This week we’re in for a treat. A few weeks back, I had the good fortune to spend a few hours with the Arizona Diamondbacks’ sports medicine and performance team. They’re an incredibly intelligent bunch of guys who have a strong manual therapy basis, a command of DNS, and how all of it fits together for baseball players. As DNS is a popular topic as of late, I had Nate Shaw, their strength coach, put together some thoughts on the basics of the DNS.
Nate will be a guest on SRE Podcast in the coming weeks, so if you have specific questions, drop them in the comments section!
DNS is an interesting topic that has received a great deal of attention in the recent months.
We. the Dbacks Sports Medicine team have been able to transition some of the DNS thought processes into our treatment and performance regimen. It has been an interesting process for me. When I was first introduced to DNS I tried to learn everything about it–vectors, positions, and angles. All of the things that had to happen prior to the patients beginning to move.
I was overwhelmed to say the least. In discussing DNS, I wrote feverishly, jotting down everything that Dr. Kolar said. I had a video camera rolling, I took pictures and jumped in every time they needed a subject. I even resorted to sending my mom to see a local DNS Practitioner in an effort to try and figure out what exactly Reflex Locomotion was all about. With some critical thinking, I finally started to get the point.
All at once, it hit me like a ton of bricks. DNS was so simple and I was overthinking it. It could not be this easy. Could it?
The common theme to this DNS stuff is as easy as proper breathing and proper rib cage function and position. I started to truly understand DNS after watching Pavel Kolar evaluate 3 different Baseball players, a pro tennis player, a soccer mom, a baby, and then some more baseball players. I realized then that DNS really is not that complicated at all. Most patients can be broken down into something very simple.
It boiled down to one thing; Proper function and strength of the core.
It seemed each of the patient evaluations had a few themes in common; Rib cage position, Diaghram function, and the ability to use the entire kinetic chain. Each one of the athletes that was evaluated did not posses ideal breathing mechanics. The majority of the findings were that the “scissors” were open and the breathing pattern was way off. It was pretty simple. Rib cage position and diaghram breathing are large pieces of the DNS puzzle. When these pieces are not operating efficiently there is a cascade of events that begins to pull the CNS away from optimal function. There it is; Simple and easy.
As I began to understand the process a bit more, I learned how to select patients and treatments that would benefit from this new thought process. The actual injury type is not as important as the findings from the evaluation and the type of patient you are dealing with. Not everyone crawls when you press the breast zone so sometimes the ability to sell the new treatment paradigm to your patient is a bit challenging. The treatment flow usually materializes and progresses as the learning curve permits.
I look at it as a bit chain of events. At the Dbacks, we start with breathing technique and cueing. This used to take a week or so and that was with a diligent baseball player. However if you couple Breast zone and ASIS vectoring (DNS) with breathing education the process is dramatically hastened. I have found that with a blend of education and rib compression and zone depression the results are augmented so much that the majority of players can get the hang of it after two sessions.
Once appropriate rib position and breathing technique have been developed the patient is then progressed through a series of dead bug exercises. This process is also expedited via DNS. It is important to make sure that the fundamentals are not overlooked at the cost of speed or strength. Progression is not about sarcomere diameter. This treatment paradigm is all about the CNS and its ability to recruit the most efficient motor pattern. This phase could really be called learning not strengthening. As the athletes go through these progressions the focus continues to be on proper technique. If your joints are centrated, meaning all of the length tension relationships are neutral and you can maintain appropriate rib position and diaghram function then you can continue to progress. Positions and variations of exercise are not as important as being in a good position and staying centrated.
That is pretty much the jist of DNS. It is very simple and in that if you just get the patient to breath and hold their ribs appropriately the sky becomes the limit.
With DNS or with training, really, I believe in the KISS method. Keep it simple, Stupid. Function is an expression of the CNS and if you keep it simple you are less apt to make mistakes and are less likely to reinforce the improper firing pattern.
Arizona Diamondbacks Sports Medicine
If you have questions, comment!