Saturday, January 17, 2009

Nerve Flossing Z Health Style: I Can Rotate My Neck!

Z Health Level 4 Work
I've had some questions about what the advanced (level 4) Z Health work entails lately, so I thought I would use an example from an athlete last night. This is just one item that is covered and is not the whole course. This material has existed before and was not invented by Dr. Cobb or Z Health, but it is an amazing tool.

I had the athlete rotate his head to the left and right and found that it was less than ideal. Actually it would only turn to about a 45 degree angle (which is not ideal, but relatively common). I remember Kent Johnson saying at the Z Health Master Trainer eval in CA last week to "not confuse common with normal" and I am going to steal that one!

I noticed that his sternocleidomastoid muscle (SCM) on each side would "pop" out when he turned his head. The SCM is a longer, strap like muscle that runs from under the ear lobe to the sterum (top part of the chest) /clavicle area (mastoid process of the temporal bone and superior nuchal lin for all you anatomy geeks--you know who you are).

The main motor nerve is the accessory nerve so we did some nerve glide work (nerve flossing) for it, had him walk and retested. He gained about 2Xs as much rotation and was able to go almost to 90 degrees on each side. Welcome to the Owl club! Whooooooo whhhooo (you know, that noise owls make)
Nerve Flossing?
Nerve glides or nerve flossing is a technique where an exercise is performed while a nerve is SLIGHTY tensioned. Just like flossing your teeth, the nerve is moved a little bit through various tissue to allow better movement of the nerve itself.

Nerves are a HUGE priority for the body and since the body is survival orientated, it will go to great lengthens to protect the nerves. This includes shutting down muscular function and force production along with range of motion (ROM). Result--not good for athletic performance!

How Can I Do It If I am Fitness Professional?
Anyone interested in can sign up for the Z Health Level 4 cert, but you must do R Phase then I Phase first (which are both amazing). Drop me a line and I am more than happy to chat with you about it or call the Z Health office directly by clicking HERE for more info and be sure to tell them Mike T Nelson sent ya.

Full disclosure: I am not currently an employee of Z Health, nor do I make any money off of referring people to their certs. I do get a few bucks off future certifications that I take though.
What If I Just Want To Get Better Myself?
Keep in mind that any active joint mobility drill (like the Z Health R Phase exercises) also work to slightly move the nerves, lymph, blood, and active muscle etc by themselves! That is another reason why precise, active joint mobility work is so important. As always, make sure it is done in a relaxed state and NO pain!

You can purchase the R Phase manual and 2 DVD set on the link from the upper right.
Full disclosure: the price here is the same as anywhere else, and I do make a few bucks off each one. Again, I never recommend anything that I don't 100% believe in.

If there is a Z Health trainer in your area, that would be your best bet. You can never replace custom work for YOUR body.

Nerve glide work can have amazing effects very fast when it is the bottleneck. As with anything else, it is not always this easy, but about 50-70% of the time with the correct knowledge it can be!

Any comments/thoughts, let me know.

Selected References
A great review is
"Improving application of neurodynamic (neural tension) testing and treatments: a message to researchers and clinicians".Shacklock M.

His book "Clinical Neurodynamics: A New System of Neuromusculoskeletal Treatment" is one I own and is quite good.

The ones listed below are a good place to start and are taken from "Neurodynamics in a broader perspective". By Butler DS, Coppieters MW

Butler DS. Mobilisation of the nervous system. Melbourne: Churchill
Livingstone; 1991.

Butler DS. The sensitive nervous system. Unley: Noigroup Publications;

Butler D, Gifford L. The concept of adverse mechanical tension in the
nervous system. Part 2: examination and treatment. Physiotherapy

Coppieters MW, Butler DS. Do ‘sliders’ slide and ‘tensioners’ tension?
An analysis of neurodynamic techniques and considerations
regarding their application. Manual Therapy, 2007, accepted
pending minor changes, in press [Epub ahead of print; doi:10.

Erel E, Dilley A, Greening J, Morris V, Cohen B, Lynn B.
Longitudinal sliding of the median nerve in patients with carpal
tunnel syndrome. Journal of Hand Surgery [Br] 2003;28(5):439–43.

Gifford LS. Factors influencing movement—neurodynamics. In: Pitt-

Brooke J, Reid H, Lockwood J, Kerr K, editors. Rehabilitation of
movement. London: WB Saunders; 1998. p. 159–95.

Greening J, Leary R. Letter-to-the-editor in response to the editorial
by Shacklock (doi:10.1016/j.math.2005.03.001). Manual Therapy,
2006 [Epub ahead of print; doi:10.1016/j.math.2006.01.004].

Hough A, Moore A, Jones M. Restricted excursion of the median
nerve in carpal tunnel syndrome. In: Proceedings of the second
international conference on movement dysfunction, Edinburgh,

Maitland G. The slump test: examination and treatment. The
Australian Journal of Physiotherapy 1985;31(6):215–9.

Moseley GL, Nicholas MK, Hodges PW. A randomized controlled
trial of intensive neurophysiology education in chronic low back
pain. Clinical Journal of Pain 2004;20(5):324–30.

Rozmaryn LM, Dovelle S, Rothman ER, Gorman K, Olvey KM,
Bartko JJ. Nerve and tendon gliding exercises and the conservative
management of carpal tunnel syndrome. Journal of Hand Therapy

Shacklock M. Improving application of neurodynamic (neural tension)
testing and treatments: a message to researchers and clinicians.
Manual Therapy 2005a;10(3):175–9.

Shacklock MO. Clinical neurodynamics: a new system of musculoskeletal
treatment. Edinburgh: Elsevier Butterworth-Heinemann;

Shacklock M. Author’s reply to the letter-to-the-editor by Greening
and Leary (doi:10.1016/j.math.2006.01.004). Manual Therapy,
2006 [Epub ahead of print; doi:10.1016/j.math.2006.01.005].

Tuzuner S, Ozkaynak S, Acikbas C, Yildirim A. Median nerve
excursion during endoscopic carpal tunnel release. Neurosurgery

Valls-Sole J, Alvarez R, Nunez M. Limited longitudinal sliding of the
median nerve in patients with carpal tunnel syndrome. Muscle &
Nerve 1995;18(7):761–7.