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April 30, 2021

Dynamic Neuromuscular Stabilization. What is it and how can it help you?

Dynamic Neuromuscular Stabilization.  What is it and how can it help you?

Dynamic Neuromuscular Stabilization, or DNS, is a manual and rehabilitation technique that was created by Dr. Patel Kolar out of the Prague School of Rehabilitation.

The Prague School defines DNS as this: “The nervous system establishes programs that control human posture, movement and gait. 

This ‘motor control’ is largely established during the first critical years of life. 

Therefore, the “Prague School” emphasizes neurodevelopmental aspects of motor control in order to assess and restore dysfunction of the locomotor system and associated syndromes.”

So, what does this even mean? To simplify, DNS is a rehabilitation technique that uses specific positions from childhood development to stimulate the movement centers in our brain, which will help us restore ideal movement and stabilization patterns.  

Some Basic Principles of DNS

The basic principles of DNS are Intra-Abdominal Pressure (IAP) and Sagittal stabilization.   In most injuries we see and treat, one or both of these has been compromised. 

The sagittal plane is one of three planes of movement that we operate in.  The saggital plane runs through the midline of the body, dividing it into a right and left half.   Sagittal stabilization is the first plane of movement that we as humans learn how to control, and therefore the first we need to correct in injury and movement dysfunction. 

Movements in the sagittal plane include any type of forward flexion and backward bending (extension).  The most common postural faults that we see are dysfunctions in this plane.  Examples of this would be the upper and lower cross syndromes.   These can include forward head carriage, forward rounded shoulders, rounding/hump of the mid back, and anterior pelvic tilt, which are all results of loss of proper stability in the sagittal plane. 

Sagittal stabilization is completely dependent on the diaphragm’s ability to create Intra-abdominal pressure (IAP), while still performing its breathing function. Because of its critical function in creating and maintaining stability, DNS approach begins with assessment and correction of the diaphragm and its breathing function. 

Stabilization is automatic and unconscious!!

Dynamic stabilization is required and essential for movement of the head and limbs, and it’s key to proper spinal support when standing or sitting.

Stabilizing our body is automatic: prior to a movement, our short intersegmental spinal muscles, deep neck flexors, diaphragm, abdominal wall, and pelvic floor prepare to stabilize the body (this is called our Integrated Stabilizing System).

And why does this matter?

If one muscle is dysfunctional, the whole stabilizing function gets out-of-whack and then movement is compromised.  

Other muscles will overcompensate to make most regular movements possible, but the inefficiency of the imbalanced movement eventually overloads the superficial muscle groups.

This, overtime, will lead to injury.

How do we use DNS to fix these problems 

The first step is to assess and correct the function of the diaphragm.  This is done by assessing both the breathing pattern, and the patients ability to create IAP in several different positions.  Specific cues and manual therapy interventions will be used to optimize diaphragm function.  The treatment is usually started in lower developmental positions such as, 3 Month Supine (see below), because these are familiar positions for the brain, and the pattern will be adopted much quicker.  

Once the patterns is normalized in the lower developmental positions, progressions to higher developmental positions and active “flows” between positions can be introduced.  The goal of treatment is to achieve the ideal movement pattern and then integrate it into the patients daily life.  This can be applied to a high level athlete to enhance performance, or a desk worker who is experiencing low back or neck pain, and every person in-between. 

Is DNS for you?

Most likely, yes!  Over the course of our lifetime, we experience many different injuries, whether they be large or small, or even sickness, that can change our ideal movement pattern. 

The best way to really learn what DNS is and does is to experience it for yourself.  It is very important to actually feel and experience the difference between proper activation vs improper activation. Activating these pathways and centers in the brain is what creates that lasting and powerful changes that DNS can make. 

Schedule an appointment with us today to feel the impact DNS can make!

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