent” that we see in the masters of sports, music, etc. It’s the deeply ingrained understanding and perception of the basics that allow the great ones to become great. And the good news from all of this is that anyone–anyone–can move closer to fast, nimble, pain-free movement if we dedicate ourselves to perfecting the basics of movement.

I Need More Rest & Recovery

Sometimes I tell my clients, “I make all the dumb mistakes so you don’t have to.” Well, I continue to make less-than-intelligent decisions from time to time when it comes to exercise. I’ve been working out very hard for several weeks and I seem to have overstepped my boundaries. I’ve got some aches and pains that are proving difficult to resolve. Therefore it’s time to dial back my efforts, prioritize rest, and let all my various tissues and functions restore themselves.

I want to deadlift 500 lbs. That’s my big goal this year. In order to hit this goal I must put in very hard work. Hard workouts must be balanced by adequate rest–but not total rest. I’ve been lifting three days per week with the idea that I’m doing one heavy workout, followed by a light workout 48 hours later, then a medium workout again 48 hours after that. Then it’s two days off lifting and I start it all over. As important as it is to lift hard on the hard day, it’s equally (maybe even more) important to ease up on the other days, especially the light day. So while I’ve definitely been hitting the hard days, I believe I have fallen short of my goal of lifting light.

So here’s my strategy. I’ve based the next few weeks on a variation of the Texas Method as discussed in Practical Programming for Strength Training, the brilliant book by Rippetoe and Killgore. This calls for a Monday/Wednesday/Friday type of pattern with a medium workout on Monday, a light workout on Wednesday and and the heavy workout on Friday. Here’s my plan:

Monday: Medium Day

Back squat: 3 x 8 reps
Pushups: 3 x to exertion (10-25) but not exhaustion; alternated each workout with
chin-ups: 3 x 5 (I may play around with band chin-ups to get more reps; I’m not terribly strong on the pull/chin-ups and my forearm is banged up.)
Back extension: 3 x 8-10 reps
I must stay far away from anything that feels like exhaustion or muscular failure.
I’ll likely add back bench press and/or overhead presses once my wrists and shoulders feel better.

Wednesday: Light Day

Turkish Get-Ups: 1×5 reps each arm–AND THAT’S IT!

Friday: Heavy Day

Deadlift: work up to 1 x 2 reps near goal max
Speed deadlift: 3 x 3 around 70% of goal max alternated each workout with kettlebell swings
Romanian Deadlift: 3 x 5 reps
chin-ups: 3 x 5 alternated each workout with
pushups: 3 x to exertion (10-25 reps)

The key to all this is paying attention to how I test during each workout after every exercise. I’ll be assessing and re-assessing my range of motion frequently (most likely with a standing toe-touch type of assessment), and I’ll be performing Z-Health joint mobility drills often. If I tighten up at all or if I feel any pain then I MUST stop and call it a day. This is of course counter-instinctive to me but I know I’ll feel better if I do. The ultimate goal is 500 lbs. on that deadlift and I won’t get there if I’m beat up.

“I guess the main thing to note is that, as biomechanists, we really do not know how orthotics work.”
– Dr. Joseph Hamill, University of Massachusetts professor of kinesiology

Orthotics. Some people swear by them. Some people swear at them. (That would be me.) Some of them cost a few bucks at the grocery store. Others cost several hundred dollars and must be fitted at a podiatrist, physical therapist or chiropractor. So what about them? Do we need them or not? (And if they are important for our health, how did the Egyptians, the Romans, Gengis Kahn, the Vikings, etc. ever manage march across the earth and conquer everything in site without them?)

All runners and other fitness enthusiasts–anyone who wears shoes really–must read the latest dispatch from the New York Times Personal Best section titled Close Look at Orthotics Raises a Welter of Doubt. It’s a fascinating discussion on how and why orthotics may or may not work. As the quote above indicates, no one really seems to know what these things actually do for the feet. There are several important points in the article.

Analysis of Orthotics

Dr. Benno Nigg, professor of biomechanics and co-director of the Human Performance Lab at the University of Calgary in Alberta has made a career of researching orthotics. He makes a point that I’ve observed in my own experience with orthotics, namely that they tend to work in the short-term. However he says that idea that they are supposed to correct mechanical-alignment problems does not hold up.

Further Dr. Nigg says, “If you do something to a shoe, different people will react differently.” Different feet react differently: One person might respond by increasing the stress on the outside of the foot, another on the inside. Another might not respond at all, unconsciously correcting the orthotic’s correction.

The article discusses something I’ve heard discussed among those who make orthotics. That is, there are different ways to make orthotics. Depending on where you go, you’ll likely get a different device. Dr. Nigg conducted a study in which a runner went to several different orthotics makers and each one made him a distinctly different orthotic to “correct” his pronation. He liked two of them–yet they each were made differently. More research by Dr. Nigg yielded the following:

“They (orthotics) turn out to have little effect on kinematics — the actual movement of the skeleton during a run. But they can have large effects on muscles and joints, often making muscles work as much as 50 percent harder for the same movement and increasing stress on joints by a similar amount.”

“As for ‘corrective’ orthotics,” Dr. Nigg says, “they do not correct so much as lead to a reduction in muscle strength.”

Support for Orthotics

Several seemingly well-educated people voiced support for the use of orthotics. Jeffrey P. Wensman, director of clinical and technical services at the Orthotics and Prosthetics Center at the University of Michigan makes a sound argument when he says the key measure of success is his patients feel better in orthotics.

(On that note, I think it’s wise that if you’re in an orthotic and feeling good, running fast and all is well, then don’t change anything.)

Seamus Kennedy, president and co-owner of Hersco Ortho Labs in New York says there are hundreds of papers and studies showing that orthotics can treat common foot ailments.

So maybe there’s a lot of solid evidence in favor of orthotics right? Well… The article states:

“In one recent review of published papers, Dr. Nigg and his colleagues analyzed studies on orthotics and injury prevention. Nearly all published studies, they report, lacked scientific rigor.”

Maybe the lesson is to be skeptical of orthotics makers who show you evidence of the benefits of orthotics.

What About Flat Feet?

The article goes on to profile someone who has flat feet and his quest to “correct” this issue. Every orthotics provider he went to attributed his injury to his previous poorly made orthotics and goes on to provide him with different orthotics.

(The article mentions this fellow has an “injury” though there’s no mention of what this injury is. I’m not sure if we’re to take his flat feet as an injury.)

Dr. Nigg explains that flat feet shouldn’t be any problem. Our arches are an evolutionary leftover of when we used to grip trees with our feet. This is interesting to me because I recall reading elsewhere a study of third-world populations that never wear any sort of supportive shoes. Their feet tend to be flat yet there are far fewer numbers of the type of musculoskeletal injuries we have in the U.S. So maybe these all important arches aren’t all that important?

My view on all this is that orthotics are of limited use and the science behind them is quite murky. I’ve used several different types of orthotics and I’ve had either no results or I’ve experienced increased discomfort. I think they are far from an essential component for human health and performance. That said, on an individual basis, an orthotic may be very helpful.

http://successfulhealthcoach.com/wp-content/uploads//2010/12/elbow_oa_treatment01.jpg

YEEEOUCH! Don't do that!

Guy Edwards is a British health and fitness professional and fellow Z-Health practitioner. I recently wrote a post on cortisone injections for his blog Successful Health Coach. If you’re thinking of getting a cortisone shot (or another cortisone shot) please read this piece. A boatload of research is out there indicating that while cortisone provides dramatic relief from pain, it actually slows down the healing process. It’s definitely a case of robbing Peter to pay Paul. Thanks to Guy for letting me post.

Here are a few of the points on the scale that are used to determine if you have a food addiction. Does any of this sound familiar? If it does, you may be an “industrial food addict.”

Food Addiction

We’ve got several interesting fitness-related things in the news recently. First, from the Huffington Post comes Food Addiction: Could it Explain Why 79 Percent of Americans Are Obese? Here the food industry and its products are compared to the tobacco industry and their products. Turns out our junk food is skillfully crafted and manipulated by the food industry to make it highly palatable possibly to the point of being addictive. Key to the discussion is the following information from the article:

Researchers from Yale’s Rudd Center for Food Policy and Obesity validated a “food addiction” scale.(i) Here are a few of the points on the scale that are used to determine if you have a food addiction. Does any of this sound familiar? If it does, you may be an “industrial food addict.”

I find that when I start eating certain foods, I end up eating much more than I had planned. Not eating certain types of food or cutting down on certain types of food is something I worry about.

I spend a lot of time feeling sluggish or lethargic from overeating.
There have been times when I consumed certain foods so often or in such large quantities that I spent time dealing with negative feelings from overeating instead of working, spending time with my family or friends, or engaging in other important activities or recreational activities that I enjoy.
I kept consuming the same types of food or the same amount of food even though I was having emotional and/or physical problems.
Over time, I have found that I need to eat more and more to get the feeling I want, such as reduced negative emotions or increased pleasure.
I have had withdrawal symptoms when I cut down or stopped eating certain foods, including physical symptoms, agitation, or anxiety. (Please do not include withdrawal symptoms caused by cutting down on caffeinated beverages such as soda pop, coffee, tea, energy drinks, etc.)
My behavior with respect to food and eating causes significant distress.
I experience significant problems in my ability to function effectively (daily routine, job/school, social activities, family activities, health difficulties) because of food and eating.

Based on these criteria and others, many of us, including most obese children, are “addicted” to industrial food.

Here are some of the scientific findings confirming that food can, indeed, be addictive(ii):

Sugar stimulates the brain’s reward centers through the neurotransmitter dopamine, exactly like other addictive drugs.
Brain imagining (PET scans) shows that high-sugar and high-fat foods work just like heroin, opium, or morphine in the brain.(iii)Brain imaging (PET scans) shows that obese people and drug addicts have lower numbers of dopamine receptors, making them more likely to crave things that boost dopamine.
Foods high in fat and sweets stimulate the release of the body’s own opioids (chemicals like morphine) in the brain.
Drugs we use to block the brain’s receptors for heroin and morphine (naltrexone) also reduce the consumption and preference for sweet, high-fat foods in both normal weight and obese binge eaters.
People (and rats) develop a tolerance to sugar — they need more and more of the substance to satisfy themselves — just like they do for drugs of abuse like alcohol or heroin.
Obese individuals continue to eat large amounts of unhealthy foods despite severe social and personal negative consequences, just like addicts or alcoholics.
Animals and humans experience “withdrawal” when suddenly cut off from sugar, just like addicts detoxifying from drugs.
Just like drugs, after an initial period of “enjoyment” of the food, the user no longer consumes them to get high but to feel normal.

Exercise & the Common Cold

“The most powerful weapon someone has during cold season “is to go out on a near-daily basis, and put in at least a 30-minute brisk walk.”
– Dr. David Nieman, director of the Human Performance Laboratory at Appalachian State University in North Carolina,

It’s always nice to see research that backs up something that we think is true. In this case, researchers at Appalachian St. University have evidence that exercise is possibly the best way to avoid colds. Read more in Regular Workouts Ward Off the Common Cold from MSNBC. The results of this study are in line with other studies discussed in the article.

There are all sorts of products out there such as Airborne, echinacea and zinc losenges that claim to shorten or prevent colds. The evidence on that stuff is spotty. The evidence on exercise and its preventative powers is far more solid. Exercise!

Rocker Shoes

An article from MSNBC, Do those funky shoes really promote fitness? discusses rocker or toning shoes, the increasingly popular shoes with a curved bottom. The claim by these shoe manufactures (Sketchers, Reebok, MBT) is that wearers will burn more calories when they walk around in these things.

A study by the American Council on Exercise suggests that these shoes do nothing of the sort. (Hard to believe? A magic shoe actually doesn’t lead to weight loss??) Participants walked all of five minutes on a treadmill while researchers monitored their heart rate, oxygen consumption and muscle usage (abdominals, butt, quadriceps, hamstrings and calves). (I don’t know that five minutes is an adequate amount of time in these things. Seems like participants should be monitored over the course of days or weeks). The article goes on to discuss the possible injurious effects of wearing these weird shoes as well as a a lawsuit brought by a woman who didn’t lose any weight wearing them. On the topic of the biomechanics and rocker shoes, this article by Denver-area chiropractor and gait specialist Dr. Ivo Waerlop, goes into deep detail as to why these shoes are a bad idea.

I see these shoes as the latest fitness fad pushed on people who are hoping and praying for a fitness magic bullet. (I love the fact that people are looking at their shoes and thinking about their calories! How about looking at your food???) This type of thing comes up frequently and the results of such stuff rarely lives up to the hype. I’ll be interested to see what happens to medium- and long-term wearers of these shoes. I think they’ll a) be disappointed in the weight they don’t lose and, b) possibly beset by chronic pain. If nothing else, they’ll be embarrassed that they ever put on those big clunky Frankenstein clodhoppers.

Trainer? Therapist? What Do We Call Ourselves & What’s Our Role? Part II

Post Therapy

What comes after physical therapy? By various standards and regulations, personal trainers can’t claim to offer injury rehabilitation. That’s for physical therapists. Physical therapists are licensed by states where as the term “personal trainer” is very loosely regulated. But what happens when someone is finished with physical therapy?

Simply finishing physical therapy may not mean someone is ready to return to sport or vigorous exercise. As I discussed in this post, the damaged structure may be repaired, but the nervous system may still be on guard. Thus pain and tightness may persist in someone who has been technically cleared to exercise. He or she still needs the proper guidance in their return to physical activity. Are personal trainers prepared to handle this challenge?

“Personal trainer” has a negative connotation in some circles. According to some, trainers are undereducated, sloppy, and use unsafe methods to get clients in shape. From what I’ve seen, this opinion is often spot on. Many trainers are totally unequipped to work with anyone with movement dysfunction and/or pain. Most trainers are still caught up in machine weight training, bicep curls and simply making their clients work harder and not smarter.

What’s Needed

Seems like we need some other grade of exercise professional. We should have higher standards than the typical personal trainer. We should be in conversation with physical therapists, surgeons, chiropractors–even mental health professionals. The education requirements must be higher than what we see with the typical trainer certification. For good or ill, some sort of state licensure may be necessary if for no other reason to convey to our clients that we’ve reached a certain status.

The bottom line is a sizable portion of our population and potential clientele need help overcoming pain and poor movement. Many of these folks have gone through physical therapy, chiropractic treatment, acupuncture–all sorts of treatment and they may still be looking for pain relief. (The frustrating thing is, in my experience a good number of these therapists are also unprepared to address the cause of pain and dysfunction. Again, this is just my experience but in my quest to address my own pain, most of them never recognized that the site of my pain was not where my problems were rooted.) These people aren’t ready for the typical commercial “kick your butt” sort of workout. There is a clear opportunity here if we’re willing to step into the role of…. what? I’m calling myself a Movement Re-education Specialist.

Trainer? Therapist? What Do We Call Ourselves & What’s Our Role? Part I

A recent article in the Wall St. Journal titled Getting Fit Without the Pain got me thinking about a few things. What, for instance does it mean to be a “personal trainer?” How is that job viewed by the public and medical professionals like surgeons and physical therapists? Should some of us take on a different title? Further, do our experiences in the fitness setting match our job definition?

Physical therapists are charged with rehabilitating injuries and post-surgical patients. By various standards and regulations, personal trainers can’t claim to offer injury rehabilitation. Personal trainers help people exercise and get “in shape.” Personal trainers, by most definitions, are allowed only to work with people who are injury-free and completely healthy.

The Journal article states, “… fitness trainers shouldn’t attempt to treat, and certainly shouldn’t ignore, sports injuries, says Diane Buchta, spokeswoman for IDEA, a trainer organization. ‘We must refer those clients to a physician,’ she adds.

Injured vs. 100% Healthy

I’ll tell you as a practicing personal trainer/fitness professional/movement specialist–whatever my title is–that there is a significant gap or gray area between physical therapists and personal trainers. I don’t think I’ve met a gym goer over the age of 25 (including myself) who doesn’t have some sort of strange ache or pain. The vast majority of these people don’t quite fall into the “injured” category. They’re still active and their pain isn’t so severe that they’re prevented from coming to the gym and exercising. I think most personal trainers have similar clientele. If we were to turn away these folks we’d have no business whatsoever.

Still other clients I’ve worked with have pain that has proven resistant to physical therapy, chiropractic, acupuncture, drugs… X-Rays, MRIs, neurological exams and blood work may all be normal. These folks assumed they were injured and sought what we might call the appropriate care–but they’re still hurting. Are these people injured? It’s difficult to say. Again I think I’m seeing a gray area, this time between “injured” and “healthy.” Maybe we need to consider the issue of pain vs. injury.

Injury, Re-injury & the Brain

Many of us have experienced recurring injuries. From Achilles tendon pain, low-back pain and whatever else-type of pain, we often feel great only to have the maddening issue return–often for no clear reason. Anyone who’s experienced this pattern knows how crushingly disheartening it can be when after a layoff, you feel good and with great joy you’re able to return to your chosen activity… only to fall back into the same injury pattern as before. It’s more than just physical pain. It’s a highly emotional and psychologically challenging obstacle to overcome.

To this point, the Peak Performance newsletter features an excellent article called Once Injured, Twice Fearful. (Peak Performance is an great resource. You can register for free and access many well-researched and well-written fitness and performance-related articles. For a fee you can access more of Peak Performance.) The main issue is how our brain is affected by an injury. We may reach a point where our tissues are healed yet mentally we aren’t yet prepared to return to our sport.

Most interesting to me is the discussion on the pain neuromatrix. What is the pain neuromatrix? Well, there is no easy answer. This is a theoretical construct that sort of consists of our perception of a threat and whether or not the brain decides that the threat is sufficient to create pain. For instance, we sprain an ankle. The damaged ankle is literally a potential threat to our survival (Not so much in 2010 but for most of human existence a sprained ankle may indeed have led to our starvation or death from the elements or predators.) The nerves in the ankle send a status update to the brain, the brain then interprets this information as damage and thus gives us pain. Why? Pain gets our attention. Pain will cause us to alter our activity so that we don’t further damage that ankle, thus we should survive longer. (In contrast, if we sprain an ankle while we’re running away from an erupting volcano, the brain may say “That volcano is a far bigger threat, so no pain for you–KEEP RUNNING!!!“) This is a fairly complex thing. Here’s a brief explanation. For further information, read Ronald Melzak’s paper on the topic.

Once injured, our brain pays particularly close attention to the damaged area. The neuromatrix keeps close watch so that we don’t re-injure ourselves. If all goes well, the tissue heals, we start moving normally and pain free, the neuromatrix senses no threat and the pain is gone. However, this close scrutiny by the neuromatrix may sort of get stuck in the “on” position. The tissue may heal but the athlete may still feel pain and anxiety at the prospect of re-injury. This often results in poor performance because the brain is focused on monitoring the area of injury and thus can’t devote full attention to sport skills.

So what’s the solution? First, simply explaining this psychological model to the athlete can be quite helpful in calming anxiety. His or her knowing that pain doesn’t necessarily equal injury can be very reassuring.

Next, we must modulate the threat as it’s perceived by the neuromatrix. If for instance a soccer player sustained a major injury on the field, simply returning to the field in soccer cleats may be perceived as a threat and pain and/or anxiety may be the result. Certainly then running, cutting, dribbling, etc.–playing soccer in other words–may be a huge threat.

(A more overt example of this type of situation can be seen in war vets suffering from post-traumatic stress disorder. Though the person may be safe and the actual threat long gone, any number of minor events may trigger extreme reactions such as panic attacks or violent behavior. The sound of a book dropped on the floor or trash bag in a yard may cause the sufferer to react in a way that’s vastly inappropriate relative to the actual threat posed by the event or object.)

The player must be gradually re-introduced to the movements and environment of soccer. Brief, easy jogging on the field; simple ball handling drills, and slow- to moderate-speed agility drills may be introduced as a way to ease the player back into the sport. Variables may be added as the player feels more confident. Speed, duration and predictability of drills may be adjusted. Opponents may be introduced. Playing surfaces may be changed.

A key part of this process is movement reeducation. An injury doesn’t only include tissue damage. The connection between the brain and the injured region (let’s say it’s the ankle) is also disrupted. Such a disruption means the ankle tissue may heal but control of the ankle may remain deficient. This sort of thing may cause pain–but it may not be ankle pain! A poorly moving ankle may cause pain at the knee, hip, back, anywhere along the spine, shoulder, even the jaw. Such is the nature of this highly interconnected system we live in called the body.

The Z-Health system has by far helped me more than anything in addressing my own pain as well as my clients’ pain. R-Phase is the introduction to Z-Health. With R-Phase we start to relearn the ABCs of movement. We reestablish control over every joint in the body: feet, ankles, knees, hips, spine, shoulders, elbows, wrists, hands, fingers, jaws and even the eyes. Through methodical, mindful movements we can very effectively reduce pain and increase performance very quickly. Here we recreate and reinforce the foundation for all our more complex movements such as running, stair climbing, shooting baskets, swinging a golf club, etc. We can then safely reintroduce our favorite sporting movements and activities. It’s a very powerful and exciting system.

More News & Questions on Stretching

Stretching–and whether or not to do it–is one of the most debated issues in health and fitness. What’s the final verdict? (I’ve given my opinions a few times already here, here, and here.) Does Stretching Before Running Prevent Injuries comes from the New York Times and it’s the latest comment on the issue. The article discusses a study from USA Track & Field that involved about 3000 runners over the course of three months. These subjects were split into two groups: one group followed a pre-run stretching routine, the other group did not stretch. (From the description, the stretching group engaged in static isolated stretching, or what many of us would recognize as stretching: bend over and stretch the hamstrings for 20-30 seconds for example.) Both groups followed the same running program. The result? Both groups experienced the same injury rate. Thus, pre-run static stretching does not appear to help guard against injuries. There is an exception though.

The study states:

“If runners who normally stretch prior to running were assigned to stretch, they had a low risk of injury but if they were assigned not to stretch, the injury risk was double those who kept stretching. It’s this result that most startlingly exhibits why people consider stretching to prevent injury. This study shows that those who are comfortable with their pre-run stretching routine should maintain it. They risk injury if they discontinue their pre-run stretching. For runners comfortable without pre-run stretching, they don’t necessarily improve their injury protection by starting a pre-run stretching routine.”

As I see it, the broad point to take from this observation is that any changes to your program should be undertaken slowly. That goes for adding speed work, hill work, more mileage or engaging in barefoot running. Sudden dramatic changes may leave you sidelined.

Chronic Pain & Z-Health

I find chronic pain to be a tremendously fascinating topic. It’s all around us and it’s mysterious. Even though it’s 2010 and we’re the beneficiaries of thousands of years of medical advances, we still have trouble fixing various lingering aches and pains.

Reconceptualizing Pain According to Modern Pain Science comes from the wise Australians at Body in Mind. Much of the world’s population is wracked with chronic pain. It seems anyone near the age of 30 has at least a little bit of mysterious lingering pain. Many a neck, shoulder, knee and/or low back has been treated over and over again yet the pain stays. Why? Further, chronic pain is typically very different from acute pain. There’s no blood, perhaps no swelling, and the pain often comes on gradually and for no apparent reason. Chronic pain is very different from the pain of a sprained ankle or dislocated shoulder. So what are we dealing with? The article makes four key points:

Pain does not provide a measure of the state of the tissues. (i.e. Pain doesn’t necessarily = injury.)
Pain is modulated by many factors from across somatic, psychological and social domains.
The relationship between pain and the state of the tissues becomes less predictable as pain persists.
Pain can be conceptualized as a conscious correlate of the implicit perception that tissue is in danger. (The PERCEPTION of a threat may generate more pain than the actual threat itself.)

Many Z-Health methods are based on these factors. We recognize that pain may be rooted in any number of sources including emotions and stress. We also recognize that the nervous system is in charge of pain, and that the site of the pain is often not the site of the problem. We may be wasting our time if we spend time at or around the painful area.

For example, Z-Health practitioners may make use of opposing joint motion to address pain. If someone has left knee pain then we might go to the right elbow and ask the client to perform elbow circles. To take it a step further, we may ask the client in what position does he or she experience pain? Does the left knee hurt when the hip is extended (leg behind the torso) or flexed (leg in front of the torso)? If the left knee hurts in hip flexion then we may put the client’s right arm into extension (arm behind the torso) and then call for elbow circles. Many times I’ve seen a client’s pain reduce in moments as a result of these types of drills.

I’ve seen big-toe pain reduced through opposite thumb mobility. I’ve seen shoulder pain reduced through opposite hip mobility. Low-back pain may be eliminated through neck mobility drills. (This stuff is wild!)

Further, if either our visual or vestibular reflexes are faulty then the result may be joint pain. The nervous system is sending a message: Change something. Our eyes and inner-ear structures are the seats of very powerful forces. If these two mechanisms aren’t working together then the nervous system will perceive a threat. The nervous system can use pain to alert us to that threat. Addressing the visual and vestibular systems is vital if we’re combating chronic pain.

None of this obviates the need for other diagnostics. MRIs and X-Rays may indeed show structural problems contributing to pain. Various drugs may cause pain in some regions of the body. Some cholesterol meds may cause low-back and leg pain for instance. The main point here though is that pain is often a very complex issue, the causes of which may not be obvious. You can have power over your pain if you recognize how it works.

Please go to the link above and read the article to learn more about how chronic pain works. For further reading on Z-Health, Todd Hargrove’s Better Movement is an excellent source.

Denver Fitness Journal

All Things Health and Fitness by Kyle Norman, MS, CSCS, FMS, RRCA Running Coach

Injury Rehabilitation