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com 3/12/17

Dynamic
Neuromuscular Who is the Founder of DNS?
Stabilization ®

Professor Pavel Kolar, PaedDr.

Director of Rehabilitation Clinic 2nd
according to
According toKolář
Kolář Medical Faculty Charles University
Prague, Czech Republic

▪ Physiotherapist by training who holds

SPORT AND FITNESS,

a doctorate in pediatrics and
physiology

PART I
▪ Professor of physiology
▪ Head clinician for the Czech Olympic
teams – soccer, ice hockey, tennis.

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What is DNS? Sport

Sports performance
▪ Concept of DNS is based on the scientific
principles of developmental kinesiology (DK) i.e.,
the neurophysiological aspects of the maturing ▪ Level of physical condition
locomotor system. ▪ Power/strength/speed
▪ It includes both, knowledge and a theoretical base, ▪ Endurance
in addition to assessment, treatment, exercise and
functional strategies. ▪ Sport technique
▪ Optimal postural foundation
▪ Movement quality/coordination
▪ Quality of cortical functions

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Sport loading Functional Threshold

▪ Movements with maximum muscle ▪ Training for sports
power involves pushing one‘s
self, sometimes
▪ Increased demands on muscular beyond your limits
coordination ▪ Ideal locomotor
▪ Maximum range of motion strategies has its
threshold
▪ Maximum loading on ligaments
▪ Whenever this
and tendons
threshold is exceeded
▪ Increased respiratory demands the athlete will resort
to a more primitive
stabilizing strategy
(hyperextension of spine, shoulder protraction, anteversion
of pelvis

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Training Training
▪ Adequate amount of load to evoke body adaptation ▪ Training has to respect
▪ Adequate loading time and repetition individual anatomical
parameters (biomechanical and
▪ Neuromuscular adaptation neurophysiological aspect)
• Cortical control – process of motor learning (slow
movements) = allows for optimal sport
• Motor programs – learned and fixed programs technique – optimal movement
(cerebellum, basal ganglia pathways) pattern
▪ Biochemical and morphological adaptation

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Anatomical Norms Training Posture

Anatomical norms ▪ Should respect anatomy and
are well defined physiology of the body
(local, regional and global
anatomical parameters)
▪ Local: shape of bones
caput-collum diaphysis angle ▪ Neutral positions of the
joints during whole course of
▪ Regional: landmarks
movement
defined by multiple
anatomical segments like sacral slope • How to define neutral
▪ Global: relationship between distant joints position?
anatomical segments • Why is it necessary?

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Ideal Posture? Neuro-anatomical development

▪ Not exactly defined
Program → Function → Structural maturation
▪ Brüegger, Pilates, Alexander?
▪ Which concept defines ideal posture? CNS → Muscle → Bone (joint)
▪ Genetic information defines ideal posture – physiological development

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Postural Foundation
Development of Postural Function
▪ Definition of ideal posture
▪ Postural function
Foundation of neutral position – established during
▪ Dynamic function motor development
▪ Precedes and follows every movement ▪ Neutral joint positions
▪ Ensures position of the trunk, spine and pelvis during • enables optimal loading
movement • ideal balance between
▪ Universal pattern that stabilizes any movement – controlled agonists and antagonists
on subcortical level • ideal interplay with other
muscles and segments
▪ Its quality depends on quality of motor development
in the whole system
during early childhood

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Neutral (centrated) Joint position Functional Joint Centration

▪ Dynamic neuromuscular strategy that leads to optimal joint
position that allows for the most effective mechanical
advantage
▪ A centrated joint has the greatest interosseous contact to
allow for optimal load transference across the joint and
along the kinetic chain.
▪ Allows for maximal muscle pull and protection of passive
structures

Optimal development – in any position, all the joints

are functionally centrated.
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Optimal (CNS) Maturation

Functional joint centration – Sagittal Trunk Stabilization
= Neutral joint position
▪ Enables generation for maximum
muscle power
▪ Improves sport performance
▪ Ideal/balanced joint loading
- decreased load on ligaments Newborn 3 months old baby
and tendons, prevents cartilage
overuse and degeneration
▪ May prevent repetitive strain injury

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Differentiation function – stepping forward and Developmental Kinesiology

support – basic milestones of human locomotion
1s t phase 0 – 4 months
5 months 8 months
9 months sagittal stabilization matures

10 months 14 months
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Stabilization in a Sagittal Plane

Stabilization of the trunk and pelvis
Optimal pattern of core stabilization in 3 m/o infant and in a weight lifter.
Same muscle coordination; weight lifter just needs more strength; joint
during movement
centration same in both.
▪ Intra-abdominal pressure (IAP) is
main stabilizer of the trunk and
pelvis
▪ Regulated IAP is result of
proportional co-activation between
diaphragm, pelvic floor and whole
muscles of abdominal wall

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Stabilization of the torso The diaphragm: 3 functions

▪ Respiration
Phenomenon of ▪ Stabilization
the liquid ball
▪ Sphincter

Intra – Abdominal Pressure (IAP)

Anatomically related to transversus abdominis.
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Muscle Activity during Ventilation Ideal Respiratory Pattern

Muscles of quiet inspiration 1. Must be maintained during any dynamic functional
activities and exercises
Diaphragm 2. Spinal stability results
▪ Lowering and flattening of the 3. Competition between postural and respiratory function of
dome, increased diameter of vertical the diaphragm - affects the quality of phasic movement
thorax
For example: a tennis player w/weak stabilization - Unable
▪ Increased IAP results from
to maintain postural diaphragmatic function while playing
diaphragm descending; diaphragm
expands the lower ribs laterally. Yoga trainers usually train abdominal breathing (ventral
▪ Once stabilized by increased IAP, protrusion only!) and forget to include the lateral expansion
continued contraction of the costal
fibers elevates the middle and lower
ribs (Neumann, 2002).

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Ideal Respiratory Pattern

Ribs movements during respiration
▪ Initial position – relationship between chest
and spine ▪ Upper ribs – rotation in CV
joint, movement in ventro-dorsal
▪ Upper ribs – rotation in costo vertebral joint
(CV) - chest expansion in ventral direction direction
▪ Lower ribs – rotation in CV joint causes
expansion in lateral direction ▪ Lower ribs – rotation in CV joint
▪ Sternum is stable causes movement in lateral and
cephalad direction
▪ Movement occurs at SC joint – if
inadequate, AC joint movement substitutes

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Respiration and Exercises

“If breathing it is not normalized ▪ Optimal respiratory pattern is essential for IAP regulation
– no other movement pattern during exercise
can be.” ▪ Strength exercise – expiration while exerting strength
▪ Increased oxygen consumption reinforces activity of
Karel Lewit auxiliary respiratory muscles

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Stabilization function of the diaphragm with Timing of Trunk Stabilizers

abdominal and pelvic muscles Muscle Activity

Correct activity Incorrect activity

incorrect correct of abdominals of abdominals
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Stabilization Function of the Diaphragm

Optimal position of the chest is essential for correct

diaphragm function

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Optimal Trunk Stabilization Stance: chest-pelvis relationships

ABNORMAL:
ABNORMAL:
Abnormal chest Chest in front of
“Opening scissors”
Chest & Pelvic axis:
and pelvic position Pelvic Oblique
IDEAL: ABNORMAL:
Chest and Pelvic axis: Chest behind
Horizontal & Parallel the pelvis

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Opened Scissors Syndrome

Developmental Kinesiology
1st phase - 0 – 4.5 months
▪ Sagittal stabilization
2nd phase - from 4.5 months
▪ Extremity function differentiation within global
patterns

3rd phase - from 8 months

▪ Development of locomotor function

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Global Motor Patterns

Trunk Stabilization
▪ Sagittal Stabilization
▪ Ipsilateral patterns
Precedes and follows every movement.
– develop from supine
▪ Contralateral pattern
– develop from prone
• Differentiation of extremities’
function
• supporting function
• stepping forward function Activation during purposeful movements of
extremities and static loading.

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Trunk Stabilization during Baby Development Trunk Stabilization during Baby Development
▪ Axis of the diaphragm and pelvic floor is parallel b) In Close Kinematic Chain
- controls diaphragmatic pressure from 3M prone – symmetric support
▪ Allows for stabilization of muscle attachments during from 7M All 4 - quadruped
movement of the extremities
from 9M Bear
a) In Open Kinematic Chain from 14M Squat
from 3M supine – movements of extremities

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Ipsilateral Pattern Ipsilateral Pattern

Turning process from supine to prone.

Stepping forward
- top limbs

Support
- bottom limbs

Axis of shoulders and pelvis are parallel during the turning

process and in planned movement go in the same direction.
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Ipsilateral Pattern - Sport

Ipsilateral Pattern

OBLIQUE SIT

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Contralateral Pattern Contralateral Pattern

Supporting & stepping forward function
on opposite sides (reaching for the toy,
crawling, walking).

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Open Kinematic Chain – Proximal Muscle Pull

Biomechanics of the Muscle Work PF
▪ proximal muscle attachment is
stabilized (punctum fixum)
Concentric muscle contraction – always acts bring two
muscle attachments together ▪ distal segment (on periphery) is
moving (punctum mobile) with
The direction of muscle pull depends on stabilization of the proximal muscle pull
proximal or distal attachment, which is provided by another ▪ stepping forward function of PM
muscle (stabilizer). extremities OPEN KINEMATIC
CHAIN
▪ Head of the joint is moving against
the socket

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Differentiation of Limb Function

Closed Kinematic Chain – PM
Distal Muscle Pull ▪ Right kicking leg is moving
SUPPORTING
in open kinematic chain LIMB
▪ Distal segment is stabilized (punctum ▪ PF is on pelvis
fixum)
▪ Proximal segment is moving against PF STEPPING FORWARD
distal (punctum mobile) with distal FUNCTION
muscle pull
▪ Left standing leg is
▪ Support function of extremities in closed kinematic chain,
CLOSED KINEMATIC CHAIN ▪ PF is on femur STEPPING FORWARD
(SWING PHASE)
▪ Socket of the joint is moving against
SUPPORT FUNCTION
the head

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Developmental Kinesiology Based Exercise Developmental Kinesiology Based Exercise

▪ Allows to train muscles in physiological function

(purposeful movements)
▪ Automatically activates ideal quality of the stabilization
function
▪ Prevents repetitive strain injuries 4m 4,5 m 8m
▪ Performance enhancement

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Developmental Kinesiology Based Exercise Conclusion

▪ Muscles may be strong enough in phasic function
(anatomic) but lacking in postural (stabilizing) function.
▪ Quality of motion depends on quality of coordination
between agonist and antagonist musculature (co-
contraction).
9m 10 m 14 m

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Conclusion DNS Tests

Core stability is not defined by strength of abdominals or
back muscles (or any others) but results from optimal intra-
abdominal pressure regulation

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1. Test of Sagittal Stabilization

Evaluation of Stabilization Function in sitting position
a) Do the joints and segments stay in neutral position when
loaded and during full ROM?
b) Which muscles are activated to much and which are
insufficient?

Postural instability – segment or joint looses neutral

position during postural loading or movement

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1. Test of sagittal stabilization in sitting position 1. Test of sagittal stabilization in sitting

position
▪ Palpate laterally below the lower
ribs We examine respiratory and postural function of the
diaphragm in three levels
▪ Slightly press against the lateral
group of the abdominal muscles ▪Respiratory – palpation during regular breathing (see
previous page)
▪ Check the position and
movement of the lower ribs ▪Postural – pressure of diaphragm, which opens the lower
part of the chest (“Push my fingers away, without using
▪ Assess: Quality and inhalation“)
symmetry of activation
▪Combination of both functions - flattening of the
diaphragm, which must be maintained during respiration –
(“Push my fingers away and breathe, don’t lose the
pressure under my fingers")

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1. Test of sagittal stabilization in sitting 1. Test of sagittal stabilization in sitting

position position
Correct activation Insufficient activation
▪ Symmetrical activation ▪ No or very weak activation
against the therapist’s ▪ Cranial movement of the ribs
fingers – the patient is unable to
▪ The lower chest expands maintain the caudal,
in a lateral direction expiratory position of the
▪ The intercostal spaces chest
widen ▪ Insufficient widening of the
▪ The position of the ribs lower chest and intercostal
in transversal plane spaces poor
remains the same (the ribs must not be lifted!) stabilization of the L spine.
▪ Flexion of the T spine
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1. Test of sagittal stabilization in sitting position

1. Test of sagittal stabilization in sitting position

▪ Palpate area above inguinal ligament.

▪ Watch intensity/symmetry/distribution of intra-abdominal
pressure.
▪ Simultaneously evaluate change in shape/position of rib cage.

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1. Test of sagittal stabilization in sitting position

Poor Stereotype
▪ Unable to activate lower abs
– poor coordination of trunk
muscles
▪ Umbilicus is pulled inward
and up during activation
(hyperactivity of the upper
section of the rectus
Instruction: push against my fingers , increase intra-abdominal pressure abdominis)
above your groin ▪ Frequently associated with
Correct stereotype: abdominal crease
The umbilicus must not be pulled in and up during activation; rather it
should move caudally
Strong symmetrical activity above the groin (pelvic floor muscles)
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Expiratory position NO
of the chest

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2. Test of sagittal stabilization in Supine position

2. Test of sagittal stabilization in Supine position
Initial position
▪Patient supine Assessment
▪Triple flexion of the legs ▪ The therapist brings the
▪The lower legs supported patient’s chest passively
▪Hip abduction corresponds to in caudal, expiratory
the width of the shoulders, position
slight external rotation at the ▪ Then the support is
hips – centered position slowly, gradually
Assessment removed from under the
patient’s legs
Movement is isolated from trunk:
▪upper limbs ▪ The patients holds this
▪lower limbs position actively
▪head

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2. Test of sagittal stabilization in Supine position Ideal model

Correct activation
Ideal activity of
▪ Well balanced
activation of all the
(co-contraction)
parts of the
abdominal wall ▪ The diaphragm
▪ The chest is kept in ▪ The abdominal muscles
a caudal position
▪ The pelvic floor
▪ Vertical axis of the
diaphragm
▪ The lower chest
widens

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2. Test of sagittal stabilization in lying position

Poor activation
▪Activity of upper part of
rectus abdominis
predominates
▪The umbilicus is pulled in
a cranial direction
▪Inspiratory position of the
chest Hyperactivity of the
▪Concavity of the Rectus abdominis
abdominal wall above the – upper part
level of the groins

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2. Test of sagittal stabilization in supine position

Poor activation
Diastases
▪ No or very little activity of
the laterodorsal parts of
the abdominal wall
▪ Hyperactivity of the
paravertebral muscles
▪ Instability
(hyperextension of the
T/L junction)

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Faulty stereotype
Trunk and Neck Flexion ▪ During neck flexion the
Correct stereotype chest is pulled in a cranial
direction
▪ During neck flexion
▪ The collar bones are lifted
abdominal muscles cranially
become activated ▪ Convexity (bulging) at the
▪ The collar bones are lateral aspects of the
not lifted (no abdominal wall
hyperactivity of
the pectoralis m.)
▪ The chest is kept in
a caudal position
Poor stereotype – the ribs
▪ During trunk flexion
are not correctly fixed, move in a
the lateral abdominal lateral and cranial direction
muscles are activated

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Trunk and Neck Flexion Ideal core stabilization

corresponds to muscular
coordination of 3-month old baby

Training (instructions):
▪ Caudal (neutral) chest position
▪ Diaphragm/pelvic floor coordination
▪ Cylindrical activation of all abdominal
wall sections
▪ Care for neutral neck position
▪ Avoid arching of the L spine
▪ Patient must actively maintain neutral
hip position
▪ Direct patient‘s breath as far as the
groin and lateral dorsal aspects of the
abdominal wall

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Developmental aspect!
Physiological development
Posterior angles of the ribs
Newborn In newborn placed anteriorly to the spine 3 months – rib angles behind the spine
Structural and functional Normal function and normal
immaturity structural maturation

Man, unlike many

animals, is immature
at birth.
After birth maturation
of the CNS occurs.
Abnormal dev elopment (s tabiliz ation) Ideal s tabiliz ation c orres ponds with
– anterior plac ement and ”immature” ideal dev elopmental pattern
s hape of the ribs remains
Individual w/abnormal
early development

(1st year of life)

Structural
consequences:
anatomy of a newborn

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3. Core stabilization Correct stereotype

test in prone position ▪ Support on medial epicondyle of
Trunk extension test humerus
▪ Shoulder blades placed on ribs
in abduction, slight external
rotation, adequate flexion,
abduction of shoulder joint
▪ Fluent extension of mid-thoracic
spine with elongated cervical
spine
▪ Abdominal wall retains
cylindrical shape

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Insufficient segmental Extension test

movement middle T spine Insufficient
▪ Insufficiency of the deep neck stereotype
flexors: co-activation with
extensors ▪ The upper angles of the
▪ Hypermobility of the C spine, shoulder blades are
(head reclination) pulled in a cranial
▪ Auxiliary respiratory muscles direction (activity of the
hyperactivity upper and middle
▪ Upper scapular fixators & short trapezius), adduction of
neck extensors hyperactive the upper angles
▪ Insufficient lower scapular ▪ Abduction of the lower
fixators angles

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4. Quadruped Rock Forward 4. Quadruped Rock Forward

Performance Evaluate:
▪ Support on palms
▪ The patient (tripod)
slightly shifts the ▪ Scapular stability
head and trunk ▪ Symmetry of T/L
forward (rock paraspinals
▪ Hypertonia of
forward) upper fixators?
Wrong stereotype:
Assessment ▪ Hypothenar hand
▪ Hand support support (ulnar side
▪ Position of the of hand)
shoulder-blades ▪ “WINGING“ position
of scapula (cranial, and lateral direction)
▪ Hypertonia of PV T/L and of upper fixators = elevation of the lower
leg
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NO

YES
Kapandji, 1974
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5. The Bear Test 5. The Bear Test

▪ Higher & more challenging
position Correct stereotype Pure stereotype
▪ Mistakes are more pronounced ▪ From hands and knees client ▪ Movement starts with kyphotic
▪ Watch the position for lifts knees and keeps support or lordotic T/L junction
centration of the ankles and on palms and forefoot ▪ Restrictions in hip joints lead to
knees ▪ Spine upright premature dorsal flexion of
▪ Position of the pelvis, L spine ▪ Cylindrical shape of abdominal pelvis
▪ Position of the shoulder-blades wall ▪ Hip joints collapsing into internal
▪ Neutral position of legs (ankle) rotation lead to valgus knees
▪ Activation of the laterodorsal
and knees and ankles (X shape legs, poor
parts of the abdominals
▪ Neutral position of hands arch of feet)
▪ Centration of the neck, head (wrists), elbows and shoulder ▪ Elevation of shoulders and head
position girdle in protraction

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6. The Squat Test 6. The Squat Test

Correct stereotype
▪ Neutral pelvic position
▪ Good activation of the laterodorsal
sections of the abdominals and posterior
diaphragm
▪ Centration of the low back – neither
lordosis nor kyphosis
▪ Centration of the hip, knee and ankle
joints
▪ Correct position of the shoulder blades -
ABD & slight external rotation
▪ Shoulder, hip and foot should be in 1 line
▪ Medial knee should line up between 2nd &
3rd toes

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6. The Squat Test 6. Squat

Poor stereotype
▪ Hyperactivity of the
paraspinal muscles (T/L
region)
▪ Anterior pelvic tilt
▪ Decentration of the hip, knee
or ankle joint
▪ Shoulder elevation,
protraction
▪ Head in forward drawn
position

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The Squat Test – Modified DNS Assessment

▪ If squat with no support ▪ Evaluate core stabilization in different positions, during
is too challenging loading, during sport
▪ Use this modification ▪ Evaluate and analyze sport technique or movement
▪ Modification both for ▪ Joint centration and torso/pelvis axes during the
assessment and movement
training ▪ Choose 2-3 DNS test - identify insufficient or incorrect
motor patterns
▪ In tested position start corrective exercises

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Sport technique evaluation Exercise in sport and fitness based on

the DNS principles
▪ Videotape athlete
during sport
▪ Pay attention to joint
centration and
movement pattern’s
characteristics Notice
any incoordination,
jerky movement,
coupled movement
▪ Watch for quality of
relaxation!

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DNS exercise principles DNS Exercise Principles

▪ Correct respiration ▪ Number of repetitions
– depends on stabilization
▪ Optimal sagittal
stabilization ▪ Exercise only as long as
the neutral position and
▪ All joints and
good quality of movement
segments in neutral
is achieved and
(centrated) positions
maintained
▪ Establish a good
▪ Exercise in static
quality of support
positions - improve
▪ Timing segmental stabilization
function

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What position and load to start with? DNS principles in athletes

▪ Start in easier postural (lower) DNS based training
positions (developmentally ▪Respect ideal posture as
younger) defined by develop.
▪ Exercise must activate the kinesiology
optimal motor patterns ▪Train variability -
(stabilization, support, stepping adaptation to sport loading
forward) ▪Cortical function training –
▪ Reduce the load if abnormal improve sensory
position in any segment shows integration
up

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Preparatory exercise with load Supine with gymball

▪ The patient supine, the legs flexed
Chest positioning IAP proper activation
▪ Initiate rolling by loading one side -
shoulder blade and pelvis
▪ Or push one hand and contralateral
thigh against the gymball
Mistakes:
▪ The patient elevates the shoulders
▪ Increased L lordosis
▪ The patient holds her breath
Assist neutral position of the rib Teach client how to breathe and
cage and costal expansion during regulate IAP, to activate
inspiration “abdominal cylinder” prior to any
movement of the limbs

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“90-90 supine“ with T-band Exercises in supine

▪ Supine “90-90 position”
▪ Neutral = caudal position of
the ribcage both during
exhalation and inhalation
▪ Hold hands, palms facing
up
The T-band is wrapped around the Maintain the basic supine position
shins (just below the knees) crossed with the head, spine, trunk and pelvis ▪ Extend your elbows as
from the front to the back side, and in a neutral position, breathe into the performing a bench press
brought forward around the thighs (just area above the groin. Supinate your
above the knees), and held in the hands while performing external ▪ Use loads for exercise
palms (wrapped twice), with the free rotation at shoulders. progression
end of the T band placed between the
thumb and index finger. Arms are
flexed 90°at the elbows.
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Exercise in supine with pulleys

Exercises in supine Set up position in supine with legs 90-90 and sagittal stabilization

▪ Supine “90-90 position”

▪ Hold weights, bend
elbows and shoulders
while maintaining caudal
position of the chest,
neutral position of the
spine and pelvis
▪ Extend elbows as in a
triceps curl
▪ Posterior deltoid, ER, triceps, obliques ▪ Ventral delt, pecs, obligues
▪ One arm - from 90° flexion pulls to ▪ Supporting arm is in abduction 90°
abduction against pulley resistance ▪ Stepping forward hand with pulley in
flexion, ER and ABD pulls to adduction
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Exercise in prone Low kneeling exercise

▪ Prone position, elbows support ▪ Sit on your heels
▪ Increase intra-abdominal ▪ Knee distance = shoulder
pressure and load the distance
symphysis (without activity of ▪ Elbows support, forearms
the gluts). pronated.
▪ Depress the shoulder blades ▪ Stabilize the shoulders!
while keeping them apart
▪ Cue the client to lift his head
▪ Lift your head from mid thoracic with C spine straight.
spine and with the C spine
straight. ▪ Guide the T spine and L spine
straightening while patient is
▪ 3-6 reps with maximum quality lifting from his heels.

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Quadruped exercise
Basic position Horizontal abduction with load Quadruped
modification
▪ Centrated quadruped
position
▪ Slide one knee back and
forward while
▪ Centrated quadruped position ▪ Use pulley or weight to move maintaining the pelvis
▪ Spine straight! one arm horizontal and spine
▪ Knees distance = hands ▪ Joint centration throughout straight.
distance the whole ROM
▪ Hips in 90,°shins and feet ▪ Direction of moving arm can
converge. vary
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Active Sitting exercise

Quadruped Proper IAP prior to load Arm press with optimal IAP
modification and centrated pelvis

▪ Contralateral arm and leg

support
▪ Supporting knee is placed
in front
▪ Spine, pelvis, rib cage,
shoulders and supported
hand well centrated at all
times!
▪ Stepping forward arm First train well balanced IAP &
moves against pulley from “abdominal cylinder” during: Put the legs on the bench in 90-90
extension with IR to FL ▪ respiration Knee distance = shld distance
with ER ▪ exercise Balanced IAP first and then arm
press
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Modification Exercise categorization DNS

application

A) Skill Acquisition of
optimal stabilization
B) Skill Application of
stabilization during
basic movement
pattern (squat, leg
press, throwing…
C) Skill strengthening
of stabilization during
load

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A) Skill Acquisition B) Skill Application

▪ Exercise with the goal of teaching ▪ Exercises where athlete is taught to apply the DNS
optimal stabilization patterns – majority movement strategy to a particular movement
of DNS exercise
▪ I.e. slow tempo squat with the loose belt, bench press in
▪ Exercises in developmental positions 3 months position
3m supine – IAP with breathing into
dorsal part of abdominal wall, glute
activity in high kneeling…

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C) Skill Strengthening Developmental positions 3 - 14 months

▪ Athlete is working to raise his threshold for DNS pattern
▪ I.e.snatches x3 at threshold (usually 50 - 60%)

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Dynamic Neuromuscular Stabilization 21

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3 Month Prone 3 Month Supine

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4 Month Supine 5 Month Supine

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4.5 Month Prone 5 Month on the side

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Dynamic Neuromuscular Stabilization 22

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6 Month Prone
6 Month Supine

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7 Month Prone 7 Month “on hands

and knees”

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7 Month Oblique Sit 8 Month Oblique Sit

(mature)

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Dynamic Neuromuscular Stabilization 23

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9 Month Crawling
10 Month Sit

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10 Month transition phase

11 Month Tripod
from oblique sit into
crawling

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11 Month High 12 Month Bear

Kneeling

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Dynamic Neuromuscular Stabilization 24

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12 Month Squat 12 Month Deep Squat

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13 Month Verticalization

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DNS principles
for athletic population and training!

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Dynamic Neuromuscular Stabilization 25