---
title: BSMPG Blog | dynamic neuromuscular stabilization
description: dynamic neuromuscular stabilization | BSMPG is New England's leader in continuing education.
---
[](https://www.bsmpg.com/)
# Boston Sports Medicine and Performance Group, LLC Blog
## [DNS Course Listings - DNS A and DNS B courses offered in New England](https://www.bsmpg.com/Blog/bid/93883/DNS-Course-Listings-DNS-A-and-DNS-B-courses-offered-in-New-England)
Posted by Boston Sports Medicine and Performance Group on Sat, Jan 12, 2013 @ 09:01 AM
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### Interested in completing DNS Course A & B this coming year? Now you can!!
### Register for DNS "A" course in January and be eligible to take DNS "B" course in April of this year.
# **DNS Course A**
**Date: ****January 25-27, 2013**
**Location: ****OA Performance Center, 15 Lund Rd., Saco, ME**
**Contact: ****Michael Mullin: [mmullin@orthoassociates.com](mailto:mmullin@orthoassociates.com) (207) 828-2121**
**
**
# **DNS Course B**
**Date: ****April 27- April 30, 2013**
**Location: ****Northeastern University, Boston MA**
**[Visit: bsmpg.com for complete course details](https://www.bsmpg.com/dns-course-b-registration-2013/)**
**Contact: bostonsmpg@gmail.com with questions**
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Topics: [Clare Frank](https://www.bsmpg.com/blog/topic/clare-frank), [DNS course](https://www.bsmpg.com/blog/topic/dns-course), [dynamic neuromuscular stabilization](https://www.bsmpg.com/blog/topic/dynamic-neuromuscular-stabilization)
## [Attention DNS Journeymen!](https://www.bsmpg.com/Blog/bid/90978/Attention-DNS-Journeymen)
Posted by Boston Sports Medicine and Performance Group on Mon, Oct 8, 2012 @ 07:10 AM
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## Already completed DNS Course "A" in the past or planning to take Course "A" later this year?
## Looking to take your next step in the DNS Journey?
## Thinking about heading to The Prague School of Rehabilitation to complete your DNS Certification in the near future?
## Whether you are simply looking to advance your skills in DNS approach or are planning on completing the entire certification process, your next step is BSMPG and DNS Course "B" in Boston - April 27-30, 2013.
## Clare Frank and Marcella Safarova return to Boston to teach DNS Course "B"
 
## [Register today for this exciting event! Seats have already begun filling up and we are only able to host 30 people. Sign up today to avoid disappointment. Click **HERE** for complete details.](https://www.bsmpg.com/dns-course-b-registration-2013/)
0 Comments [Click here to read/write comments](https://www.bsmpg.com/Blog/bid/90978/Attention-DNS-Journeymen#comments-listing)
Topics: [Clare Frank](https://www.bsmpg.com/blog/topic/clare-frank), [DNS course](https://www.bsmpg.com/blog/topic/dns-course), [dynamic neuromuscular stabilization](https://www.bsmpg.com/blog/topic/dynamic-neuromuscular-stabilization)
## [DNS Course in Boston a Huge Success!!](https://www.bsmpg.com/Blog/bid/84468/DNS-Course-in-Boston-a-Huge-Success)
Posted by Boston Sports Medicine and Performance Group on Mon, Apr 2, 2012 @ 07:04 AM
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### This past weekend, BSMPG hosted Dynamic Neuromuscular Stabilization Course "A" in Boston.
### This sold out event featured Clare Frank (pictured below) and Marcela Safarova (from the Czech Republic) as course instructors and was a huge hit!
### Interested about attending a future DNS course?
### Read more about the DNS approach below as well as future opportunities both within the BSMPG network and offerings through Craig Liebenson.
 
### Click [**HERE** ](http://www.craigliebenson.com/?p=666)to read more about DNS and about Craig Liebenson's experiences with DNS.
### If you missed out on this exciting course work, don't worry! BSMPG is already making plans for another course "A" offering next year as well as a course "B" for those looking to advance their skills in DNS.
### Can't wait for next year to learn more about DNS? No problem - Craig Liebenson is offering course work for both Sports Medicine professionals as well as fitness and strength professionals in the near future. Click **[HERE](http://www.craigliebenson.com/?cat=11)** to learn more about these exciting opportunities.
### See Craig Liebenson lecture in Boston this May 19-20 as he presents both a Keynote presentation at the annual 2012 BSMPG Summer Seminar as well as a breakout session the day following. For complete details on Craig's presentation as well as a complete list of presenters and event details click **[HERE.](https://www.bsmpg.com/2012-summer-seminar/) **
### Seats are limited for this event and are certain to sell out again this year.
[](https://cta-redirect.hubspot.com/cta/redirect/52884/5eab198d-d075-4abd-9540-fd9c6293e219)
0 Comments [Click here to read/write comments](https://www.bsmpg.com/Blog/bid/84468/DNS-Course-in-Boston-a-Huge-Success#comments-listing)
Topics: [Art Horne](https://www.bsmpg.com/blog/topic/art-horne), [basketball conference](https://www.bsmpg.com/blog/topic/basketball-conference), [BSMPG](https://www.bsmpg.com/blog/topic/bsmpg), [Craig Liebenson](https://www.bsmpg.com/blog/topic/craig-liebenson), [boston hockey conference](https://www.bsmpg.com/blog/topic/boston-hockey-conference), [Andrea Hudy](https://www.bsmpg.com/blog/topic/andrea-hudy), [Cal Dietz](https://www.bsmpg.com/blog/topic/cal-dietz), [Bill Knowles](https://www.bsmpg.com/blog/topic/bill-knowles), [Alan Grodin](https://www.bsmpg.com/blog/topic/alan-grodin), [Dr. DiMuro](https://www.bsmpg.com/blog/topic/dr-dimuro), [Clare Frank](https://www.bsmpg.com/blog/topic/clare-frank), [dynamic neuromuscular stabilization](https://www.bsmpg.com/blog/topic/dynamic-neuromuscular-stabilization)
## [Craig Liebenson - Keynote Speaker at 2012 BSMPG Summer Seminar](https://www.bsmpg.com/Blog/bid/84266/Craig-Liebenson-Keynote-Speaker-at-2012-BSMPG-Summer-Seminar)
Posted by Boston Sports Medicine and Performance Group on Fri, Mar 30, 2012 @ 07:03 AM
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by **Craig Liebenson **
## **Mid-Thoracic Dysfunction: A Key Perpetuating Factor of Pain in the Locomotor System **
Dysfunction involving excessive T4-T8 kyphosis is common. Symptoms arising from regions at a distance to the mid-thoracic area are often secondary to T4-T8 dysfunction. This article will discuss why (rationale), when (indications), what (skills), and how (practical integration) T4-8 dysfunction is addressed.
**Why**
Mid-thoracic dysfunction involves increased kyphosis of the thoracic spine from T4-T8, usually the result of prolonged sitting in a constrained posture. Thoracic, lumbopelvic and cervicocranial posture are interrelated as links in a chain (see Figure 1). When excessive slumping becomes habitual, according to Brügger, it is called the sternosymphyseal syndrome (Lewit 1996, 1999, Liebenson et al., 1998, Liebenson 1999).
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Mid-thoracic dysfunction affects the whole body's center of alignment and posture. Head and shoulder forward posture causes orofacial, neck and shoulder disorders; slumping affects breathing by leading to inhibition of the diaphragm and overactivation of the scalenes; and lumbar disc syndromes and nerve impingement have been shown to result from repetitive end-range flexion overload (Callaghan, McGill 2001).
**When**
Indications for treating the mid-thoracic region arise from postural analysis, passive joint mobility testing, and active joint mobility testing. The postural sign of increased thoracolumbar hypertonus is a classic sign of overactivity of the superficial "global" muscles and indicates poor "deep" muscle function (Janda 1996, Richardson 1999, Jull 2000, Hodges 2002).
|  |  |
| --- | --- |
Palpation of passive joint mobility and quality of end-feel is best performed in the seated position, as shown by Brügger (Brügger 2000).
|  |  |
| --- | --- |
The dynamic mobility screen of choice is the standing arm elevation test (Liebenson 2001).
|  |  |
| --- | --- |
**What**
Managing T4-8 dysfunction requires a broad skill set incorporating postural advice, manual manipulation, and therapeutic exercise.
**Sample Exercises for Improving T4-8 Extension Mobility**
- Brügger relief position - beginner
- Back stretch on the ball - intermediate
- Kolár's wall slide with arm elevation - advanced
**How**
Knowing why mid-thoracic dysfunction is clinically important, when it should be addressed, and what techniques are therapeutic is only the beginning point for successful management of the patient with a problem in this area. Satisfactory results will result from learning how to incorporate this knowledge and skill into patient care efficiently. A moment or two per session spent explaining the relationship between function and pain is one such step. Each exercise requires a unique "report of findings" to motivate the patient to incorporate it into his or her daily routine.
The Brügger relief position is an ideal workplace "micro-break." It activates an entire chain of muscles linked to the upright posture. To prevent the tendency to hyperextend the lumbar spine with this exercise, it should be performed with active exhalation.
The back stretch on the ball is comfortable and relaxing. It promotes improved respiration. It can cause dizziness at first, so the patient should be guided slowly onto it until he or she has learned how to balance on the ball.
Kolár's wall slide with arm elevation is a functional exercise, since it combines arm elevation, squatting and breathing. Patients typically feel a nice stretch in the lattismus dorsi with this exercise.
**Summary**
T4-8 dysfunction is a common source of muscle imbalance, trigger points, joint dysfunction, and faulty movement patterns. While often asymptomatic, it is nonetheless a key source of biomechanical overload involving the neck, TMJ, shoulder, arm, and even low back regions. Treatments which aim only at the site of symptoms are bound to fail if function is disturbed due to excessive kyphosis in the mid-back.
Rehabilitation of the upright posture is fundamental to optimization of function in the locomotor system. Neurological programs for maintenance of the upright posture are "hard-wired" into the central nervous system, making rehabilitation of the mid-thoracic area of central importance, both biomechanically and neurophysiologically. The mid-thoracic region is "linked" to a multitude of common musculoskeletal pain syndromes, and the simple assessment and treatments shown here are an excellent complement to chiropractic practice.
**References**
- Brügger A. Lehrbuch der Funktionellen Storungen des Bewegungssystems. Brugger-Verlag GmbH, Zollikon, Benglen, 2000.
- Callaghan JP, McGill SM. Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clinical Biomechanics 2001;16:28-37.
- Hodges PW, Jull GA. Motor relearning strategies for the rehabilitation of invertebral control of the spine. In Liebenson CS. Rehabilitaiton of the Spine: A Practitioner's Manual (2nd ed). Lippincott/Williams & Wilkins, Baltimore, sched pub 2002.
- Janda V 1996. The evaluation of muscle imbalance in Liebenson CS (ed) Rehabilitation of the Spine: A Practitioner's Manual, Lippincott/Williams and Wilkins, Baltimore, 1996.
- Jull GA. Deep cervical flexor muscle dysfunction in whiplash. Journal of Musculoskeletal Pain 2000. 8:143-154,
- Lewit K 1996. The role of manipulation in spinal rehabilitation in Liebenson CS (ed) Rehabilitation of the Spine: A Practitioner's Manual, Lippincott/Williams and Wilkins, Baltimore.
- Lewit K 1999. Manipulative Therapy in Rehabilitation of the Motor System. 3rd edition. London: Butterworths.
- Liebenson CS, DeFranca C, Lefebvre R 1998. Rehabilitation of the Spine: Functional Evaluation of the Cervical Spine, Williams & Wilkins, Baltimore.
- Liebenson CS, Advice for the clinician and patient: The Brugger relief position. Journal of Bodywork and Movement Therapies 1999. 3:147-149.
- Liebenson CS, Advice for the clinician and patient: Self-treatment of mid-thoracic dysfunction: a key link in the body axis. Journal of Bodywork and Movement Therapies 2001. 5:90-100.
- Richardson C, Jull G, Hides J, Hodges P 1999. Therapeutic Exercise for Spinal Stabilization in Lower Back Pain, Churchill Livingstone.
## See Craig Liebenson speak at the 2012 BSMPG Summer Seminar this May 19-20 in Boston MA.
[](https://cta-redirect.hubspot.com/cta/redirect/52884/5eab198d-d075-4abd-9540-fd9c6293e219)
 
**SPONSORED BY:**
****
**[](https://www.zflomotion.com/index.php)**
****
**CRAIG LIEBENSON**
LA Sports and Spine
**Keynote Topic: **Regional Interdependence: How Functional Pathology Limits Performance
**Sunday Breakout Lecture:** The Core as the Punctum Fixum in Sport: A Key to Making Movement Patterns More Efficient
Dr. Liebenson is an Adjunct Professor in the School of Chiropractic, Division of Health Sciences at Murdoch University, Perth Australia and consultant for the Murdoch University and the Anglo-European Chiropratic College M.Sc. program in Chiropractic Rehabilitation. The first ever chiropractic member of the McKenzie Institute (U.S.) Board of Directors, he serves on the editorial boards of numerous journals including the Journal of Occupational Rehabilitation; the PM&R Journal of Injury, Function and Rehabilitation; the Journal of Bodywork and Movement Therapy; and Journal of Manual Therapy.
Dr. Liebenson is the first health care provider to receive a Certification of Recognition from the *National Committee for Quality Assurance (NCQA)* on Achievement of Recognition for Delivery of Quality Back Pain Care. He is actively engaged in ongoing research on the spinal stabilization system as a Visiting Scholar at Pr. Stuart McGill’s Spine Biomechanics Laboratory at the University of Waterloo. He regularly assists Pavel Kolar in his courses and has worked with both Dr. Karel Lewit and Pr Vladimir Janda beginning in 1987. Dr. Liebenson publishes extensively and is the editor of the book/DVD **Rehabilitation of the Spine: A Practioner's Manual** (2nd ed), 2007.
He has had books published into Spanish, Greek, Korean and Japanese. He was the team chiropractor for the N.B.A. Los Angeles Clippers from the 2006-2007 season until 2009-2010 seasons and is currently a consultant for the M.L.B. Arizona Diamondbacks and Athletes Performance International.
0 Comments [Click here to read/write comments](https://www.bsmpg.com/Blog/bid/84266/Craig-Liebenson-Keynote-Speaker-at-2012-BSMPG-Summer-Seminar#comments-listing)
Topics: [Art Horne](https://www.bsmpg.com/blog/topic/art-horne), [BSMPG](https://www.bsmpg.com/blog/topic/bsmpg), [athletic training conference](https://www.bsmpg.com/blog/topic/athletic-training-conference), [Craig Liebenson](https://www.bsmpg.com/blog/topic/craig-liebenson), [barefoot strength training](https://www.bsmpg.com/blog/topic/barefoot-strength-training), [Andrea Hudy](https://www.bsmpg.com/blog/topic/andrea-hudy), [Bruce Williams](https://www.bsmpg.com/blog/topic/bruce-williams), [Alan Grodin](https://www.bsmpg.com/blog/topic/alan-grodin), [Dr. DiMuro](https://www.bsmpg.com/blog/topic/dr-dimuro), [dynamic neuromuscular stabilization](https://www.bsmpg.com/blog/topic/dynamic-neuromuscular-stabilization)
## [BSMPG Announces DNS Course in Boston March 30-April 1, 2012](https://www.bsmpg.com/Blog/bid/76461/BSMPG-Announces-DNS-Course-in-Boston-March-30-April-1-2012)
Posted by Boston Sports Medicine and Performance Group on Thu, Oct 13, 2011 @ 09:10 AM
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BSMPG is proud to annouce the first **Dynamic Neuromuscular Stabilization** course on the east coast this coming March 30th through April 1st, 2012.
## Introduction to Dynamic Neuromuscular Stabilization
The “Prague School of Rehabilitation and Manual Medicine” was established by key neurologists/physiatrists, all of whom were giants in the 20th century rehabilitation era i.e. Karel Lewit and the late Professors Vaclav Vojta, Vladimir Janda & Frantisek Vele. Based on groundbreaking neurodevelopmental and rehabilitation principles by these men, Professor Pavel Kolar has successfully integrated the work of his predecessors in proposing the underlying neurodevelopmental mechanism for how the movement system develops hand-in-hand with CNS maturation. This complex approach is “cutting-edge” in that it provides a window into provides a window into the complexity and plasticity of the CNS and its effect on the movement system. The DNS approach can be used in the rehabilitation of a myriad of neurologic, musculoskeletal pain syndromes as well as performance athletic training.
### Click **[HERE](https://www.bsmpg.com/dns-course-boston/)** for complete details and additional course information
**ATTENTION:** This course is limited to 30 seats only! Once seats are filled registration will close. Sign up before you miss this once in a lifetime learning opportunity.
0 Comments [Click here to read/write comments](https://www.bsmpg.com/Blog/bid/76461/BSMPG-Announces-DNS-Course-in-Boston-March-30-April-1-2012#comments-listing)
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- [motivation (5)](https://www.bsmpg.com/blog/topic/motivation)
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- [off season training (2)](https://www.bsmpg.com/blog/topic/off-season-training)
- [orthopedic assessment (3)](https://www.bsmpg.com/blog/topic/orthopedic-assessment)
- [orthopedic risk factors (2)](https://www.bsmpg.com/blog/topic/orthopedic-risk-factors)
- [Ownership (16)](https://www.bsmpg.com/blog/topic/ownership)
- [Pat Riley (5)](https://www.bsmpg.com/blog/topic/pat-riley)
- [patient centered care (2)](https://www.bsmpg.com/blog/topic/patient-centered-care)
- [Patrick Ward (4)](https://www.bsmpg.com/blog/topic/patrick-ward)
- [Pavel Kolar (1)](https://www.bsmpg.com/blog/topic/pavel-kolar)
- [Pavel Tsatsouline (1)](https://www.bsmpg.com/blog/topic/pavel-tsatsouline)
- [Perform Better (1)](https://www.bsmpg.com/blog/topic/perform-better)
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- [performance testing (5)](https://www.bsmpg.com/blog/topic/performance-testing)
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