Dynamic Neuromuscular Stabilization (DNS) is a concept in rehabilitation and sports medicine that focuses on the restoration of optimal movement patterns and neuromuscular control. It is based on the principles of developmental kinesiology, which emphasizes the importance of early motor development and the role of the central nervous system in controlling movement. DNS aims to activate and stabilize the deep stabilizing muscles of the body, such as the diaphragm, pelvic floor, and deep spinal muscles, to improve overall movement efficiency and prevent injuries.
DNS differs from traditional rehabilitation methods in several ways. While traditional methods often focus on isolated muscle strengthening and stretching exercises, DNS takes a more holistic approach by addressing the underlying neuromuscular imbalances and movement dysfunctions. It emphasizes the importance of proper breathing, postural alignment, and coordination of movement patterns. DNS also incorporates developmental positions and movement patterns that mimic the natural progression of motor development, allowing for a more functional and integrated approach to rehabilitation.
Sometimes a point in your career is reached where you just want something different. Other times, a particular case can ignite that spark or drive to make the change. Today, we're joined by Dr. Ryan Martin, who is making waves currently in the MSK Ultrasound world. You can follow him on LinkedIn here. Ryan gives his origin story and how he got where is today, a leader in the field of MSK Ultrasound and advocate for PTs. Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-05-23
In this episode, Erson is joined by Dr. Malik Parker. He happened to stumble upon some quick fixes for bilateral thumb issues. Have you ever seen something like this in your practice? Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-05-16
In this episode, Erson is joined by Dr. Hannah Cox who recently attended one of his live TMJ Seminars. Upon leaving, she felt prepared to take on the TMJ world! Until that is two days later, she had a patient with high fear avoidance and complaints of open lock TMJ, headaches and neck issues. Luckily, Erson was able to instill her confidence over an online mentoring session and all worked out great over 3 sessions only! Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started. https://modmt.com/helixCheck out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-05-08
Erson follows up with the difficult lumbar lateral shift patient from this episode a few weeks back. As in the past, he's doing much better and this time Erson takes care not to flare him up! Interestingly enough using the Activforce 2 handheld dynamometer reveals some significant hip and trunk rotation strength percentage differences that could be key to better prevention. Untold Physio Stories is sponsored byHelix Pain Creams - I use Helix Creams in my practice and patients love them! Perfect in combination with joint mobs, IASTM and soft tissue work. Get your sample and start an additional revenue stream for your practice. Click here to get started.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded IndividualCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practicesKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-05-04
Introduction SummaryLow back pain (LBP) is a prevalent and costly health problem that affects a significant portion of the global population. Pain developers (PDs) are individuals who are considered a pre-clinical LBP population at risk of developing clinical LBP, which can exact great social and economic costs. Prolonged standing has been identified as a risk factor for LBP, and it is necessary to investigate the risk factors of standing-induced LBP in PDs comprehensively. By identifying these risk factors, appropriate preventive measures can be planned, which may reduce the incidence of standing-induced LBP and its associated costs.This study1 used a systematic review and meta-analysis approach to investigate the distinctive characteristics and risk factors of standing-induced LBP in PDs. The study aimed to identify statistically significant differences between PDs and non-pain developers (NPDs) in demographics, biomechanical, and psychological outcomes and to determine the pooled effect sizes of these differences. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Characteristics of Pain Developers and Non-Pain DevelopersThe systematic review and meta-analysis identified 52 papers and theses involving 1070 participants (528 PDs and 542 NPDs) that were eligible for inclusion. The studies used a prolonged standing duration greater than 42 minutes to classify adult PDs and NPDs without a history of LBP.Significant differences were found between PDs and NPDs in terms of movement patterns, muscular, postural, psychological, structural, and anthropometric variables. PDs exhibited altered motor control in the anterior hip abduction (AHAbd) test and displayed higher lumbar lordosis in individuals over 25 years old. These factors were found to have a statistically significant association with standing-induced LBP.Muscular differences were also identified between PDs and NPDs. PDs had a higher level of co-activation between gluteus medius and the erector spinae muscles, which can lead to increased lumbar loading and potentially contribute to the development of LBP.In terms of postural characteristics, PDs had less trunk control and increased trunk sway during standing compared to NPDs, which may suggest a lack of postural stability.Psychological characteristics were also found to differ between PDs and NPDs. PDs had higher levels of pain catastrophizing, which is the tendency to magnify the threat value of pain and to feel helpless in the face of it, and is associated with increased pain intensity and disability.Finally, anthropometric and structural differences were found between PDs and NPDs. PDs tended to have higher body mass index (BMI) and shorter stature compared to NPDs, which may result in altered spinal loading during standing.These findings suggest that PDs have distinct biomechanical and psychological characteristics that may predispose them to standing-induced LBP. Altered motor control displayed in AHAbd test and higher lumbar lordosis in individuals over 25 years seem to be probable risk factors for standing-induced LBP. The study’s findings have important implications for preventing and managing standing-induced LBP in PDs and for future research investigating the association of these distinctive characteristics to standing-induced LBP and interventions that may modify them.Risk Factors for Standing-Induced Low Back PainThe systematic review and meta-analysis identified several factors that were found to have a statistically significant association with standing-induced LBP:Lumbar fidgets – Participants with PDs displayed more lumbar fidgets, defined as small voluntary or involuntary movements of the lumbar spine, which are indicative of discomfort or pain. This factor was found to have a significant negative effect size (Hedge’s g − 0.72).Lumbar lordosis in participants over 25 years – Participants with PDs had higher lumbar lordosis, defined as the natural curvature of the lumbar spine, in individuals over 25 years old. This factor was found to have a significant positive effect size (Hedge’s g 2.75).AHAbd test – Participants with PDs displayed altered motor control in the AHAbd test, which measures the ability to control the hip and pelvis while lifting one leg. This factor was found to have a significant positive effect size (WMD 0.7).Gluteus medius co-activation – Participants with PDs had higher levels of co-activation between the gluteus medius and erector spinae muscles. This factor was found to have a significant positive effect size (Hedge’s g 4.24).Pain catastrophizing – Participants with PDs had higher levels of pain catastrophizing, which is associated with increased pain intensity and disability. This factor was found to have a significant positive effect size (WMD 2.85).These risk factors suggest that altered motor control, higher lumbar lordosis, increased gluteus medius co-activation, and pain catastrophizing may predispose individuals to standing-induced LBP. The findings may help identify individuals at risk of developing standing-induced LBP and plan appropriate preventive measures.Future research should investigate the association of the reported distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. Such interventions may include physical therapy, posture correction, and mindfulness-based stress reduction, among others. Identifying modifiable risk factors may lead to the development of effective interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP.Implications for Future ResearchThe systematic review and meta-analysis identified several distinct characteristics and risk factors for standing-induced LBP in PDs compared to NPDs. However, the study authors note that the identified risk factors do not necessarily prove causality or provide a complete understanding of the mechanisms underlying standing-induced LBP. As such, future research should investigate these factors in greater detail, and identify modifiable risk factors that can be targeted for preventive interventions.The study authors recommend that future research should investigate the following areas:Association with standing-induced LBP – Further research should investigate the association of the identified distinctive characteristics and risk factors to standing-induced LBP. Studies should investigate whether these factors are predictive of standing-induced LBP and whether they are specific to standing-induced LBP or generalizable to other types of LBP.Mechanisms underlying standing-induced LBP – Future research should also investigate the underlying mechanisms of standing-induced LBP, such as the interplay between motor control, muscle activation, and posture. Understanding the mechanisms underlying standing-induced LBP can help identify modifiable risk factors and develop effective interventions.Intervention strategies – Future research should investigate the efficacy of various interventions for preventing and managing standing-induced LBP in individuals with pre-clinical LBP. Such interventions may include physical therapy, posture correction, mindfulness-based stress reduction, and other strategies aimed at reducing risk factors identified in this study.Generalizability of findings – Finally, future research should investigate the generalizability of the study findings to other populations, such as individuals with clinical LBP or those with different occupational or lifestyle factors. This will help to determine the applicability of the findings to a broader population and inform the development of preventive measures for standing-induced LBP.ConclusionIn summary, this systematic review and meta-analysis found that pain developers (PDs) – individuals with a history of low back pain (LBP) – have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing. These characteristics include altered movement patterns, muscular, postural, psychological, structural, and anthropometric variables. The study also identified several risk factors associated with standing-induced LBP, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale.These findings have important implications for preventing and managing standing-induced LBP, particularly in individuals with a history of LBP. The study suggests that altered motor control displayed in the AHAbd test and higher lumbar lordosis in individuals over 25 years old are probable risk factors for standing-induced LBP. Therefore, future interventions may focus on improving motor control and reducing excessive lumbar lordosis. Additionally, the study highlights the importance of addressing psychological factors, such as pain catastrophizing, as a potential risk factor for standing-induced LBP.Overall, the study emphasizes the need for a comprehensive approach to preventing and managing standing-induced LBP, including a focus on biomechanical, psychological, and other factors. Future research should investigate the association of these distinctive characteristics to standing-induced LBP and whether they are manipulable through various interventions. By identifying and addressing these risk factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.This study emphasizes the importance of developing appropriate preventive measures for standing-induced low back pain (LBP) in pain developers (PDs). PDs are individuals with a history of LBP and are considered a pre-clinical population at risk of developing clinical LBP, which can lead to significant social and economic costs. The study found that PDs have distinct characteristics compared to non-pain developers (NPDs) when exposed to prolonged standing, which suggests that targeted interventions may be necessary to prevent standing-induced LBP in this population.The development of appropriate preventive measures requires a thorough understanding of the risk factors associated with standing-induced LBP in PDs. This study identified several risk factors, including lumbar fidgets, higher lumbar lordosis in participants over 25 years, AHAbd test, GMed co-activation, and higher scores on the Pain Catastrophizing Scale. These risk factors suggest that interventions targeting motor control, lumbar lordosis, and psychological factors may be effective in preventing standing-induced LBP in PDs.In addition to identifying risk factors, the study highlights the importance of comprehensive interventions that address biomechanical, psychological, and other factors associated with standing-induced LBP. These interventions may include postural education, physical therapy, and cognitive-behavioural therapy. By addressing these factors, it may be possible to reduce the prevalence of LBP and improve the quality of life for individuals with a history of LBP.Overall, the study underscores the importance of developing appropriate preventive measures for standing-induced LBP in PDs. Identifying risk factors and developing targeted interventions may help reduce the burden of LBP in this population and improve their overall health and well-being.Dynamic Disc DesignsDynamic Disc Designs offers dynamic anatomical models that musculoskeletal healthcare workers (chiropractors, medical doctors, physiotherapists, osteopaths) can use to help explain how the spine is impacted when one stands, for example. The models are designed to simulate the spinal movement dynamically, allowing various spinal specialists to better illustrate to patients the impact that standing can have on the spine.Using the dynamic disc model, a healthcare worker can demonstrate how the intervertebral discs are compressed when standing due to the force of gravity on the spine. They can show how the discs lose water content and height throughout the day, resulting in reduced shock absorption and increased pressure on the spinal nerves. This can lead to various symptoms, including low back pain, stiffness, and numbness or tingling in the legs. In this particular research highlighted in this post, a practitioner can explain dynamically what excessive lordosis means and how the facets are approximated in this case. Explore.Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below!Learn more online - new online discussion group included!Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion GroupLive caseswebinarslectureLive Q&Aover 600 videos - hundreds of techniques and more! Check out MMT InsidersKeeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
![[RESEARCH REVIEW] The High Cost of Standing: Uncovering Risk Factors for Low Back Pain](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXTsCQGpK-PEaVaLh2d-4MDJt3iZYFUMfzgmUKypDoGEjgXskP71pa-s8bMk_XOK-iWRrL8pLt-vIE6tD_i8NbsgluTbBpfCrbP80CWO3oFOoSZauwQ7U375LUV9hsBh7bwaSz6BJiYSFJfEniuRnDbSGa6swxPr0DzfpYmpWkljZ5TeS2P6031Ioh/s16000/Low%20back%20pain.png)
Posted by on 2023-04-27
The key principles of DNS include the activation of the deep stabilizing muscles, the establishment of proper breathing patterns, and the restoration of optimal movement patterns based on developmental kinesiology. DNS recognizes the importance of the diaphragm as a primary stabilizer of the spine and emphasizes the coordination of breathing with movement. It also emphasizes the role of the central nervous system in controlling movement and aims to restore the natural movement patterns that are established during early motor development.
DNS addresses neuromuscular imbalances by activating and stabilizing the deep stabilizing muscles of the body. These muscles play a crucial role in maintaining proper alignment and stability of the spine and joints. By activating these muscles, DNS helps to restore optimal movement patterns and improve neuromuscular control. It also helps to correct compensatory movement patterns that may have developed due to injury or dysfunction, allowing for more efficient and coordinated movement.
Yes, DNS can be used to prevent injuries. By addressing neuromuscular imbalances and restoring optimal movement patterns, DNS helps to improve overall movement efficiency and reduce the risk of injury. It focuses on activating and stabilizing the deep stabilizing muscles, which play a key role in maintaining proper alignment and stability of the body. By strengthening these muscles and improving neuromuscular control, DNS helps to prevent excessive stress and strain on the joints and tissues, reducing the risk of injury during physical activity.
DNS can be used to treat a variety of conditions, including musculoskeletal injuries, chronic pain, postural imbalances, and movement dysfunctions. It is particularly effective in addressing conditions related to poor core stability, such as low back pain, hip pain, and shoulder instability. DNS can also be beneficial for athletes looking to improve their performance and prevent injuries by optimizing their movement patterns and neuromuscular control.
DNS utilizes specific exercises and techniques to activate and stabilize the deep stabilizing muscles of the body. These exercises often involve developmental positions and movement patterns that mimic the natural progression of motor development. Examples of DNS exercises include supine diaphragmatic breathing, quadruped rocking, and rolling patterns. These exercises aim to restore optimal movement patterns and improve neuromuscular control by activating the deep stabilizing muscles and integrating them into functional movement patterns. DNS also incorporates manual therapy techniques, such as joint mobilizations and soft tissue techniques, to address any restrictions or dysfunctions that may be present.
Individuals with hypermobility syndrome should follow specific exercise protocols to help manage their condition. These protocols typically focus on strengthening the muscles surrounding the joints to provide more stability and support. Exercises that target the core, such as planks and bridges, can help improve overall stability. Additionally, low-impact exercises like swimming and cycling can be beneficial as they put less stress on the joints. It is important for individuals with hypermobility syndrome to avoid high-impact activities that may exacerbate joint instability. Stretching exercises should also be included in the exercise routine to maintain flexibility, but caution should be taken to avoid overstretching. Working with a physical therapist or exercise specialist who is knowledgeable about hypermobility syndrome can help individuals develop a personalized exercise program that addresses their specific needs and limitations.
The Feldenkrais Method is a somatic educational approach that addresses chronic musculoskeletal pain by focusing on improving movement and body awareness. Through gentle and mindful movements, individuals are guided to explore different patterns of movement and discover new ways of organizing their bodies. This method emphasizes the connection between the mind and body, and aims to retrain the nervous system to move with greater efficiency and ease. By increasing body awareness and promoting more efficient movement patterns, the Feldenkrais Method can help individuals with chronic musculoskeletal pain to reduce tension, improve posture, and alleviate pain. Additionally, this method encourages individuals to develop a greater sense of self-care and self-regulation, empowering them to take an active role in managing their pain and promoting overall well-being.
Iliotibial band syndrome (ITBS) is a common overuse injury that affects the iliotibial band, a thick band of connective tissue running along the outside of the thigh. Biomechanical factors play a significant role in the development of ITBS. These factors include excessive pronation of the foot, tightness or weakness in the hip muscles, and poor running or cycling mechanics. Excessive pronation can lead to increased stress on the iliotibial band, while tight or weak hip muscles can alter the alignment of the pelvis and increase strain on the band. Poor running or cycling mechanics, such as excessive hip adduction or internal rotation, can also contribute to ITBS. Managing ITBS involves addressing these biomechanical factors through a combination of stretching and strengthening exercises, orthotics or shoe inserts to correct foot pronation, and gait analysis to improve running or cycling mechanics. Physical therapy may also be recommended to address any underlying muscle imbalances or weaknesses. Additionally, modifying training intensity and gradually increasing mileage can help prevent overuse and reduce the risk of ITBS recurrence.
Mindfulness-based stress reduction (MBSR) has been shown to be effective in reducing pain intensity in patients with chronic pain. Numerous studies have demonstrated that the practice of mindfulness, which involves paying attention to the present moment without judgment, can lead to significant reductions in pain perception. By cultivating a non-reactive and accepting attitude towards pain, individuals with chronic pain can experience a decrease in pain intensity and an improvement in overall well-being. Additionally, MBSR techniques such as body scans, mindful movement, and meditation can help individuals develop a greater sense of body awareness and enhance their ability to cope with pain. Overall, MBSR offers a promising approach for managing chronic pain and improving the quality of life for patients.
The Alexander Technique has a profound impact on the posture and movement of musicians. By focusing on body awareness, alignment, and balance, the technique helps musicians develop a more efficient and effortless way of playing their instruments. Through the use of gentle hands-on guidance and verbal instructions, the Alexander Technique teaches musicians to release unnecessary tension and use their bodies in a more coordinated and integrated manner. This leads to improved posture, as musicians learn to align their spine and limbs in a way that supports optimal movement and reduces strain. Additionally, the technique enhances the musician's kinesthetic sense, allowing them to have a greater awareness of their body in space and make more precise and controlled movements. Overall, the Alexander Technique empowers musicians to achieve a more natural and balanced posture, resulting in improved performance and reduced risk of injury.
The McKenzie Method, a widely used approach for the classification and treatment of sciatica, employs a comprehensive system to assess and manage this condition. It categorizes sciatica into three main subgroups: derangement, dysfunction, and postural syndrome. The derangement subgroup involves a mechanical displacement of the intervertebral disc, causing nerve root compression and resulting in leg pain. Dysfunction refers to a loss of normal movement in the spinal joints, leading to irritation of the nerve root. Lastly, postural syndrome is characterized by pain arising from prolonged poor posture. Treatment within the McKenzie Method focuses on specific exercises and movements tailored to each subgroup. For derangement, directional preference exercises are utilized to centralize and alleviate leg pain. Dysfunction is addressed through mobilization techniques to restore normal joint movement. Postural syndrome is managed by correcting posture and implementing ergonomic modifications. By accurately classifying sciatica and employing targeted interventions, the McKenzie Method offers a comprehensive approach to effectively treat this condition.
Individuals with osteoporosis can benefit from specific exercise guidelines to improve bone health. Weight-bearing exercises, such as walking, jogging, and dancing, are recommended as they help stimulate bone formation and increase bone density. Resistance exercises, such as lifting weights or using resistance bands, can also be beneficial as they help strengthen muscles and bones. It is important to engage in exercises that target different muscle groups and incorporate a variety of movements to promote overall bone health. Additionally, balance and posture exercises, such as yoga or tai chi, can help improve stability and reduce the risk of falls, which is particularly important for individuals with osteoporosis who are at a higher risk of fractures. It is crucial for individuals with osteoporosis to consult with a healthcare professional or a qualified exercise specialist to develop a personalized exercise program that takes into account their specific needs and limitations.