Understanding DNS: Stabilization Made Simple


Most of us take everyday movement for granted, giving little thought to sitting, standing, walking and running. But before you ever move a muscle, your brain and central nervous system (CNS) set you up for success by activating certain muscles to stabilize you. Without stability, your chances of losing balance or becoming injured increase dramatically.

Dynamic neuromuscular stabilization (DNS) is a strategy for optimizing stability, based on fundamental patterns of early human development.

Foundations of Human Movement

Human infants are unique in that they are virtually helpless at birth, unable to move about and fend for themselves. All other mammals, including dogs, cats, horses and wild animals, are able to stand and ambulate almost immediately after birth. This innate ability is encoded in mammalian DNA.

Humans also possess an innate ability to become ambulatory, but it takes place in several stages after childbirth, culminating in the ability to walk by about the age of one. Posture, movement and gait rely on neuromuscular stabilization for motor control, which is primarily established during the first year of life. Breathing, movement patterns of the trunk and extremities and the interplay of joints are all regulated by the CNS.

The posture and movement patterns of newborn infants are considered the gold standard for human movement because they innately develop from the CNS. Over time, those patterns can be disrupted by a number of factors, including poor posture, injury, lack of physical activity, repetitive motor patterns and other habitual behaviors that compromise the stabilizing system.

DNS Basics

The principles of DNS as a therapeutic method are founded on certain fundamental factors:

  • DNS begins with an evaluation of breathing patterns. Your diaphragm performs the dual functions of facilitating breathing while simultaneously creating sufficient intra-abdominal pressure (IAP) to stabilize the core. This approach runs contrary to many core stabilization theories that emphasize contraction of the abdominal muscles. Core stabilization should be mastered before moving on to therapeutic exercises.
  • Prior to any movement, your integrated stabilizing system consisting of the diaphragm, short intersegmental spinal muscles, deep neck flexor muscles, abdominal muscles and pelvic floor muscles, are automatically activated as a functional unit to provide stability, balance and efficiency of movement. When those muscles are not appropriately activated, it can lead to dysfunctional movement patterns that result in pain and injury.
  • When dysfunction occurs, it most frequently affects the muscles that support and stabilize the joints. The problem is not muscle weakness, but rather the inability to properly activate the muscle. To achieve optimal movement, the joint must be maintained in an ideal position throughout the entire movement.
  • DNS therapy strives to instill appropriate motor activation patterns in the brain, so they become automatic. The ability to sense joint positions (proprioception), heighten movement awareness and increase motor control are all goals of DNS.

DNS and Sports Performance

DNS is becoming increasingly popular among athletes who want to achieve their performance potential and avoid injury. The same principles of stabilization and movement optimization apply to execution of sports skills. Elite athletes rely on DNS to maintain their competitive edge and prolong their careers.


At NYDNR, our clinical director, Dr. Lev Kalika, learned DNS directly from its founder, Dr. Pavel Kolar of Prague’s renowned School of Rehabilitation and Manual Medicine. As a long-time practitioner of DNS, Dr. Kalika’s experience and expertise set him apart as one of the foremost DNS therapists in the United States.


If you want to move better without pain and stiffness, DNS therapy can lay the foundation for enhanced movement and improved quality of life. Contact NYDNR today, and get moving like you were born to.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

Buy now 3D Gait
Payment Success
Request Telehealth Request Telehealth Request in office visit Book now