Dynamic Neuromuscular Stabilization (DNS) in Laguna Niguel, CA

In the first year of life, people learn to breathe, roll, and crawl in an order that builds trunk control before upright skill. DNS borrows those positions for adults whose control has been replaced by bracing, holding the breath, or hanging on the low back. You are not asked to act like an infant. You are asked to reuse a strategy the body once had.

Dynamic neuromuscular stabilization often starts on your back, knees bent, with one hand on the belly and attention on a breath that expands the lower ribs without the neck joining in. If that breath shoves the belly out and the ribs up, the position is already teaching something. Dr. Tara Kohen pauses there. Upright work can wait until that breath is available.

The trunk can make a steady pressure that supports the spine while arms and legs move. People often fake that support by gripping the abs or by holding air in. The DNS cue is a breath you can keep while a limb moves, with the spine staying quiet. Joint centration is the plain version of a technical word: the joint stays seated in its middle while the limb works, instead of sliding to an edge.

A shoulder that hikes as soon as the arm lifts has lost that seating. A hip that pinches at the front of a step may be doing the same. The position on the table is a place to feel the difference at low load. Lower back pain that flares every time you brace hard is a reason to learn pressure you can grade, not a reason to brace harder.

Rolling from back to side links the breath to a reach and a bend of the hip. Crawling patterns, on hands and knees or in a modified support, ask the trunk to stay supportive while the limbs trade weight. These look simple and are often humbling. Shaking, holding the breath, or the low back sagging are the findings, and they are useful.

The pattern is scaled. Someone who cannot be on hands and knees works in a higher support or on the back. Pain changes the shape immediately. Hip and sacroiliac joint pain during a crawl is not pushed through for the sake of the position. The position serves the joint. The joint does not serve the exercise.

A long plank can be a strength task you already compensate through. DNS is interested in whether the trunk organizes before the plank even starts. If you can hold a plank and still cannot breathe and reach without the ribs flaring, the plank is not the first drill. It may come later, once the easier position is clean.

The pattern has to show up in something you do upright: a hinge, a carry, a throw, a get-up from a chair. Corrective exercise therapy is where that transfer is programmed. Visits often run 30 to 60 minutes depending on the plan. A DNS-heavy hour feels precise and a little tiring in muscles you do not usually notice, not like a conditioning class.

Wear clothes you can move in. You will spend time on your back, on your side, and possibly on hands and knees, with coaching on the breath and on where a joint is going. The doctor may use hands to show you a rib or a hip position. The work is quiet. You should be able to talk in short phrases.

Expect muscles to fatigue in an unfamiliar way, and expect the drill at home to be short. A free 20-minute consultation can decide whether this kind of retraining fits before a longer neuromuscular visit. The office is out of network, takes HSA and FSA cards, and gives a superbill. If breathing drills have made you dizzy before, say so at the start.

Out of network, superbill, HSA and FSA. Same policy as the rest of the county. We recheck findings instead of assuming a standing weekly visit. If you are better, the gap between visits should grow. If you are not, we change the plan or we say that someone else should see you.

Drs. Sani and Tara Kohen run the practice together. Read about them on the about page. The rooms, including the rehab space, are on the office page. No referral is required from a Laguna Niguel physician, and we will coordinate if you have one.

Laguna Niguel is hills and planned neighborhoods: Bear Brand, Kite Hill, the streets above Crown Valley, and the parks along Salt Creek. The walking is rarely flat. Youth sports and weekend rounds of golf share the calendar with freeway jobs north of here. Knees notice the downhills. Low backs notice the car. Necks notice the laptop that follows the commute. We use those specifics in the exam instead of a checkbox that says active.

Salt Creek and the regional park give people a place to walk that is not a treadmill. If walking helps your pain or provokes it, we want to know which path. A loop that is fine on the flat portion and painful on the return grade is a clue, especially for spinal stenosis patterns and for hip pain.

From most of Laguna Niguel you reach La Alameda by Crown Valley Parkway or Alicia Parkway. About 8 miles, often 15 to 25 minutes outside the Crown Valley rush. The address is 26400 La Alameda, Suite 100, Mission Viejo, CA 92691. Park at the building. Hours are Monday through Thursday, 9 to 6. Being close is an advantage. It also makes it easy to treat the clinic like a drop-in chiropractic stop. That is not how this office works.

Book enough time for an exam, not a crack on the way to an errand. The complimentary 20-minute consultation exists so you can meet the doctors before a longer visit. Call (949) 312-1754. If you are coming from the south end of town near the 73, say so when you schedule. The return toward the toll road in the afternoon is the slow direction.