A short history of DNS

Dynamic Neuromuscular Stabilisation (DNS) was developed by Dr Pavel Kolar, building on the work of Dr Vaclav Vojta.  Fundamentally, DNS is a method for explaining the origin of specific physical injury, including spinal lesions and a methodology for correcting the patterns of body movement that created those lesions and leads to further degeneration.  It answers the questions, for example “why did this person acquire an intervertebral disc lesion?” and “why at lumbar 4/5 level?”.

 

Dr Pavel Kolar

Dr Pavel Kolar

You can start the story of DNS with Developmental Kinesthesiology.  In the 1960s Dr Vojta, a  Czech Paediatric Neurologist concerned with the motor development in very young children with brain injury and motor developmental problems, noticed that the manner in which he held or picked up a healthy child elicited predictable reflex movements.  He also noted that these reflex movements changed with the increasing motor developmental sophistication as the child became more physically competent and engaged with their physical environment.   In children with neurological disorders such as cerebral palsy, these reflexes were either absent or were more primitive than were appropriate for the child’s chronological age.

Human children, almost uniquely among placental mammals, are born neurologically underdeveloped and physically helpless.  Whereas a horse foal can become upright and walk within minutes of birth and a newborn chimpanzee may cling to its mother, a newborn human baby is not capable of organised voluntary movement.  Motor control (Ontogenesis) develops hand in hand with the baby’s growing awareness of their environment, along a genetically determined developmental pathway.  Dr Vojta’s insight enabled him to develop a physical therapy for children with motor control deficits that exploited his discovery of reflex movements to lay down and reinforce stereotypical movements required for normal kinesthesiological development.

During the same years as this technique was developed, Dr Janda (Dr Vojta’s colleague) was developing a very sophisticated and influential approach to adult musculoskeletal medicine.  Dr Janda’s legacy is too far reaching to be dealt with in a sentence, however some of his ideas are instrumental in understanding Dr Kolar’s approach.  In particular, Dr Janda developed the idea of phasic muscles whose purpose is to stabilise and control the movement of tonic muscles.  In addition, Dr Janda advanced the concepts of muscle trains and pathological syndromes of muscle imbalances.

Dr Kolar, a physical therapist, took Dr Vojta’s methods and Dr Janda’s approach and asked two questions.  The first was “what is causing my patients who didn’t experience trauma, physical injury?” Could patients with scoliosis, intervertebral disc prolapse or even athletes with recurrent injuries, have their lesions caused by a form of neuro-motor incompetence which focussed mechanical stresses at their individual point of injury?

The second question was “do the effects of Dr Vojta’s methods of reflex movement stimulation persist into adulthood and can they be used to retrain the core stabilisation muscle trains Dr Janda identified, to treat physical injury and prevent lesion reoccurrence?”

From these two questions the methodology of DNS developed.