More DNS thoughts…Punctum Fixum and Trigger Points

One of the concepts that DNS uses in assessing and treating movement or activation dysfunction is called “punctum fixum.” I may or may not have mentioned it in the three-part series on DNS I posted over the past week, but it’s summed up nicely in this quote from Jeff Cubos’ blog:

The “Punctum Fixum” as taught within DNS by the Prague School are the specific areas where movement begins. They are places in the body that act as stable bases for movement. The direction of muscle pull, in general, project toward these regions and the choices of support zones that our body makes depend on the initial position of that body.

These are also the “special points” that DNS creator Pavel Kolar holds during his manual therapy on the patient in this video (see 15:47, this full sequence begins at 14:00).

Charlie Weingroff had this to say about the “punctum fixum” concept:

Kolar’s integration of Vaclav’s work is through Reflex Stimulation. As babies transition to milestones, they require a “point of stability,” almost something to push off of to change position. For those that have little ones at home, they will see that this point of stability is bone. This force into bone causes morphological changes in the bone changing its orientation. For instance certain angles of the ribs that are posteriorly oriented in adults and anterior in infants. There is almost no femoral neck in babies. Poor development potentially causes anteversion or retroversion. Vaclav’s hypothesis was that it is this stimulation of bony changes that was the automatic starter for movement transitions. And in normal babies, there is always a standard for what “good” movement looks like.

I’ve long wondered whether or not trigger points in muscles could be nexuses of stress from (dysfunctional) muscular actions. What I mean by that is that a trigger point is a place where lines of pull from various muscle groups (from above or below) converge on a single spot.

In dysfunctional movement, those patterns are over-used, and the points harden into spasming bundles. Hence the referring pain when you press on them, and the “global” release when they are manually released.

But the other ramification of this view is that trigger points represent dysfunctional movement…not dysfunctional muscle. So the full treatment of a trigger point involves movement re-education.

I haven’t had any experience with the advanced levels of punctum fixum in the DNS model, but I’d love to hear from anyone who has on the possible connections between these concepts.

DNS – The Foundations of Human Movement – Part 3

This is part 3 of a 3 part series on DNS…for Part 1, click here, for Part 2, click here.

Part I covered the history and background assumptions of DNS, and went into reasons for its use.

Part II I’ll covered some of the process that I learned at the seminar.

Here in Part III I’m hosting a “philosophical” discussion about movement in the light of DNS and will include some observations of my own around assumptions we make regarding movement in our culture.

I think the second biggest thing that happened for me during the DNS seminar (the first being learning an approach to movement and motor organization that suddenly MADE SENSE) was the experience of multiple coincidences between DNS and other movement methods I’ve learned or been exposed to.

For instance, DNS is similar in ways to the developing field of Functional Neurology, which seeks to address and influence neurological (read: brain) structures through muscular and sensory stimulation.

When you’re doing these “developmental” patterns, you can’t help but think of Feldenkrais, Alexander Technique, or the work of Bonnie Bainbridge Cohen or Annie Brook. Why? Because they based their work off an observation that these types of movement patterns are the ones we start with, and are ones that make us feel better.

If we were taking the stance that DNS is accurate we’d say that the principles all of these creators were recognizing were the reflex locomotor ontogenesis of the human animal.

The Big Difference, I think, is that DNS is organizing this approach under a very clear physiological (and developmental) framework, where most somatic disciplines I’ve been exposed to approach their work only from the felt-sense of the body.

Nothing wrong with that, and at the same time, DNS to me has the benefit of having a clear theoretical framework, that can be tested against across individuals. But don’t throw out feeling!

Speaking of “somatics” and movement-based work, what about Gray Cook’s FMS/SFMA (Functional Movement Scree/Selective Functional Movement Assessment) and DNS?

Note – I do not have a certification in either the FMS or SFMA methods. Please correct me if I’m speaking out of turn here.

My take on FMS/SFMA is that they’re useful tools to standardize the assessment process of patients/clients. I’ve seen a good amount of video on these methods, and been taught the FMS assessment by a certified FMS’er.

The real value I see for these methods is that because they’re highly standardized they offer a good way to pass information along to other practitioners or to assess large numbers of people (e.g., teams or squadrons) at once.

Beyond that, though, I don’t see any difference between FMS/SFMA and any other assessment method. The practitioner still has to be skilled in identifying movement patterns and movement pattern dysfunction in order to do any type of quality work with the patient/client based on that assessment.

DNS helps the practitioner, I think, in offering a deeper perspective on what’s happening in the body.

For instance – one of the attendees is a certified FMS assessor. He has always had trouble with the shoulder mobility test, with one shoulder being much less mobile than the other in this test. In the DNS course, we had him put his scapulae into an optimal neutral position, and then perform abdominal coactivation the DNS way, and…voila…totally equal results from side to side on the shoulder mobility test.

How does this help? To me it showed that his “shoulder problem” was more about a lack of global stabilization. Working on good positioning for stabilization and proper “core” activation, and progressing those methods through movements, will likely “cure” this patient.

RKC/Primal Movement Patterns
Gray Cook has another series of videos out that are more RKC (Russian Kettlebell Certification) based that deal with “primal patterns.”

From what I’ve seen, now that I’ve been to the DNS course, Gray and Lee have borrowed DNS material and put it into various movements they feel are appropriate for RKC folks.

That’s fine, but what I’ve seen on the DVD’s doesn’t replace what you get at a DNS course, and doesn’t provide the full spectrum of information you need to (help other to) perform proper core coactivation through the use of the diaphragm, breathe well, or move through “primal movement patterns” effectively while maintaining core coactivation and breathing.

Martial Arts
Of course there are huge martial arts implications in DNS as well. After all, martial arts are usually ways of understanding the most effective (and often efficient) way to move your body when confronting another (or multiple others) in conflict.

I’ve always practiced internal martial arts (IMA’s), which rely on the manipulation of advantages of potential and kinetic energy in conflicts, rather than the direct use of potential and kinetic energy. Most IMA’s have some form of standing practice, and many do “Zhan Zhuang” (standing like a post).

Here’s Chen Taiji master Chen Xiaowang doing three variants of the Zhan Zhuang posture:

Here’s a baby exhibiting the posture that DNS calls Supine Sagittal Stabilization:

Connection not clear? Try this one:

Well that’s funny! If we look at the Zhan Zhuang posture from the side…it looks…well…

Now have a look at this image of a Skylab astronaut in weightless posture:

All so strangely similar, no?

Perhaps the similarities aren’t so strange after all. They all represent a foundational or primary postural “set-point” in the human animal. It is the posture from which we stabilize and begin to learn to interact with the forces of gravity.

The posture is determined by our ontogenetic (species-genetic) structure, which also determines the reflex neuromotor patterns in our central nervous system, and the ways in which our muscles are organized.

Chen Xiaowang is replicating a sagittal stabiliation posture (and doing proper breathing) in an upright position.

The astronaut is exhibiting a primary posture of structural stabilization while asleep in a weightless environment. You’ll notice that the astronaut’s head position isn’t “ideal.” I don’t know how long he was in space at the point the picture was taken, but eventually the flexor system begins to dominate in weightless environments, since the extensor system doesn’t have anything (gravity) to oppose.

Just as importantly, RELAXATION is emphasized in all of these iterations of this posture.

My friend and extremely experienced internal martial artist Scott Phillips and I had a chat once about the predominance of thoracic kyphosis (rounded upper back) in many older Tai Chi practitioners. Why were they developing that postural abnormality.

Scott said that it was due to a misunderstanding of the “sunken chest” prescription in Tai Chi postural cues. The goal is not to collapse the chest by rounding it in, but rather, to let the sternum “fall” or relax, while the shoulders stay broad and the upper back stays erect (as in Chen Xiaowang’s demonstration above). The head stays on top of an erect spinal cord.

This is precisely the type of relaxed posture we seek in DNS SSS. Laying on your back, allow your ribcage to relax down into the floor. Many people have a concept of good posture as the classic “military” posture – chest up, shoulders pinched back, etc. But this throws us completely out of whack and is a terrible posture for any kind of movement.

When you can attain this relaxed posture while maintaining coactivation of the “core” musculature and breathing well in a circular fashion (i.e., allowing your chest and abdomen to expand to the sides and back as much as to the front), you can start to add mobility.

Adding movement one step at a time reeducates the body regarding effective, efficient, and stable movement. That also equals powerful movement, since the expression of power depends on all of those things as prerequisites.

Going from one side to another can reeducate the body regarding bilateral deficiencies or compensations (which may have underlying sources in scar-tissue or unresolved tissue trauma…which should be treated).

Moving this posture into standing creates the “Grand Ultimate Fist” of Taijiquan.

Well…that wraps it up for now. If you have questions about DNS or anything else here, feel free to leave a comment below.

Thanks for reading!

DNS – The Foundations of Human Movement – Part 2

This is part 2 of a 3 part series on DNS…for Part 1, click here.

Part I covered the history and background assumptions of DNS, and went into reasons for its use.

Here in Part II I’ll cover some of the process that I learned at the seminar with reflections on similar movement patterns in other disciplines.

Part III will be a “philosophical” discussion about movement in the light of DNS and will include some observations of my own around assumptions we make regarding movement in our culture.

So let’s get going!

As discussed in Part I, the main observations to make at the beginning of DNS are whether or not the joint is functional – that is, centrated and capable of full ROM. If not, why not?

Karel Lewit notes that it’s important to remove any restricting lesions before beginning any other work. A “lesion” here means any neuromuscular block to normal movement. Lewit often refers to these as “scars” and has a definite method for releasing scars.

Once you’ve removed lesions or blockages to restoring mobility or centration, get to work.

But first thing’s first. Numero uno – check your breath!

This resonated with me very deeply since I’d just finished a Wilderness First Responder course a week prior to the DNS seminar. In first-responder scenarios after considering basic scene safety and triage, the first things to assess in a patient are the “A, B, C’s.” That is – What is the quality of their Airway, Breathing, and Circulation.

Life won’t continue long without any of those three. And life is certainly diminished when any of those are diminished. Consider the relative quality of life of any person suffering from airway, breathing, or circulatory disorders.

Adequate and efficient intake and distribution of oxygen is primary to the function of the body.

Check your breathing by doing the following – place your hands on the fleshy bits between your hip bones and your lower ribs, with your thumbs toward the back by your kidneys, and your fingers pointing forward toward your navel. If you can’t get into this position without restricting your shoulder movement (hunching forward) DO SOME SHOULDER/THORACIC MOBILIZATION FIRST (here, or here).

Now that you’ve got a grip on yourself, push out against your hands.

How? By using your diaphragm, of course. When your diaphragm pushes down, it presses against your guts, which have to squeeze out somewhere. When they push down and out, they should automatically trigger a “myotatic stretch reflex” in the abdominal and pelvic floor (and gluteal/deep hip) musculature.

This move is different from just pushing your belly out…or “belly breathing” as they like to call it. Instead, think in terms of breathing circularly. The entire hoop around your midsection should expand and slightly contract as you breathe.

Practice keeping that tension while breathing.

One key here is to RELAX. Let your shoulders relax, let your arms relax, let your brain relax. Relax all over. If your shoulders are hiking up when you breathe (or even if your clavicles or sternum are moving upward toward your head) you’re using accessory muscles to breathe rather than the diaphragm. RELAX.

Now put your hands up on your lower ribs, making sure they’re expanding and contracting laterally (out to the sides) with each breath. When you’ve got that (while keeping your core coactivation) move up to the upper ribs.

Once you’ve got your breathing functioning well again, it’s time to integrate that into some movement.

The 13:00 mark on this video shows clear application of the method in a supine sagittal stabilization (SSS) phase. Once you’ve got yourself stabilized, start adding slow limb movement.

If you get the limb movement down well, move on to transitioning from SSS through developmental patterns, starting with the ipsalateral/homolateral support pattern. Again, watch the video for the different patterns.

Remember throughout your exploration to maintain abdominal coactivation, “circular” breathing, RELAXATION, and focused awareness.