Dynamic Neuromuscular Stabilization and Quadrupedal Locomotion

DNS (dynamic neuromuscular stabilization) is a manually assisted functional exercise method based on the developmental stages of an infant during the first year of motor development. Every infant follows specific gravity-dependent patterns as they progress by small increments, from lifting the head in a prone position to gradually walking and running. As each new skill emerges, the baby experiments and practices with it until it is mastered.

Developmental skills mastery is dependent on the maturation of the central nervous system (CNS), which governs physical maturation and is thereby responsible for the structural development of muscles, bones, and connective tissues. As the brain develops, skills mastery of motor patterns progresses, and structural development ensues.

The DNS method follows these same principles, tapping into the patient’s innate instinctual motor patterns to optimize movement. Bad postural habits, injuries and compensation patterns can cause the muscles to “forget” optimal motor patterns. The role of the therapist is to choose the right position to restore the brain-muscle connection, and to manually guide the patient into correct movement with a specific DNS skill.

Spinal stability is key to efficient movement. Achieving spinal stability requires a 3-way interaction between the CNS, muscles and skeletal system. Conventional injury rehab and pain treatment typically focus on healing and strengthening the musculoskeletal system, to the neglect of the motor control mechanisms of the brain and central nervous system, but all three must be addressed if optimal movement is to be restored.

Intra abdominal pressure (IAP) plays a key role in spinal stability. During the early stages of an infant’s development, the diaphragm functions as mainly a respiratory muscle, but as breathing becomes coordinated with abdominal activity at around the age of 6 months, the diaphragm assumes dual roles as both a respiratory and a postural muscle. During physical activity, the diaphragm plays a critical role in stabilizing the spine during complex motor sequences.

One key posture and skill level achieved at around 9 months is quadrupedal locomotion, or crawling, where the infant learns to coordinate the movement of all four appendages to accomplish forward momentum. Crawling requires not only strength and coordination of the arm and leg muscles, but also shoulder and scapular centration, stabilization of the thoracic spine, recruitment of the core abdominal muscles, and intra-abdominal pressure to stabilize and unload the spine.

In the quadruped position, a stable spine depends on hip and shoulder/scapular centration to optimize axial extension. In this position, the core musculature is automatically activated and communicates with the contralateral oblique chains to coordinate movement.

DNS uses the crawling position to retrain the brain to properly align and stabilize the spine, to restore optimal movement. By repeating this fundamental developmental exercise, the clinician guides the patient to “remind” the muscles of their ideal motor patterns, and restore optimal connection between the CNS and the musculoskeletal system.

DNS in the quadruped position can be used to treat multiple pain syndromes, including:

• low back pain
• mid back pain
• neck pain
• shoulder pain
• hip pain
• knee pain

Integration of ideal stabilization patterns in sports activities can potentially reduce the risk of injuries and secondary pain syndromes caused by overloading of the muscles and joints, and is likely to enhance athletic performance.