Proprioception: A Sixth Sense
Published: 19 August 2024
Today we wanted to talk about proprioception, our sixth sense. An important skill that might help reduce your risk of injury and keep you doing what you love.
By the end of this blog you will have an understanding of:
- What proprioception is!
- Why it is so dang important!
- How physiotherapists might go about improving it!
Proprioception
Proprioception is ability to sense of where your body is in space. If I stand up and close my eyes, I can feel that my legs are straight, that my hands are open and that my arms are by my side. Even without looking I can feel where my limbs and joints are. This is proprioprioception.
This allows me pick a cup up without looking, or walk on uneven surfaces without falling or rolling my ankle.
Proprioception is also importing in grading force eg deciding how hard to push, pull or even how forceful I need to move my body for a specific task. For example, if I want push a door open as I enter a room I won’t want to push as hard as say, pushing past a defender on the rugby pitch.
Proprioception is not a simple ability. It combines our visual system (what), our vestibular system (how we balance), our sensation of touch and specialised nerve endings in our soft tissue close to joints. Together these systems provide our sense of where our body is. Any disruption of any one of these systems can have an impact on our proprioception.
So... What If Proprioception is Inadequate?
Well… reduced proprioception may be linked to various injuries and pains, from simple neck and back pain to rotator cuff pain of the shoulder. However, where we see proprioception most frequently affecting injury is probably in sprains and injuries to the ligaments of the ankle and knee.
Now, as proprioception allows us feel how we land and move, if this ability is inhibited we might see athletes move or land in less than optimal ways. In the case of the ankle it could involves athletes landing or pushing off with the outward portion of the foot encouraging the foot to invert (turn inwards) leading to a higher risk of an "ankle roll".
Or in the case of the knee, poorer proprioception could lead to athletes twisting with greater force or not controlling twisting movements as well. This can stress the meniscus and ligaments of the knee, and the anterior cruciate ligament in particular.
What Can Be Done to Improve Proprioception?
Proprioception is a skill of the nervous system, and like any skill it can be improved with practice. Drills that challenge our proprioception can effectively rehabilitate this ability.
It must be mentioned almost any exercise should yield some improvements in proprioception. However, we (physios) will often prioritise exercises that challenge your balance in a variety of activity or sport specific positions. In the upper limb, this might include various movements in a press up position on the wall or floor. In the lower limb we might use exercises that have you single leg balance while reaching, or tapping your foot in different positions.
Later stage rehab often includes more explosive upper limb and lower limb exercise called plyometrics. And in particular we might work on landing drills with athletes with lower limb proprioception deficits.
But like we discussed, almost any exercise should help us improve our proprioception.
The Bottom Line
If you think you have issues with proprioception it is best to seek assessment from a qualified physiotherapist. They can assess this and provide a manageable rehab plan that is specific to the sports and activities you feel are effected.
And they can reduce your risk of pain, and further injuries!
