Our clinical director, Dr. Lev Kalika, first brought Dynamic Neuromuscular Stabilization to the US in 2002. Used by elite athletes like Roger Federer, Novak Djokovic and Jaromír Jágr, DNS taps into innate motor patterns from early development, such as crawling and turning, to retrain the body to move naturally and safely after injury has introduced negative patterns that cause imbalance and pain.
Origin: Famous Prague school of rehabilitation PRAGUE SCHOOL OF REHAB
Creator: Pavel Kolar PT. Paedr, PHD
DNS is based on developmental kinesiology. Developmental kinesiology is a science of maturation of the human movement system during the time of early development from birth until the child starts walking.
The position acquired by the child during development is the process in which the human brain and musculoskeletal system starts to cooperate in order to overcome gravity and establish posture and locomotion (walking).
Human movement is based on transferring body weight over for support. Proper support allows optimum dynamic stability.
Optimum stability allows maximum mobility with no expense to support structures such as disks, ligaments, etc. No expense literally means that load and force distribution acting on the body from inside and outside are in balance.
DNS is a combination of manually assisted exercises and reflex stimulation. The patients movement patterns could include; dysfunction, misalignment, loss of control and postural deviations. Based on these and the overall movement of the patient, a therapist chooses a position from early development in which proper support though the hip, shoulders and spine could be established.
Special manual joint centration by the therapist reinforces different movement strategy based on preprogrammed ideal movement patterns in brain. All joint mobilization and soft tissue manipulations are also performed in these positions with the only goal of preparing the body to be able to handle this position. The doctor or therapist follows developmental progression to different higher positions in which support and stability is more demanding.
Reflex locomotion is used when a certain global or local movement patterns are unavailable to patients on regular cuing physical therapy exercises. The therapist can start this particular movement pattern by manual reflex stimulation of zones in developmental positions such as creeping or turning.
The reflex stimulation is also an excellent method to use with acute conditions. Some of these conditions include sciatica, radiculopathy and herniated disc. There can also be situations where the patient has poor body awareness and cannot use his muscles properly upon the therapist’s command.
Although DNS is an all inclusive methodology clinicians are required to be proficient at soft tissue manipulation and joint mobilization approaches.
The superiority of the DNS lies in its ability to invoke ideal or close to ideal movement patterns from the nervous system based upon genetical coding.
Dr.Kalika is one of the first practitioners of DNS in US with 14 years of experience and personal training from prof. Kolar.
Dr. Lev Kalika, NYDNR’s clinical director, introduced dynamic neuromuscular stabilization (DNS) to the US in 2002. The treatment is popular among several elite athletes, including tennis greats Roger Federer and Novak Djokovic.
DNS activates innate developmental motor responses present in all humans. The ability to roll over, crawl and eventually stand are all preprogrammed stages of human development. Muscle imbalances and injury from sports or other activities can lead to impaired movement that diminishes physical performance. DNS can help restore normal motor patterns and retrain the body to move in natural and safe ways after injury.
The concept of DNS emerged from the famous Prague School of Rehabilitation, thanks to research conducted by its creator, Dr. Pavel Kolar.
DNS is based on the science of developmental kinesiology, which is the study of the development of human movement from birth to the walking stage. Developmental milestones are ingrained in the human brain, triggering the musculoskeletal system to gradually overcome and master the force of gravity, to establish posture and locomotion.
Human movement requires the transfer of body weight while maintaining dynamic stability. Optimal stability allows for efficiency of movement, with no wasted energy or excessive stress to supporting structures like spinal discs, joints, muscles and connective tissue. Stability means that the distribution of loads and forces inside and outside the body are in balance.
DNS is a treatment method that combines manually assisted exercises with reflex stimulation. It is an effective treatment for patients with movement dysfunction, structural misalignment, loss of motor control and postural deviations. Depending on the patient’s needs and overall movement patterns, the DNS practitioner selects a position from early development that helps establish proper support through the hip, shoulders and spine.
Specialized manual joint centration performed by the therapist serves to reinforce movement strategies based on preprogrammed ideal movement patterns stored in the brain. Joint mobilization and soft tissue manipulation are performed in developmental positions to help the body adapt. Once the patient can handle a position, the therapist progresses the therapy to higher developmental positions where support and stability are more demanding.
Reflex Locomotion (Vojta Therapy)
When certain global or local movement patterns are not available upon normal cuing during physical therapy, the therapist may introduce reflex locomotion to stimulate a particular movement pattern. With the patient in a developmental position such as creeping or turning, the therapist uses manual reflex stimulation to invoke a motor response.
Reflex locomotion therapy is often used to treat acute conditions like sciatica, nerve pain and herniated discs. Patients with poor body awareness can benefit from reflex locomotion to recognize and recruit specific muscles to reproduce desired movements.
The ability of DNS to invoke near-ideal movement patterns from the nervous system based on innate genetic coding makes it a superior treatment for certain motor deficiencies. Dr. Kalika is one of the very first practitioners of DNS in the United States, having received one-on-one training from Dr. Kolar himself.
At NYDNR, we explore every avenue of treatment to help you achieve the best quality of life. DNS therapy has proven effective for treating patients with chronic back pain and other orthopedic conditions that restrict movement and cause pain. DNS offers an innovative treatment approach when pain medications and conventional methods have failed.
DNS stimulates the movement control centers in the brain, helping the brain and body communicate more effectively. DNS restores proper function of the entire body, improving mobility, range of motion and stability. DNS enables your body to reestablish global movement patterns, retraining it to do what it once did naturally.
During DNS treatment, the patient is placed in the appropriate movement position, and the therapist applies gentle pressure to reflex pressure points, stimulating innate global movement patterns.
Benefits of DNS include:
After multiple sessions, optimal posture and movement are once again restored.
Although DNS is now being practiced around the globe, it is still a relatively new treatment approach with limited availability. Dr. Kalika was among the first to introduce DNS to the United States, and he was the only certified practitioner in NYC at the time. Other members of the practice have since been certified, making NYDNR the most experienced and professional clinic for DNS treatment in New York.
Train your body to move the way it should again with DNS at NYDNR, and leave pain and restricted movement behind. Our goal is to help you restore musculoskeletal health so you can enjoy the very best quality of life.
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
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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