CK-FMS and Z-Health

April 12, 2010 12:31 PM

Currently there are two systems popular with the RKC community, the CK-FMS program and Z-Health system. I have studied both being a presenter and teacher for Functional Movement Systems and having attended Z-Health R, I, and S phase. What follows is my perspective on how these two systems differ and/or compliment each other.

Let me say up front that there is incredible information available within Z Health. Dr. Cobb brings cutting edge neurological information, visual and vestibular information together when few are looking at them at all. There are however certain areas of Z Health that are areas of concern.

The SAID principle definition as Z presents it
  • Treatment of pain by non-clinicians
  • Application of neurological "manipulation"
  • Confusion of training principles used by RKC
The Z Health definition of the SAID principle (Specific Adaptation to Imposed Demands) as the body always adapts to exactly what it does is a definition created to support Z health but does not represent the SAID principle. The SAID principle is a general principle stating that the body adapts "specifically" to the demands placed upon it. "Always" and "Exactly" were added to incorporate the concept of neuroplasticity but this changes the SAID principle. There is a significant difference between a neurological response and a neurological adaptation. The body does not always adapt to exactly what it does but the body will adapt over time to the stresses placed upon it. Hence, we also have the General Adaptation Syndrome or GAS model and progressive resistance concepts.It must also be remembered that the SAID principle is a principle not a Law of adaptation. Otherwise marathon runners would not run 800 meter "sprints" to improve their marathon results.

Pain is a huge consideration for dealing with people in the physical realm. There are clinicians (physical therapists, Doctors etc…) who are trained at dealing with pain. Personal Trainers however, while placed in the role of having to deal with client pain are not trained for this. Now before fingers start getting pointed at the state of health care. We can all come up with instances where a friend or client got less than optimal care from a health care professional but those same health care professionals get lots of patients from local personal trainers (and not in a good way). So there is a lot of "blame" to go around.

Clinicians who are trained to treat pain have a variety of diagnostic tools, tests and treatment options available to them that the trainer is not qualified for nor has access to and there are many situations where referral is the right thing to do. Within the FMS system there are two "arms" – the Functional Movement Screen arm meant for trainers and the Selective Functional Movement Assessment arm meant for Physical Therapists, Athletic Trainers, Dr.'s and Chiropractors as a movement based approach to treating pain. FMS trained Trainers are placed in a structure where they look for pain in any of the 7 tests and have three clearance tests designed to look for pain in critical areas. If pain is found then referral is the appropriate response. Z Health targets the pain and places non-clinicians in the role and responsibility of treatment of that pain. This can open trainers up for a huge liability as they can be placed well beyond their scope of practice.

On this same vein of thought in the treatment of pain Z Health uses a variety of techniques based on the current neuroscience to treat or change that pain. While Z Health is very clear about not moving into pain, the negative effects of pain etc… the basis for addressing that pain is manipulating the neurological system without seeking out the underlying issues that may be the actual source of the issue. There are a couple of issues with this. Most importantly there is the idea that some pain exists for a good reason and simply manipulating the neurological pathway for "relief" of that pain might mask the symptoms and delay proper referral and treatment. Also from a Manual Therapy perspective the targeting of the pain is considered a detour in the wrong directions. The site of pain is very rarely the source of pain and in the SFMA system breaks movement into 4 categories:

  • Functional Non-painful
  • Functional Painful
  • Dysfunctional Non-painful
  • Dysfunctional Painful
And it is the Dysfunctional Non-painful movement that is the issue. That movement that is dysfunctional and "hiding" (not producing pain) is causing another part of the system to be overloaded and painful.

Continuing with the treatment of pain within Z Health is the type of neurological manipulation used. Borrowed from the current neuroscience and cutting edge pain treatment information such as mirror boxes and the research in Explain Pain etc… the Z approach is based on the idea that most pain within the body is simply signals that are misinterpreted in your brain. Every "itis" (arthritis, bursitis, tendonitis, etc…) is labeled as signals misinterpreted in the brain. And while I am very familiar with the fact that x-rays do not tell the story of which joint is painful vs. non-painful this does not mean that you can discount every pain. Pain can and often does have very real roots in movement dysfunction and simply manipulating the signals does not deal with the root issue.

Now there are times where manipulating the pain signals and addressing pain from that standpoint is extremely effective. Add in the Visual and Vestibular information and Z Health has powerful tools and potential for helping people.

And I know that Z advocates addressing mobility all over the body and in that process hopes to address the underlying issue behind the pain but some serious gaps are left here. Core stability and stability in general are dismissed. The idea is that my stimulating the mechanoreceptors the brain will map the body better and muscle firing will be taken care of in the process. This ignores a growing body of research and definitive deep ultrasound research on high threshold strategies and core firing dysfunction. Stability does not mean "locked down" or immobile. Rather, it is a timing issue where certain stabilizing musculature needs to fire first in a sequence to literally stabilize a joint prior to and during movement. Stability in the shoulder for example is based on the timing of the rotator cuff firing. The rotator cuff must fire first and pull the head of humerous over the lip of the glenoid labrum to initiate the force coupling mechanism that is shoulder stability. For the spine this involves the inner core unit firing first to produce stability. But it does boil down to a neurological issue, one of the timing of the firing of stabilizing muscles. Mechanoreceptors play a roll in mapping the body but mechanoreceptors are stimulated by joint movement which involves and needs the muscles action. Only approaching joints is only approaching part of the system.

Within the RKC system there are certain principles of compression that are at the least confused by and at worst contradicted by Z principles. In the RKC compression of the joints, or joint packing is emphasized but in Z the opposite or opening the joint is emphasized. But as illustrated above in the example of shoulder stability and rotator cuff firing, it is precisely the stabilizers firing and "packing" the joint that is so critical to joint health and mechanoreceptor stimulation.

Abdominal bracing or developing intra-abdominal pressure is also an area where Z and the RKC seem to differ. Z teaches that tension and relaxation must be "balanced" and that a "long spine" will "automatically" produce stability for the spine. The research of Stu McGill and other spine experts would disagree. The inner unit activation of the diaphragm, pelvic floor, transverse abdominus, and mutifidus along with proper breathing can produce a bubble of pressure known as intra-abdominal pressure. Which not only stabilizes the spine but will also stimulate baroreceptors in the abdomen increasing overall neurological stimulation.

Balancing Tension and Relaxation is another Z principle of efficiency that leaves many RKC trainers confused. The high-tension techniques as presented by the RKC would seem to be in direct contradiction of this principle. Although I have had conversations with Dr. Cobb re: using tension and he is much closer to or understands the use of tension during higher load activities as the RKC does.

"Our nervous system is guided by the 'dominanta', the single focus, in our case lifting a weight. Additional excitation (tension) feeds this dominanta and allows one to be stronger. Focusing on the tension and forgetting about lifting changes the dominanta, as it happens with a heavy gripper. So use as much tension as possible—without shifting your focus from lifting. This will take practice. In the beginning you will see a lot of 'coordination tension', beginner's stiffness during skill practice. It makes you weaker. As you get better you will learn to channel the tension into strength as a gymnast or a lifter."

This explanation of tension from Pavel is perhaps the best description of how to properly balance tension during a lift. Z trainers come away with a message of relaxation being primary and it is in certain circumstances but not when lifting a heavy weight or bracing for the ballistic load of a swing or snatch.

CK-FMS uses the Functional Movement Screen as a baseline movement assessment then addresses asymmetries and restrictions with corrective strategies. These corrective strategies can involve stretching, soft tissue work, re-patterning drills, stability training and progressions to "full function" activities (deadlifts, presses, get-ups etc…). In fact, the blending of the two systems and the creation of the program for the RKC by FMS grew out of the idea that the Kettlebell and certain core movements like the Get-up are extremely effective for assisting in correcting movement issues. Z Health drills can be effective within this framework as well. Personally, I know of trainers that successfully blend these two schools of thought but they are the exception.

I have to say that I am thankful for the information learned from Z Health. The neurological, visual, vestibular and precision joint mobility are excellent. As stated above, however, there are some concerns regarding the application of Z Health as system.

Brett Jones is a Pittsburgh, Pa based Strength and Conditioning professional and Master Instructor with the RKC program. He holds the CSCS certification from the NSCA and is co-creator of the CK-FMS program combining the Functional Movement Screen and RKC. You can keep up with his blog at www.appliedstrength.com