Vibram FiveFingers & Z Health: Moving and Feeling Even Better.

Enhance the benefits of Vibram Five Fingers with a neuromuscular training approach called Z-Health developed by Dr. Eric Cobb. Z-Health practice enables you to have better movement, improved reflexes, more energy and fewer aches and pains.

Written by guest author mc of

If you’re at it’s likely because you’ve either caught the vibram five fingers bug and are happy to go about in foot gloves, or you’re thinking about diving in and getting a pair. Or perhaps you’ve heard some of the great things about “freeing your feet” and want to learn about how to get as close to bare as you can, er, bare. Excellent!

In this article,’s author Justin Owings has kindly invited me to talk a little bit about how to enhance some of the benefits of freeing your feet in VFF’s with a neuromuscular training approach called Z-Heatlth developed by Dr. Eric Cobb, DC.

I’ll overview some of the Z-Health concepts below, but the take away message is that complementing the foot freedom afforded by VFF’s with just some Z-Health practice enables you to have better movement, improved reflexes, more energy and likely fewer aches and pains.

That sounds like a tall promise. But really, our bodies are pretty well designed for movement already. It’s our lifestyles that aren’t. So the more we can help our bodies remember and perform what we’re designed to do — which is where the Z-Health neuralmuscular training comes in — the better we function overall.

Background: Hallway VFF wearing and ZHealth

A couple months ago, I wrote a story about my experience of Vibram Five Fingers (VFF’s) after five months of as much regular wear as was possible in the snow and rain of east coast US and south coast UK winter. After five months of daily indoor wear, when I finally got outside with the VFF’s again, I found that my gait seemed to have improved, my running in them was faster and I generally felt far less clutzy — my reflexes were surprising me. I was going a lot longer without my lower back flaring up, too.

I put the improvements down to two things: VFF’s and Z-health. Z-Health is an approach in part to improve the informaiton the nervous system gets about where we are in space and how we’re moving. VFF’s already allow the joints in the feet to move more freely than in shoes, and so enable the feet to send back more neural information to the body; Z-health helps amp up that signal. Stronger signal means better positioning, and often, if we have any, lessened pain.

Site of Pain Not Always the Source of Pain

Let’s take a moment to consider pain. There’s an old weight lifter joke that Pavel Tsatsouline tells at a Charles Staley seminar: all the weight lifters in the room are asked, “So how many of you have had a shoulder injury, raise your hand?” Most put up their hands; some don’t. The joke goes, those who don’t put up their hands, can’t. Most of us, similarly, have had or do experience some kind of movement-related pain.

Interstingly, quality of movement and pain are often linked: better movement, less pain; better movement, likewise fewer missteps. This linkage between better movement and less pain comes back to how we’re designed: anything can cause anything because pretty much everything is connected. Literally.

If we look at the neuromechanics of running, when our lower body moves, and torques say to the right, the upper body counter-torques to the left. Indeed, since the early twentieth century, scientists like Sheriton (1910), Janda (1963) and Gracovetsky (1988) have looked at how the body links in terms of various cross overs, such that someone with a right shoulder pain may also have a sore left hip. Similarly, pain in the right knee may be approached by doing work with the left elbow.

These connections underpin interdependencies of the body: if one part of us can’t move normally (say the action of our toes or ankles), other parts start to come into play to try compensate in ways they weren’t necessarily designed to do. That compensation sets up it’s own problems, which pushes on other parts, and eventually that cascade of effects causes a pain signal (or a few) to be sent up to the brain for attention. But again, here’s where at least from the Z-Health perspective, it’s critical rather than focusing on a site of pain to the person moving (“It hurts when I do this”) to look at a more holistic approach of the person in motion. These same assessment heuristics apply to those who have restricted mobility, too: getting any limb to move more freely will enhance overall well being. Really. More on this below.

So the Z-Health approach is elegant in its simplicity: help the body move each joint through its full range of motion, and that range of motion will improve; with improved range of motion comes improved overall function, like reflexes, speed, energy, pain free movement. Why that is so is one of the coolest parts of how we work, and the role of the feet in that is why VFF’s are such a potent health aid.

Better Joint Function, Better Movement, Better Neurological Signal

So how do moving joints in particular ways achieve this remarkable health improvement? In Z-Health, it’s not really about the joint but about the nervous system, where joint mobility is a path to better communication with the sytem. Optimizing that communication is critical because the nervous system is our governor. No matter what, it’s always on, and it’s always responding to exactly what we’re doing.

Whether we’re awake or asleep, the nervous system is constantly monitoring signals from the body. This always on, always responding effect is captured by the SAID principle: specific adaptation to imposed demand. This means that the nervous system is responding to our actions all the time. Eric Cobb will add “exactly and immediately.” If we continually tell our bodies through a lack of movement that a set of our joints stays pretty fixed, the body works to support that position, and find ways to hold it in that position, whether this means muscles crunching up to hold our shoulders slumped for hours at a keyboard, or laying down bone to maintain that curve in the spine — or removing bone, for that matter, from where it’s not used. Likewise, as the text Anatomy Trains richly illustrates, tissue will adapt to tighten in one area and loosen in another. Usually there are consequences from this adaptation. Aches and pains in other places that are also pulled out of normal alignment to support other areas where there is current demand.

The body monitors that state to which it needs to adapt in part from proprioception. There are multiple types of proprioceptive information, but within our movement context, we’ll look at the types in the joints in particular: mechanoreceptors and nocirecptors. Nocireceptors respond to anything noxious, like pain or poison. Mechanorecptors have another job: to tell the body about the joints’ positions and about their acceleration. The more freely our joints move, the richer the information coming back to the body about where and how each part of us is in space. Likewise, the more joints that move, the more points of information that come back to the nervous system to create, as Cobb puts it, the body’s map of where it is and how it’s moving.

Openning the joints to be able to send more signal from more surfaces is like the difference between seeing a stick figure crafted from a few lines and points, to seeing a more anthropormorphic represenation. Both convey something about the thing being represented, but there’s more usable biomechanical information likely in the second image.

Triangulation to find locationAnother analogy may be cell phone towers. Where there are few towers, and coverage is poor, it’s hard to get a signal, the signal can break up when in motion, and sometimes simply get disconnected. Where there are loads of towers and coverage is good (full bars on the hand set), the signal/call comes in far more clearly, it doesn’t break up when moving, and disconnections are reduced. Getting more joint action is like putting in more cell towers: clearer, stronger signal not only standing still but in motion, too.

This is why Z-Health is first and foremost a neurally focused approach, with the secondary benefit (rather than primary focus) on dynamic joint mobility. To use the cell tower analogy again, with joints, it’s like the towers are there, but they have been disconnected. And ther are lots of them around the joint just waiting to be turned back on. Z-Health helps liberate the joints to reconnect the signal just waiting to flow. But the signals from the joints are so much more than just receivers/transmitters. The more joints that are available to respond to a signal request, the more smoothly and effectively we move. These signals help us respond reflexively, subtly and rapidly to our environment (Some nerve signals are moving at 300mph). Consequently, joints are just the most obvious system to get back on line first. If they work better, many other things begin to work better too. And that’s a foundation for bulding better strength and function (see I-Phase in more Z-Health below).

The Foot as Super Signaler

Given this context that (a) the more freely our joints move, the better the information, and (b) the more joints that are sending back these signals, the richer the picture of how we’re moving, let’s consider the foot. All those joints!. Twenty-five percent of the body’s joints are in the feet: per foot, there are 26 bones, 33 joints, 107 ligaments, 19 muscles and tendons. We are designed to send 25% of our physical orientation from our feet!

And yet in a conventional shoe — especially a “supportive” trainer, the arch is blocked from flexing, the ankle is restricted, we heel strike with abandon, and the squishiness of the soles deadens any true sense of the state of the surface to which we might otherwise be adapting by our highly flexibily designed foot. Modern shoes are like sensory deprivation tanks for the feet. And this is only the latest in a series of outrages against our feet going back at least 300 years in the west; longer in parts of the east.

Aside: A Moment in Western Footwear History

Over the past three centuries we’ve designed footwear to nullify the nerual map of the foot with shoes that elevate the heel or squish the toes or in the most innocent of flip flops cause them to flex incessantly, or keep them on fixed think flat surfaces that never let the foot flex. All very anti-foot, if pro-fashion, of whatever stripe.

It wasn’t always like this. Take a look at full length portraits in the national gallery in London from the elizabethan era, and you’ll see all these really rich people have no-heeled slippers on, whether it’s Henry VIII or Philip II of Spain or Edward VI. Amazing. These folks, whether they knew it our not, knew how to let their feet be feet.

It’s not till the late 17th century that fashion introduces that now inescapable evil, the multi-gendered heel.

What’s been lost in the current heel is the Sedan Chair that went with it. The heel was a class statement: the rich, including men, were the “well heeled.” And they could wear heals, unlike “the mob” (or the mobile) because they did not have to walk themselves. Those sedan chairs carried the elite feet from door to door. At leaset they knew it was rediculous to attempt to walk in them. Only the poor, who could not afford the carriage or the chair, had to wear sensible shoes. It didn’t hurt that heels also made the Nobility taller than the peons (Neal Stephenson’s Baroque Cycle novels has wonderful descriptions of such culture clashing contrasts}.

The heel, alas, eventually made its way to the rest of society who did not have the sedan chairs to go with them, and generations of foot, hip and back problems have ensued.

18thC Men’s Shoe; 21st C men’s trainer. Differences?

VFF’s with Z-Health

VFF’s get our feet out of the might-as-well-have-foot-binding heels and their opposite sensory deprivation tank trainers and back into the world of the ground beneath our feet.

VFF’s are rather like taking the Matrix’s red pill — at least at first — because the transition can be a bit of a challenge (and there’s no going back). As with Neo being rehabilitated to get his body ready for the real world from machine world, our mechanics will need to change: unused or atrophying muscles need to be brought back on line. Thanks to the SAID principle, we get used to the near-barefootness relatively quickly. Try to go for a run and heel strike and that adaptation is accelerated.

The thing is, though, we may still have various compensations in our movements that don’t know how to let go of their dysfunction: we need to reeducate them on how to perform normally.

Z-HealthEnter Z-Health: it helps reeducate the foot (and other parts of our body) to move like we were designed to move.

So, joint movement — and freeing all those joints in the feet — is a very good idea just for their local health: if joints don’t move, crap can collect around them and not get moved on; surfaces can wear from uneven use or simply atrophy from lack of use. SO VFF’s help get the feet to move. Z-Health helps optimize that opportunity so that we get moving well.

How Z-Health goes about this re-education is in several phases. The first phase is all about this neural re-education, and is appropriately called R-Phase, descrribed in detail at Here a set of joint movements are taught via the R-phase and Neural Warm UP I DVD’s (or via in-person instruction). The goal here is precision: perfect movements to hit each joint in the body for getting greater signal to the nervous system. Better joint health is a wonderful side effect. It’s because of this precision that seeing a Z-Health coach for a tune up, as with the performance of any skill, can improve effectiveness and technique immensley, very quickly.

For instance, a key movement in R-Phase is an “outside toe pull” as shown in the table below, and as described in this t-nation article featuring Dr. Cobb. First a person is asked to press a dumbbell a few times with their right arm and rate their perceived exertion; then they’re asked to do a series of toe pulls with their left foot, one of these is described below.

Target Position

The Outside Toe Pull: Begin in neutral stance, reach your leg behind your body, and curl the toes under with the knee in a neutral position. Let your ankle fall to the outside of your body and then use the knee and foot position to create a “stretching” mobilization just below the ankle in the target area pictured.

Once positioned correctly, perform five slow mini-squats with the front leg. Again, if you’re doing this correctly, you should feel a strong stretching sensation in the target area.

Once the person has done the pulses with the toes, they’re asked to press the weight again and re-rate perceived exertion. Two things happen: improved efficiency; better form. The story of why this happens again gets down to reminding the body how it moves best, openning up signal paths, and enabling better control throughout the whole system to perform the movement. And Z-Health is very big on each rep of a movement being a Perfect Rep (more about that perfect rep here)

Time spent in R-Phase is time spent learning and practicing “hitting the target” of these joints perfectly. It makes all the difference. When I was first learning toe pulls, I was not getting this precision of being sure to go for the space between the calcanus and the cuboid on that outside toe pull. It felt ok, but not revolutionary. When I went to the R-Phase certification, and we learned to cue each other in exactly where to feel that pull, well yes, it was pretty amazing. And now, I can trigger that sensation any time. It’s like a little rush of relief and release in my feet.

But there’s more. It’s that signal openning effect which is great to turn on before physical activity like a walk or a run or a lift. In working with athletes at a recent RKC certification, one of our team said that his hip flexors were feeling tight. I showed him a middle toe pull (not a big honking stretch) and voila. He looked at me with amazement in his eyes that his movement freed up. We are just that connected.

If you want even more signal for more movement more of the time: more Z-Health

Once these “hitting the target” moves are well established, preferably having had the form checked by a Z-Health coach, the next stage is to integrate these moves into more real life work. Hence I-phase, described in this more detailed overview. Effectively, once the vocabulary of Z-Health is learned in R-phase, I-phase lets athletes practice building movement statements by adding new positions and having those positions add muscular load. Adding load to mobility moves into strength/stability, and also fires up even more signals to the nervous system, as the muscles are well populated with mechanorecpetors as well.

There is a third phase to Z-Health movement work, S-phase, which gets into translating that laoded mobility work (what some might call strength work) into speed (the new S-Phase DVD’s are being readied for release as of this writing). Speed work is a fabulous test of mobility control and a fabulous way, with the basics in place, to develop higher preparedness for moving through the world at any speed. This concept of speed is introduced right from R-phase: the movements are learned to be practiced at 4 speeds, from super slow to what’s called “sports speed.” Each has its challenges; maintaining movement control and efficiency at speed is a particularly gnarly one (makes me feel very much like the “when you can grasp the pebble in my hand, grasshopper…”)

So Z-Health is an approach to help us get the absolute most out of our VFF’s by helping us move our absolute best with those freed up joints, from head to toes.

And just to reiterate, while the general practice of following along with the Z-Health DVD’s is fabulous for improving movement and wellbeing, supplementing that practice with a tune up session with a Z-Health coach is really worth doing. Likewise, if you’re feeling some pain when you “move like this” – where this is getting up from a chair, moving your arm up to brush your hair, doing your deadlift, or sometimes when you go for a run, then a movement assessment with a Z-Health coach can help you fire up your own best movement to heal yourself. Seriously. If you’ve gone to a Chiro or Physio to help you get out of a crisis, Z-Health can help lock in the fix, too.

I know this all sounds a bit amazing, but it’s us: we are pretty amazing. If you’re interested, look into the concept of neuroplasticity in a book like “the Brain that Changes Itself” (Amazon Us | Amazon UK) to see what Z-Health is leveraging to help us train ourselves into wellbeing.

Summing Up: Putting VFF’s and Z-Health together.

VFF’s let our feet move more naturally in the environment. That means there’s very little mediating how the foot can move or of what it can be aware.

Right away that openess enhances the information the nervous system has to use to make sure our bodies are safe moving in the environment.

Z-Health provides an approach to enhance the neurological signals that a freed foot can send to the nervous system. It does this in several phases: the first phase, R-Phase, teaches the drills I’ve described to get all our joints to move as they’re designed. If folks only do R-Phase they find huge benefit – including reduced pain and improved function.

The second phase, I-Phase, takes these movements that have been done “standing in neutral position” and runs them through more postures that increase demand on the body. If we move from standing to a lunge position, with 80% of our weight on a lunging leg, we feel that muscle being used more; we’re also in position that requires more balance. Being able to perform precision movements of joints in these postures fires up more of those nerves to signal position in space; it also means that we are practicing moving our bodies in more positions that we will find ourselves in in real life.

Practice, as with anything, prepares the mind and body to better cope with the real (Here’s a long digression on practice and lots of it). If you do ankle work in a lunge position with your foot turned in, your body will know better how to respond to that position when in encounters it running on a trail at speed. And speaking of speed, S-Phase is the “Run Forrest, Run” of Z-Health — but not just linearly; it zigs, it zags; it stops; it starts. Just like life.

Better joint function, better ifnromation for the nervous system to use to keep us moving safely through space. Better movement througout our bodies, less pain.

So while VFF’s are fabulous if in no small part because they let a foot be a foot in an urban environment, Z-Health helps optimize that freedom to move and feel better.

mc, phd, holds a readership in computer science in the UK, doing research on creativity for innovation, discovery and quality of life. Related to this, she also holds various training certifications, including nsca cscs, rkc, ck-fms, ikff ckt and of course the Z-Health movement integration specialist certification. She also runs the blog and “i am geekfit” blog, and is a big fan of drop her a note her via her RKC page.

If you think you might want to get Z-Health certified yourself (review here), email [email protected] and let them know mc suggested you write 🙂

© mc, 2009, creative commons license.

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8 replies on “Vibram FiveFingers & Z Health: Moving and Feeling Even Better.”

Sorry, that was my fault – I meant to say “this,” referring to Z Health.

Pose and ChiRunning – from what I understand – are methods of promoting good form/alignment via strengthening exercises that cause a midfoot strike. I’m just curious to find out how this differs (besides the fact that it doesn’t seem specific to running!).
They seem to be similar in that they reeducate the foot.

Chi or Pose running has nothing to do with Z-Heath. Both are good to get better running technique. But you could easily combine Z-Helth with either as they are completly different modalities and want to achive different goals.

My take on Midfoot, Forefoot or Heel strike: All are correct techniques. Landing more on the rear of the foot has less damping but saves a little energy. Landing more on the front of the food has more damping and enables you to generate more power. So a heel strike has advantages for slow very long runs where the forces aren’t very high so the damping isn’t as important but saving a little energy might be an important factor. Faster shorter runs profit from landing more on the front as the forces get higher at higher speeds so the better daming makes sense. Running a 60m sprint with a heel strike is just plain dumb as you are trashing your joints and you’ll never achive your highest possible speed as you don’t use the powerer of the calves/Achilles tendon to their full potential.

I am currently training for a marathon (just finished my 12 mile long run week) and I’ve noticed that my lower calves and ankles hurt a lot. I wear ASICS Gel Nimbus 10s. Last Sunday, a friend asked me why I run on my toes/mid-foot to which I replied I don’t know, I just run. Has anyone known someone that seems to naturally run midfoot form or is it something that really has to be taught? And could the shoes I’m wearing actually be hurting me since they weren’t designed for the way that I naturally run?


It’s possible that your shoes are getting in the way of your training, but it’s hard to say for sure. To complicate matters further, I don’t think it’d be wise to test the shoes-theory by barefooting 12 miles out the gate, either.

However, you might be better off consulting with the various forum members who run — check it out at


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