Joint Centration… Joint what??
Barbara Schultze Therapy __ January 21, 2019

Joint centration refers to the mobility you have in a joint when the joint is correctly positioned or “stacked”. Correct positioning means that the joint has a perfect axis of movement needed while supporting proper disassociation of movement from other joints. The most powerful component of proper joint centration is that a properly activated joint will send 100% accurate information from the joint to the brain on proper muscle activation and positioning. In return, this will give you the best mechanical advantage to ensure maximal stable loading – or stacking – of the joint.

Dynamic Neuromuscular Stabilization, or “DNS” as it is commonly referred to, is a manual therapy and rehabilitative approach to optimize the movement system based upon the scientific principles of developmental kinesiology. DNS was developed by Professor Pavel Kolar, PT, PhD, Director of the Rehabilitation Department, University Hospital Motol, School of Medicine, Charles University, Prague, Czech Republic. He was profoundly influenced by his instructors Professors Karel Lewit, Vladimir Janda, Vaclav Vojta and Frantisek Vele. DNS is rapidly gaining attention and acceptance in the sports rehabilitation and performance arena for both the recovery from musculoskeletal overuse injuries and injury prevention. DNS also provides a critical role in treatment and guidance of appropriate motor development for infants and children.

Development of human motor functions in infancy and early childhood are genetically pre‐determined and follow a predictable pattern. These motor patterns or programs are formed as the central nervous system (CNS) matures, and will allow the infant to control posture, and eventually achieve upright posture. These movement patterns are inborn and “hard‐wired”. For example, an infant learns how to lift its head up, grasp a toy, roll over, creep, or crawl. All these movement patterns occur automatically in a specific developmental sequence throughout the course maturation of the central nervous system.

There is also a strong relationship between CNS maturation and development of bones, muscles, and other soft tissues. Maturation of the brain influences development of motor patterns, which in turn, influences structural development. Disturbed muscle coordination, soft tissue, and joint development subsequently alters joint position, morphological development, and ultimately, the entire posture.

The major flaw in the common approach to mobilization is that it focuses on increasing joint mobility, but does not optimize motor control and neurological input to the brain. For example, you can be extremely mobile through the hip joint, and, at the same time, extremely unstable. In other words, you are “jacking the joint” rather than “stacking” it. That is where functional joint centration comes in to play.

Regrooving the Movement:

When motor patterns, movement and stability are observed clinically, we often see that the gross overall pattern appears as if the individual is able to accomplish the movement, for example standing upright or walking. When we examine the motor pattern in more detail we look at “how” the individual is accomplishing this – we often see something totally different. We need to ask – what motor patterns and muscles is the individual using to make things happen?

We shouldn’t just be observing “IF” someone is performing a task, but also “HOW”.

Many times, we see very inefficient motor patterns. The person is overusing muscles and joints that aren’t designed to do the work. The person is often using other areas in the body to help keep themselves upright. This is both a huge energy expenditure for the body and creates overuse and strain in other areas of the body including muscles, joints and also organs.

Information that is being sent from the body to the brain is inaccurate and unreliable. This creates confusion in the nervous system. Other systems in the body are often recruited to obtain or verify sensory motor information. This is a common factor in children that have been diagnosed with ADD/ADHD. Instead of “attention deficit” we should be thinking “attention priorities”.

Regrooving inefficient and inaccurate motor patterns to their original innate pattern becomes a key factor in successful rehabilitation and development.

Élan Osteopathic Clinic provides individually tailored motor development and rehabilitation therapy for all ages and levels of abilities. Therapy may  consist of Osteopathic treatment (Manual Physical Therapy) combined with active rehabilitation which may include neurodevelopmental, sensory motor, Dynamic Neuromuscular Stabilization and Applied Functional Science.