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The program will begin with a Controlled Articular Rotations and DNS translates to Dynamic Neuromuscular Stabilization. The former was created by Dr. A. Spina, DC and the later by Dr. Pavel Kolar PT, PhD years ago and consists of postural exercises (LOADS) that target specific joints and work to decompress, relieve pain, and restore function and balance.
Joint (mobility) training is a valuable architectural and neurological input. We know that mobility has a lot of value. Primarily that value is going to allow us to maintain the positions we want in good training. To be able to achieve mobility, there are lots of different tools. There’s a reason why it’s more than just being ‘flexible.’ When looking at certain parts of the body, we have certain areas very rich in sensory receptors. We’re talking about Merkel cells, Pacinian corpuscles, Meissner’s endings, free endings and all these different types of mechanoreceptors. The joint capsule is clearly one of them. When these mechanoreceptors are stimulated positively, the nervous system is stimulated causing an overall calming effect. DNS promotes the breath. When we talk about mobility positions, the breath is going to tell the autonomic nervous system, ‘hey, this is okay. We’re allowed to be here.’ Keep that in mind in all of your mobility positions.
The program will begin with a Cardiovascular and Movement Preparation ("Warm Up"). The Movement Preparation is an integrated approach to prepare you physically and mentally for the demands to exercise through a progressive and specific preparation period. It involves General Movement, designed to increase heart rate, and core body temperature to heat up the body and muscles before making it more ready to perform mobility exercises. From there we will perform activation drills to the mobility segments of the body against a strong pillar of the trunk. This is followed by dynamic stretching within you physiological joint ranges of your individual capacity and not beyond at this point. We than put this all together to perform movement integration in the linear, lateral and rotation joint specific movement followed by neural activation thus completing the Movement Preparation phase. The importance of this phase is to prime the tissue environment to respond to training input. Static stretching in its traditional sense is not performed prior to activity for fear of sedating the nervous system, because the nervous system is down-regulated any time a long static stretch is performed. The goal of the Movement Preparation should be to awaken the proprioceptor and, of course, to pump and lubricate the joints getting you ready to GO!
Level 1 – Movement Focus
This involves general movement. The goal in this level is to inject joint movements into your life to increase articular afference as well as to promote frequent movement practice. By movement practice, you develop kinesthetic awareness, body control and in general the ability to sense different types of movements in the body. Our first job is to have the client familiarize the person with himself or herself. Can you isolate a joint and recognize if the movement is occurring exclusively in that joint? This is way harder than most people think because of the poor kinaesthetic awareness. We will ask you to do CARs and to do the best not to cheat. This is what we call conscious blocking or awareness of there abilities. This can include visual aid such a mirror, low-level irradiation (low CNS demand), watching someone else do it, etc.
In level 1 you develop a sense of your ability. That you may move your low back while doing hip CARs, twisting and rotating from the t-spine during shoulder CARs etc. Use the most ROM you’ve got, but only from the right areas. “Does your shoulder/hip/ankle do what is supposed to do?” We are trying to get them to disassociate their joints. To perform CAPSULAR CARs, which means to focus on articular rotations you get direct access to the CNS. To start the cortical remapping process. To start to give information to the brain about the shoulder. We start to familiarize the CNS with their body. As time is going there biology is being altered, and remodelled. The information is being uploaded to the CNS. Teach the brain how to use the biology – articular space. They are developing workspace. Later on this will carry on to better movement skills in everyday life activities and in your training.
Level 1 can also be used for active recovery, regeneration, and inflammation pump activation.
As level one progresses we will start to identify articular restriction and maybe pain. When you have pain the nervous system takes action to remove real or anticipated threat to the tissue and this can be achieved by motor output. Muscle activation may be modified to splint the painful part or ‘inhibited’ to reduce the amplitude or velocity of a painful movement. If you have pain than you would automatically go back into the health layer to diagnose and treat the pain before undertaking any level of fitness.
The reason why fitness does not work for a lot of people is because they have underlying articular or structural problems.
Level 2 – Articular focus
At this level they are developing greater kinesthetic awareness, and more body control. Now we can demand more isolated joint control and more complicated movements. In other words we want very high specificity making CARs more refined. The brain is becoming more familiar with your body. We will use medium irradiation at this level. We will challenge the CARs in different positions thus expanding the workspace. We call this Positional Joint Isolation. Further enhancing the cortical remapping. In order to enhance uploading to the CNS we will continue with CAPSULAR CARs thus expanding the articular workspace even further. The movements are slow in order to stimulate the type II affarents in order to get direct cortical representation of the joint to teach the brain about the slowly improving joint, to keep the nervous system coupled with the biological changes.
Note: By performing sustained Positional Joint Isolation we are increasing core temperature, and are going to recruit aerobic/anaerobic activities for lactic acid and growth hormone release to assist with regeneration and remodelling of the local biology, superior peripheral vascular structure/function, increase in the concentration of skeletal mitochondria increasing local oxygen capacity of the local biology. The following comes from the work of Dr. Tom House.
With the increased uptake of cortical input we expect a significant decrease in CNS smudging.
Note: When performing the articular movements you must be mindful. We are talking about afferents and cortical maps. This requires cortical concentration on the joint structure you are working on. You must feel that area the entire time you are working on it.
Level 3 – Capacity focus
At this level your joint capsular movements are well defined with good kinesthetic awareness and cortical mapping. The client has developed good workspace. There is excellent dissociation. The next level in CARs practice is using high level of irradiation as a means of internally loading the joint to develop articular conditioning. Once the client is able to adequately articulate the joint with 100% irradiation then next phase would be to start adding external load.
When performing high-level irradiation we are putting high demand on the CNS. With the highest level of CNS demand we will lose specificity.
This level will focus on articular conditioning using the weigh scale of irradiation (internal loading). We are trying to improve neural drive. The client is fighting for neurological sovereignty.
You should be able to control your internal environment before you can control an external environment.
In Level 3 we will be using Indian Clubs, variable resistance bands, and anti-rotation work broken into hinges, hovers and lift offs.
When you finish the CARs portion of the program, we will proceed to the DNS section of the program and perform the DNS Exercises. There are many exercises so we will always be changing the routine. During DNS, you are decompressing the joints of the body to give them space and freedom. The Dynamic Neuromuscular Stabilization (DNS) approach provides functional tools to assess and activate the intrinsic spinal stabilizers in order to optimize the movement system for both rehabilitation purposes and for athletic development.
The last section to complete is the Global Postural Stretches. Global postural stretches are just what they sound like: Unlike the myofascial stretches, they stretch the body globally, not in specific places. You have already warmed up the tissue, stretched the fascia and opened up the joints and, so now is the perfect time to open the body globally for the best outcome. The goal is to increase the mobility of the thoracic cage to protect the lumbar spine and more.
CARs and DNS for Recovery
Mobility training is another valuable neurological input. We know that mobility has a lot of value. Primarily that value is going to allow us to maintain the positions we want in good training. To be able to achieve mobility, there are lots of different tools.
Why does having great mobility maintain this level of integrity and stave off sympathetic responses? When we talk about a lot of the great systems in rehab that are able to get rid of pain very quickly, they are all based on mobility. When we talk about training systems that have huge results, there’s always some kind of mobility piece.
Some people call it recovery or restoration days, but the key is maintaining mobility. There’s a reason why it’s more than just being ‘flexible.’ When looking at certain parts of the body, we have certain areas very rich in sensory receptors. We’re talking about Merkel cells, Pacinian corpuscles, Meissner’s endings, free endings and all these different types of mechanoreceptors. The joint capsule is clearly one of them. When these mechanoreceptors are stimulated positively, the nervous system is stimulated causing an overall calming effect.
These quality messages and quality stimulations are being sent to the brain. Mobility training is telling the brain, ‘Hey, we have a nice buffer zone.’ Meaning more mobile something is, the more information comes in. The way to know this buffer zone for large movements is by stimulating the mechanoreceptors. There are constant conversations between the joints and the brain, whether we’re moving or not, and that conversation is mediated by those mechanoreceptors.
When we’re constantly up against your buffer zone of mobility and those mechanoreceptors are receiving very threatening bits of information that they’re going beyond the natural excursions of the capsule, the joint, the muscle, the tendon, that’s where the emergency brake gets kicked on through sympathetic tone. That sympathetic tone shoots back muscularly and facilitates a compensatory protective mechanism. The compensation leads to tissue overload with the end result being adaptation or injury.
The goal of the ReCovery Room is to help ReSTORE, ReBOOT and ReSHAPE a patient, and clients normal state of health, mind and strength. Recovery can be used as part of a rehab protocol, recovering from a strenuous workout such as high intensity training, high level athletic training or workloads due to ones lifestyle.
At SquareONE Rehabilitation we do not make clients sign monthly or yearly contracts. Instead you pay as you train for your session prior to your attendance.