Dynamic neuromuscular stability is sometimes referred to as “core stability.” Core stability is not just a function of adequate muscular strength in the abdominal and spinal muscles; rather, it is a function of the precise coordination of these various muscles. Dynamic neuromuscular stabilization training (DNS) can be used to rehabilitate the injured and can be used to optimize the movement of the athlete to prevent injury. It can also be used to improve sports performance by optimizing the efficiency of motion.
When compared to conventional physical therapies the advantages of the DNS become apparent. DNS uses neuro-plasticity of the Central Nervous System producing rapid and long lasting improvements in pain relief and the function. Conventional physical therapy methods, on the other hand, take a longer time to produce any effect and those tend to wear off soon after the therapy stops.
The DNS method is the only therapy that focuses on improving spinal stability and motor control acting directly on the Central Nervous System. The training is conducted in the most natural (ideal) body positions. These are the positions that infants assume when straggling against the gravity to stand up and walk. When trained in this way, the pathologically disrupted neural pathways of the central movement control are re-established and stabilizing mechanisms become automatic providing basis for healthy and efficient movement.
In contrast, conventional Physical therapy works by strengthening weakened muscles in isolation from the rest of the locomotor system. The effect of such therapy is strictly localized and does not guarantee that established muscle power will automatically transform into adequate overall performance. Moreover, trained movements are not integrated into the global locomotor patterns and cannot become involuntary and therefore would be of little help to the patient.
Unlike the conventional physiotherapy, DNS does not rely on the passive care. Instead DNS teaches patients self correction, prevention techniques and exercises that do not require clinicians assistance and can be performed in the privacy of the patients home. This proactive approach ensures patients dynamic involvement in the healing process and minimizes doctor-patient dependency.
The advantages of DNS over the conventional physical therapies show that patients with neuro-muscular disorders have a superior alternative to the commercially established methods of treatment.
DNS was invented by Pavel Kolar, a pediatric physiotherapist. The basis of DNS is the mechanism of natural maturation of the human infant. The infant learns in a progressive, natural way how to control posture and move in a purposeful way. All infants exhibit the same progression of postures during development.
Underneath the “core” muscles lies “the deep core.” The deep core consists of a balanced use of the deep cervical flexors, the spinal extensors, the diaphram, pelvic floor, and abdominal muscles to regulate intra-abdominal pressure and spinal stiffness. This process provides dynamic stability of the spine. The deep core operates under automatic and subconscious control. Adjustment of the deep core to properly prepare the spine precedes any purposeful movement. Injuries and developmental disorders that interfere with this process cause impairments in anticipatory postural control. Training programs intended to restore or improve the precise muscular coordination and timing of the deep core can improve the efficiency of movement.
Kolar talks about the concept of “joint centration” which refers to a joint that is dynamically stabilized throughout its range of motion to allow the joint and muscles to operate at their optimum. A centrated joint experiences minimal stress. An example of lack of centration is work by Kolar suggesting that abnormal postural activation of the diaphragm can contribute to chronic lower back pain. Individuals who don’t use the diaphragm effectively in postural control have increased compressive forces on the spine, thus incorrect use of the diaphragm prevents t