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Code of Ethics

Having a code of ethics is imperative for a healthy practitioner-participant relationship. This also extends to the learning environment with our peers. As therapists, we have a responsibility to create safety for both our clients and ourselves. In the following content, we combine how we keep the container safe for our clients, ourselves, and the learning environment in a seminar.

Tenet #1: Keeping the Container Safe

The context of the word container is appropriated from psychology. The container refers to the available coping strategies we have learned as a protection mechanism. Keeping the container safe builds safety in the nervous system through displacement rather than replacement. What does this mean?

Within a therapeutic setting, we are ultimately assessing how our clients’ nervous systems (containers) are adapting to their environment. Our nervous systems have three ways in which to adapt to our environmental stress: beneficially, neutrally, and maladaptively. In the therapeutic context, we are not so much concerned with beneficial or neutral strategies. Instead we are looking for maladaptive strategies so that we can employ the corrective therapeutic intervention. While at one point that strategy had been necessary and appropriate, maladaptive strategies are not sustainable and lead to secondary maladaptive compensation.

Here’s the problem: 

We cannot simply remove a maladaptive coping strategy. This creates a void in the container. That void is then replaced with something. More often than not, that “something” is maladaptive as well and potentially has an adverse outcome.

Here’s the solution: 

We must honor the survival-based strategies of the nervous system. We must with clear intention displace a maladaptive strategy with a beneficial coping strategy.

There are several steps in learning the how and why behind the template we use in Dynamic Neuromuscular Assessment™ . Understanding the nature of compensation and how to have a conversation with the nervous system sets the foundation for all of our assessment strategies.

Let’s explore the nature of maladaptive compensation further. The needs of the changing environment, an event, prompts a response from our nervous system. The initial response becomes the prime driver. When the nervous system perceives that the prime driver doesn’t have sufficient energy to sustain the adaptation, it will then recruit more compensatory players. These are referred to as secondary compensations. Their role is to boost the energy level of the prime driver.

If we remove a secondary compensation, we are potentially weakening the prime driver. This is effectively creating a void in the container. The analogy of the three-legged stool works well. If we kick out a leg of the stool, a secondary compensation, the stool often becomes unstable and crashes.

The nervous system has many options for filling the void created by removing secondary compensation. The trine of Applied Kinesiology: movement and structure, physiology and subtle body energy, and limbic associations and emotions become the subsets of options that the nervous system can utilize to boost the energy of the weakened prime driver. This is potentially disastrous when the nervous system chooses an energy system from our physiology or limbic associations. When we see our clients having adverse responses to treatments, this is often what is happening.

The template we use in Dynamic Neuromuscular Assessment™ addresses this in multiple ways. Module One is entirely devoted to acquiring the nuances of how to safely have a conversation with the nervous system. When we can effectively have a conversation with the nervous system, then we can recognize the markers needed to maintain a safe container, both for our client and for ourselves as practitioners.

Creating a safe container begins with the practitioner. 

Container

Keeping the container safe starts with understanding the term container.  The container refers to the coping strategies that we employ that keep us safe. They include setting clear boundaries and grounding. When our container doesn’t have appropriate coping strategies, inappropriate elements can enter our personal energetic field and cause disruption or harm. Keeping the container safe is necessary for our physical, emotional, and spiritual well-being.

Keeping  the container safe starts with our intention to create a beneficial environment.  We have an opportunity to grow and learn when we are safe. This requires mindfulness. 

Mindfulness is awareness and in this instance means being appropriately responsive. Be the observer before you speak or act. Being a facilitator of a healing process, one would consider first “to do no harm.”

Boundaries

Boundaries are integral to the container. Boundaries are the intention we set that brings into our energetic field what is appropriate and safe. The spectrum of individuals we encounter will challenge our boundaries. There is a certain amount of vigilance needed to reinforce and maintain the sustainability of our boundaries. Maintaining awareness and mindfulness will keep the container safe for both ourselves and our clients. 

Developing boundaries starts in the classroom with a teacher/student relationship. As a student grows into a practitioner, then the same clear boundaries extend to a practitioner/participant relationship.

Grounding

Grounding starts with intention. Our intention is to maintain a clear and safe energetic field. This is deeply personal and affects all those we meet. Grounding exercises can bring awareness to outside elements “sticking” to our energetic field. Here is a short list of grounding exercises you can do to clear and maintain your energetic field.

Getting barefoot on the earth

Imagining being connected to the core of the earth

Sitting at the ocean feeling the rhythm of the waves

Laying on the ground staring at the sky

Salt baths

This brief introduction is meant as a summary. I invite you to expand your understanding by researching how you can better create a container, set boundaries, and bring grounded mindfulness into your practice.

TLC, a template for a safe container.

T ~ Touch

L ~ Language

C ~ Choice

Touch ~ Safe touch is vital to create a safe container 

Safe Porting 

Safe Porting is a communication model that brings mindfulness to touch. The essence of Safe Porting is to inform another person what you are going to do before you do it. This clarifies intention before action. 

We use Safe Porting to let the client know what is happening next or ask their permission to continue. This has two beneficial aspects. First, it prepares the person for contact. The nervous system is less likely to go into a defensive mode when it is understood what is happening next. This removes the surprise element. The second aspect is that Safe Porting empowers personal choice. Yes, I would like you to proceed. No, I would prefer you not proceed.

Language ~ The words we use affect people’s response


Be clear in the language you use and the intention behind those words. 

Mutual respect starts with thought, thoughts become words, and words become action.

There is zero room for locker room talk, sexual innuendo, or sexual harassment of any kind.

Inappropriate or leading questions are disrespectful of another person’s process and privacy.

Ask yourself before you speak: Is it kind?  Is it truthful?  Is it necessary? Do some self examination. Do you use nocebo language in your communication?

Choice ~ Empowering another person with choice keeps the container safe

Ask the question: would you like for us to continue with XYZ?

Double check with an indicator. Ask if it is safe to continue. While an individual may give us permission to proceed, that is that person’s mind answering the question. The mind can construct and mislead, while the nervous system knows the truth of our capacity to unpack and process the information received in a therapeutic process. We do not want to open the preverbal Pandora’s box if that individual does not have the inner resources to process and close their container appropriately.

Safety for the Classroom

Developing the mutually respectful teacher student relationship, this includes assistants also, creates a safe container in the classroom. Different students will have different needs and responses. Honor everyone for their uniqueness. Respecting the space for all participants means being sensitive to other people’s needs and responses. During different breakouts with the material, you and the participant on the table may be okay with the process, other participants may not be. Monitor your intention, language, and action.  Other people that have had similar experiences may be sensitive to the subject matter. Be considerate of other people around you.

Safety for the Client

Clients will present a spectrum of response to different modalities. Continually check in with your client to ensure their safety. They may not have the capacity to know their boundaries are being crossed. Use a qualified indicator to monitor the safety of their nervous system.

When your client has an emotional response, remain present and  grounded. You are the anchor to assist them with their process.

Safety for the Practitioner

As a practitioner, maintain clear boundaries, this keeps you safe. Continually check in with yourself and trust your intuition.

If you realize that the component you are treating is something that you are personally experiencing or triggered by, be aware that your own relationship to the presentation can be unsafe for both you and the participant. If you are triggered by the presentation, your assessment and treatment may be inappropriate, and you can easily find yourself in transference situation. This is when the participant becomes a surrogate for the practitioner’s nervous system.  If/when this occurs, the appropriate thing to do is take a little space to regroup, ground, get a sip of water, and reevaluate.  Being a facilitator of a therapeutic process is recognizing when it is appropriate to stop and take inventory.

DNA™ Specific: Using a Menu

DNA™ uses limbic resonance to ask the nervous system questions. This can pose a unique challenge for not crossing ethical boundaries. It is primary to consider that we keep the container safe by asking only appropriate questions while respecting the privacy of others.

During assessment, we will be using a menu and asking questions. Ask permission to proceed with questions or the process. 

Holding space needs to be appropriate to the issue. This means no leading, pushing, or digging into the emotional content of an event.

When asking questions, ask to yourself rather than out loud.  Verbalizing can make the client uncomfortable, embarrassed, or potentially trigger a limbic reaction.

When working with an emotional correlation, have the participant hold a thought in their mind rather than ask is the issue XY or Z. This ensures privacy and keeps the participant empowered while creating a safe space.

If you’re not comfortable with a correlation or unable to stay grounded do not attempt to treat. This is an important transference safety issue.

If you’re not comfortable with the location or the point of contact of a TL, ask the client to do it for you. If they are unsure, show them on your body and use clear language. You can also ask them if it’s okay for you to assist. Then guide their TL to the specific location. 

Be cautious and aware of the language you use. The power of the words you choose affects the outcome.

If you get to an emotional piece, remember to pause and take a breath. Continue with deep breathing while client-releasing. Consider yourself as simply a vessel for the energy to flow through. Breathing helps you keep the energy moving.

How we work with the limbic system affects the outcome of the process. In our DNA seminars we demonstrate the proprietary process of Self Rescue. This is a potent tool to tone down the energetic charge of a compartmentalized event/association.

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Stress, Breath, and the Modern Dysregulated Breathing Apparatus

Our breath and the breathing apparatus is one of the primary systems in the body. It is so important to the regulation of our autonomic nervous system, that I generally start with the breathing apparatus as the template for establishing a normally responsive nervous system.

Stress and a dysregulated breathing apparatus is epidemic in our modern stress-reward culture. Understanding what is a normal parasympathetic breathing system versus an induced sympathetic breathing pattern is a key aspect of restoring parasympathetic response. Let’s define a normal parasympathetic breath and the paradoxical breathing of sympathetic arousal.

Sympathetic arousal is an important survival strategy. Stress loading our sympathetic threshold is also very important for the human animal. The problem is when the system loses its ability to restore a normal parasympathetic response after sympathetic arousal. This is the major contribution to dysregulation in the autonomic nervous system.

During normal parasympathetic breathing organization, the four major diaphragms are moving in synchronization. They follow the lead of the thoracic diaphragm. During the inhalation, the thoracic diaphragm is moving downward in concentric activation. Concentric activation is defined as the muscle fibers moving towards one another, or shortening. This action creates the negative pressurization of the thoracic cavity. In turn, atmospheric pressure then fills the space to balance the pressure, filling the lungs. The lungs are like a sponge and respond to pressurization.

The pelvic diaphragm, when moving in sync with the thoracic, is moving downward as well. However, the pelvic diaphragm is eccentrically lengthening. The muscle fibers are moving apart, or stretching.This combination of the thoracic diaphragm moving downward acting in coordination with the pelvic diaphragm creates intra abdominal pressurization, or a positive increase of pressure. When the diaphragms are moving in sync, thoracic and intra abdominal pressurization are functional opposites. 

During the exhalation phase of our breath, the thoracic diaphragm is moving upward in eccentric activation and the pelvic diaphragm is moving upward in concentric activation. The exhalation phase of our breath is the sweet spot for our nervous system. The reason for this is the pericardium, the tissue that supports the heart also shares connective tissue with the thoracic diaphragm. When the thoracic diaphragm is moving downward, during inhalation, this puts stress on the pericardium, heart rate increases, and the nervous system starts to arm the sympathetic response. Conversely, when the thoracic diaphragm is moving upward, during exhalation, the pericardium restores a neutral position and safety returns to the system. 

This physiological principle is utilized in most yogic and martial practices. For example, at the bottom of the exhalation a pause is experienced. This is referred to as the control pause. At this point in the breathing cycle we have full access to the skill sets we have developed. Archers utilize the control pause to find the stillness between heart beats so that when the arrow is released it may find its target.

Paradoxical breathing patterns are a necessary survival strategy. There are two different modes of paradoxical breathing. One is sneezing or coughing. Here the thoracic and pelvic diaphragms are moving apart. Both thoracic and intra abdominal pressurization are positive. Have you noticed that when you sneeze there is a reflexive closing of the eyes? This is a protection mechanism for the increase of cranial pressurization. The second paradoxal pattern is the startle reflex.The startle reflex is a pattern of bracing for perceived or impending harm and/or trauma. The primary characteristics are the sharp inhalation with intra abdominal pressurization. Here the thoracic and pelvic diaphragms are moving towards each other. The survival strategy of the startle reflex is to brace and support the internal organs from impending harm. 

It’s important to note that during an event that evokes the startle reflex there is a vast amount of neurological data embedded in the memory and association to that event. There are three phases to that event: before, during, and after. Before the event, the nervous system is registering something is about to happen. The mind questions what is about to happen.During the event – Iit is happening now! The mind is in real time interpreting the unfolding of the event. After the event, the story is created. The mind is questioning what just happened. This is when we interject constructed thoughts around the circumstances of the event. Differentiating between which phase of the event is keeping the autonomic nervous system in an upregulated or sympathetic response can be key in the therapeutic process. 

There are many types of breathing patterns that can strengthen the breathing apparatus and sympathetic threshold. In order to receive the full benefits of any of those techniques, the participant must start with a normally responsive nervous system. Meaning that throughout the breathing cycle, and challenging paradoxal patterns, the nervous system has capacity to quickly restore the parasympathetic mode. When the participant is unable to do so, that particular breathing pattern is reinforcing the copying strategy utilized to compartmentalize and create perceived safety. This is the primary aspect why people blow up with different kinds of breathing and movement practices. Their coping strategy becomes overwhelmed and the safety of their container becomes compromised. To keep the container safe we can use incremental progression to appropriately challenge and restore safety into the system.

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Developing Better Therapists: Integrating Somatics and Assessment

The field of Somatics has been growing exponentially in the four decades I’ve been a therapist. Somatics is defined as the integration of mind, body, and spirit. As humans, multiple complex feedback loops define our experience.

To become better therapists, we must be as much a generalist as a specialist.This means we need to have an understanding of how psychology is interacting with physiology at any given moment. We also need to be competent in working from both the top-down and the bottom-up world view.

Top Down: 

The nervous system follows the mind. Structure follows the nervous system.

Bottom Up: 

Structure informs the nervous system. The mind interprets the relevance of those afferent inputs. 

This is not an either/or scenario. This is the bi-directional feedback loop that defines our perceived experience. There are three main categories that relate to our lens of experience.

Structure: 

These are the neurological inputs that are both conscious and non-conscious. The conscious inputs are recognized as sensations.

Feelings: 

This is the emotional context that results from stimulus from the structure and/or thoughts.

Thoughts: 

The mind is interpreting and responding to the environment. This interpretation is a combination of the field of awareness plus past experiences. 

As therapists, how we work with this bi-directional feedback loop defines the outcome of any interaction. Somatics generally starts with the bottom-up approach. We first calibrate a benchmark based on a client’s movement capacity. Some of the capacity metrics we can use are joint mobility and integration, kinetic chain integration, and coordination. Volume and work production metrics can only be evaluated after assessing the foundation. The most foundational element is the breathing apparatus. 

Tip: With clients that have chronic symptoms, start with the breathing apparatus. With clients that have acute symptoms, start with assessment of the involved structure and evaluate how the breathing apparatus is tied into the coping strategies.

As human beings we all have experienced varying degrees of trauma, both physical and emotional. The autonomic nervous system responds the same to both variants. Often, both occur simultaneously as the  mind interprets the occurrence of an event.

Let’s unpack the concept of an event. There are generally three phases to an event. The first being before the event occurs. These are neurological markers that are registered by the nervous system. Thoughts and emotions often take precedence over sensations. The emotional context of a person’s  thoughts prior to the event will be embedded in the neurological inputs at the occurrence of the event. This phase is defined by what is about to happen. 

Next, is the occurrence of the event. Here, the primary neurological markers are based on physical sensations and structural receptor inputs. The physical body affected by the event. This phase is defined by what is happening.

The third phase is after the event has occurred. This is the phase of evaluation. The mind is interpreting the context of the two previous phases. This phase is defined by what  just happened.

Let’s simplify the physiological process of how the nervous system registers and records neurological inputs. It’s a challenge to adequately qualify the complexity of how the autonomic nervous system is communicating with the different feedback loops of the brain centers. We can generally say that the neurological inputs are received in the limbic system to create a memory and association. These memories and associations will have both conscious and non-conscious attributes. As a survival strategy and depending on the severity of the event, the nervous system may deem it necessary to compartmentalize and repress the memory.

In addition to the neurological inputs that are received during the three phases of an event, the nervous system also creates a coping strategy to respond to those neurological inputs. That coping strategy is what leads to nervous system dysregulation. Dysregulation is when the stimulus from those neurological inputs creates a sympathetic response in the autonomic nervous system and the nervous system has lost the capacity to down regulate and restore a parasympathetic response. Here, the nervous system responds as if the event is still occurring.

Nervous system dysregulation is a result from both real and perceived trauma. Trauma, both conscious and non-conscious, repressed and compartmentalized, can be accessed through the breathing apparatus. Trauma, both physical and emotional, has a specific relationship to the breathing apparatus. 

The fundamental signature of trauma is a paradox to a normal parasympathetic breath. Under a normal parasympathetic breath the four main diaphragms are moving in sync. On the inhalation the diaphragms are moving downward, and on the exhalation the diaphragms are moving upward. 

During paradoxical breathing, the pelvic and thoracic diaphragms are either moving apart or they are moving towards one another. During a cough or a sneeze, the diaphragms are moving apart. If you have experienced sneezing while driving, you may have noticed that the eyes involuntarily close and there is temporary tunnel vision. These are autonomic responses. 

At the occurrence of the paradoxical sympathetic fear or trauma response, the autonomic responses are more profound for the nervous system. Here, the diaphragms are moving towards one another to create additional intra-abdominal pressurization to protect the organs. There is more occurring than the physical function, there are chemical signatures that relate to the somatic context of the event. Those signatures are encoded in memories and associations. Even if we do not have conscious awareness of those somatic inputs, our nervous system is responding to them. 

When a similar stimulus to a past event is encountered, the limbic system is looking for a reference to keep us safe. The past events and the coping strategies that were utilized at the time of that previous event come forward as a in the now real time solution for responding to the stimulus. This is how we are unconsciously hijacked from the present moment to our past. This is also why the mechanics of a properly responsive breathing apparatus is altered. The nervous system is seeking safety by moving away from the input that would stimulate the memory and association to a previous event.

Somatic inputs to the nervous system is one potent method of asking the nervous system if it has capacity to appropriately respond to those inputs.

We must use caution when we evaluate breath and breathing. If we overstimulate an individual’s nervous system, they may experience a limbic system response that is akin to re-experiencing a past trauma. The way we keep our client safe is a specific progression of breathing apparatus stimulus. This progression starts with qualifying the capacity to have a non-binary conversation with the nervous system. Then we evaluate the Intrinsic subsystem in both feedback and feedforward movement assessment strategies. It is important to note that we must be incremental and have a priority to the first tenet of DNA, Keeping the Container Safe.

This process is the first step in learning how to utilize and apply the DNA template. There are multiple layers of understanding that occur when we learn to apply The 5 Tenets, The 5 Essential Skills, and The 5 Primary Kinetic Chains. 

DNA helps to develop better Somatic Therapists because the integration of the template allows the therapist to access unresolved trauma in a safe container for their client’s nervous system. 

Demonstration Video

This video demonstrates a Top Down approach to nervous system dysregulation. A few things to consider. Movement is the most tangible benchmark. While a person’s experience is the most important, that subjective experience is not tangible. When we create a tangible experience we are also creating a more complete experience for the individual. Another important aspect to consider is that It is important to follow up with structural reinforcement after restoring appropriate nervous system response. This reinforcement needs to be incremental so as not to overstimulate the ANS which in turn would potentially undue the benefits of the initial nervous system tone down.

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Acronym: EGO

In many disciplines the concept of the ego is something to be defeated. This is akin to the ego being the enemy or somehow inherently bad. However,  the ego is a necessary part of our psyche. The ego has a role in keeping us safe.

To further promote the positive aspect of the ego, I’ve coined an acronym EGO. This particular acronym relates to movement. Whether conscious or not, our experience is a relationship we have with our movement. This relationship has three aspects: 

Expression

Grace

Organization

Expression is the spectrum of our experience:

The spectrum of our experience relates how our limbic system is interacting with movement. This in turn directly affects our physiology and adaptation capacity.

Our emotional experiences are a spectrum from love to fear.

Our memories and coping strategies are a spectrum from safety to guarded.

Our engagement of the challenge at hand, and the skills to meet those challenges is a spectrum from flowstate to blocked.

Grace is the neutral observer:

Grace relates to how the mind is interacting with our movement. This is the non-judgmental state of awareness. It’s the accepting, the letting go of, or ceasing of judgment. This allows grace to naturally erupt, and to flow out of our experience as that is our true nature.

Organization is the assembly of the fundamental building blocks of movement:

Organization is the relationship between structure and the nervous system. Organization defines efficiency in the activity. As we progress in skills acquisition, the assembly of those fundamental building blocks become more sophisticated. Our skills acquisition follows an incremental progression so that we can access our true nature, flowstate.

Let’s consider the need to reframe the little ego into something more evolved. The acronym EGO opens the door to a more sophisticated relationship with our movement. Our personal practice is a reflection of our experience. This is an interdependent relationship. Relationships require nurturing and sometimes hard work. Our movement is no different. The development of our movement practice has many attributes. The process of claiming our true nature has a progression. The movement mentorship program is designed to empower you in your own process of experiencing that progression.

The movements you taught in the Immersion supported my healing and massively improved pain from a cervical herniated disk as well as other pain I’ve been carrying for so long. I most connected with slowing down the movements and listening to the subtle body and the emotional experience in between. I’m looking forward to diving deeper and understanding more in the Movement Mentorship Program.

— Olivia N. from a recent Yoga Immersion, discovered the potency of joint flossing in helping her experience being in the body. Olivia will be joining us in the upcoming Movement Mentorship Program.

Learn more about the Movement Mentorship Program.

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Breaking Misconceptions around Sacroiliac Joint Function

Recently, I was reading a thread on another forum. The comments on that thread led me to believe there are several misconceptions about the SIJ. I thought it would be good to share a synopsis from the perspective of Dynamic Neuromuscular Assessment.

The SIJ is a joint that has minimal movement. Movement is not its job. The job of the SIJ is two fold. First is the SIJ transfers load between the lower extremity and the axial skeleton. The sacrum supports the axial skeleton in the pelvis. The SIJ is the interface between the pelvis and the spine. 

Secondly, the SIJ is rich in mechanoreceptors that relay load to the cerebellum. Inturn, the cerebellum responds from those afferent inputs with muscular activation and deactivation. In other words, those afferent inputs have a direct effect on kinetic chain sequencing. The dynamic platform, the integration of the intrinsic, deep longitudinal, and lateral kinetic chains are interdependent with SIJ function.

The SIJ needs to have balanced integration as the structure is loaded during gait and other locomotive movement expressions. There are five muscle groups that need to be evaluated for appropriate nervous system response across their full range of motion…i.e. closed, middle, open position as well as the eccentric action from closed to open. The pelvic floor, the sacral spinalis/multifidus, glute max, piriformis and iliacus are the five muscle groups that act directly on the sacrum and affect the SIJ. 

Additionally, we also must evaluate how the femur loads the acetabulum. This includes internal and external rotation of the femur, compression and distraction, lunging and squatting, and shinbox variations. These movements and movement combinations make up the vernacular for leg drive. Leg drive is the primal reflex that we need at birth as we must use leg drive to push out of our mothers uterus and through the birth canal. Infants that have a c-section birth, may be deficient in this reflexive movement. One in four people are delivered by c-section birth (reference here).

Like any presentation, we must map the nervous system response. This starts with the appropriate movement benchmarks, like how the nervous system responds to those benchmarks, and whether it is safe to interact with and provide stimulus to those benchmarks.

When we prioritize the  safety of the nervous system, we can provide the appropriate stimulus to the prime driver and its main pair. This creates a huge change in the nervous system and normalizes SIJ response. This is an advanced topic in Dynamic Neuromuscular Assessment because there are several foundational concepts that must be developed so that one can safely interact with the client’s nervous system.

Are you looking for an entry point into better client  assessment? Do you want to deep dive into movement and be fully in your body? Then the Movement Mentorship Program that kicks off September 2021 is for you. Learn more and register here. 

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Why Joint Flossing

Joint flossing not only helps me and my clients’ healing journey, it also helps me understand the body better as a physical therapist. Our movement patterns involve joints moving in certain ways. It teaches us that each building block of a movement pattern is important for the way we move and our body to thrive. – Nick Keekstra

Recently I was asked by a colleague why Joint Flossing can be profound in helping people recover movements and for resolving pain.

Here is the short answer:

Toggling between end ranges of motion stimulates the nervous system.  This can restore balanced homeostasis when the source of imbalanced homeostasis is due structural correlations.

The  longer answer:


As human beings we all will experience a spectrum of stress, strain and trauma. Our nervous system responds to these events. That response is a coping strategy based on the best choices with available resources.

Joints and the surrounding connective tissue structures have various densities of an array of receptors. These receptors communicate the state of our structure and movement. When stress, strain or trauma occurs, some of these receptors will become up-regulated or hypertonic as a response to the circumstances of that stress, strain or trauma. 

When an individual or group of receptors become hypertonic, there is a need and resources are delegated to meet the need of the upregulated receptors. Another group of receptors will give up their resources to meet that need. This is the process of homeostasis.

Joint Flossing is stimulating the receptors in the targeted region. When we toggle between the hypertonic receptors and the receptors that are giving up their resources, also known as hypotonic response, the nervous system recognizes this relationship and can restore balanced homeostasis. 

When the receptor balance is restored, the structure can restore as well. There is a bi-directional loop of the nervous system informing structure and the structure informing the nervous system. When the structure has balanced homeostasis, tissues can regenerate, and the nervous system has capacity to respond to movement. This restores the capacity to generate force production.

It becomes important to recognize that muscular capacity or force generation is a byproduct of neural drive. The nervous system controls muscular output. Additionally, muscles are at the bottom of the food chain in the hierarchy of the sensory motor system. This makes muscle response a good benchmark for assessment. However, often muscles themselves are not the reason why there would be structural imbalance.

To go higher up the hierarchy we would start with joint receptors and their influence on muscle response. This is why Joint Flossing and movement can have such a profound effect on an individual’s experience.

We need to be fluent in the vernacular of joint flossing so that we have the capacity to respond optimally to movement. This inturn translates to our ability to help our clients and patients.This is also why you need to be fluent in the vernacular of Joint Flossing.

In September 2021, I’m offering a Movement Mentorship program. We will go through the body joint by joint exploring the relationship of open chain/closed chain/open chain joint flossing. This restores the fundamental building blocks of movement. Once these fundamental building blocks are in place, then we can assemble those components into combinations of movement that require multiple joint coordinations. Everyone that has gone through the progression of joint flossing programs has had epiphanies of lost capacity of movement that they did not realize was unavailable. These are the kinesthetic blindspots that cause less than optimal movement coordinations that result in future stress,strain and trauma.

Learn more and register for the 6 month Movement Mentorship program.


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Why Movement Matters

As a manual therapist, your role includes being a guide for others. You are helping clients reconcile their experience being in their body. There is a saying: we cannot lead a person on a path that we have not travelled ourselves. As a guide, you are tapping into your experience which then provides insight for helping them to navigate their experience.

When working with clients, you are helping them to create a new outcome from what they have been experiencing. They come to you because they view you as having a skill or expertise that can help them.  This is why it is important for you to do both your own inner and outer work. 

Inner work consists of things like:

  • self-examination, taking inventory of past events and associations you have to those events, 
  • being reflective of how you respond to the joys and stresses of life, 
  • having a mindful relationship with your sympathetic load, and using tools to down regulate to a parasympathetic state, 
  • and continually working with the triggers that show up in your life. 

Outer work includes:

  1. how you take care of your physical body, 
  2. the nutrition you take into your body, 
  3. the nourishment you get from socialization, 
  4. and your method for exercising your body for health and vitality. 

Particularly as a manual therapist, your movement practice is a critical  interface between your inner and outer experience.  In order to be of the greatest benefit to your clients, you must be doing your inner and outer work. This includes having  a potent movement practice 

The three lenses of perception, sensory, feelings and thoughts are the three categories of information that your nervous system is sorting through as you create associations that define the present moment. These three lenses are a critical component of DNA-Assessment, and here’s why. Sensation in relation to movement offers feedback that informs physical experience. When you can change the sensations in movement, you are also changing the feelings that arise from that movement. This inturn changes your thoughts and the feedback loop of perception in its entirety. We like to say in DNA, “change your movement, change your experience.”

When movement is practiced mindfully, it is one of the more tangible and objective feedback tools in your toolbox. You can sense and feel when movement is smooth, flowing, and at ease. Conversely, there is also a distinct sense and feeling when movement has elements of resistance and/or awkwardness. This is the spectrum of the movement playing field, ease to resistance. The nervous system is also following this spectrum, from normally responsive to hypertonic, or an up-regulated nervous system. (See my homeostasis blog).

A well-balanced movement practice has several attributes: recovery, skills acquisition, and workload generation. Recovery of range of motion is discovering what has been lost due to inactivity or stress, trauma, and injury. Recovery consists also of restoring the fundamental building blocks that provide the nervous system with the options to solve a solution in the movement environment. When these building blocks are available, the nervous system can assemble them in the most efficient way. However, when they are not available, the nervous system must create a work around, like a coping strategy, to contend with the movement environment.

Skills acquisition is the next stage of motor learning. This is when we combine the fundamental building blocks into more sophisticated motor skills. Different activities require  different skill sets. As such, the optimal method for  developing those skill sets also differs.  For example, a swimmer needs different skill acquisitions than a track and field athlete. What is a constant between all athletic forms is the foundational building blocks. How these building blocks are organized and sequenced defines the differences in the skill sets. 

Once we have a level of mastery in place, then we can explore workload generation by taking those skill sets and further developing them by changing variables of resistance like load, speed, duration are variables one would toggle to develop workload generation.

In DNA, we use a modality called joint flossing to put these movement concepts into practice. Joint flossing is movement that toggles between available end ranges of motion under no or low load. Joint Flossing is also the entry point to recovering the fundamental building blocks of movement and it is diverse in its application. 
As a therapist you want to be the very best you  can be for your  clients. This is why you need a daily mindful movement practice that not only helps you as your own client first, but also is helpful in developing the vernacular used in your assessment process. In my course, Gait Master Class, I have clearly laid a progression of recovery of foundational building blocks, skills acquisition and workload development as it pertains to the walking gait. When you own this type of work, your capacity to help your clients will be exponential. You need movement so that you can help your clients move better and create change in their experience.

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EXPANDED! Manual Muscle Testing Will Produce Skewed Results

In  the past I have discussed that binary Manual Muscle Testing can and will produce skewed results. The traditional binary conversion is limited to a dualistic relationship, facilitated/inhibited, strong/weak, or yes/no. The non-binary conversation includes the four possible nervous system responses to the stimulation of the MMT on structure and the nervous system. I’ve categorized those four responses as hypotonic, normal, functional dysfunctional and hypertonic. Read more about this here. There is an additional nuance that needs clarity that is generally unknown in this regard. This nuance is one of the more unique and important aspects of the Dynamic Neuromuscular Assessment™ method of working with clients. 

One of the ways that people get confused in MMT is when a direct test flips to an indicator. A direct muscle test can flip to an indirect test under specific circumstances. When this occurs, it is an unknown variable that the practitioner is not aware of. This produces confusing information from the result of that direct movement evaluation.


Direct Test: This is a feedback movement evaluation where the practitioner is applying a gentle force along a specific vector to elicit a musculoskeletal response from the nervous system. The practitioner is evaluating the capacity of the NS to respond to that force and vector.

Indirect Test: This feedback movement evaluation utilizes a prequalified movement response. A qualified indicator has capacity to temporally facilitate or inhibit under specific neurological stimulation. That stimulation can be receptor based or limbic, ie… thought-based. Our thoughts and experiences can and will affect the outcome.

Now let’s clarify how the nervous system would flip a direct movement evaluation to an indicator. The nervous system is responding to stimulus. That stimulus is both conscious and non-conscious. When we are using a direct testing strategy, the nervous system can flip that direct test to an indicator in a few ways. 

One way is the previous stimulation can be active in the sensory motor system. If there is a dysfunctional component within that active motor program, the NS will flip the direct test to an indicator. It is indicating that there is something wrong in the previous stimulation. This is why we must evaluate each motor component in the clear. If we don’t, we risk getting forced into the “searching for a needle in a haystack” kind of process.

Another way is either the client or the practitioner is altering the direct test by providing a secondary stimulus. For example, a client’s NS will self TL to increase their capacity to respond. In addition, the practitioner can unknowingly be adding a TL with either a secondary body contact or through limbic resonance.

As practitioners, our clarity in the objective of the assessment process affects the outcome. We can do better and we must do better. The first step to this is learning to get out of a binary conversation. A primary objective in Dynamic Neuromuscular Assessment™ is to learn how to have a conversation with the nervous system. It is through this conversation that we apply a template that vets out the skewed data points resulting from a binary conversation.  After we learn the fundamental vernacular, then we can have a conversation with the structure. Vetting nervous system response in a clear and concise methodology is the beginning to have a meaningful conversation with the nervous system. This leads to deriving precisely what the NS needs to restore balanced homeostasis.

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Becoming Better Therapists

Understanding Motor Sensory Apparatus

Our motor sensory apparatus requires three sets of inputs to respond to our movement environment: ocular, vestibular, and proprioceptive. These three sets determine the quality of output or motor response. This is a bottom-up approach. The bottom-up strategy relies on the inputs to derive output.  The top-down approach includes motor planning.

Our somatic experience is based on perception. How we perceive and respond to the world around us is directly affected by the three lenses of perception: sensory, limbic, and thought. There is seemingly a lot going on with the input and response relationship of our motor sensory apparatus. We can dissect these inputs and outputs into these three general categories. Those three categories can then be expanded into subsets. The sensory set is based on how our structure is relaying somatic inputs from our five primary senses: smell, taste, touch, hearing, and vision. There are non-primary senses as well. Proprioception is considered one of them. Proprioception is the set of inputs that allows us to close our eyes and touch our nose. There is an inner map of where our body is in space and the relationship to movement. Without proprioception, we would not be able to develop fine motor skills. 

Proprioception relies on the other two motor sensory apparatus inputs to respond appropriately. Impede any of these inputs, and the output will be impeded as well. The three inputs of sensory apparatus and the three of lenses of perception are intrinsically interdependent. Understanding this helps us become better therapists as we fundamentally cannot separate or compartmentalize any of these attributes when working with people.

Read the entire paper by clicking below.

Becoming Better Therapists: Understanding MotorSensory ApparatusDownload
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The Five Principles of Optimal Movement

When we watch a really talented athlete perform their craft, it is hard to discern the amount of training that went into their development. For instance, when we watch a gymnast on any one of their four apparatuses, the physicality of their performance elicits strong feelings. The effort feels like ease, time seems to slow down for them as they can compact more movement into smaller increments of time. Their movement flows in spirals and the human potential brings a sense of awe to the observer. This is a product of both talent and conditioning.

The five elements I outline in The Five Principles of Optimal Movement white paper below are a recipe for performance. The ingredients for that recipe are as varied as the spectrum of sports and activities that we all love to participate in, but are rooted in these five elements that exist in order to optimize our movement.

5 Principles of Optimal MovementDownload