WHAT IS IT?
You see, proprioception is your brain’s ability to know your body’s positioning in space. For example, if you close your eyes and lift your arm out in front of you with your elbow bent to 90degrees, you know it is in that position because of proprioception. Proprioceptors are the sensory organs that give us that sense of position, and they reside inside our muscles (muscle spindles), tendons (Golgi tendon organs) and joint capsules.
WHY IS IT IMPORTANT?
Our sense of proprioception is important for many things; balance, coordination, and application of complex movements. It provides us with an innate sense of coordination, helps us control our movements, and protects our muscles and joints from strains and sprains. Without proprioception, we wouldn’t be able to run safely on uneven surfaces, throwing a ball would be more difficult, and we certainly would have trouble closing our eyes and touching our nose at the same time!
Proprioceptors play important roles in injury prevention in a couple of ways.
Firstly, muscle spindles and Golgi tendon organs (GTOs) detect changes in length and tension of our muscles, which helps protect us from muscle, ligament and joint injuries. For example, if you are walking along an uneven path, and you roll your ankle, the GTOs and muscle spindles pick up a change in the tension and force being applied to your muscles and tendons, and are able to send a quick signal to your spinal cord, which then sends a message to your muscles so they react before damage can occur. Without this reflex movement, you would be on the ground before you knew it, and would have a very sore ankle to show for it.
Secondly, muscle spindles play an important role in the stiffness or tightness of skeletal muscle. You know that feeling you get when you stretch your hamstrings? That is the result of an involuntary muscle contraction caused by the muscle spindles in your hamstrings. As you hold the stretch, your muscle spindles tire, allowing the muscle to lengthen. The reason behind this muscle contraction is to protect your muscles and joints from injury by keeping them in a ‘safe’ range of motion. Your central nervous system (CNS) has a default setting for its idea of the ideal maximum length of each muscle, and the muscle spindles prevent the muscles from going past this length by causing the muscle to contract. Repeated sustained stretching ‘convinces’ the CNS that it is OK for your muscle to go past this length, and thus changes the default setting to one that allows for a greater muscle length. Without this sense, even the simple act of running would cause severe injuries much more frequently.
SO WHAT’S THE POINT?
Even with these amazing little sensors throughout our bodies, why do we still injure ourselves? Why, if proprioceptors are so quick to pick up a rolling ankle, do we still, well, roll our ankles? Like basically all normal body functions, proprioception can be reduced, altered or lost completely, for a variety of reasons:
- As a result of ageing
- Ligament, muscle or tendon injury
- Neurological conditions (eg Multiple Sclerosis, sensory disorders)
If your proprioception is negatively affected by any of these conditions, all is not lost; proprioception can, like most other functions of our musculoskeletal systems, be trained! Studies show that proprioceptive deficiency can significantly increase the risk of serious ACL knee injuries in athletes, and that proprioceptive training can just as significantly and dramatically (74-88%) reduce the incidence and risk of such injuries.
There are lots of different levels and types of proprioceptive training, and while standing on a wooden post at the beach, on one leg whilst doing Karate Kid (the original 1984 version!) style jumping Crane kicks with your eyes closed might be appropriate for Daniel-san, it might not be for you. Your physio will, however, be able to show you appropriate and specific exercises for your condition.
So see your physio, and get out there and train… proprioceptively!
- Joint mobilisation (neck, back, shoulder, elbow, wrist)
- Neurodynamics (nerve mobilisation techniques)
- Home exercises
- Advice for activity modification
- Soft tissue massage
- Dry needling or acupuncture
- Stretches
- Fitting of an elbow brace to offload the aggravated areas
Other treatments can include corticosteroid injections, platelet-rich-plasma injections, and surgery, though as with most conditions, it is well worth having some conservative treatment such as physiotherapy before considering more invasive options, and in fact, studies have shown that long-term benefits of physiotherapy vastly outweigh those of corticosteroid injections.
Your physio will guide you in the right direction, and will tell you which of these treatments are best suited to you. If any of this sounds familiar to you, call 82892800, or click here to book an appointment.
