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Athletic development specialists dedicated to the art and science of excellence in movement

Dynamic Neuromuscular Stabilization, Sport II: Review and Recap

Recently we attended DNS Sport I and II in Los Angeles, again taught by Dr. Petra Valouchova from Prague and hosted by Dr. Craig Liebenson with teaching assistance from Dr. Yoav Nagar and Dr. Michael Rintala.  Katherine attended Sport I for two days and then I joined for Sport II to conclude the week.  (Please go HERE for a recap of Sport-I, which I attended in September).

*To really understand Voitja (ie. Reflex locomotion), you must understand developmental kinesiology.  But people in the USA people want to learn the advanced stuff NOW.  Sport courses (I and II) are important to better appreciate the fundamentals behind Voitja.   

*DNS doesn’t take away from what we already do….Can still use whatever manual therapies you choose in tandem with DNS (sometimes your chosen manual therapy will contribute to the outcome faster).  And you can still condition the movements with whatever exercise modes you choose in the gym, as pristine movement still need load to develop performance capacity.  But DNS is a window into the underlying movement “software” and is a basis for a highly discerning movement audit.   

*Main impact of DNS for sport and fitness = interventions become more resonant to the brain.  Athlete is not being told what to do verbally; athlete is given the tools to figure it out.  A normally developing baby is the paragon of uncoached movement…. 

*When you understand the detail behind these developmental positions, you understand the hubris of coaches/trainers who think “I can just coach ‘em up.”  The real essence of DNS sport is harnessing developmental gateways to move us beyond skill acquisition and into skill mastery.   Yes, you can "coach 'em up" but many great athletes are great “fakers”; important to assess critically and then peel back layers of movement. 

*The same mental strategies of automatic movement that can get someone out of pain are the same strategies that help people achieve gallant feats of athletic skill.  Different applications, but same underpinnings.  Yet both have a basis in autonomous movement.

*…In other words…Bring the movement to the subcortical whenever possible.  The less you have to think about, the more reliable skilled performance becomes under pressure. 

*The baby doesn’t rely on verbal cueing (or cheerleading); it relies on sensory input to progress through developmental milestones.

 *“Methods serve the goal” –Dr. Lewitt

*Much emphasis upon hand position, even more than last September’s course.   Hands, wrists, and palms are microphones to amplify signals from the external world and are critical (and often overlooked) for shoulder girdle biomechanics. 

*Hand placement during exercise…rethink cases where people claim they can’t do an exercise because their wrist hurts (i.e. pushups), even without a wrist injury history.  Easy to give up and say “do something else” rather than find the source of the problem, which may ultimately manifest elsewhere if not addressed.    

*Emphasis on oral-facial coordination and integration of eyesight.  Biomechanics don’t happen without the sensory impulses to move and explore.  DNS is certainly not the only movement approach that respects these properties, but the integration of the sensory with the biomechanical occurs quite seamlessly within the DNS approach. 

*Takes 4+ years to become upright on one leg.  Single leg stance is one of the most crucial elements of gait.  Baby learns to roll on the ground, but single leg stance involves learning to prevent rotation while upright.  Same basic pattern though.

*Distal stability to create proximal mobility (ie, glenohumeral mobility via stability of the elbow and hand; hip mobility via foot stability).

*Gait and sensory exploration.  Rolling, creeping, and crawling involve ever-changing points of stability along the body, forcing the baby to learn different movement strategies from varied fixed points.  This is food for the nervous system (and why kids need a variety of early sporting experiences, not early specialization…) 

*Joint centration measured by muscle tension…  (Janda: optimal co-contraction of agonists and antagonists around the joint…lot of Sahrmann in here too, even though not specifically mentioned)

*Maintain joint centration throughout movement --> importance of audit in each movement and each exercise position (Janda – "every exercise is an assessment").  This is where the attention to detail comes in, and not being satisfied with “looks good enough.”  If you move with non-centrated joint, the brain compensates in some way, even if not readily apparent to the naked eye.

*That said, it’s definitely a challenge to implement this level of exactitude in the real world, especially in a group environment, but also with individual clients too impatient to master these details. 

*Progressions not always linear in seeking optimal exercise intervention.  Although the developmental sequence happens in established order, interventions need not track identically.

*Even if you don’t agree with specifics of DNS techniques/approach, the importance of priming the nervous system to achieve automaticity is beyond dispute.

*Assistance exercises = giving people chance to succeed (use of assistance  in developmental positions should look familiar to FMS people….FMS 4 x 4 matrix starts with assistance in simplest postures; supine/prone)

*Facilitate core activation by resisting planned movement (example: transition from sidelying posture to triped or quadruped...resist ankle that is planning to dorsiflex "turns on" the core to stabilize next posture). Dual application of rehab and sport ...painful patients may suppress core activation even before experiencing painful movement.  Similarly, difference between great athletes and merely good athletes is ability to anticipate "what comes next."  DNS uses pre-downloaded movement patterns to teach the brain optimal stabilization strategy.  

*Bridging the gap from basic movement to sport specific movement… Kara Patterson, American record holder in the javelin visited on Sunday as a case study.  A patient of Dr. Michael Rintala, she has been rehabbing a torn left ACL suffered during Olympic trials, though she did compete in London...(see her blog HERE)  

*Though not specifically covered during the course, it is interesting to read her journal describing technique flaws she had been struggling with and how they may have contributed to injury (“I was forward on all my throws in preliminaries, but I was even more forward on my fourth throw.  I approached the runway knowing that I needed to attack my block better than I had in prelims, and I brought more speed than I had previously into that left leg.  Unfortunately, my upper body being forward and on top of my legs instead of at an angle behind them meant that lots of pressure got forced down into my knee instead of forward through my whole leg.”). 

*Relation to DNS…Forward torso = flexion bias?   Flexion bias = default infantile tendency (flexion and internal rotation vs. extension and external rotation).

*ACL tear in throwing athlete = plant leg instability.  Rolling baby has ground to help support its “plant” leg.  Athlete with ACL tear failed to stabilize this same pattern in single leg stance.     

Conclusion

In my opinion, the magic of DNS for sport is the marriage of fundamental movement with higher level athletic skill, as we saw in the case study.  The ability to discern finer points of movement in the most basic infantile postures simultaneous to complex sporting tasks is game changing for motor learning and athletic performance.  

Most importantly, the information allows the non-clinician to effectively work alongside the clinical process.  Often the difference between a great season and a good season is simply the ability to turn a two week injury into a two day injury.  Though I would not recommend this course for any coach/trainer who lacks a working partnership to the clinical realm, for those that do have this partnership the DNS Sport courses are without parallel to help bridge the gap between fitness and rehabilitation.  

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