Dynamic Neuromuscular Stabilization Overview with the Team

Richard  0:05 

All right. Let’s get straight into it. Hey guys, we’re here, the full team representing. We’re jammed into our humongous rehab space. Today, we wanted to talk about DNS or dynamic neuromuscular stabilization. And the reason for that is Muse actually had an opportunity to go all the way over to the Czech Republic in Prague back where DNS was discovered, and sort of started the process of finishing his certification. So, that was a week-long course. And once he’s done with that process, he will be a certified practitioner, and then we’ll actually have four docs all in the same clinic who are certified practitioners of DNS, which, as an instructor, I don’t know of another clinic in the country that has that. So, why don’t you kick us off with your recap of your experience in Prague? Not the beer drinking.

Muse  0:54 

So, I first started learning DNS in 2015, with this guy. And then, now fast forward eight years later, I finally got the chance to go to Prague. Prague, in and of itself, was an amazing time, but the course itself, you spend a week at the hospital there training under the PTs who are a lot of the main instructors for this technique based out of Prague. You’re learning under them for eight hours a day. So, it’s 9 to 5 every single day in the neurological clinic at the hospital Modal, which is the hospital they practice out of. And it’s just hands-on, it’s lecture. And as nerdy as it sounds, that was my dream scenario that I’ve been looking forward to for eight years. So, I’m very happy that…

Richard  1:47 

What was your favorite part of it?

Muse  1:49

Do you want the learning part or the fun part after…?

Richard 1:52 

Just the fun part. It’s a whole big week-long experience we’ve all done. We’ll, we’ll just kind of go through what was our favorite part of the D-course.

Muse  1:59 

My favorite part is being surrounded by like-minded people who all enjoy going to courses like this. So, we got to hang out at the main guy’s country home, Pavel Kolar, who created DNS. But all of us got together on one of the nights, and hang out, and just talk about all things DNS, all things practice, and…

Richard  2:21 

You were stuck with water the whole time, right?

Muse  2:23 

Oh, yeah. It was well…

Richard  2:24 

Clear liquid, at least.

Muse  2:27

Well hydrated.

Richard  2:27 

Jordan, what about you when you went? You went last year, right?

Jordan  2:29 

Yeah. Ben went last year. And, again, kind of to piggyback off you, I just thought it was such an invaluable experience to learn from these people that have been doing this under Dr.Kolar. Spending the amount of time that we got to spend with them, ask them the questions that we wanted to ask, like the in-depth stuff and geek out a little bit, I thought it was pretty awesome.

Richard  2:48 

Benjamin, twice?

Ben  2:50 

Went to twice, Went in 2019, and then, again last year with Jordan. Yeah, I think also just the perspective. So, you’re getting doctors from all over the world together who, their native language, maybe different, whether it’s Czech or it’s like Malaysian, there are people from all over. But just to see what they’re seeing and have them describe it in a different way, it’s kind of enlightening in that way.

Richard  3:14 

For me, DNS has had a huge impact on all of our practices. But there’s a long tradition of fantastic therapists, and medical doctors, and neurologists, and physical therapists, from a guy named Vladimir Yonder, or Carl Levitz, who were both medical doctors, all the way up to like the current torch holder, Pavel Kolar. So, there’s a lot of legacy in there. And what’s really cool is to be able to actually go back to where it started in the ‘60s, 1960s, and see this old hospital. They’re kind of renovating now, but to be in there and walk in the halls of these great minds was just kind of humbling to me when I went.

Muse  3:54 

So, did you want to talk a little bit about DNS?

Richard  4:00 

Seems like a good idea. So, for us, as you might have heard us mention here and there in videos and in emails, DNS stands for Dynamic Neuromuscular Stabilization, which is a mouthful. But really, what it’s trying to encapsulate is that movement is very, very complex, and it’s all about sort of motor control and stability. And that’s really one of the main goals of therapy here. It’s not just to get people out of pain, it’s to get them moving well. And if you dig way into the weeds, moving well means moving with good motor control, with good stability. So, dynamic neuromuscular stabilization is just that. And so, where it started was in the Czech Republic, that we all got to kind of visit there. And it was discovered by a guy… Not discovered, it was created by a guy named Pavel Kolar that Dr.Muse just mentioned, who’s a brilliant physiotherapist that was trained by some of these great minds there. And he had a lot of time with Carl Levitts, sorry, Vaclav Voizza, who is a pediatric neurologist. And he spent a lot of time studying children, and how they develop, and how they learn to roll, crawl, grab, stand, walk, all those kinds of things. And it’s built this beautiful system, that is not only a mode of assessment, but then also very, very powerful treatments to restore optimal function in patients. So, that’s sort of, in a nutshell, what DNS is. The thing I was always curious, I think it would be interesting for everybody listening is how has it impacted your guys’ practice? So, what do you think?

Muse  5:37 

So, obviously, we talk a lot about the McKenzie Method, which is a very powerful tool that we use, but the way that I look at…

Richard  5:47 

Certified.

Muse  5:48 

Certified.

Richard  5:50 

Soon to be certified. Crossed fingers. And Ben, Ben’s here too. (Laughs)

Muse  5:53 

Yeah. DNS is the all-encompassing explanation of human anatomy, neurology, and movement. So, at the base of how I treat, at least, this is the common understanding of just human locomotion and how the body functions. So, at the end of the day, even though we use a lot of McKenzie, just like he was just mentioning, we are interested in getting people out of pain, but DNS is what I fall back on to then change function in the individual. McKenzie won’t necessarily change function so much…

Richard  6:28 

Watch it.

Muse   6:30 

In a way, it will. DNS, though, is going to then backup what we do with the McKenzie Method and then stabilize the individual and change function. So that’s how I utilize it.

Jordan  6:40 

Yeah, I would agree with that. We kind of think about it in phases of care, right? And, for DNS, for me, at least in my practice, I tend to think of it as we use it later on in the treatment plan so that, once they’re out of symptoms, that’s when we’re really trying to restore what is good movement for them. So then when they go back to a back squat, or a deadlift, they’re actually doing it with more efficiency, as opposed to just like, okay, it’s the same injury over and over again. So, I tend to think of it as, like, kind of later on, I don’t know about you guys.

Ben  7:07 

The majority of stuff that walks in here is mechanical issues. It’s not like someone came up with a bat and hit you on your knee and your knee hurts, it’s something they’re doing to themselves. So, DNS is a way that we can assess the movement and kind of figure out and problem-solve with the assessment. And then, also, injury prevention so we can correct movements that they’re not coming back here with the same problem.

Richard  7:28  

Yeah. I think that what we’re all basically saying is that DNS is a way to sort of dig down and actually address the cause of the problem. So, the cause of the problem is not your bones, your backs slipped out, or your bones aren’t moving, right or something, the problem is actually in the quality of your movement. So, Jordan has said when someone’s squatting, like, how they squat. Brad mentioned improving movement quality, that’s our way of actually digging down to what we all believe is the source of the patient’s problem. So, Ben just said they’re not acute trauma. We treat this, of course, but most of the stuff that we see might be a runner that’s got some knee pain. It’s not that they fell on their knees, it’s that they, through repetition with bad movement patterns developed a knee problem. And DNS is a way to go in and assess the quality of their movement, identify any movement dysfunction that they have that will actually then produce their pain or their injury. And so, it really is, I think, for all of us, a way to kind of dig all the way down and address the source of the problem which is then going to result, hopefully, in longer lasting results, and maybe even just completely resolving the issue altogether. What about how it’s impacted your practice? We all answered the question, “How does it fit into the treatment plan?” We come in at the beginning, and usually, as Jordan said, at the end, that’s when we’re really hammering the function. Like Muse was saying, restoration of function, improving the quality of the movement. But how does it actually impact your practice? For me, it really comes down to being able to address highly complex cases. So, that’s where it really shines, in either the elite athletes or the really complex cases. So, someone with low back pain for 10 years, or they’ve had knee pain with squatting for however long, or these really really complex cases. That’s, to me, because we’re able to identify the actual source of the problem and address it on the most deepest fundamental level. For me, that’s how it’s had a big impact in my practice. It’s those complex cases.

Muse  9:34 

Yeah. I came out of that world of athletic training. And especially early on in my career, there was a lot of the typical rehabilitative exercises with strong focus on strengthening of muscles.

Richard  9:51 

Three sets of 10.

Muse  9:51 

Three sets of 10. I worked a lot with baseball, so sideline, doing band aid stuff here. And once I took that first DNS course — and I’m using this reference because I’ve watched this movie on the way back from Prague — but it’s like I entered the matrix all of a sudden. So, my eyes were just opened up so much more to what human function actually looks like. And then, not that there’s not a time and place for strengthening typical rehabilitative exercises, but this just completely flipped my understanding of the human body on its head and just changed how I practice it all together.

Jordan  10:26 

Yeah. I just feel like I see practicing in a way different lens than maybe I would have done before. It’s like, basically, the foundation of how I think about human movement, like you guys have said. Just the way I look at a patient versus, like, “Okay, do they have pain or no pain?” It’s way more than that. And so, it’s just changed so much in terms of where I want to take the patient after symptoms.

Ben  10:49 

Yeah. I think you guys kind of all said it, but the understanding of the body. So, that all-encompassing knowledge. So like when someone comes in with back pain, and we can do an assessment, and I can tell them, “Yeah, your back hurts, your hamstrings are tight, I bet you have acid reflux.” It gives you this whole understanding of how the body works and you can fix things that the patient doesn’t even tell you about.

Richard  11:17 

Yeah, it’s a super powerful thing. So, we don’t want to go too long, but DNS has had a humongous impact on each of our practices. Whether you’ve been treated by us and you know it or not, you’ve had DNS used on you. And if you’ve never been treated by us, the reason that we’ve all actually gone through the process to get certified is it is so stinking powerful in being able to produce long-term results in even highly complex chronic cases. So, we’ve got scheduled, we’re going to start putting out a lot more videos kind of explaining DNS. So, be on the lookout for those. But if you have any questions, feel free to comment below. We would love to kind of answer that. But have a good…

Muse  12:00

Wednesday.

Richard  12:00

Or whenever you’re watching this.

Jordan  12:03

Thanks.

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