Chronic Pain Lecture at Cherry Creek Athletic Club, Denver

For anyone who’s interested in learning more about chronic pain and how to use the Z-Health Performance System to start overcoming chronic pain, I’m giving two lectures next week at the Cherry Creek Athletic Club in Denver. Both members and non-members are welcome. The lecture is free. Dates and times are:

5:45 pm, Tuesday, December 6th
9:30 am, Thursday, December 8th

This is an interactive lecture so you will be moving around. It’s not a full-on workout by any means but please wear clothing that will allow you to move comfortably.

For more information call the Cherry Creek Club at 303-399-3050 or you may email me at DenverFitnessJournal@Gmail.com.

Z-Health S-Phase: Athletic Vision Skills

Last weekend I finished the third of four basic courses (R, I, S, T) that make up Z-Health. S-Phase (Sport, Skill, Strategy Phase) deals with two things: vision training and sport specific mobility. There was a lot of learning but there was also a lot of real fun. We spent a good bit of time out on a grass ball field working on all sorts of sport movements from sprints to catching to changing direction and accelerating. This is a breakdown of the athletic visual skill portion of S-Phase.

The Power of Vision

I think it’s probably obvious to you that vision is important. Very important. As humans it’s our most valuable sense. (If we were dogs, we’d be talking about our noses. If we were bats, it would be our hearing that’s the big topic.) The loss of any of our other senses (hearing, taste, touch, smell) would make life quite difficult but loss of vision would likely make life nearly impossible for most of us. (This is taking nothing away from blind people who are able to live a full, rich life. My point is to say that we rely on vision more than the other senses.)

Thus, our visual skills impact every part of us. We know if we have a bad prescription for lenses then we can experience pain often in the form of headaches. Similarly, visual impairment may throw off our balance or make us nauseous. We may be scared or extremely cautious of driving or walking stairs if our eyes don’t function correctly. In the other direction, we can enhance our balance, mobility, speed and strength if we enhance our visual skills.

Visual Skills

When I speak of vision skills, I’m not really talking about eyesight. Eyesight is what your optometrist measures in his or her office. That’s simple stuff. You’re seated. They eye chart isn’t moving at all and neither your balance nor any type of coordination is tested along with your vision. In other words, there’s very little real-world stress or stimulation that’s used in an eyesight test. When we discuss vision skills, we’re talking about a skill set made up of the abilities:

Dynamic visual acuity: This skill allows you to see objects clearly while either they or you are in motion. In very nearly every sport (and in non-sport activities such as driving) we must have exceptionally good vision anywhere from a few inches out to 300 feet.
Eye tracking: This refers to your ability to move your eyes and track an object in motion. It pertains to “keeping your eye on the ball.”
Focusing/Accomodation: This is the ability to change focus quickly and accurately from near to far and back again.
Peripheral vision: This skill is well described by the phrase, “how well you can see what you’re not looking at.” These are the things you should be able to see “out of the corner of your eye.”
Vergence flexiblity and stamina: This is the skill to keep both eyes working together in unison under high speed, physically stresfful situations and differing environments.
Depth perception: This skill allows you to quickly and accurately judge the distance and speed of objects moving towards and away from you.
Imagery: This is the ability to picture events with your “mind’s eye.”
Sequencing: This refers to the skill to correctly see and put together a series of movements in order. It’s sort of a Simon-says type of thing. We see this particularly when learning sports movements: “First do this, then do that, then do this….”
Eye-hand & Food-hand coordination: These interactions are the ultimate basis of athletic skill. Here we use our ability to take in visual information and translate it into the necessary body movements. (It’s also how we live a big part of our non-athletic lives.)

If any of these skills are deficient, then we won’t perform as well as we should be able, whether it’s on the playing field or in every day life. Conversely, if we spend a little time training these skills, then we can expect progress in any number of areas from sport skill to pain reduction. Most recently I’ve been using some visual drills to help a client overcome hip pain. It’s quite interesting stuff.

The S-Phase course taught us tests and exercises to evaluate these visual skills. The video below is an example of one of the drills we learned. It’s called the Pencil Pushup.

For further information on what’s behind visual skills, how to assess them and how to improve your visual skills, the Z-Health site offers an article titled, The Eyes Have It. Another article, Reflexive Lifting, discusses ways to modify your eye position and posture in order to increase your performance in the deadlift and the kettlebell swing.

Finally, this video illustrates (among other things) the role of the eyes in the chin-up. Watch the whole video to learn more about Z-Health in general. At about the eight minute mark Dr. Cobb demonstrates what happens when we change eye position during a chin-up. Try it out on your own and see what you discover.

My First Barefoot Excursion & What is Tightness?

1st Barefoot Run

Anyone who reads this blog knows I’m a fan of minimal footwear. I believe the best foot is a strong foot, not a foot that’s been made weak by modern “good shoes.” The foot has been a foot for a looooong time. Relative to the span of human existence, “good shoes” and orthotic-type devices are a very new trinkets. The ancient Egyptians, Greeks, Romans, Vikings, Gengis Khan’s Golden Horde, Comanches, Apaches, Aztecs, Zulus… and the vast majority of our fellow humans who’ve ever marched across the earth have done so while wearing nearly nothing on their feet. It wasn’t until the 1970s that we got the modern running shoe from Nike. In terms of research & development, one has a huge head start over the other. All kinds of new research suggests that “good shoes” may not be all that good for us at all.

While minimal shoes have gained in popularity so has barefoot running and I’ve pondered playing around with the concept. So I was quite interested when our local running store the Runner’s Roost advertised a barefoot/minimal shoe seminar. My wife and I attended the seminar last night and it was really fascinating. It got me all excited to start experimenting in a shoeless direction. Today was my first day out.

Of the four speakers, Michael Sandler of RunBare.com was the most interesting informative. (Among other issues, he’s missing the anterior cruciate ligament on one leg–the result of a roller blade crash. So for people who say running is bad for the knees, you might think again. He was also an orthotic addict and orthotic designer.) He suggested that newly barefoot runners must listen to their feet. The moment you feel a little bit of irritation, the run is over. Put on your shoes and come back to run barefoot another day. He suggested a first barefoot run of 200 meters. Then take a day off. Next run is 300 meters. Day off. Next run is 400 meters and so on. It is a very slow starting process this barefoot running.

So today I went for a walk with our dog. It was great weather: sun and 70-ish degress. I walked out barefoot but I had my shoes in a backpack. I ran down the sidewalk to the end of our block. My steps were very quick and light and everything felt fine. First run done and done. I walked another couple of blocks barefoot then put on the shoes. No barefooting tomorrow but I plan to hit it again on Friday. As I sit here writing this, my heel and Achilles pain is non-existent. Seems like a good start.

What is Tightness?

In a somewhat different direction, one of my favorite exercise geek blogs is Begin to Dig. It’s written by a fellow Z-Health practitioner, a woman named MC. (I actually don’t know her full name.) The latest post discusses the whys and hows of tight muscles and how to address them. Among other things, she describes why using a foam roller is probably not the best idea. If you want to learn a bit about the underlying cause(s) of tightness (first and foremost it’s all about your survival) then you should check it out. Beyond that, there’s a lot more informative stuff on her blog about getting strong, lean, fast and pain-free.

The Dangers of Sitting & How to Fight Back With Z-Health

I’m behind on the news here a little bit but a fascinating story appeared recently in the New York Times Magazine. Is Sitting a Lethal Activity discusses the idea that spending too much time sitting is harmful to our health. In fact the article suggests the following:

“Sitting, it would seem, is an independent pathology. Being sedentary for nine hours a day at the office is bad for your health whether you go home and watch television afterward or hit the gym. It is bad whether you are morbidly obese or marathon-runner thin. ‘Excessive sitting,’ Mayo Clinic researcher Dr. James Levine says, ‘is a lethal activity.'”

Okay, so this is no revelation to most of us. We know that moving is generally healthier than sitting. So if we exercise enough then we should be able to counteract the effects of sitting right? Not so fast. The Times article suggests that in fact we may not be able to exercise our way out of the risks of our seated lifestyle. The article states:

“A growing body of inactivity research, however, suggests that this advice makes scarcely more sense than the notion that you could counter a pack-a-day smoking habit by jogging. ‘Exercise is not a perfect antidote for sitting,’ says Marc Hamilton, an inactivity researcher at the Pennington Biomedical Research Center.”

So what does this mean? It seem that according to the evidence in the article, sitting is unhealthy. (Specifically we might say that lack of movement not sitting in and of itself.) If we do too much of it we’ll get sick and die early–whether or not we exercise a lot. This isn’t good! Most of the Western world sits for a living. We sit at computers. Then we sit in cars for transportation. Then for entertainment we sit in front of a television. HOURS and HOURS of sitting is our way of life. So what can we do?

Well, part of the research into this issue by Dr. Levine included the wearing of a special electronically wired “magic underwear” that measured the wearer’s movement. The researchers found that healthier people moved more during the day but it wasn’t necessarily in the form of exercise. They fidgeted more or simply engaged in many small movements throughout the day. Even leaning down and tying a shoe can generate a burst of movement that should ultimately lead to better health. (The term for all this small, non-exercise movement is NEAT or Non-Exercise Activity Thermogenesis. Read more about NEAT here, here and here.)

Z-Health R-Phase joint mobility drills are tailor made to address our modern lack of movement. Any number of these drills directly counter the hours we spend immobilized in chairs. Following are three joint mobility drills that you can perform while seated. Moving our joints in these ways sends bursts of mechanoreceptor signals to the brain and basically lets the nervous system know that we’re still alive.

Wanna See Something Cool?

Icelandic powerlifter Benedikt Magnússon (You’ve GOT to be strong with a name like that) recently recorded a world-record deadlift 1015 lbs! He did this “raw,” meaning he wasn’t wearing a powerlifting suit. (In a nutshell, these suits are incredibly tight things that actually aid the effort of the lifter. Lifting raw means someone is wearing something like a t-shirt and shorts.)

httpv://www.youtube.com/watch?v=q4jO21-a2W0

Okay, so I find this effort simply astonishing. I love to deadlift so watching this is fun for me personally. But what else do we see? This large lad is graceful. Elegant! Look at the ease with which he performs the lift. He makes it look easy. He even gives a big grin to the crowd while he’s locked out at the top of the lift. If you’re a Z-Health person, then this is exactly the sort of thing we want to strive for whether it’s during our joint mobility drills or our conventional “workout.” Or for that matter, during your golf swing, tennis serve, swim stroke–whatever activity we’re doing. To become excellent at something, we must establish precise command of all of our joints in every position at all speeds.

For further reading on creating excellent movement, I suggest you have a look at this article, Making the Hard Possible and the Easy Elegant from Todd Hargrove’s blog Better Movement. He does a superb job at explaining concepts of movement, central nervous system function, proprioception and lots of other similar stuff.

“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.

Z-Health: the Performance Enhancement System

For about two years now I’ve been involved in an exercise system called Z-Health. I’ve suffered from various chronic pain issues and the methods employed by Z-Health have helped me reduce my pain and regain function to a tremendous degree–far more than any other treatment modality I’ve ever experienced. (I’d like to give great thanks to Dr. Eric Cobb, creator and founder of Z-Health.) I get to share this unique system with clients every day. As a Z-Health Certified Movement Re-Education Specialist, I get to help them find their way out of pain and dysfunction. For clients in pain, Z-Health R-Phase and I-Phase are key to calming the nervous system and re-establishing good, pain-free movement. But Z-Health isn’t only about pain relief. It’s also about performance enhancement.

On that theme, I’d like to show you a couple of articles (here, here) and a video on a 14-year-old Seattle area sprinter named Hannah Cunliffe. She’s a nationally ranked in both the 100m and 200m events for her age group and she’s able to hold her own against college sprinters. She hopes to compete in the 2012 Olympics. She’s also one of Dr. Cobb’s clients. For someone like Hannah, Z-Health S-Phase offers powerful visual and sport mechanics drills. Sprinting, agility, acceleration, decelerating and jumping are all part of S-Phase.

So the big message here is that Z-Health isn’t just about addressing pain. It’s about achieving the highest level of performance you want.

Here are a couple of videos:

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.

Recommended Products

I’ve realized recently that there are a lot of books, nutritional products and other such things that I think highly of. Because of that I’ve added to this blog a Recommended Products page. I’ll add to it periodically as I come across stuff that I think is worth owning and using. If you have suggestions for such items, please contact me and let me know.

Z-Health Day 1

Yesterday was the first day of the Z-Health R-Phase certification here in Denver and I found it very informative and enjoyable. We learned a tremendous amount about the nervous system and why doing joint mobility drills can relieve pain. (I started the day with some low back pain. We progressed through only a few drills: foot/ankle drills and knee drills. Soon after there was no back pain and I still am pain free this morning as I type this.) It sounds strange I know, but the ways of the body and nervous system are often less than obviously logical.

The class of about 20 students is the most diverse class I’ve seen at any sort of exercise course. In addition to personal trainers there’s a physical therapist and a PT school student in attendance, a yoga instructor, a school teacher, and a nurse. One man is a client of a Z-Health trainer who’s simply been impressed enough by the results that he wants to learn more. One woman has seen her elderly mother go through hip and knee surgeries with poor results. She said she didn’t want to get old in the same fashion.

I don’t want this to sound like some sort of a weird cult thing or blind devotion to some oddball system. Z-Health creator Eric Cobb has drawn on a wide variety of sources in developing the system. Much of what informs Z-Health is neurological research and an understanding of what pain is, how the brain views pain and they myriad ways we can address pain. Cobb urges students and Z-Health trainers to read a lot and learn as much as possible about these issues.

One criticism of Z-Health is that it’s hard to explain. People ask “What is Z-Health?” and those of us who’ve been exposed to it often can’t give as succinct an answer as we wish we could. I think the Z-Health web site should give a better explanation of what Z-Health is and how it works. The course I’m taking is called R-Phase. “R” stands for restore, rehab, and re-educate. There are other phases but R-Phase forms the basis for the other phases. I’ll do my best to give an explanation.

The driving concept is that the nervous system is the key driver of of every facet of the body. Absent an acute injury like a broken bone, cut or dislocation our pain is a movement problem. For example “My knee hurts when I climb stairs,” or “My shoulder hurts when I reach overhead.” Those are movement problems. The nervous system drives movement, not the muscles, not the bones, not connective tissue but the nervous system. Thus is if we want to eliminate pain then we must address the nervous system in order to improve movement. (Interestingly, if any movement pattern is compromised–ankle movement for example–then it may create pain and/or weakness in other regions such as the neck or a shoulder. It’s sort of similar to the way a storm in Seattle may impair air traffic in Miami.) The way we do this is by moving each joint one at a time through its full, pain-free range of motion. We do this very precisely under strict control. In this way we improve the brain’s map of the body (the homunculus). We increase the nervous system’s recognition of these joints and limbs thus we improve movement and control of the body.

That’s the brief, non-technical explanation! I wish I could put it more briefly. Medical and body work professionals may still prefer a more thorough explanation. Z-Health looks somewhat like tai chi. In fact Z-Health draws on martial arts, tai chi and dance for various mobility drills.

For anyone wanting more information I suggest you call the Z-Health offices. The people who work there are very much willing to discuss Z-Health and answer any questions. They’re a very helpful and well informed staff.

Denver Fitness Journal

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

Z-Health