Below is a case study of pre Z Health and post Z Health along with some tips from yours truly.

Fawn and Aaron stopped by for some deadlift work the other day. Fawn is an RKC who trains clients here in MN, so check out her blog here. Aaron has a blog also, click here. Fawn has not deadlifted for quite some time recently, but has done lots of yoga and KB work and Aaron has been getting busy with the KBs too. Both will be competing at the upcoming TSC (Tactical Strength Challenge) here on Sat Sept 8 along with myself and some other athletes here in MN. If you are in the area, come on out and sign up! It is a max deadlift, max pullups in a row, and max reps on the KB snatch in 5 minutes. Good times!

Here is Fawn’s deadlift preZ/instruction. Pretty good and she worked up to 215 X 1 (old PR back in early Spring 2007 was 225 lbs). Video below of 215 lbs

If the above video does not run, click here for the youtube version
It looked like her glutes and hamstrings could use a little help. I had her perform some Z Health drills (lateral ankle tilts, outside toe pulls, and elbow circles) and then did a re-assessment (brief gait and manual muscle tests). She deadlifted again with only those 2 changes and it looked better and she reported that it was easier. Nice!

Now the tricky part. I had her alter her technique some based on the Z Health principals of long spine and used the Bone Rhythm to move the weight.

The first one was to keep a long spine with a flat back. This includes the head also, so you start looking at the floor not the ceiling. Next I had her use the Bone Rhythm to move all her joints at the same time to lift the weight. She gradually worked back up to the the same weight along with a few other tips and tricks along the way.

Here is the video from about 30 minutes later, post Z and some tips

Youtube version here
Note the bar speed is faster and much smoother. She reported that it felt easier also. A few days later she broke her PR with a pull of 235 and then again later with 245 lbs. Whoooo ha. Nice job!
click here to see it!

Aaron stopped by at the same time and I ran him through a similar process. Here is the pre Z/instructions pull (deadlift).

Youtube version here

I did not get to record his “post Z pull” but below is some video he shot from the Press gym a few days later. Much smoother!
Click here for the video

Both reported less strain on their low back and actually felt GOOD afterwards and the next day , even after some heavy pulls. Make sense since the weight is shifted more towards the glutes and hams (which is the goal for everyone doing the deadlift), since the muscles in the low back are actually quite small (esp. compared to the glutes, hams, adductors, etc).

Take Away
Weight training should ENHANCE your life, posture and movement!

It should not leave you beaten into a blood pulp and barely able to wash your face in the sink the next morning (that was me 1 year ago). Aaron said “Mike, end of the session was great. I didn’t feel beat up at all and had a lot of energy.”

Fawn stated, “Mike, after lifting Aaron and I both felt great. In fact, on the way home, (after splitting a protein shake) we joked about turning around and going back for another workout.LOL!” Both were lifting MORE weight than they had in the past also!

If your training is leaving you feeling like a train wreck, you may want to rethink it.

If you are in the Minnesota area and are interested in a weight training session or a Z Health session, click here for more information.

Misc stuff

EliteFTS on Youtube
EliteFTS has some great videos up on youtube now. Check them out. Jim Wendler cracks me up all the time, but I am not sure he should have a camera. Click here for the link

Z Health Presentation in Minnesota
Brad “No Relation” Nelson, Andrea DuCane and myself are doing a Z Health presentation at Kinetic Edge in Minnesota on September 5. Unfortunately it sold out in 36 hours, but we will be doing more; so if you want in on the list for the next one please email me at michaeltnelson AT yahoo DOT com to be added to the list.

Rock on
Mike N

Another Z Health and Mike T Nelson testimonial
I was skeptical of Z-Health when I first heard about it, But, after spending one hour with Mike I’m hooked! I wish I would have gone to him sooner. 15 years of nagging , ongoing, bothersome lower back pain has disappeared in an instant! You see, I sprained my lower back 15 years ago and it hasn’t been the same since. Mike had me go through a series of drills and now my back doesn’t hurt. My gluteus and hamstrings weren’t firing. That meant that my lower back muscles had to take up the slack which causes pain. He also did some work on my shoulders. Now they don’t go snap, crackle, pop and feel great!

Joe Pavel
www.pavelfitness.com
Enjoy The Kettlebell Difference!

Thanks Joe! Joe is a local RKC, so check him out!

Rock on

Mike T Nelson

Here is a great Z Health email I got the other day from a local trainer

I just got done doing (KB) snatches today and the 32kg’s are just flying up! Unbelievable how much more power I have now that my glutes and hammies are actually working properly. My back is feeling great and I also did arm bars and gained mobility in my shoulders and hips too.

Awesome!

Mobility, even in the lumbar region?

Aright. I did it this time. This will get my banned off Eric Cressey’s Christmas card list, pull Dr. McGill away from his study of belly dancers–seriously, I did not make that part up, check the reference), and send most “personal trainers” running for the hills (cue the Iron Maiden music).

Yep, I am talking about LUMBAR FLEXION and EXTENSION. Holy crap, I just suggested that you should move your low back and for some of you (not the readers of this blog–way too bright for that) are thinking that I have lost my friggin’ mind now and confirmed that really am out on a weekend pass from the funny farm.

Here is why I believe you should move your lumbar spine.

1) I am paraphrasing Geoff Neupert here, “If you were not supposed to move it, there would be a BONE there instead of a joint” The premise is that you were designed with a joint there, so you move it!

Now, one of the rules of the Z Health system is that you never move into pain, but pain free movement is good! Maybe this means you need to move slower, cut the range of motion or in extreme cases cut the loading (work in a pool for example). Either way, the body was designed for movement.

Living systems are built up with use, and ATROPHY with disuse.

This is the direct opposite to anything else. If you built a bridge and stuck it in a vacuum, it would last forever. Shoot someone up into space, confine them to bed rest, or severe the nerve supply to muscles and they will atrophy like crazy. Countless studies show that one of the WORST things is space flight (due to zero gravity and the unloading effects) and bed rest!

What is normal?
There is a debate about what is considered a “normal” ROM (range of motion) for the lumbar (low back) area. Zigler, J et al. (15) stated, “a normal ROM at the implanted level (for L3–L4 and L4–L5 between 6° and 20°; for L5-S1 between 5° and 20°).

Herp et al (14) compiled a nice table or range of motion in degrees in 20-30 year old from 5 different studies. Click here for the study

Denoziere, G et al. (1) stated “The rotational mobility offered by the device is limited to 12° in flexion, extension, lateral bending and is not limited in axial rotation.” This study was done to investigate the normal ROM for a computer model.

The take away is that none of them said ZERO for a ROM. Strike 1

What else you got?

An extreme case would be zero ROM and lots of ROM. Well, that type of well controlled study is hard to find, but if you look in the biomedical engineering literature you can find some neat stuff.

Zigler, J et al. (15) did just that in a prospective, randomized, multicenter (all good words for studies!) FDA (Food and Drug Administration) investigational device of a disc replacement versus fusion for the treatment of 1-level degenerative disc disease. So we have one case with some movement (artificial disc) and another case with no motion (fusion). Not the best since we have to jam this foreign object into someone’s back, but it is a start.

Keep in mind, that for this study what they define as “success”. “By the FDA definition in this study, ROM success required greater motion at 24 months than at preoperative baseline for investigational patients. Using this analysis, 89.5% of investigational patients were clinically successful.” (15) We all know that it just not as simple as a ROM test 2 years later, but in the realm of this study, it is a “success”

To get a new medical device approved, you need to show that your new widget is better than the FDA approved widget/therapy at that time. In this case that is spinal fusion!

The study (15)showed a trend towards less pain (done by VAS–Visual Analogue Scale pain score) in the disk group, but the patients were still in a fair amount of pain at 24 months with a small (although statistically significant) reduction. Hmm, slightly better ROM and still in pain after 24 month—welcome to state of the art! Realistically, this just shows that pain is a huge, really complicated area.

Spinal Proprioception?
There is also a hypothesis that spinal proprioception may play a role in modulating protective muscular reflexes that prevent injury or facilitate healing. That would make sense that the body would want to protect the spine at all costs.

Feipel et al. and others (2, 9-11) has shown a loss of proprioception in patients with chronic low-back pain, although not conclusive (5) I saved you a diatribe on each study, but some very fascinating stuff.

2) Mechano vs noci (what the hell is he talking about now?)
As the spine gets more “locked down” and approaches a more fusion type state, there is evidence to support the idea that there will be an increase in the number of nociceptors and a decrease in the number of mechanoreceptors. I remember Dr. Cobb mentioning this at the last I Phase training. So why do you care?

Mechanoreceptors are little guys (ok, not really but go with me on this) that live in the joints (and muscle) to monitor mechanical forces. Now there are all sorts of flavors of them, but we will keep it general for now and just call them mechanoreceptors.

Nociceptors are little guys that monitor noxious (bad) stimuli. Now, a noxious stimulus may or may NOT be painful; but it’s generally viewed as bad and can lead to pain. Remember, pain lives in the brain and that part get complicated really fast.

So, if the mechanoreceptors are going down we get less info about the environment and t
he nociceptors are going up there is an increased chance of noxious stimulation. Sounds cool in theory, but are there any data?

Roberts, S et al. (13) at first glance looks like a killer study, but there were no controls; so the data is not really useful—drat. McLain, RF et al (6-8) has completed some interesting studies looking at concentrations of mechanoreceptors around the spine and shown that there are more in the cervical area than any other area. That makes sense, look how much more you can move your head than your lower spine! As Mc Lain, RF (6) states “The predominance of receptors in the cervical spine is consistent with its greater mobility, the need to accurately position the head in space, and the need for coordinated muscle control for protection and posture.”

We have a bingo!
Onodera T et al (12) did a great study looking at the density and distribution of neural endings in rabbit lumbar facet joints after anterior spinal fusion and to evaluate the effects of intervertebral immobilization. The author states, “These results suggest that immobilization of the intervertebral segment causes a reduction in the number of mechanoreceptors in the facet joint capsules because of the reduction in mechanical stimulation. Moreover, in the upper adjacent facet joint there may be neural sprouting caused by nociceptive stimulation.” This is further evidence (in an animal model) that the body will remodel in a possibly negative way to immobility. Is that really that far of a reach?

Now, one study does not “prove” anything and neither does a collection of studies, but it goes give us evidence toward the right direction as long as we are asking the correct questions.

What if everyone is talking about the same thing?
Johansson, H et al (3, 4) have found a close relationship between activation of joint mechanoreceptor and stimulation of the gamma efferents (to sensitize the spindles) which results in increases in muscles “stiffness” and joint stability. Now the work of Johansson was done on knees, but the same principals probably apply.

So maybe our end result is more muscle “stiffness” but we need to TRAIN MOBILITY to get there?

Mc Lain, RF states (7) “Previous studies have suggested that protection muscular reflexes modulated by these types of mechanoreceptors are important in preventing joint instability and degeneration”

In English, this means you should move your lumbar spine! Please discuss.

Rock on
Mike N

References

1. Denoziere G., D. N. Ku. Biomechanical comparison between fusion of two vertebrae and implantation of an artificial intervertebral disc. J Biomech. 39(4):766-775, 2006.

2. Feipel V., C. Parent, P. M. Dugailly, E. Brassinne, P. Salvia, M. Rooze. Development of kinematics tests for the evaluation of lumbar proprioception and equilibration. Clin Biomech (Bristol, Avon). 18(7):612-618, 2003.

3. Johansson H., P. Sjolander, P. Sojka. Receptors in the knee joint ligaments and their role in the biomechanics of the joint. Crit Rev Biomed Eng. 18(5):341-368, 1991.

4. Johansson H., P. Sjolander, P. Sojka. A sensory role for the cruciate ligaments. Clin Orthop Relat Res. (268)(268):161-178, 1991.

5. Koumantakis G. A., J. Winstanley, J. A. Oldham. Thoracolumbar proprioception in individuals with and without low back pain: intratester reliability, clinical applicability, and validity. J Orthop Sports Phys Ther. 32(7):327-335, 2002.

6. McLain R. F. Mechanoreceptor endings in human cervical facet joints. Spine. 19(5):495-501, 1994.

7. McLain R. F. Mechanoreceptor endings in human cervical facet joints. Iowa Orthop J. 13:149-154, 1993.

8. McLain R. F., J. G. Pickar. Mechanoreceptor endings in human thoracic and lumbar facet joints. Spine. 23(2):168-173, 1998.

9. Newcomer K., E. R. Laskowski, B. Yu, J. C. Johnson, K. N. An. The effects of a lumbar support on repositioning error in subjects with low back pain. Arch Phys Med Rehabil. 82(7):906-910, 2001.

10. Newcomer K., E. R. Laskowski, B. Yu, D. R. Larson, K. N. An. Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects. Spine. 25(2):245-250, 2000.

11. Newcomer K. L., E. R. Laskowski, B. Yu, J. C. Johnson, K. N. An. Differences in repositioning error among patients with low back pain compared with control subjects. Spine. 25(19):2488-2493, 2000.

12. Onodera T., Y. Shirai, M. Miyamoto, Y. Genbun. Effects of anterior lumbar spinal fusion on the distribution of nerve endings and mechanoreceptors in the rabbit facet joint: quantitative histological analysis. J Orthop Sci. 8(4):567-576, 2003.

13. Roberts S., S. M. Eisenstein, J. Menage, E. H. Evans, I. K. Ashton. Mechanoreceptors in intervertebral discs. Morphology, distribution, and neuropeptides. Spine. 20(24):2645-2651, 1995.

14. Van Herp G., P. Rowe, P. Salter, J. P. Paul. Three-dimensional lumbar spinal kinematics: a study of range of movement in 100 healthy subjects aged 20 to 60+ years. Rheumatology (Oxford). 39(12):1337-1340, 2000.

15. Zigler J., R. Delamarter, J. M. Spivak, et al. Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine. 32(11):1155-62; discussion 1163, 2007.

There is a battle going on. In the blue corner we have abdominal hollowing and coming from the red corner we have abdominal bracing. Abdominal hollowing is generally defined as where you pull your belly button to your spine and “suck in those abs man.”

Abdominal bracing is gnerally defined as preparing like you are about ready to take a punch in the gut. Each side has its proponents and recently it seems like abdominal bracing is taking an early lead.

Research done by Grenier, SG from Dr. McGill’s (big name biomechanics/spine researcher dude) lab recently published a study looking at this debate even! (1).

But wait, what is this, a third competitor has entered the ring! Oh no, more confusion!

I think that NEITHER of these methods are optimal and/or practical. “Oh no honey, I bent down to pick of fee fee the cat and forgot to suck in my abs and I blew my back.” Pleeeze. I know people can have back issues by picking up pencils, but I can gaurantee most of them had some pretty large compensations for some time.

The crazy idea that I picked up at the Z Health R Phase training is to axially lengthen your spine. Imagine someone set a book on top of your head and you are lengthening up against it and pressing your heals into the ground. Keep a nice neutral spine with your head forward (don’t tilt your chin up).

By axially lengthening (tall neutral spine) your body is so smart you will AUTOMATICALLY fire ALL your stabilizing muscles. This is much stronger (although it will not “feel” that way) than either ab practice in my opinion.

Demo time. Try this

Ok, do not do the cannonball drill at home!

Try this instead
Stand normal, close your eyes, have a buddy push you in various directions as you try to resist him/her.
Now stand tall, axially lengthen, close your eyes and stay tall (in Z Heath it is also referred to as dynamic postural alignment) and repeat.

What you will find is that in the tall spine case you are much more stable since your body is firing ALL its stabilizing muscles.

Tall spine (dynamic postural alignment) allows you to stay in various positions withOUT tension AND it is more (at minimium as effective) as any other ab method in my book. Ok, so it is a short, small book, but nonetheless.

Words to the wise
This takes some practice, just like everything else and you need to get your reps in. Start in a neutral position, and then just do various body weight partial lunges. Once you lunge, re-lengthen. If you can re-lengthen, that means you were not in a tall spine. Practice this with just body weight first and when you add weight, make sure you stay in a tall spine.

After some time, you will find that you will almost automatically lengthen before you pick up anything heavy. Makes more sense that this should be more of a reflex action then something you need to think about each time you pick up something heavy!

In another study done by Krajcarski, SR et al. (2)states “pre-activation of trunk extensor muscles can serve to reduce the flexion displacements caused by rapid loading. The abdominal oblique muscles, especially external oblique, will rapidly increase their activation levels in response to rapid loading. ….resulting in lower initial trunk stiffness and spine compression force”

Hmm, sounds good to me. The faster you can fire the correct muscles to oppose an external force the better off you are. Sign me up!

If you live in Minnesota and want to learn this and other “cool stuff” click here

Mike

References
1) Grenier, SG, McGill, SM Quantification of lumbar stability by using 2 different abdominal activation strategies. Arch Phys Med Rehabil. 2007

So, I came back from the Z Health I Phase training (see blogs about 2 weeks back for details) all excited to try it out; but would it work in the real world?

On a personal note, I went wakeboarding a few times this past Sat and Sun and it felt awesome! I normally feel a little tension in my back knee, but nothing at all this time. I was able to do a few nice wake jumps by Sunday afternoon and that was a great feeling.

For those not familiar with wakeboarding, to clear the wake you cut out as far as you can and turn back towards the wake, edging on the board. As you get closer you edge harder and harder to create more tension in the rope. Once you hit the wake, this tension is released and it “flings you” across the wake to the other side. It is kind of like being slingshot off a ramp. Below is a picture of yours truly from a few years ago.

Great times and special thanks to Rob and Mike (aka Supersize) for the pulls behind the boat!

So, how does Z work on other athletes?
Case #1
So far, I am 4 for 4. The first guy I worked on, I tried the I Phase visual and vestibular tests. He had a soft positive on the visual (which means he may need some visual work), and his vestibular was negative (clear). We worked through some R and a few I Phase drills and watched his gait after each one. At the end of the session his gait was much better, could move his head back without pain (initially it was a 4 on a 1-10 scale with 1=very mild and 10=loss of a limb) and shoulder ROM (range of motion) was about 40-50 degrees better. Nice!

Case #2
The next athlete had a positive on the visual test, so we played around with eye positions some. I had her do a Z Health wrist drill with eyes in neutral and it helped some, and then I had her do the exact same Z wrist drill but I had her alter her eye position based on the test—huge difference. Same Z drill, but now with a visual component and her shoulder ROM was much better with less pain. The only difference was the eye work for that drill. Amazing. At the end of the session her gait was much better, and shoulder ROM was much better too. Pain had dropped a little, but not a huge drastic change, but she had been dealing with some issues for a long time so we will see how it goes.

Case #3
Next guy up was a guy I’ve been working training for over a year now and he has been doing awesome! He has seen everything from foam roller work to dynamic drills to tons of standard corrective drills to Z Health. He is doing a great job on the Z Health R Phase and has been using the Z Neuro Warm Up 1 for 3 months now and loves it. After 1.5 weeks off, he started to complain about his right wrist and it was a 5 out of a 1-10 scale. We did the visual and vestibular tests and he had a soft positive on the visual and vestibular. We did some Z Health drills, especially some I Phase work on his feet and his gait improved quite a bit, but the pain was still there. We were able to get the pain in his wrist to less than 1 by incorporating both a visual and vestibular component along with an R Phase drill–bingo! We went to train–bench press and inverted rows with some KB swings and snatches. At the end of the session I asked him how his wrist was and he said it feels just fine. Even though we were loading his wrist relatively heavy (70-80% 1 RM on the bench), it was ok. He will have to keep up with specific Z Health work (get his reps in) for awhile, but I was very happy (and so was he).

Case #4-Z Health and Deadlift Session
The last session I just finished last night. A local trainer stopped by and worked on his deadlift technique. He had been complaining that his low back had been bother him. So we kept it light at 135 lbs and his technique was good, but could use a little work. I could tell by watching that even at a light weight his glutes did not look like they were firing, so we did a manual muscle test for the glute med, then a Z drill on both ankles, had him walk again, retested his glute med and it tested strong this time (but I did not tell him), and then had him perform the deadlift again. His form was much better and hips and low back were matching now. He was kind of doing a stiff legged deadlift before, so he was probably creating some high stresses on the low back. He said it felt much better and I had not altered his form at all at this point!

Hmmmmm, funny what happens when the right muscles are working at the right times! Now, I could have broken out the old dusty bunny ridden foam roller, do some X band walks, clams shells, static stretch the psoas and rectus femoris and call me in the AM. Why do all that when I can just do a Z Health drill? I am not saying that those may not be effective over time (ok, I don’t think the foam roller is– I have 4 of them in my closet, anyone want one?) but I am inpatient and athletes want results NOW. The Z drill took a total of 60 seconds to do and his lift was MUCH better. How sweet is that!

But we were not done yet! We did some thoracic Z work and some cervical work also, altered his form to keep a neutral spine (yes, this includes the head–don’t look up at the ceiling or else you may shut off your hamstrings–another post I am working on) and had him pull (deadlift). Looked nice and he said it felt good. Last thing we added was some Z specific neck work right before he pulled and had him use the Bone Rhythm method (see post here for info on that). Bar speed was way up (I wish I had a tendo unit but at 1K I will have to wait, has anyone used the power factor device -if so, please contact me as I am interested in your feedback). He said the weight never felt that light and compared to before it felt like it just floated up. So he will be doing lots of Z and relearning his deadlifts now before he competes, along with myself and other in the area at the Tactical Strength Challenge here in MN on Sept 8.

Behold the power of some well placed Z joint mobility work, a good work ethic and positive thinking!

So that is the update from here! If you are in the MN are and interested in a training session or Z session or combined session, check out the info here and contact me

Rock on
Mike