Great question here about scar tissue and the use of SMR (foam roller) and other implements from Chris and Mark Young had some great comments too in response to my foam roller posts.

Foam Roller Exercises : Just Say No

I figured that I get lots of questions on the standard 4 phase Z Health approach I would republish the answer here for everyone.

Mike,

What do you suggest for removal of scar tissue if self release (foam rolling, baseball/lacrosse/golf ball) is removed from the picture?

Chris

Great question Chris.

I think the bigger question is “What can’t you do?”

Now this may be a problem for various reasons and scar tissue may be one of them.

I tend do the the following to get athlete bodies working correctly again:

1) joint mobility work

2) visual work (eye movements actually)

3) vestibular work (head rotation, tilt or chin down or up)

4) hands on work

Most of the time on a first session, joint mobiity work is enough.  Guy came in a while back and his shoulder did not go all the way when moving it out in front.  Joint mobility work (Z-Health) on the same side wrist, opposite hip, opposite foot/ankle got his arm almost all the way up (was only at about 70% before).

If joint mobility work is not having a good response, I will test their eye reflexes (PREP, taught in Z Health I Phase).   PREP=postural reaction to eye position.  If they were not normal, they do drills with an eye position and joint mobility.

Example: bad ankle

A female athlete came in a while back with an ankle issue.  In order to get her hip muscles to fire better, she had to move her eyes up and while holding them up, do some ankle joint mobility work.  Hip muscles (glute med, psoas and RF) fired up and her gait (along with her ankle) was much better.

If eyes + mobility don’t work I will add in vestibular work, using PNRT (postural neck reflex test).  A recent athlete came in post ACL replacement and post Physical Therapy  and on his first visit the joint mobility was not working, so I tested his eyes and they were normal (PREP test only), but his PNRT was positive (not normal) for his head rotated right. So his drill was an ankle mobility drill with his head turned right.  Moved much better, knee was much better.  (note I find it is rare to find ONLY vestibular issues)

Some times it is a combination of all 3

Mobility +  eyes + inner ear = optimal function and movement

This is hold the brain gets information to execute movements too (joints + vision + vestibular).  We are reverse engineering better movement by fixing the “bad” signals!

If that still does not work, I will check the tissue by just moving it in specific orientations at 3 different layers 1)skin 2) fascial 3) deep.   Note, most of the time I am not FORCING the tissue to move, I am holding it in a specific orientation and then using joint info, visual (ocular motor too) and inner ear (vestibular) work to ALLOW it to release.  I am working to find the correct combination to the safe via spinning the dial, vs trying to blow up the safe.

Another Example: Powerlifting and hamstring strength

Awhile back a powerlifter came in and her left hamstring would not fire up to 100% and gait could be better.  At the time she was deadlifting about 3xs body weight.  Went through the testing above, using a gait assessment after each drill.

On a manual muscle test, the left hamstring was still weak and gait was off.  Ending up doing a right elbow circle (neuro reflex to the opposite knee/hamstring aka probably interlimb coupling), with her head rotated right (vestibular input), with her eyes open and in the up position (looking up), while I held deep (not remotely painful) pressure on the whole hamstring (all 3) in a position to the “right.”

As she rotated her head and did the elbow circle, I could feel the hamstring tension to the right melt and it moved easily.   Had her walk and gait was much better, left hamstring fired up great.  Later I heard her DL went up, but hard to say what I did was directly related to it; but moving better is always a good adaptation.

I hope that helps a bit.

Summary

Basic joint mobility work is Z-Health R Phase, eye and head movements (vestibular) is Z Health I Phase, hands on work (holding tissue) is Z-Health T Phase (level 4) work.  Minimal amount to get the job done = less collateral damage to fix later (although I don’t see them again as much which is my goal, but is a crappy business model–hahaha)

Most don’t need direct tissue work right away, but that is not to say it can’t work.  Physiology is messy and many things can work.

If anyone has comments/questions on this one, post away in the comments!  Comments make me feel all warm and fuzzy and it is getting colder here in Minnesota now.

Rock on

Mike T Nelson

PS
If you want any info on the Z Health certs, let me know and drop me an email or give them a call and tell them I sent ya.  I am NOT an employee of Z-Health, but I do make a few bucks off of cert referrals.   Again, I would never recommend something that I don’t use myself or feel that works great.