Z-Health Question

[RyanP]

Most of us know that trigger points can impair neuromuscular functioning and set up a chain of inefficiencies throughout the body. I was curious with the Z-Health approach, if the principle had any alternative methods to subdue/eradicate the trigger point that are different than your typical methods of massage therapy, myofascial release (foam/stick/ball work), and active release? Thanks.

[mc]

Originally Posted by RyanP

Most of us know that trigger points can impair neuromuscular functioning and set up a chain of inefficiencies throughout the body. I was curious with the Z-Health approach, if the principle had any alternative methods to subdue/eradicate the trigger point that are different than your typical methods of massage therapy, myofascial release (foam/stick/ball work), and active release? Thanks.

There may be a misapprehension of what trigger points are, here.
It's not really about eradicating what is just the way we are mechanically laid out.

Whether you call them acupuncture points, trigger points, or more physiologically, motor points, they are specific sites on the body where nerves enter the muscle and are, because of this location, also discoverable readily by electrical stimulation and also by certain tactile characteristics. They are like live wire leads into the muscle, but just conveniently placed nerves. Sensitive spots.As such they do not of themselves "impair" anything. They're just part of us.

You would not find too many z-health folks advocating either manual manipulations or anything that increases pain as a primary, persistent care mechanism. That doesn't mean that there is not a place for manual manipulations, but that the z-health model takes a different approach to physical state.

It tends to suggest that
1) the site of pain is not always the source of pain
2) if the body is "tight" somewhere, perhaps it is so for a reason, and that wailing away on a tight or sore point (wailing away being my characterization, not z's) may be band-aid'ing, where the issue will recur, rather than looking higher up the chain to what may be inducing this particular response.

In each case, whether the assessment is to look at one's mobility, or palpate for dermal or fascial lack of movement, the approach is similar: to use that point mainly for assessing or assisting ACTIVE work on the part of the person.

If you're interested in the rationale for that active approach, here's an overview and a ton of articles.

mc

[JasonL.Ac.]

Acupuncture points are not the same things as trigger points or motor points, nor are they used the same way. This is a common source of confusion, especially with physical therapists, occupational therapists, and chiropractors.

Also, the two points you make are far from unique to Z, or orginal to it. Z may have its own take on those ideas, and if so I would be fascinated to learn about it. Unfortunately its not described at all in the R-phase manual

[darryllardizabal]

Originally Posted by JasonL.Ac.

Acupuncture points are not the same things as trigger points or motor points, nor are they used the same way. This is a common source of confusion, especially with physical therapists, occupational therapists, and chiropractors.

Also, the two points you make are far from unique to Z, or orginal to it. Z may have its own take on those ideas, and if so I would be fascinated to learn about it. Unfortunately its not described at all in the R-phase manual

We normally don't go towards the site of pain like mc said and those tight points may be compensation - which are normally a result of your movement patterns (my massage therapist noticed the change in my tissue integrity and health after doing Z)

The principles we use are different because we combine the active work/passive work on other tissues away from the source when a person is in pain. No It's not Z. Z is a system of combined tools that work, that's it. The motor points, etc are part of the T-phase Manual. In R-Phase you learn a very "blurry" image of what it really is - mechano stimulation. You just learn a better way to apply it on specific points, and specific directions. No biggy.

To reiterate Z doesn't have a lot of things it can call it's own. It's just a collection of results based tools that work - if you want to learn this collection easily, rather than sorting it all out yourself, then you learn Z and how it applies it - most of the application is in R-Phase, the later phases for the most part change how many tools you have at your disposal.

For trigger points we may give you a joint mobility drill, an eye drills, a vestibular drill, nerve flossing drill, connective tissue (skin, superficial/deep fascia work) on lymphatic, visceral, or simply the skin itself, or even a cranial drill. It all depends what will work on you best.

[resrie]

Originally Posted by mc

There may be a misapprehension of what trigger points are, here...

Whether you call them acupuncture points, trigger points, or more physiologically, motor points, they are specific sites on the body where nerves enter the muscle and are, because of this location, also discoverable readily by electrical stimulation and also by certain tactile characteristics...

You would not find too many z-health folks advocating either manual manipulations or anything that increases pain as a primary, persistent care mechanism...

It tends to suggest that
1) the site of pain is not always the source of pain
2) if the body is "tight" somewhere, perhaps it is so for a reason, and that wailing away on a tight or sore point (wailing away being my characterization, not z's) may be band-aid'ing, where the issue will recur, rather than looking higher up the chain to what may be inducing this particular response.

That doesn't sound compatible with the definition of trigger points I'm familiar with " hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers" to cite Wikipedia (which cites Dr. Janet Travell).

To play the devil's advocate, trigger point release practitioners agree that pain site != pain souce, in fact if you read Claire Davies you'll find that he suggests exactly this.

I think it'd be interesting to see what Z practitioners actually think--some aren't very into soft tissue work, some that I have met or seen do use it in conjunction with active self-mobilization.

And while I agree that practicing pain may not be a great way to get out of pain, if you are treating satellite points to address pain elsewhere (let's say releasing the SCM or sternocleidomastoid to address TMJ pain, if you happened to have forgotten that the coccyx is the 'opposing joint' to the TMJ re: self-mobilization), I'd argue that this is quite a bit better than blunt force foam roller work as it is supposed to be short and specific in duration (7-10 one second strokes in a single direction as per Davies).

Another point is that trigger point release and in some cases active joint self-mobilization can be effective only if you continue doing them, and in some cases they work very quickly and it sticks. To me this suggests they both have something to offer.

The other poster is correct, though, in that the R-phase client manuals don't have this sort of detail, you need to get the cert manuals for that.

I'm personally trying to figure this out myself, but am in general a fan of some soft tissue work, but not necessarily as a be all end all or primary care modality. It is however, much more affordable, as a foam roller is MUCH cheaper than a real massage, and Claire Davies' trigger point manual is more affordable than attending a Z cert.

~Leslie (Z-health R/I-certified, also attended the 3day DD Secrets workshop which I recommend for the DD / RKC curious)

[resrie]

Originally Posted by RyanP

Most of us know that trigger points can impair neuromuscular functioning and set up a chain of inefficiencies throughout the body. I was curious with the Z-Health approach, if the principle had any alternative methods to subdue/eradicate the trigger point that are different than your typical methods of massage therapy, myofascial release (foam/stick/ball work), and active release? Thanks.

To put what Darryl said in a different way, whereas we often try to release trigger points in muscles to have an effect elsewhere in the biomechanical chain, we have to ask ourselves, why did those trigger points accumulate in the first place?

Whatever the case, one might argue that the body then compensates by adjusting how it holds itself, and by actually changing the physical composition of various areas (tight knots here, adaptations as per Wolff's or Davis's law). As Thomas Hanna argues in Somatics, there is then SMA (sensorimotor amnesia) where we stop recruiting certain parts of the body and in essence forget they exist.

You could also argue that through soft tissue work, one can partly address SMA, but also that you need active mobilization (autotelic if you will) rather than just passive mobilization to make any bodymind adaptations actually stick.

So, to keep things simple and stick to R-phase, if you have trigger points around your hips, you might use a tiger tail on them or get hands on with 7-10 pounds of force (more depending on the person, some people like pain! I think we forget the individual nature of neural chunking if we just blindly say that moving into pain is always bad, since some of us do on occasion enjoy spicy Sichuan or Korean food, rollercoasters, grad school, or snatch tests), or you might fight SMA by actively mobilizing your knee joints or your contralateral shoulder joint. Over time then, you may end up indirectly affecting soft tissue quality by addressing the movement dysfunction that maintained the trigger point in the first place.

In other words, the proposed causal chain might be

nervous system > proprioceptive map > SMA > body compensation > trigger points > referred pain > impaired performance > KB snatch fail

Trigger point therapy might fix things in the short term, but it's worth addressing the underlying movement dysfunction first, and practicing good, high-quality movement is one way to do that. There are many such ways to practice good movement, such as having a top movement coach work with you, but what sets Z apart is its neurological focus and the way it tries to develop test / assess / re-assess schemes and a joint-by-joint decomposition of the body. This sort of melding of clinical, divide-and-conquer view and a holistic bodyworking view, based on what we know scientifically, seems rather unique to Z.

Does that answer your question?

[darryllardizabal]

Don't think in cause and effect as much. Think in terms of organic. What are the possible causes and possible effects? And how can one cause promote multiple effects. Or how can multiple causes promote one effect? Similar thinking different perspective.

In terms of Neural Chunking (how people organize movements, emotions, thoughts together into patterns), yes you could use pain to get someone out of pain, but at what cost? When you eventually reach T-Phase, a whole next "rehab" toolbox opens up, where soft tissue work can help, and tends to be a final choice if R and I phase work, eyes, and vestibular work fails. There's more to soft tissue work than what most people think at that 7-10 lbs of pressure is only working on the deeper layers of fascia and tissue. You still have to look at skin, and superficial fascia and see if the tissue quality is different in each layer.

All soft tissue is, is really another degree of Neural stimulation specifically mechanoreceptor stimulation that helps create a blocking effect on nociceptive (pain) signaling. Soft tissue work is just another tool, we can use if necessary, but like resrie any passive work, needs some form of active work (movement done on the part of the patient) to facilitate a "sticky" effect. It's based on motor learning where someone can put you into that position, alter your spine (chiropractic), change your tissue quality and dynamics (massage therapy), but if you can't teach your body how to maintain it, you will have to constantly get tune-ups.

It all leads back to body maps, how your brain has "memories" of your self, and that if you don't somehow change the "memory," your body will constantly keep telling itself to go back because that's how you are "supposed" to be, built up from years of practicing faulty posture, poor biomechanics, or whatever else you want to call it.

It's basically what is time efficient, what will promote lasting changes, and what do you want in the long-term?

No matter how much massage you get, it will always revert back. If you practice moving better, moving your body, your parts in all degrees, and at different speeds. The foundation for which you actually want, change in tissue quality, change in performance, etc. gets better. Perfect Practice, Makes Perfect...:-). If you want to get better at relaxing on a table with someone putting their hands on you, awesome, get massages. If you want to get better at relaxing in different positions, different speeds, different environments, practice it. Your tissue, your joints, your muscles, etc. will thank you.

[ZachariahSalazarRKC]

First of all lets all look up the def of Trigger Point By Travell so we can be on the same page. As far as how Z Health treats them:
Like any other area of pain or poor movement using R,I,S and T drills to relieve the area. IF you go hands on then it is a combination of your background and licenses as to what you do. Here is one idea: since stretching (beyond spray and stretch originally offered by Travell and Simmons) seems to irritate trigger points Z Health looks at a model of improve coordination and contraction to relieve a painful nodule. Since the model of trigger points (for better or worse) speaks of states of ischemic tissue and poor local metabolism preventing ATP recovery and maintaining a state of irritation due to calcium release in addition to damaged reticulums etc all of this can be alleviated be improving function/contraction at the sight. This can be done with massage, lidocaine injections etc all of which in a neuroplastic model alter the threat and the brains proprioceptive map of the body in the brain. Therefore any tool from any level of Z or ART or acupuncture etc can alter the map and relieve the issue. I have used hands on techniques, neuro-developmental points, I Phase drills-lots of things. There are MANY ways to alter a lack of info in the virtual maps of the brain and therefore many strategies. How Z deals with them is like any other issue: it is just as dependent on the practitioner and their education and tools as it is on the final approach. Many things work 100% of the time and %100 of the time every drill will not work on everyone. If Z "fixes" a drill and acupuncture didnt then that DOES NOT mean accu doesnt work. It means that whatever that practitioner did at that time didnt work for that person. And if the Z technique failed but accu worked same thing. As a Master Practitioner and teacher of Z principles we are trying to spread the word of inclusion not exclusion to practitioners of all healing and performance arts. We just want everyone to take a look at a neuroplastic perspective to their craft for a modern picture of why things MIGHT work.
zzzzzzzzzzzzzzzzzzzzzzzz

[resrie]

Originally Posted by ZachariahSalazarRKC

First of all lets all look up the def of Trigger Point By Travell so we can be on the same page.

To cite Travell Trigger Points--Molecular and Osteopathic Perspectives -- McPartland 104 (6): 244 -- Journal of the American Osteopathic Association

"Janet G. Travell, MD, (1901–1997) was an internist in general medicine who developed an interest in spinal manipulation in the 1940s,1 but later shifted her focus to myofascial trigger points (TrPs). In 1955, she relieved then–Senator John F. Kennedy of disabling back pain (after he endured a failed diskectomy in 1944 and laminectomy in 1954).2 Travell's ensuing post as White House physician, followed by the publication of her two-volume "Red Bible," Myofascial Pain and Dysfunction: The Trigger Point Manual,3,4 coauthored with David G. Simons, MD, brought prominence to her approach for treating TrPs.

Travell defined a TrP as "a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender when pressed and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena."5 An example of this is shown in Figure 1. The taut band of muscle is best characterized as a palpable, ropy structure.

...

The 1999 edition of Travell and Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual5 proposes an "integrated hypothesis" regarding the etiology of TrPs. Such an integrated hypothesis involves local myofascial tissues, the central nervous system (CNS), and biomechanical factors."

[mc]

Originally Posted by JasonL.Ac.

Acupuncture points are not the same things as trigger points or motor points, nor are they used the same way. This is a common source of confusion, especially with physical therapists, occupational therapists, and chiropractors.

as far as i can tell from the mappings of where motor points are, they sure seem to line up against mappings for acupressure/accupuncture points; i'm not sure how you're assuming they're used such that they're different or not?

Also, the two points you make are far from unique to Z, or orginal to it. Z may have its own take on those ideas, and if so I would be fascinated to learn about it. Unfortunately its not described at all in the R-phase manual

What two points aren't original to z?

mc