Chiropractic and DNS
There are two main questions that I am often being asked by my Chiropractor colleagues whenever I teach a DNS course. I will not only answer these questions but also show how they are actually closely related to each other.
The first Question is usually “How I can find the time to incorporate DNS in to a busy Chiropractic schedule?”, and the second one is usually “Do you still adjust your patients with traditional Chiropractic techniques or just treat them with DNS methods?”
These questions arise because practitioners often see the prescription of exercises as time consuming and a deterrent from the other traditional treatments methods. I have often heard Chiropractic Colleagues say things like: “DNS seems very interesting, but I don’t think I would have the time to add it in to my clinic work”. The problem here is that until Chiropractors have been properly exposed to the DNS concept they think it will require a large amount of extra time in performing assessments, giving exercise prescriptions and instructions.
The fact is that once Chiropractors learn the DNS concept properly they will find that it is instead time saving and very complementary to our traditional work methods. The DNS assessments are not focused on finding specific muscles that are tight or weak, but instead aim to identify movement patterns that are non-ideal in regard to stability and mobility. By correcting the faulty pattern the tight muscles relax and elongate while the muscles that seem weak will be facilitated. By utilising positions from Developmental Kinesiology as a template for ideal joint positioning and movement, the corrective work is very easy to incorporate. By performing a couple of easy to perform tests it is possible to quickly identify what the problems are and what exercise would successfully achieve the correction. Patients are not instructed in a large amount of exercises, but will usually only have the most challenging movement they can perform with good stabilization as a home exercise. My patients often leave with one or two exercises as home-work.
The basis of the DNS principles is that all ideal joint stabilization patterns are pre-programmed in our brains and can therefore readily be activated. The ideal stabilization is the same in each individual joint regardless of the activity performed. Movement patterns are not sport-specific, so the ideal stabilization patterns should look the same in a swimmer or a golfer, as well as in a weight-lifter or a cricket player etc. This enables the DNS practitioner to work with patients doing every kind of activity, including athletes in sports where they actually do not have any specific knowledge.
On the question about whether I still adjust my patients with Chiropractic treatments, I would like to provide some background information before answering.
Most of the problems Chiropractors see in their offices are often related to insufficient stabilization of the spinal joints. This lack of proper stabilization is often not due to specific muscle weakness, but rather a “weakness” of the control system that regulates the stabilization and controls the movements of the spinal joints. The control system of the joints is dependent upon accurate sensory messages received from movements, but unfortunately most people are severely restricted in the amount of functional movements they perform.
The modern sedentary lifestyle does not provide enough proprioceptive sustenance to sustain a healthy brain and nervous system, which results in distortions of the cortical map that is essential for postural control and efficient movement patterns. The most pronounced effect of exercises is the improvement in proprioceptive control of the joints and their movements.
Often due to excessive sitting and general inactivity, many people's lives contain only a small amount of daily movements that do not provide the brain with the variety it requires. The brain becomes adapted to this reduced amount and range of movement patterns, and therefore can often get caught out when the individual suddenly does something novel, such as gardening on the weekend.
So where does the Chiropractic Adjustment fit into this scenario?
If we not only focus on the biomechanical model of restoring joint function, but also embrace the neurological model of Chiropractic, it fits in very well.
A Chiropractic Adjustment can be described as an intense barrage of Proprioception, composed of a novel mixture of sensory inputs delivered accurately to one of the main sensory organs of the balance system- the spine.
The Chiropractic Adjustment would therefore provide an initial novel proprioceptive stimulus that could fast-track the improvement of perception of the joint position and movement. By adding DNS exercises after an adjustment, we can take advantage of the initial stimulus to the mechano-receptors and more efficiently achieve the desired result. In a scenario where there for example is a fixed Thoraco/lumbar kyphosis an accurate adjustment of the region would facilitate proprioception and allow a better control of the segments and therefore make corrective exercises more effective.
Adding DNS exercises after an adjustment will in return allow for a prolonged effect of the proprioceptive stimulus provided.
Proprioceptive training is dependent upon novel stimulation, hence the increased effect when new exercises are included. An adjustment is a unique stimulus to the proprioceptive system of the segments involved.
There is further a close link between proprioception and balance, where the muscle spindles of particularly the Multifidus are incorporated into the intrinsic balance system. We can therefore easily recognise that a Chiropractic adjustment can have beneficial effects on the individual’s balance, but also that balance exercises should be incorporated after an adjustment to prolong the effect of such.