I recently had the opportunity to take part in the first public offering of VOILÀ - Structural Joint Balancing out in Los Angeles, California. The intent of this post is to give an account of the course and what I have taken away from it. So, here is a rather quick checklist before you continue reading on:
Cool. Let's get after it then:
What is VOILÀ?
VOILÀ is "a Structural assessment and treatment tool to assist the practitioner in saving time. VOILÀ quickly and efficiently finds the dysfunctions causing the loss of Equilibrium forcing the body to adapt and overcome deficiencies of movement within the human structure."
This approach was created by Joel Crandall, owner of PhysioCareCenter. VOILÀ is the pseudo-end product of Joel's various studies in the fields of bodywork, kinesiology, and strength & conditioning to name a few. I say pseudo-end product because:
a) VOILÀ is still very new and I am sure will continue to evolve over time, and
b) Is any method or approach beyond growth & development? I tend to not think so. I think everything evolves based on the individual clinician who is assimilating the knowledge, and how they integrate it into their own experience and treatment methodology.
The Course Experience
The course was held over 2 days at AmenZone, which was a really cool training gym in Manhattan Beach, CA. I can honestly say that I had NO expectations walking into this course. I can admit, with confidence, that I really had little knowledge of what the course was going to teach, how it would integrate into my practice, and what I would come away with by the end of the weekend. I was intrigued, like so many others who sent text & Facebook messages to me during that weekend (and over the week following!) because there were a lot of posts related to the ease if this system and the remarkable effectiveness of its results by those who were already trained and using it.
I was happy to see that It was nice size class, with plenty of access to both Joel and his teaching assistants, all of which were super helpful and able to make sometimes complicated information easily understandable. There were a few familiar faces of people I have met in other courses, and it was great to meet a lot of new people as well! What I also liked was the diversity of the group. Many different professions and disciplines working in a variety of settings, all coming together to add to their knowledge base.
One word of caution in a course of this nature -- I was very much not prepared for the mental & energetic workload, and each day I can say I was exhausted...but in a good way! It was the kind of exhausted that feels like your nervous system has been taxed, but your body feels great as you get all your own dysfunctions worked on. My advice is to go in mentally & energetically prepared. This course is very hands-on, and you definitely get a lot of time to go through the assessments and corrections, and talk through the process with your fellow attendees.
Also big props to Proven Nutrition, who is a sponsor of the Structural Joint Balancing - VOILÀ Seminars. Richard is definitely good people, and they as a company are built on great values, which therefore is a company I can get behind. To top it off, they provided a really great all natural energy drink to help keep us focused and hydrated. Looking forward to exploring their other products.
How Does VOILÀ Fit into Clinical Practice?
This is still a question that I am working on answering. In going through the course, we discussed a variety of areas that VOILÀ can be utilized: the physical therapy & chiropractic clinic, bodywork & massage clients, sports performance and strength training. It is easy to identify where this approach can fit, the questions I am still working over in my brain (and with some of my clients) are:
A) At what point do we utilize it?
B) What patients/clients is it the best fit for?
C) How does it fit with other systems or models?
I see application here in a variety of places. I think for the discussions on calming the Autonomic Nervous System and Syncing the Diaphragms, this can be a great starting point for a client session, especially for patients dealing with chronic pain who haven't responded to more active or exercise-based approaches. This may be a way to calm the system, reduce the brain's perception of threat, and open a window to start making changes to the movement system. I also see application in sports & performance training, as well as in general orthopedic rehab. The benefit that is most striking is in the area of Preparation, where you have a system that you can use to quickly and efficiently balance the body, reduce excess tension, improve proprioception, sensory awareness, and mental focus. As I read this last line, I am also inclined to say it would fit in the Recovery/Regeneration bucket as well.
Of course there will be the usually complaints that there is no evidence base, as there are no RCTs or Systematic Reviews on this modality from either an assessment or treatment perspective. This is true. The best we have is to extrapolate information from other disciplines to give a logical explanation as to what is happening and why certain changes are taking place. Based on information from other areas such as Bodywork, Osteopathy, Motor Control, Physical Therapy, etc, I am confident that with the right resources and opportunity, a literature base can begin to be built to help provide a high quality evidence base for this approach. All that is needed is documentation that fits the rigors of the scientific method to show positive effect, not to show that it is somehow "better" than another approach. This is were many lose sight of what research is and why an Evidence Base is important. And judging by some of the flawed methodology, poorly designed, over-reaching crap that is making its way into some of the journals these days, I often find myself losing faith in the "rigors of peer review and the scientific method." But for me personally, there is one test that I have grabbed onto over the years that seems to be the most logical, common sense, easy to apply test out there which even gets used to appraise the research.
You're curious now, huh? "What is this test you speak of?" If any of you are familiar with Mike Boyle, you may have come across his mention of "The Shit Test." I credit Coach Boyle with it, because he's really the first person I heard it put so eloquently.
Not what you expected, huh?
The 'ST' for short, simply means that if an exercise doesn't look right, the form is off, the alignment is not maintained, the person is working like mad when they shouldn't have to be, then the exercise doesn't pass the 'ST' and should be stopped and coached. I have applied the 'ST' time and time again when reading research articles, assessing movements, listening to sales pitches, etc. In my world, the 'ST' is on par with 'The 4 Agreements,' as both have yet to steer me wrong. So my point -- having no prior expectations of what this course would be, I have to say that it passed with flying colors! I was not willing to host a new program without going through it and experiencing it first, and I am more than willing to host VOILÀ here in Las Vegas in the future. I am looking forward to continuing my study of the cranials and their effect on the system, and I am looking forward to continuing to utilize and refine my use of the VOILÀ assessment and treatment. Another big plus to this work is the community of individuals that I can bounce ideas or questions off of. I have had this format of 'community education' from a few other courses in the past, and it seems to be the way many are going thanks to the technology. I believe this is a good thing.
So for now I will keep working through the course material, keep applying it with family, friends, and clients, and I will continue to see what the results are like in my own daily n=1 environment. How it fits into or with other systems is also something that I am working through. I think for a long time I always wanted to put everything together, like educational treatment legos. Over the last few years I think I have gotten a little wiser. I think my view has more to do with determining where the client is at, what it is that they need, and which buckets do we need to focus on. ALL the skills sets and modality options don't necessarily need to be used ALL the time. Deciding what intervention is best suited to fill in the gaps and needs of the client is the tricky part. I don't believe there is one holy grail system or intervention, rather, I believe it has more to do with the ability to identify needs and then create solutions.
I suppose another way to say it is "The Model is more important than the Methods." At least that's how I am seeing it, but that's a post for another time!
Some may feel that my initial check list comes off as harsh. Some feel it is a failed attempt at humor. Others understand exactly what I am talking about and where the list comes from.
I found it interesting that I received so many inquiries regarding the course, what it was like, and was it "the end-all, be-all." It seems there was a bit of perceived controversy surrounding this course and program. I can only say that "perceived" is the operative word here. I am always amazed at how people want to poke holes in a system without ever going through a course or actually studying the system. I would venture to say that a vast majority of people who bash the Functional Movement Screen and attempt to put out publications aimed at discrediting it have never even taken the course. MAYBE the have read Gray Cook's 'MOVEMENT' book, or took the online FMS Certification....maybe. Personally, I have a terrible time with MDT, and when I break out repeated end range movements and get a reduction in symptoms (like I did earlier today!) - for me that's a win and happy-dance worthy. For some of my colleauges who are MDT trained, I'm an idiot who's mostly bastardizing a system. And it's true, I haven't taken the courses. I haven't gone through the program. I'm working on limited capacity based on basic training and a basic knowledge of their principles, so why should I expect to win more than I lose? Same applies for any system, in my opinion.
The most common input I received regarding the resistance to this course was that people didn't like how it was portrayed in writing via Facebook posts or testimonial videos.
?? Seriously ?? (...rolling my eyes the way only my 8 year old daughter can...)
Let's take a step back for a minute. There are a few people who I would like to study with, some I have started taking courses from, and all are on record being very adamant about their system and way of doing things. Andreo Spina. James Dunning. Gray Cook. Charlie Weingroff. Even Stuart McGill could make this list, as all are super intelligent, believe in their method or way of doing things, achieve great success with the patients and clients they work with, yet for those of you who are aware of these names, I am sure it is obvious that there are some stark contrasts in these various programs. What I admire and respect about each is that they know who they are, what they believe, and your opinion is irrelevant. I mean, certainly they would like you to understand and agree with what they are teaching, but ultimately your views and beliefs are not going to change the way they practice. This one might come back to bite me, but I'll throw it out there anyway: To say that a program is promoted as being 'too successful,' what does that say about your expectations for your clients? I am FAR more inclined to take a course being touted as a game changer than one that's just another approach. But that's just me.
So, in conclusion -- It's great to be involved with a program at it's in its infancy, and I do recommend this course if the content resonates with you. For me, it filled a knowledge gap that I had related to the cranials and has provided me with a path of continued study. I see benefit to this line of thinking, so for me it was a win! Joel and his teaching assistants are also readily available to answer questions, and he has encouraged attendees to continue blending the foundation we've gained in the course with our own imagination and skill sets. Certainly there is much work to be done, and I look forward to the advancement of the work.
Questions or comments? I am more than happy to entertain them!
Kristopher Bosch, PT, DPT, ATC, FAAOMPT is a practicing physical therapist and athletic trainer in Las Vegas, NV where he founded Athletes Physiotherapy. Located in Henderson, Athletes Physiotherapy specializes in Orthopedic & Sports Physical Therapy with a niche in High Performance.
Thank you for stopping by the Athletes Physiotherapy Blog! Kristopher Bosch founded Athletes Physiotherapy in Las Vegas, NV. He is a Father, physical therapist, athletic trainer, pilates teacher, & perpetual student!
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