Course Notes: DNS Summit


In my short time out I have gotten heavily into the influence that breathing has on the nervous system. Obviously PRI has been my favorite explanation thus far, but the DNS approach had me intrigued. The summit is the first of two DNS courses that I took this past week.

This summit was the first of its kind, and was an amalgamation of many different speakers. Unfortunately, this summit was mostly review and wrought with little innovation. Here are some of the big points I got from a few of the speakers.

“Developmental Kinesiology: Three Levels of Motor Control in Assessment and Treatment of the Motor System” by Dr. Alena Kobesova

  • There are three levels of development: spinal, subcortical, and cortical
  • Spinal level of motor control is primitive reflexes; subcortical motor control is core stability; cortical motor control includes individual patterns.
  • DNS suggests inhibiting primitive reflexes instead of facilitating them for function.
  • Core stabilization occurs first at 4.5 months development, then locomotion follows.
  • All movement patterns are either ipsilateral or contralateral. The former develops in supine, and the latter in prone.

“DNS Among Elite Athletes – MLB” by PJ Mainville

  • Didn’t get much out of this one except PJ dancing around PRI 🙂
  • Recommended using theratube around the wrist so you can perform hand movements with PNF patterns as such.

 “DNS in Gynecological and Obstetrics Disorders” by Martina Jezkova

  • When in quadruped, the pelvic floor does not create a base for the trunk and had no postural function. The diaphragm acts purely respiratory. Thus, training in this position could potentially restore diaphragmatic respiratory function before throwing on increased demand.
  • Suck on the thumb to feel the pelvic floor contract.

“Somatovisceral Relations” by Petr Bitnar

  • Petr spoke very little English, so I had no idea what was really going on.
  • The upper GI correlates to the cervical spine. Dysfunction in one can affect the other.
  • The diaphgram has a respiratory, postural, and sphincter function. The diaphragm is your true esophageal sphincter. He had a great video regarding the sphincter function and breathing which I was too slow at acquiring.

“Chronic Pain” by Brett Winchester

  • Easily the biggest surprise of the show. Was talking about pain being a cortical phenomenon all day. Was so refreshing after a bunch of postural garbage. Saw a ton of Butler and Moseley here.
  • “Almost every patient with chronic pain carries a bag of shit.”
  • “The more red, yellow, blue, and black flags a patient has the more readily the clinician is going to wave a white flag.”
  • “Pain meds are the new white collar drug.”
  • We should direct therapy at restoring the integrity of cortical information processing.
  • Brett estimated that 5% of our patients may have cranial nerve dysfunction…perhaps something we should all be checking more often.
  • A study done in 2011 showed that those with scoliosis have an altered visual midline.

“The Role of Manual Therapies in DNS” by Robert Lardner

  • Yep, the guy who wrote the Janda book.
  • “Manual therapy is part of the grooming process in our society.” As he states the work by Sapolsky that shows baboon’s well-being is determined by the amount of grooming they received and if they had stable social relationships.
  • The kinetic chain is governed by the CNS, so working at one spot affects the entire chain.
  • Manual therapy’s goal is to normalize input.
  • Input content and quality will determine output activity and behavior conditioning through neuroplasticity.

“Establishing the Evidence Base: Acceptable Levels of Uncertainty?” by Michael Schneider

  • Evidenced-based medicine (EBM) is a clinical jazz composed of best current available evidence, clinician experience, and patient values. If any one takes over too much, the ensemble falters.
  • “Systematic reviews subjectively define objectivity.”
  • “There has never been a RCT that shows smoking increases cancer risk.”
  • “The best science depends on your question.”
  • Health service research is going to be the next big thing, as it looks at treatment cost effectiveness.
  • Was in favor of the evidence house over the evidence hierarchy.
  • “A lack of evidence is not evidence of lack.”
  • Clinical trials are crazy expensive. A single RCT costs $1-2 million and takes 3-5 years to perform.
  • It takes 17 years from when a research finding gets published to become standard clinical practice.

More to come.

  1. Interesting post, i liked the comment on diaphragm being purely respiratory in quadruped, as I have really seen good results using the all 4 belly lift with more with my PEC patients.

    1. Those were my thoughts exactly when I heard it srharris. Establishing and separating diaphragmatic respiratory activity from abdominal activation is critical for your patients who are patho PEC. Abz on abz 🙂

    1. Thanks for the comments Marian.

      I don’t really know what to say about his treatment, as he never really explained what he was doing. He assessed a baby to determine it’s age. Assessed a couple other people and tried to determine their pain. 50/50 success if I recollect. He did restore full behind-the-back ROM on a shoulder by working on a trigger point in the right foot which was somewhat cool; but for those initiated in PRI this was not surprising.

      I am sure he is a brilliant individual. But combining the language barrier and Pavel being Pavel as his cohorts say, made knowing his thought process and what he was trying to achieve non-existent.

      Also got a patient to move with RL…but if you looked at her the right way she’d creep 🙂