Dynamic Neuromuscular Stabilisation

05 September 2018

In August, I took a lovely trip up to Newcastle where I had the privilege to understand the underpinnings of neurodevelopment and how it relates to proper breathing, postural function, spine stability and alignment.

The course, Dynamic Neuromuscular Stabilisation (DNS), has become an internationally accredited system which is gaining fast popularity in the sports medicine and exercise rehabilitation world today.

From the time you are born till the first 12 months of life, there are many developmental sequences which allow us to go from lying flat on your stomach, standing on 2 feet and finally, the ability to walk and navigate your way through space.

Unfortunately, many health professionals (Trainers, Yoga and Pilates instructors) fail to recruit the underpinnings of neurodevelopment in everyday practice, and therefore are unable to maximize their clients' potential for gaining better quality of movement and function.

Breathing is of utmost importance to all of us, as it is always our last call of survival. With that being said, there are many factors that drive poor breathing patterns and many schools of thought exist with the aim of improving breathing. However, most exercise rehabilitation methods fail to address correct breathing patterns in conjunction with the optimisation of developmental sequences.

FUN FACT - The diaphragm has 3 functions:
1) Respiration control/breathing
2) Postural tone and function
3) Bowel, bladder and sphincter control

Therefore, it is no surprise that breathing problems, neck/back pain, poor postural control and sphincter incontinence go hand in hand in some people.

So, without going into any more detail, enjoy the read below! I have supplemented the explanations with some useful visuals to better enhance the understanding of what we do each day in clinic. We believe you deserve to know why we do things.

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What happens when we breathe?

Image 1

Upon inhalation (breathing in), the diaphragm must descend towards the pelvic floor creating optimal intra-abdominal pressure. The blue shade represents the expansion of air created by the descending diaphragm and contraction of pelvic floor. Note how the arrows are pointing inwards towards the midline, which equate to the expansion of air within the abdomen, leading to increased intra-abdominal pressure. This enables the rib cage, respiratory and pelvic diaphragm to approximate and become stable, whilst the muscles of the hips and shoulders can exert force to move the extremities, minimising excessive segmental loading and instability.

 

 

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Image 2
A) Optimal orientation of diaphragm and pelvic floor. Notice how they are both facing directly parallel to each other. This allows for optimal intra-abdominal pressure being generated.

B) Poor orientation of diaphragm and pelvic floor, creating an "hourglass" shape (lowermost B) and open scissors deformity (uppermost B).

Those clients who cannot regulate optimal intra-abdominal and intra-pelvic pressure, display muscle imbalance between the back extensors, diaphragm. pelvic floor and abdominal muscles. This results in the over-development of the long "strap" muscles of the back, as seen with the red arrow pointing below. This patient will develop either an "hourglass shape", open scissors deformity or both. Common symptoms are muscle fatigue and general tightness along the entire length of the spine.
Image 1
Below, I am demonstrating and maintaining spinal stabilisation in the sagittal plane, with correct orientation of the pelvic and respiratory diaphragms.
In Video 1 below, my colleague is maintaining optimal intra-abdominal pressure whilst I guide thorax rotation on a stable shoulder, and pelvis on a stable hip.
Video 1
In Video 2 below, my colleague is maintaining sagittal and frontal plane stabilisation of the spine with co-activation of the deep front line.
Video 2

Did You Know?

We are continually adding to our cache of apparatus with the purpose of enhancing your exercise rehabilitation sessions.

Ask us about our latest acquisitions!