Pediatrics: Dynamic Neuromuscular Stabilization

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Good morning. How is everybody doing in ChiroSecure land? This is Dr. Drew Rubin. I’m excited to be with you today to talk to you about another episode so we can present to me what’s one of the most important concepts, which is dynamic neuromuscular stabilization. It’s a very interesting new concept coming out of Europe.

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This is Pavel Kolar’s textbook. Clinical rehabilitation that I got this information from. Important to understand before I continue, and I always make sure people get this, is we’re not back doctors, we’re not bone doctors, we’re not spine doctors. We are nerve system specialists. So I want you to keep that in mind as we go along with this.

Even though Dr. Kolar is a physical therapist I want you guys to keep in mind are what we are looking for is not just changes in Muscles and how muscles are moving, etc. It’s really how the nerve system is working. But this is also, but this is still very good information and I think what I really like that they’ve come up with is something called developmental kinesiology.

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So there are three levels of motor control in the assessment and treatment of the motor system. And what they’re going to talk about in the motor control is I’m going to show you some pictures in a moment, a poster or two posters that these guys have made up. And what it shows is how a baby, when it first learns a neurotypical baby, when it first learns how to, lift up its head, roll, crawl, walk, et cetera, there are very specific ways that it does this.

And those are the motor control systems that they’re talking about. And this development of kinesiology is how this works, how this actually works. Goes in succession and if there’s a problem in any of those areas, then there’s problems later on downstream. And the same thing can be seen in adults as well.

What Dr. Kolar talks about is postural development occurs from proximal to distal. So in other words it occurs from the core right out to the extremities. The first thing about how a baby is on his stomach, flat down prone. And then by two or three months now, it’s able to lift his head up and then use his arms to lift his head up, right?

That’s the maturity coming from axial to appendicular. When you, Dr. Kowalke talks about posture and how, what’s interesting is the eyes, the mouth, the chest, and the pelvis all should be horizontal and parallel. So if you look at the left most picture. That’s what it shows. It shows everything is parallel.

And that’s ideal. And anything else is not ideal. Whether it’s open from the front, closed from the front, etc. Another thing that I like that he talks about is how the diaphragm and pelvis are very similar in anatomy and function. If you look at the diaphragm, the breathing diaphragm, and the pelvic floor, they’re even though these are cross sections and obviously there’s different stuff in them, but they look the same.

They have similar function in that they both allow they both act in respiratory function in postural control. They both have sphincter function and they work as a unit, when you’re breathing, it works like this. It goes up and down and up and down and up and down. So that’s an important thing to understand when what their, the the dynamic neuromuscular stabilization people have talked about is how rolling is ipsilateral and crawling is contralateral.

If you look at the, the Olympics are going on right now, you look at the ipsilateral movements. That comes from rolling. So that’s like kicking a soccer ball, doing a high jump throwing a javelin, et cetera. So that’s called an ipsilateral pattern. The contralateral pattern is more like like crawling, right?

And that’s more running, sprinting obviously winter sports like skating et cetera. But that’s where all these things come from. So what happens, according to the DNS people why is this pattern disturbed or interrupted? Because of one of several things, either A, skeletal abnormality, you can see a little munchkin there on the top left, has uneven scapula, probably a potential curve in his spine.

Number two, there’s abnormal early development you can see this little munchkin is having a hard time lifting their head up. Number three is some habits, whether it’s exercise routine like that person on the right is doing or the person in the middle there who’s on the computer screen looking down, right?

There’s all these different things that create these potential pathological patterns. And so what DNS talks about is how to stabilize how to stabilize these patterns looking at an adult, looking at even a child and saying how do we stabilize this? How do we improve the respiratory pattern, because that’s a big thing.

How do we improve locomotion ipsilaterally and contralaterally? And how do we improve body awareness? So these are the posters that I was mentioning to you so you have normally developing kids. move perfectly according to their thought process. So if you look at the child illustrations on this, you see how each position, they’re moving perfectly, and we can mimic that in our adult or older child way.

And this is how they’re using the thought process, either A, with an adult, can they go into these positions, Because if there’s a weakness in those positions, that means there’s probably weakness elsewhere. Or in a child, are they not doing those particular movements? And how can we facilitate them doing these movements?

So these are the earlier movements. And these are the later movements. So the question is, what can we do to assess normal movement and fix abnormal patterns? So the goal in this particular paper is an example, which I gave you the link for. Thank you. And is, and this is an incredible paper and I highly recommend it.

If you want to learn how to stabilize, functionally stabilize these people children or adults who are having some movement issues, there are like a whole bunch of tests that you can do. And when each one of these tests has an exercise, a corresponding exercise for you to recommend. So this paper is an incredible paper, incredible resource for you guys.

If you’re interested in improving. posture. And, but keeping in mind the nerve system, I think this would be a very helpful because the exercises, motion is lotion. The exercises are directed to help them that person or that child move better. But first you assess where they’re at, right?

So there’s, I think it’s 11 points different tests and you assess the 11 points and then figure out where they’re weak and then start strengthening each one of those weaknesses. So the great thing about this is that it gives you a long term way to get them to work better. So instead of instead of having to figure out individual by individual what to do by doing these 11 exercises, you start at the earliest.

issue of exercise and then you slowly work up. So it gives you like this longterm, like weeks and weeks worth of exercises to give your patient, which I think is phenomenal. And I always look for that kind of stuff versus just saying, here’s an exercise. I just read another book by some functional neurologist.

It was great, but they gave seven exercises that everybody gets. And I don’t like that cookie cutter concept. I’d rather do like determination, like where are you at? And then, Let’s do some exercises and then re examine and do more exercises. This gives you this list of exercises to do over a multiple weeks time.

So as you guys know, I speak for the ICPA. Love to see you at one of our ICPA seminars. I’ve now recently just changed the name of my main seminar to Brain Based Adjusting. We also have the Pediatric Midline Defect and they’re available not only live but also virtually as well. And ChiroCast, I’m just actually going to publish tomorrow my 572nd 572nd episode.

And it’s free on iTunes, Spotify, YouTube, Amazon, SoundCloud. Anywhere you listen to podcasts, you can get podcasts our podcast called ChiroCast. Ultimately, we have to protect our future, adjust more kiddos. Thank you so much, ChiroSecure, for everything you do. Any questions about this, please do email me.

Alex, I’d love to talk to you. Thank you and have a great day.

Today’s pediatrics show, Look to the Children, was brought to you by ChiroSecure.