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#152 - Michael Rintala, D.C.: Principles of Dynamic Neuromuscular Stabilization (DNS)

Mar 8, 2021 1h 35m 11 insights
<p>Michael Rintala is a sports medicine chiropractor and one of only 18 international instructors teaching dynamic neuromuscular stabilization (DNS) for the Prague School of Rehabilitation. This episode focuses on understanding DNS, including the foundational principles and how it relates to human motor development. Michael also shares the most common injuries and issues he sees in patients in his practice, such as postural problems and back pain, and how the movements of a DNS program are used to avoid injury, maintain longevity, and improve sports performance.</p> <p><br /> We discuss:</p> <ul type="disc"> <li>Michael's background in chiropractic sports medicine and rehabilitation (3:15);</li> <li>The Prague School of Rehabilitation, and functional rehabilitation as the foundation of the dynamic neuromuscular stabilization (DNS) program (5:00);</li> <li>Foundational principles of DNS, and the role of the diaphragm in muscular stability (19:00);</li> <li>Types of muscle contractions (28:15);</li> <li>Human motor development through the lens of DNS, and when issues begin to arise (32:30);</li> <li>Common postural syndromes (50:00);</li> <li>Increasing functional threshold to minimize time in the functional gap (56:45);</li> <li>DNS for injuries, pain, pre-habilitation, and performance enhancement (1:03:45);</li> <li>Etiology of back pain (1:10:00);</li> <li>How a stress fracture in his back led Michael to the Prague School (1:16:00);</li> <li>The Prague School curriculum: 3 tracks for certification in DNS (1:20:45); and</li> <li>More.</li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/MichaelRintala/">https://peterattiamd.com/MichaelRintala/</a> <br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p>
Actionable Insights

1. Master Deep Stabilization Synergy

Learn and practice the coordinated activity (synergy, coordination, and timing) of your deep stabilizing musculature, including the diaphragm, pelvic floor, entire abdominal wall, and intersegmental spinal muscles. This creates a fixed point through the trunk and pelvis, allowing larger muscle groups to anchor efficiently.

2. Optimize Intra-Abdominal Pressure Management

Develop the ability to dynamically manage intra-abdominal pressure (IAP) by coordinating diaphragm descent with eccentric loading of the pelvic floor and abdominal wall. This ‘inside-out’ strategy provides efficient, dynamic stability through full ranges of motion, unlike static bracing.

3. Identify & Correct Postural Habits

Be aware of common postural habituations, such as anterior pelvic tilt, rib cage flaring, shoulder elevation/protraction, and cervical spine extension. These patterns inhibit proper diaphragm function, leading to over-utilization of accessory breathing muscles and chronic overload in transitional spinal areas.

4. Prioritize Movement Quality

In all physical activities and training, prioritize the quality of movement, stability, and ‘centration’ (maintaining ideal joint position) throughout the kinematic chain over simply achieving high repetitions or heavy loads. This approach, exemplified by elite athletes, reduces injury risk and enhances longevity.

5. Understand Low Back Pain Root Causes

Recognize that most non-traumatic low back pain often stems from an inefficient activation of the deep stabilizing system, leading to excessive flexor-extensor activity and ‘hinging’ in the lumbar-sacral region. Addressing this underlying stabilization deficit is crucial for effective recovery and prevention.

6. Re-engage Infant Motor Patterns

Utilize active exercises based on developmental milestones, employing specific points of support and positioning, to facilitate or ‘wake up’ the natural, hardwired motor patterns you still possess as an adult. Practice these movements with awareness to feel the correct synergy and stabilization.

7. Foster Natural Child Movement

Create an environment that allows children to explore movement naturally, avoiding devices like premature sit-up chairs or walkers that force postures before they are developmentally ready. Delaying the introduction of shoes and minimizing prolonged car seat or sitting time can also support healthy neuromuscular development.

8. Commit to Consistent DNS Practice

Understand that Dynamic Neuromuscular Stabilization (DNS) is a process requiring consistent work and practice, focusing on feeling the movements and understanding the underlying philosophy rather than seeking quick, superficial results. Patience and persistence are key for integrating new, efficient movement patterns.

9. Integrate DNS Principles Broadly

For clinicians and trainers, integrate DNS concepts and principles (e.g., specific loading, cueing) into existing training programs and rehabilitation protocols. This approach enhances the effectiveness of current methods by improving fundamental stabilization and movement efficiency.

10. Explore DNS Curriculum for Professionals

If you are a clinician or trainer, consider exploring the Dynamic Neuromuscular Stabilization (DNS) curriculum, which includes clinical, exercise/sport, and pediatrics tracks, along with specialty courses. This can deepen your understanding and ability to integrate these concepts into your professional practice.

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