Manual therapies all have that one trait in common. They are the act of something being done to us, while we remain primarily the passive recipient of these ministrations. In some contexts this can be fabulous. Various kinds of massage enact a relaxation reflex that can help us - and our bodies - calm down - at least while we're on the table. And that may be sufficient for us to move past whatever effect it is we're experiencing to get to the other side.
Active approaches, in contrast, are when we do the work for ourselves. Active approaches have certain neurological benefits: they seem to require significantly great neurological engagement to be carried out. Models of motor learning that i've talked about before get engaged.
The differences between active and passive work might be expressed in the example of someone learning to swing a tennis racket. If a coach stands behind us, and does the swing for us, we get a sense of the feel of where the arc should be in our body - where our joints should move - but until we practice it for ourselves, we're not firing up all the muscle fibers in the correct sequences to hold the racket, and move the racket ourselves, through that arc. We certainly haven't coordinated the feel of that action while running one way and potentially looking another (blending in balance and visual acuity). So, pretty obviously, carrying out a movement actively engages a lot more of our systems than passively being lead through the same motion. And that active engagement is a Good Thing for our well being.
As i've written about before (here's a list), a lot of performance limitations (stalling out in a lift, or a swing or whatever) and a lot of pain seems to come from issues in movement - poor mobility (control over one's movement) in one area requires compensations in movement (that may be uncomfortable after awhile) in others.
These kinds of movement/performance challenges are so well understood, Gray Cook and Brett Jones's entire "Secrets of ..." series deals with what they frame as mobility/stability issues. In their dvd on the Turkish Get Up, Kalos Sthenos, for instance, Cook and Jones talk at length about the effects of say restricted upper spine mobility and the negative consequences this has for upper body movement in general and strength work like pressing in particular. Their functional movement approach to addressing these restrictions is not to get a person on a massage table, but to get the person active with what they term corrective drills that work with the thoracic spine and shoulders.
Threat or No Threat In Z-Health, Eric Cobb looks at this kind of mobility (control of one's movement) as the fastest path to the nervous system that is the governor of the entire muscular-skeletal/sensory-motor system. I've written before how in this model, the only thing the nervous system cares about is threat or no threat. That a perceived threat (like jammed or less independently mobile joints) causes a reduction in outputs like force production. Help address the quality of movement, threat goes down as quality of information to the nervous system goes up; performance goes up.
Recently i've talked about a wee hypothesis i'm playing with that the value of tons of movement reps with light weight has a huge benefit for moving to larger loads in a new move because the threat has been reduced. The body knows how to do the move, so the only new thing to worry about is managing the load.
To come back to manual vs active work, in manual work, with less of the nervous system engaged in translating the work done to into any active effect, it seems threat response may stay pretty high in that a real lasting change pattern has not been initiated. Trust has not been built, perhaps? And so the benefits of the treatment may not have an ongoing effect. This lack of stickiness from manual work has been demonstrated in a recent video by the Z-Health team. Here, Eric Cobb demonstrates the immediate after effect of passive work vs active.
In the example, the participant is first muscle tested - strong - is placed in a jammed joint position at the ankle, is muscle tested again - weak. He is manually maniupulated to fix the joint (Cobb is a chiropractor by license); re-tested, strong. Supposedly, this person is now fixed. He gets up to take one step, comes back for a re-test, weak again. Goes away to do 3-4 reps of the toe pull drills for that joint that have been taught in the class, comes back after walking around post-drills, is tested again, and he's solid.
What we could draw from this example is
- how little all the systems of the body are engaged in passive manipulation
- how improved funtioning after a manual experience on a table is potentially very distinct from our experience in normal active movement
- how much more of our systems are engaged in even simple small but active movements
- how necessary that engagement seems to be for well being/performance
- how rapidly that engagement kicks in
- how easy that active engagement is.
What i am not saying at all is that passive therapy is inapporpriate. A number of the athletes i coach who have decades of trauma in their bodies find that mixed methods help them, and that in particular, when they combine their passive work with active z-health drills, for instance, during or immediately after their treatments, the benefits are far more sticky. Books like the well-regarded Anatomy Trains on the fascial system talks about the neural necessity of blending active participation with the manual manipulations of the fascia a therapist may carry out.
Indeed, one person has told me they've gotten through an intense patch of combined work of manual/active therapy and are on maintenance now with just the z-health drills. For most of my other athletes, combining the z-health work with their sport work has had significant benefit for their overall performance.
Give Active Work a Chance. What these demonstrations seem to show us is that there is a real both immediate and lasting benefit to carrying out dynamic active work around our own mobility - our own volitional control of our motion. In moves like the turkish get up, we see this control in the ability to exectute a high hip bridge when transitioning from back to kneeling, or being able to keep the chest high with the arm raised in lock out when in the upright seated position.
In a z-health drill it may be simply the ability to do a shoulder circle where say the left arm circles in front of the right side of the body without the left shoulder moving/torquing at all towards the right side to get the arm over to that part of the body - just for example. For some folks, one of the most challenging movements has been a wrist movement where the wrists, not the hands, lead the movements up and down.
The quest here is not hypermobility - it's not about doing the splits, per se. It's about at least in part having better control of independent ROM in our bodies in order to move better - to move as we are designed to move. That means that the hips can move independently of the pelvis; the thoracic spine can actually move back and forth and side to side independent of the lumbar spine; that there is an appropriate degree of ankle inversion and eversion, and so on. To find out more about why that independence of joint motion also leads to greater "map clarity" and better performance, here's an article more about that.
Take Away In this context of active in relation to passive care, a ket take away, i'd say, is that it's ACTIVE work that builds up this capacity to enhance our performance, and that by deliberately practicing active mobility our performance improves - and likely incidents of tweaks go down as well.
Places to Start
Specific Work: I start my athletes with a movement assessment to see if they have any issues with particular movements (what Gray Cook calls "weak links") that if addressed may lead to improved performance. If you don't have access to a CK-FMS trainer or Z-Health coach in your area for an assessment, some of us (me included) do them online (here's some reviews).
Anytime Work: At anytime it's a great idea to get an active mobility practice in your universe. There are all sorts of programs in this space, including traditional practices like t'ai chi. Fabulous. Here's a piece on where i see z-health being different from these practices and why i think the z-health progressions are valuable to know too.
My recommendation for the folks i coach is z-health drills because of the focus on joint by joint mobility control. My recommendation is to start with the first level of Z-health that starts in neutral stance - no moving around really - and as soon as comfy there, get into I-phase. Here's a longer discussion on why the progression from R (vocabulary of movement) to I (control of movement templates) is important for performance
Related Posts
- Why Move of Die
- Arthrokinetic Reflex - model of systemic effect/interaction
- Why not Move through Pain
- The Refined Turkish Get Up
- Chronic Back Pain?
- Why and When I-Phase?
- The other side of the weight room: sensory-motor training
- Z-Health Article Index
- CK-FMS experience
- Mobility vs Flexibility: is there a difference?
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