DNS has expanded rapidly in the last decade and its coursework has been sought after world-wide. Since 2012, over 3,500 DNS courses have been taught in over 60 countries to over 65,000 participants! So far in 2025, we have over 400 courses scheduled in 41 countries. Yet despite the uptake of DNS, it remains controversial or unappealing to some practitioners who don't appear to understand it, or most typically, who have not taken the coursework. In my experience, the "controversy" surrounds a few key misconceptions, which I will discuss in this article. 

 

To be fair, a superficial assessment of DNS is ripe for misconception. I will Illustrate by responding to the following comments I have received from colleagues:

 

 

1. "DNS is about teaching people to move like babies."

 

No, it is not.

 

DNS teaches a system of understanding, assessing, training and rehabilitating human movement through the neurophysiological principles of motor control that are grounded by the scientific study of the same, and the development of posture and function during the first year of life. 

 

The nervous system establishes programs that control posture, movement and locomotor function. This 'motor control' is developed predominantly during the first year of life. The study of infant development, therefore, provides a unique lens to understand posture, human movement and locomotor function. 

 

We reference infant development to gain insight into the neurophysiological process called sensory-motor control. The goal is to gain a deeper understanding of human movement. An infants development of postural function raises and answers several important - arguably essential - questions:

 

• how does the baby coordinate function to stabilize the trunk while lying supine, effortlessly raising and lowering legs with impressive coordination; what qualities in their stabilization function make this possible?
• what are the pre-requisite functions that allow a baby to turn, crawl, stand up or independently walk?
• how does the baby utilize sagittal stabilization to access coordinated function of the oblique chains to turn right or left, and, what happens when things go awry?
  
• how does the quality of sagittal stabilization, aka trunk stability, influence support and stepping forward function in gait? And...
• how does the quality of support function influence the quality of stepping forward function, and vice versa?
• how does sensation influence motor output; does this have bearing over feed-forward and reactive stabilization mechanisms?

 

In DNS, we explore the milestones of infant motor control - that is, the positions and transitions that babies achieve according to their phase of development - to gain a better understanding of the underlying parameters that govern stabilization function. The goal is NOT to roll around or crawl like babies, but to gain insight into the qualities of stabilization function that make it possible to do so. 

 

The basic qualities of stabilization function that allow a baby to lay on their back and effortlessly raise and lower their legs, are the same basic qualities that govern our ability to stabilize our trunk while squatting and lifting. The qualities of stabilization function that allow a baby to turn from supine to side lying to develop the ipsilateral pattern - is the same basic function allowing adults to throw a ball, swing a bat (or club or racquet), or simply change direction. The contralateral pattern is first developed in crawling, the same contralateral pattern adults use to walk, run, or cross-country ski.

 

DNS leverages key principles of the developmental process, the neurophysiological principles and study of motor control to better understand, assess and restore human movement.

 

I must emphasize - DNS is not a set of baby exercises. It is not even a set of exercises. It is a system of understanding, assessing and training human movement, giving the DNS practitioner incredible flexibility in their intervention methods and exercise selections to influence it. We use developmental positions and patterns to understand, assess and train stabilization functions that transfer to all expressions of human movement. 

 

2. "I've heard DNS 'says' that adults should squat like babies... McGill said that's silly, because infants and adults have different proportions of anatomy"

 

No, we did not say this. It is clear and obvious that the anthropometrics of adults and babies are different. It would be silly to expect adults to squat like babies.

 

Babies have relatively long torsos, HUGE heads, and short limbs. Although some adults have relatively long torsos (maybe a big head 😉) and short legs, allowing for a more vertically oriented squat pattern, others may have long limbs and short torsos, resulting in the need for a larger trunk angle to maintain the centre of mass over support. However, the quality of foot support, which we refer to as support function, and the quality of sagittal (trunk) stabilization, which includes the coordinated function of diaphragm, deep neck flexors, abdominal wall, paraspinal muscles, and the pelvic floor (etc) to create balanced intra-abdominal pressure  - should be the same.

 

3. "DNS application is tough."

 

Granting that the human movement system is complex, I would argue DNS is EASY to apply when you learn the principles that underpin it. 

 

You know what IS REALLY tough? Evaluating and attempting to influence human movement from flawed principles and out-dated methods that are utterly inconsistent with research (which I have spoken of in this 1 hr 40 min presentation on scapular dyskinesis).

Gone are the days where we train 'core' or low back 'stability' by isolating and training particular muscles to concentrically contract 'more' than before. Gone are the days where we see a knee collapsing into dynamic valgus and expect to 'fix it' with isolated abductor strengthening exercises.

 

You know what else is really tough? Clinical Practice. No practitioner gets everyone better. I hate not being helpful or feeling like I didn't make a difference for a patient. And if we are honest, it happens to everyone. Even the gurus. Sometimes patients don't improve because of limiting factors inherent and intrinsic to them (their anatomy, physiology, psychology, sociology). But sometimes it's because we lack the knowledge and skills necessary to help them. Sometimes I am the limiting factor. My goal is to keep chipping away at this thing called "practice" to ensure that happens less and less throughout my career. Thus the pursuit of knowledge and skills, from wherever I can glean them.

 

DNS application isn't tough - when it makes your job of getting patients better - easier!

 

Manual therapists love DNS because it increases the effectiveness of their interventions, now more accurately targeted at the movement system dysfunction of greatest relevance to their patients complaint. 

 

Exercise practitioners love DNS because, yes, developmental positions are at times super effective entry-points into rehabilitation. But also because the principles cross over into training and sport and can be flexibly applied according to practitioner and patient preferences. One does not need to lay on back while raising and lowering legs to train sagittal stabilization; there are many ways into the matrix.

 

 

4. "I have the book (Kolar's Clinical Rehabilitation). DNS is for certain clinicians; but not me..." 

 

This is a layered statement so let's tackle it point by point. 

 

Prof. Pavel Kolar's book "Clinical Rehabilitation" is not really a book on DNS. Indeed there is a chapter devoted to DNS, but it does not do the job of teaching DNS coursework, which is more focused on basic principles and applications of assessment and exercise. The chapter on DNS in this book is in my opinion, more for a the connoisseur of DNS; someone who has taken a few courses and wants more. Prof. Kolar's book is first and foremost a text-book designed for the Masters of Physiotherapy program at Charles University in Prague. It is an impressive text. But it is not a good introduction to the practical applications of DNS.

 

 

 

"DNS is for certain clinicians" is a hard one for me to comprehend. From my perspective, what is being communicated is either a lack of understanding what DNS teaches, or a perspective that understanding human movement, motor control and stabilization function is not for "my kind of clinician". My perspective is that if you work in a space where your goal is to help humans move better - DNS is for you.

 

Granted, my perspective is biased by the fact I love learning, and will seek knowledge from anyone and anywhere I can in order to improve the efficacy of my assessments and interventions. I know for a fact - I don't know it all. Not even close. And for me, DNS was a significant catapult to a new understanding of human movement that made me a better practitioner. 

 

Perhaps a more foundational question is whether you believe assessing and training to improve movement quality and competency are relevant to an MSK-based clinical practice. If the answer is no; DNS is not for you.  Also, if you don't exercise with your patients, or work to improve their function through exercise-based interventions, then again I would agree that DNS is not for you.