Dynamic Neuromuscular
Stabilization (DNS)

About DNS Therapy

As adults, most of us cannot remember the last time our bodies felt amazing, capable of running, jumping, doing cartwheels and hanging upside down without pain or inhibition. Watching young children at a playground engaged in unstructured play reminds us of the days when our bodies were bursting with energy, moving effortlessly from one activity to the next as if gravity did not exist.

However, human children are not born that way. We are born helpless, a puddle of soft tissues and organs that are still developing. During the first year of life, we achieve developmental milestones as we learn to overcome gravity, first by lifting our heads, then rolling over, creeping, crawling, pulling up to standing, and finally taking our first tentative steps to become bipedal.

Those developmental milestones are hardwired into our DNA, triggering a natural progression from one stage to the next until we are able to run and play with reckless abandon. But for most of us, the pinnacle of our early development is short-lived. Lifestyle behaviors, injuries, and a host of circumstances beyond our control conspire to undermine our dynamic stability, robbing us of the joy of uninhibited movement.

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Dynamic neuromuscular stabilization (DNS) therapy is a method of tapping into your innate developmental software, to restore efficient muscle firing patterns and promote pain-free fluid movement. DNS rehab is used by elite athletes to override acquired compensation patterns, and by everyday patients suffering from pain syndromes and movement disorders.

Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

Dr. Lev Kalika
Dr. Kalika with
Dr. Pavel Kolar, creator of DNS therapy

About Dr. Lev Kalika, Certified DNS

Dr. Kalika, clinical director of NUYDNRehab, was among the first to introduce DNS to the United States, and he remains one of only three certified DNS practitioners in NYC.

Dr. Kalika was first introduced to DNS while studying in Prague at the renowned Prague School of Rehabilitation. He trained under Dr. Pavel Kolar himself, who discovered and developed DNS therapy. Dr. Kalika was one of the early practitioners of DNS, acquiring his skills in DNS rehab, decades before it became widespread.

Dynamic neuromuscular stabilization is one of many innovative and alternative therapies available at NYDNRehab. Dr. Kalika and the NYDNRehab team are committed to helping patients move freely, without pain, and with reduced risk of injury.

Dr. Kalika’s expertise is sought by athletes, runners and ballet dancers in the United States who rely on his knowledge and experience to achieve and maintain peak performance.

How Does DNS Physical Therapy Work?


Dynamic stability is essential for any whole-body movement, but it entails more than just muscle strength. To achieve stability with the body in motion, you need precisely coordinated muscle firing patterns, combined with diaphragmatic breathing to create adequate intra‐abdominal pressure. Dynamic stability is achieved when the forces that stabilize the spine work together in harmony. Those forces are regulated by the central nervous system.

Dynamic Neuromuscular Stabilization (DNS) gives us the tools we need to assess and activate the intrinsic spinal stabilizers, as pre-programmed from birth. During the DNS assessment, a trained practitioner looks for key factors that indicate sub-optimal coordination of movement.

There are five basic DNS tests:

  1. The seated diaphragm test, to assess breathing and intra abdominal pressure (IAP)
  2. Supine neck and trunk flexion test, to assess coordinated activation between the diaphragm, scapula and neck flexors
  3. Prone neck extension test, to assess coordinated activation of the paravertebral muscles and the abdominal wall
  4. Supine arm elevation test, to assess isolated shoulder movement
  5. Quadruped forward rocking test, to assess for balanced activation between anterior and posterior musculature, and alignment between the chest and pelvis

The goal of DNS is to restore stability to the trunk and to the integrated spinal stabilization system. During a DNS therapy session, the patient is placed in a position that mimics the posture of an infant at a specific stage of development.

Why Choose NYDNRehab for DNS Physical Therapy?

Today, DNS therapy is more relevant than ever. The technological revolution has made humans more sedentary, less fit, and more overweight. Even young children are less active, and obesity among school-aged children is rampant. Unfit children grow into unfit and sedentary adults, and movement disorders abound.

Even elite athletes develop muscle imbalances and compensation patterns over time. Injuries from trauma and repetitive overuse can disrupt neuromuscular pathways between the brain and the body, resulting in sub-optimal muscle firing patterns that undermine performance and increase injury risk.

At NYDNRehab, we are always looking for new methodologies that can help our patients to achieve better movement, and overcome pain and injury. Our personalized one-on-one approach ensures that you will get the exact care you need for your unique condition.

DNS movement therapy may be just one of several non-invasive approaches in your treatment protocol. Our end goal is to get to the underlying cause of your pain and dysfunction, and eliminate it for good. We don’t stop until you achieve your rehab goals, without drugs or surgery.

Why Choose NYDNRehab for DNS Physical Therapy?

Who Can Benefit from DNS Rehab?

By the time we reach adulthood, most people have developed some undesirable motor patterns that can lead to pain and disability down the road. DNS therapy can help you to overcome bad postural habits and uncoordinated muscle firing patterns that make movement more difficult than necessary.

  • People with poor kinesthetic awareness of their body’s position relative to gravity
  • People who are unable to perform basic physical therapy exercises when cued by the therapist
  • People recovering from injuries or surgery who have developed compensation patterns
  • People suffering from acute conditions like sciatica or herniated discs
  • People with chronic pain syndromes
  • People with movement disorders
  • People with poor posture
  • Sedentary people who want to begin an exercise program
  • Physically active people who want to perform better
  • Athletes who want to restore symmetry and optimize muscle firing patterns

Dynamic neuromuscular stabilization (DNS) therapy is a method of tapping into your innate developmental software, to restore efficient muscle firing patterns and promote pain-free fluid movement. DNS rehab is used by elite athletes to override acquired compensation patterns, and by everyday patients suffering from pain syndromes and movement disorders.

Benefits of DNS therapy

  • Improved spinal stability

  • Enhanced balance

  • Improved posture

  • Greater ease of movement

  • Enhanced athletic performance

  • Improved coordination

  • Reduced risk of injury


In each position, the practitioner provides manual assistance and reflex stimulation to train the patient to access optimal activation patterns. Once a basic level of movement is achieved, therapy progresses to more demanding and advanced positions.

Get the Best DNS Physical
Therapy in NYC

Anyone who wants to move better can benefit from dynamic neuromuscular stabilization therapy. If movement has become more difficult over time, DNS can help to restore efficient muscle firing patterns that improve coordination, balance and posture. Dr. Kalika’s training under Pavel Kolar and his years of experience as a DNS practitioner make NYDNRehab the clinic of choice for DNS therapy in NYC.

Range of Available Unique Physical Therapy
Treatments at Nydnrehab

Professional associations and memberships

Dr. Kalika is currently a certified member of:


American Institute of Ultrasound Medicine


Active member of ISMST

International Society of Extra Corporeal Shockwave Therapy


Active member of GCMAS

Gait and Clinical Movement Analysis Society


Active member of NASS

North American Spine Society


Active member of IADMS

International Association of Dance Medicine and Science


Active member of Virtual Rehabilitation Society


Active member of ASRA

American Society of Regional Anesthesia and Pain Medicine


American Academy

Association of Orthopedic Medicine


Active member of Interventional Orthobiologics Foundation

Lev Kalika Clinical Director and DC, RMSK

Dr. Lev Kalika has been working to revolutionize physical medicine, rehabilitation, sports medicine and athletic performance since 1998. He went to Prague to work side-by-side with Dr. Pavel Kolar, creator of DNS (Dynamic Neuromuscular Stabilization). After studying with Kolar and certifying in DNS, Dr. Kalika was the first to introduce DNS therapy to his New York patients. Dr.Kalika’s modern approach to athletic injuries has put him on the radar of some of the world’s top distance runners, pro athletes and professional ballet dancers.

Our Specialists

Dr. Mikhail Bernshteyn MD (Internist)
Dr. Michael Goynatsky DPT
Dr. Daniela Escudero DPT
Dr. Michelle Agyakwah DC
Dr. Tatyana Kapustina L. Ac.

In 1997 Dr. Kalika moved to Prague to work with world renowned rehabilitation specialists Dr. Vladimir Janda and Dr. Karel Lewitt. There he met physical therapist Dr. Pavel Kolar, creator of the dynamic neuromuscular stabilization method (DNS). Dr. Kalika worked one-on-one with Dr. Kolar to learn DNS, returning to New York in 2000 to introduce DNS through his clinical practice. In 2010, once a certification program was in place, Dr. Kalika became one of the first certified DNS practitioners in the United States.

Dynamic Neuromuscular Stabilization

Dynamic neuromuscular stability is sometimes referred to improve sports performance by optimizing the efficiency of motion.

When compared tops.

DNS is the only therapeutic method tomatic, providing a basis for healthy and efficient movement.

Conventional Physical therapy works by strengthening weakened muscles in isolation from the rest of the locomoto the patient.

Follow thIs link for more information about physical therapy in NYC.

Unlike conventional physical therapy, DNS doctor-patient dependency.

The advantages of DNS over conventional physical therapy give patients with neuromuscular disorders a superior alternative to commercially established methods of treatment.

DNS was invented by Pavel Kolar, a pediatric physiotherapist. DNS is based on the natural development of the human infant. The infant learns in a progressive and natural way to control posture and move with purpose. All infants exhibit the same progression of postures during the first year of development.

Beneath the “core” muscles lies “the deep core.” The deep core relies on the balanced use of the deep cervical flexors, the spinal extensors, the diaphragm, the pelvic floor, and the abdominal muscles tomatic and subconscious control.

Recruitment of the deep core tore or improve the precise muscular coordination and timing of the deep core can improve the efficiency of movement.

Kolar introduced the concept of “joint centration” to chronic lower back pain. Individuals who don’t use the diaphragm effectively for postural control experience increased compressive forces on the spine, preventing the spine from achieving centration.

If one link in a motor patterns can cause chronic pain, injuries, and reduced performance.

When trying tom. Focusing on core stability first before addressing the injured or weak limb may seem counter-intuitive, but it works very well.

Examining the entire motor patterns can be re-wired by retraining the brain.

The DNS approach to identify weak links in core stabilization.

Once a weak link has been identified, a series of active exercises are prescribed toring joint centration.

These exercises were developed by studying the motomatic.

The use of infant movement patterns is based on the idea that the human brain is designed to basics” or “re-booting” the brain’s motion pattern processor.

Once the correct motion patterns have been re-trained in the brain, they are used effortlessly in daily life and in sports Using the correct movement patterns sto heal. It can also prevent injuries from occurring in the first place, and it may improve sports performance.


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

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