What Is Neuromuscular Stabilization Therapy?
Almost every adult has developed chronic musculoskeletal pain somewhere. It might have been an injury that should have gone away but never quite healed. Perhaps it was a nagging pain that has snuck up on you from poor posture at work. Maybe it’s an annoying restriction in your range of movement that interferes with your favorite sport or fitness activity.
The nervous system establishes programs that control human posture, movement and gait. This ‘motor control’ is largely established during the first critical years of life. This view emphasizes neurodevelopmental aspects of motor control in order to assess and restore dysfunction of the locomotor system and associated syndromes.
The Prague School
The “Prague School” of Rehabilitation and Manual Medicine was established by key neurologists/physiatrists, all of whom were giants in the 20th Century rehabilitation movement: Professors’ Vaclav Vojta, Karel Lewit, Vladimir Janda, and Frantisek Vele Recent developments by Pavel Kolar and others have focused specifically on dynamic neuromuscular stabilization.
They showed that in many cases, we fail to recover because we are using some faulty movement programs. This means that we are no longer moving in a way that is natural and optimal. We have developed a series of compensations and customizations to the movement program we were born with – the same program we were ALL humans are born with.
We might have stopped bending down a long time ago, because it hurt a little. So, we bend our knees and flex our neck a little too much. Or we might have developed some limitations in the way we use our hands and wrists and started to use our elbows and shoulder differently. Perhaps we have a slight limp is barely noticeable from a old ankle injury – and we compensate with the hip on the opposite side.
Stability Comes Before Strength or Flexibility
These are all real-world examples of cause and effect, but neuromuscular stabilization takes us back to the fundamentals of movement. We must be able to stabilize our bodies against any movement, no matter how small, while the rest of our body moves dynamically in space.
Infants spend about 18 months figuring this out and every child with normal development does it the same way. Treatment for adults requires re-learning these basic movement patterns.
A basic principle of movement that every infant understands intuitively is that there is a natural Base of Support (BOS) in every position.
In addition, they also have an intuitive understanding of where their Center of Mass (COM) is.
The most comfortable and easiest position of is usually the one is which the COM is aligned over the BOS. This feels STABLE.
Challenging Our Stability
Each every and every movement requires a challenge to that stability. So if an infant laying on its back moves its arm or leg, she must stabilize against that movement with the rest of her body. It must be done dynamically, as part of the body is moving is space, and requires good neuromuscular stabilization
For most of us, the starting point is regaining control of our diaphragm and transversus abdominis with conscious deep breathing into our belly and bracing against it at the same time. Infants establish rhythmic diaphragmatic breathing as they learn to stabilize their core.
What We Do
In NST we work through a series of basic stable positions. From each, we establish our BOS. Then we practice a series of simple movements that take our COM away from our BOS. The movement is relatively unimportant. The purpose of the the exercise is to reawaken the neuromuscular pathways stabilize against these movements. Because the movements are slow and gentle, we can control how much we challenge our stability.
This a proven method for restoring more normal, functional movement at any age. It is a valuable technique for minimizing the impact of almost any mild to moderate impairment.