BASIC PRINCIPLES FOR EXERCISES
Ideal Initial Posture as a Prerequisite for All Exercises The quality and efficiency of any movement depends on multiple factors. One of the key factors is the initial body position when performing the exercise. Proper stabilization is critical for all dynamic activities ranging from simple functional tasks to skilled athletic maneuvers .
In the DNS approach, the initial body position is closely related to the pattern of sagittal stabilization. Ideal posture from a developmental perspective is demonstrated in a physiological baby at 4.5 months of age when sagittal stabilization is completed.
Ideal muscle coordination is maximized in this position to provide the best possible biomechanical advantage for movement and muscle performance(strength and power). This initial position can also significantly influence movement execution (sports technique) and hence training and sports performance.
Basic Dynamic Neuromuscular Stabilization
Tests for Stabilization Supine Place the patient in a supine position with hips and knees flexed 90° above the table. Ask the patient to maintain this posture as you gradually remove the support of the legs, while observing the patient’s pattern of stabilization.
Compare this posture with the physiological 4.5-month old baby posture. Things to look for include the following:
Head: It is in a neutral position, where the nuchal line is the natural weight-bearing zone. If the upper occiput serves as the supporting area, it is often correlated with hyperextension at the cervicocranial junction with hyperactivity of short neck extensors.
Neck: Activity of superficial neck muscles is unnecessary for this posture. Superficial muscles (sternocleidomastoid[SCM], scalenes, upper trapezius, pectoralis muscles)should be relaxed.Shoulders: These are relaxed and should not be elevated or protracted.
Elevation of the shoulders is often related to hyperactive upper chest stabilizers (SCM,scalenes, upper trapezius, pectoralis muscles) .
Chest: In neutral position, there should be well-balanced activity between upper (SCM, scalenes,upper trapezius, pectoralis muscles) and lower chest stabilizers (oblique abdominal muscle chains,diaphragm, transverse and rectus abdominis).
The most common pathology observed is the chest in a cranial position (inspiratory position) due to dominant and hypertonic upper stabilizers . Palpate the lower and lateral walls of the chest and try to spring the chest .The chest wall should be flexible.
If the chest is rigid,soft tissue release may be indicated as a precursor to further training. The posterior angles of the lower ribs should contact the table as they are positioned posterior relative to the spine.However, when these angles are in a less than ideal position, arching of the back and flaring of the lower ribs are often observed.
Abdominal wall (test of proportional activation among all sections):
Palpate the posterolateral sections(often insufficient), upper part of the rectus abdomin is(often hyperactive), and the abdominal wall above the groin (frequently insufficient). Diastasis is a sign of abnormal sagittal stabilization.