Movement is a language we must learn to speak. To speak it, we must first understand its base elements such as lettering, vocabulary and sentence structure. Once we master its elements, movement becomes less esoteric. Dynamic neuromuscular stabilization (DNS) is the Rosetta Stone for movement; it is the code that allows an individual to witness, better comprehend and speak movement.
In its simplest description, DNS is movement efficiency. DNS is based on the principles of developmental kinesiology and how the development of the neurological system affects structure and movement. DNS identifies the postures and flows of movement within the human locomotor system. To do so, it refers to the most unaltered movements we can witness within humans: those of babies. Babies are not taught to move; they simply act, in which lies the purest form of unaltered movement. Through witnessing these postures and movement patterns, one can observe how the basic elements of movement integrate into more dynamic and challenging postures and patterns. Utilizing these principles of movement as a reference point, a person can better comprehend the intent of movement rehabilitation.
DNS and the backbone of movement
With good brain development, a baby achieves specific movement, within certain parameters, as do all other neurologically astute babies of the same age. The uniqueness of this indicates there are ingrained movement patterns within the human species unique to humans. If this were not true, we all would be adopting different movement patterns. From an ontological perspective, this would impede the procreation of a species. Due to the nature of life, procreation within a species will pass along certain parameters to future generations. Throughout time, this has created an ideal way for us, as a species, to move. Movement is a key expression, if not the key expression, of life and all living beings.
The question that eludes both clinician and patient alike is, “What is ideal movement?” We all move relatively the same way; however, there are still variations from person to person. Variations may arise due to sport, anatomy, injury, trauma and surgery, to name a few. All diagnosing healthcare providers, regardless of profession, need to respect these boundaries, yet also need to understand if or when to allow appropriate deviation away from ideal movement(s). Allowing for deviation does not mean we allow the ideal movement pattern to become obsolete if the goal is to restore an individual’s health and function. Rather, the goal should be to maximize the efficiency of movements for which the individual has the capability and capacity – which is DNS. DNS is the backbone of movement. It is the observational lens through which we best witness the integration of the unaltered building blocks of language into the complex sentence structures of movement.
DNS within the chiropractic toolbox
The benefits of DNS, within the toolbox of a DC or any other healthcare provider, are substantial. Often, anatomy, movement and function are taught in a Vesalius way. Within the living world, the body and its parts do not cooperate the same as within a corpse.
DNS goes beyond providing life to the corpse model and allows a practitioner to witness where, how and why a person may be suffering from limitations within their locomotor system. DNS helps the practitioner comprehend why a movement limitation in one area of the body may be affecting another area of the body and to appreciate movement capability as a global phenomenon.
DNS helps address common thought processes
There are always catch phrases, slogans or one-liners people become attached to. Sometimes they are for the better, and at other times, they become a hindrance. A current fad over the last 10 years within rehabilitation has been the paradigm around stability and mobility.
Many practitioners currently think in terms of local stability and mobility, but often get lost in thought and assessment of regional and global patterns of stability and mobility. The philosophy of DNS empowers a DC to think about local stability/mobility paradigms along with regional and global stability/mobility paradigms. Pain in one area of the body may be the manifestation of a reductionist support zone within another area. A person cannot move without sufficient support. This is a natural law. Understanding natural support zones in all (local, regional and global) patterns enables a DC to be more targeted, specific and effective with care.
The ever-popular slogan “proximal stability for distal mobility” has reached every corner of rehabilitation within the U.S. by now. This is absolutely a true statement for open-chain movement patterns. Still, half of movement is in a support function. To some degree, this means the opposite slogan, “distal stability for proximal mobility,” is equally true. Vesalius described movement and direction of muscle pull from the torso of a human corpse. As a result, the direction of muscle pull was distal to proximal. To dissect forward gait, if a foot is in contact with the ground, the foot is in support function, and the muscle pull on the limb is proximal to distal. It’s the dichotomy of movement: You cannot have movement without support. There must be a balanced approach in all forms – assessments, treatments and audits. As a practitioner, understanding when, where and why a patient is suffering — from pain or limitations — can be crucial to providing effective and efficient strategies both in the office and at home.
DNS’s power to the patient
The power of understanding DNS principles for a patient is very similar to that of a DC. The largest difference between the two is the depth and integration of the understanding. If you are a DC, you need to know DNS not just for the things noted above, but because health is your profession.
For a patient, DNS gives answers beyond what tissue is hurting through a diagnosis. When a person can physically understand themselves better, they can become a part of their care. It is the difference between a passive and an active approach. DNS gives the “why” to a patient and the building blocks to create more elaborate movement sentence structures correctly. Then, it is on the patient to care enough or not to execute the exercise prescription(s).
DNS provides an exercise blueprint of movement efficiency. There are specific positions which a person can start training movement efficiently within; however, the starting point, or needed input of the same position, for each individual may be entirely different. It all depends on where the person’s intrinsic movement vocabulary is. However, any exercise, movement pattern, lift, etc., can incorporate principles of DNS. It is not limited to specific exercises, and this is one of the greatest benefits, if not the greatest benefit, to a patient. DNS is not just a technique; it is a philosophy of movement efficiency. DNS, in its simplest form, is movement efficiency. By understanding the principles highlighted within DNS, a person can recapture autonomy of one’s movement capability and capacity for the betterment of their overall health.
KEITH SPARKS, DC, is an award-winning doctor of chiropractic, functional medicine expert and the co-founder of ICT Muscle and Joint Clinic. Sparks is a certified DNS practitioner (DNSP) with an emphasis on care originated within the fields of rehabilitation, soft-tissue therapies and chiropractic. Sparks is often seen in the Wichita, Kan., community speaking at business events and teaching health and performance classes. He can be contacted at drkeith@ictmjc.com or for more information, visit ictmjc.com.