• Brooke Rice

Proprioception: Exactly What is our Sixth Sense?

Proprioception: Exactly What is our Sixth Sense?



What is Proprioception?


Can you walk without looking at your feet? Can you type without looking at a keyboard? Can you touch your toes with your eyes closed? These actions are a product of proprioception.


Proprioception is a very important part of how the body works. It is how we are able to know where we are in space, our ability to sense our body’s location and movements. Our balance and strength is dependent on proprioception, and it is how we are able to move without consciously thinking out every muscle contraction and extension. We don’t necessarily have to think about what is around us, but we know when we are unable to fully extend, or when we have space to move due to proprioception. Proprioception, also called kinesthesia, is the body’s ability to sense its location, movements, and actions. It’s the reason we’re able to move freely without consciously thinking about our environment. You may have also heard this referred to as kinesthesia.



Proprioception is often overlooked. It is difficult to talk about it on its own because it is barely distinguishable separate from movement, but there is a huge need to understand it, especially in the cases of balance issues, movement issues, and issues that stem from the cerebellum and basal ganglia in the brain. Issues in these areas mess with our perception of the position of our joints, movement of our bodies, and the force and effort we are putting forth to create movement.


You may not always notice the intricacies of how movement, balance, and reactivity are happening, but you most definitely notice when they are not. Have your hands or legs ever ‘fallen asleep’? How difficult is it to walk if one of your legs is asleep? This is a good way to understand what it would be like without sensory receptors, without the ability to sense movement or understand where our bodies actually are. Imagine this as a permanent issue, or one that is all over the body. That would be the lack of proprioception on a grand scale. To improve proprioception or correct issues that can occur, it is important to know how it all actually works.

The Anatomy of Proprioception


The anatomy involved in proprioception is widespread. Many parts of the brain are involved, and the entire Central Nervous System has its part to play, as well as all of the parts of the body. This is a whole body system, and understanding that the whole system matters can help when there is an issue with proprioception. If the system isn’t working properly, many different problems can occur. Here are some definitions that are helpful in understanding just how many parts of the body are responsible for the creation of proprioception. The bold areas in the definitions indicate what is tied to proprioception.



Central Nervous System (CNS): The central nervous system consists of the brain and spinal cord. The brain plays a central role in the control of most bodily functions, including awareness, movements, sensations, thoughts, speech, and memory.


Motor Nerves: A motor nerve is a nerve located in the central nervous system (CNS), usually the spinal cord, that sends motor signals from the CNS to the muscles of the body. These nerves control your movements and actions by passing information from your brain and spinal cord to your muscles.


Sensory Nerves: A sensory nerve, also called an afferent nerve, is a nerve that carries sensory information toward the central nervous system (CNS) and all those nerves which can sense or recognise the stimulie (Internal or External) are known as sensory nerves. These nerves relay information from your skin and muscles back to your spinal cord and brain.


Sensory Receptors: Sensory Receptors are specialized neurons or nerve endings that respond to changes in the environment by converting energy from a specific stimulus into an action potential (a process known as transduction). For example, taste buds are receptors on the tongue that are activated by chemical properties in food and drinks; taste receptors convert these properties into signals that our brain interprets as a sweet, salty, sour, or bitter taste.


Golgi Tendon Organs: The Golgi Tendon Organ is a proprioceptive receptor that is located within the tendons found on each end of a muscle. It responds to increased muscle tension or contraction as exerted on the tendon, by inhibiting further muscle contraction. When muscle contraction is excessive, the Golgi tendon organ protects against muscle damage.


Basal Ganglia: The “basal ganglia” refers to a group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions.



Thalamus: The thalamus is a small structure within the brain located just above the brainstem between the cerebral cortex and the midbrain and has extensive nerve connections to both. The main function of the thalamus is to relay motor and sensory signals to the cerebral cortex.


Cerebellum: The cerebellum (which is Latin for “little brain”) is a major structure of the hindbrain that is located near the brainstem. This part of the brain is responsible for coordinating voluntary movements. It is also responsible for a number of functions including motor skills such as balance, coordination, and posture.


All of these moving parts can be confusing, but they all have a part to play. If any of these are injured or set off by something, proprioception can be thrown off course, causing a multitude of problems. At its most basic, proprioception is a result of the relationship between the Central Nervous System and the soft tissues in the body, the muscles, tendons, and ligaments. All of these soft tissues have sensory receptors in them.


Sensory receptors are located all over your body. Skin, joints, and muscles all have them, and they help us send information throughout the body. The nervous system uses sensory receptors to gather information so that it can signal the brain, telling it that we are moving, using x much effort to create x much force, and so on. The sensory receptors that are responsible from proprioception are proprioceptors.


What can Affect Proprioception?


As you can see from the many parts of the body that are involved in proprioception, there are many things that can affect it. Some things can affect it permanently, but hopefully the experience of lost proprioception would be temporary.


If your proprioception skills are normal, you can walk, drive, eat, and otherwise do all of your regular, routine movements without actually thinking about what muscles you need to contract to create those movements, without concentrating on what you are doing.

Here is a list of symptoms to look out for if you think you may have an issue with proprioception:



-bad balance

-frequent falls

-trouble standing on one foot

-lack of coordination

-dropping things consistently

-bumping into things

-trouble maintaining proper posture

-having to place weight on a stabilizer, like leaning on a table or against a wall

-trouble measuring force

-feeling the need to avoid stairs

-fear of falling


There are many different ways to assess if a person is having issues with proprioception, a test you can do yourself, and if that isn’t enough, a physical therapist or doctor has ways to determine whether or not you will need additional testing. One of the most popular and useful tests is the Romberg Test. Stand with your heels together and your eyes closed for 30 seconds. If you are unable, it may be time to see someone to make sure you are all right. You may need to visit a doctor or physical therapist, but you may also just need to work through this issue on your own, depending on how severe the problem is.


Something like heavy alcohol consumption, or maybe even a small amount in some instances, can cause loss or dampening of proprioception. Roadside tests are basically a proprioception test. You walk in a straight line and then hold your arms out and touch your nose. These are proprioceptive skills.



Chronic or long-term proprioception issues can be caused by Injuries, medical conditions, or changes that are related to aging. These causes affect the muscles, nerves or brain in a way that impairs proprioception. Here are some examples of what can cause impairment of proprioception:


-ALS (Amyotrophic Lateral Sclerosis, Lou Gehrig’s Disease)

-Diabetes

-Arthritis

-Brain Injuries

-MS (Multiple Sclerosis)

-Peripheral Neuropathy

-Parkinson’s Disease

-Huntington’s Disease

-Herniated Discs

-Joint Replacement Surgeries (Hip, Knee, etc.)

-Injuries to a joint (Sprains, Strains, Ligament and Tendon tears)

-ASD (Autism Spectrum Disorder)


How do I fix a Proprioception Issue?


Of course, depending on the underlying cause, treatment of a proprioception issue will differ person to person. Treatments can include the following:


-Meditation

-Massage Therapy

-Yoga

-Strength Training

-Occupational Therapy

-Vibration Therapy, or other Somatosensory Stimulation

-Tai Chi

-Physical Therapy


Treatments for proprioception issues can be a great thing to start, even if you don’t have a problem. Evidence suggests that these types of training can be preventative, in that they reduce the risk of injury, improve motor skill, strengthen muscles, and improve balance.


How does Massage Therapy help build and/or repair Proprioception?


When dealing with scar tissue and trigger points, it can be extremely beneficial to have a skilled massage therapist to help you out. Being able to release both can advance your proprioceptive training much more quickly and effectively than if you decide to work through them without the added help. Massage therapy can also help with the stress and anxiety that comes along with injury or mental blocks that come along with proprioceptive issues. If you would like to book a massage with us, visit us here!


Especially after injury, massage is a huge help to regain proprioception. In numb, healing tissue, a skilled Medical Massage Therapist stimulates tissue by loading the central nervous system with sensory input and increasing circulation in the area. This is occurring without you having to move or see the area that is being worked on. In this way, the mind/body connection is being regenerated with little to no risk, whatsoever, of re-injury. This is a great place to start with a proprioceptive issue, because there are basically no contraindications. To learn more about Medical Massage Therapy, you can read our blog here.


How does Meditation help build and/or repair Proprioception?


Meditation can help you build proprioception in a few different ways that may be different from how you will be trained through Yoga or helped by seeing a massage therapist. There are thousands of Meditation techniques, and a great teacher will be able to help you with exactly which techniques will benefit you specifically. Meditative eye focusing techniques help with spatial awareness, and can help you build proprioception in that way.



Mindfulness training, in general, improves body awareness and can help build a sense of where you are in space. It improves focus, and when that focus is aimed at certain parts of the body, how it moves, how it feels when it moves, what muscles are activated to move it, etc., that will help the mind/body connection, and will ultimately improve and/or repair proprioception over multiple Mindfulness and Meditation sessions. To learn more about the benefits of Meditation, read our blog here!


One of the most beneficial and low impact techniques for building proprioception in the foot and ankle area is walking meditation. This Meditation technique stresses slow, precise, mindful movements in the lower body that will cause, over the course of many practice sessions, muscle memory and development of better proprioceptive skills and/or the repair of damaged or impaired proprioception. If you would like to book a Meditation session or participate in a Meditation Assessment, visit us here!


How does Yoga help build and/or repair Proprioception?



Yoga places a ton of emphasis on balance, which is pivotal in training proprioception. Balance is very important to us. It is how we are able to move in and around our world. We are equipped to be naturally balanced, and when something happens that throws us off, it is often detrimental in many ways. Impairment of proprioception can cause us to be injured physically, and it is embarrassing for us as well. Yoga develops our natural ability to be balanced. It enhances what our body already wants to do, naturally. In the process, it helps us build strength, which will also reinforce proprioception and the continuance of good balance.


Muscle coordination and inhibition can be rehabilitated and strengthened in many different ways, yoga being one of them. The consistent practice of Yoga is particularly good at developing proprioception because of the way that balance is taught. The ‘yoga foot’, meaning the way that feet touch the ground during proper yogic technique, where all four corners of the foot are touching the ground, but the arch and toes are not bearing weight, helps distribute balance properly and train the body to continue to do so throughout daily life.

This technique sends signals to the central nervous system, and consistency causes this feedback loop to occur where muscle memory and proprioception are built and gain a strength that improves the overall stability of the body over time. Practicing this way of distributing balance will be useful, and then during practice of increasingly more difficult balancing poses, proprioception becomes more and more reinforced. Further training can be completed using props such as wobble boards, balance beams, or bosu balls. These types of balance trainings have become increasingly popular, and a combination of all of these are best to gain the most well rounded proprioceptive training regimen.



What this means in daily life situations is that, should you be in a position where your balance could be compromised, such as slipping on ice or losing your footing going down a hill or stairs, you will be more likely to recover and avoid injury. You will have trained your muscles to properly and immediately engage to recover your balance. If you are an athlete, a hiker, etc., this training will improve your performance over time and decrease your risk of injury. This type of training is great for all age groups. It decreases the risk of falls and fall-related injuries. It is common for the aging and elderly to suffer broken bones due to falling, which can result in a number of potentially life threatening issues. Reducing the risk of falling reduces the risk of breaks and illnesses related to being bed ridden, such as pneumonia.


As a byproduct, proprioception training often improves posture, increases muscle strength, and decreases pain in many areas of the body. It does this because, while training balance, it is stressed to train both sides of the body equally, which levels out imbalances caused by favoring one side or the other. Weakness in certain muscles causes tightness and overuse in the muscles that are compensating for that weakness, which causes pain and increased risk of injury. Well rounded balance training will level out that weakness/overuse imbalance and decrease body pain as a result.



Parts of the body that are heavily supplied with proprioceptors are the soles of the feet, the sacroiliac area, and the neck. So, proprioceptive training targeted in these areas improves balance and strength in them as a result, which helps posture. If you would like to learn more about posture and how important it is, read our blog on it here.


Yoga focuses on all of these areas and as a result, is extremely beneficial.


In Dr. Carla Cupido’s article in Gaia, she states that:


As certain poses become less of a challenge, increasing the demands

on the systems of balance will allow for continual improvement. Some

balance poses will stress the system more than others. However, the demand

will be determined by the skill level of the practicing yogi. For example, for an

instructor who has been practicing for years, revolved half moon pose is a

piece of cake in regards to balance. However, Tree Pose can be a real

tribulation for a beginner. This illustrates the point that balance can be both

trained and improved via the practice of yoga. Drishti (gaze) plays with the

visual component of balance as it often involves looking in a direction that

makes the body feel unsteady. By utilizing drishti appropriately, it will further

increase the difficulty of balancing in many poses, therefore providing

opportunities for improvement of the balancing systems. Since the cervical

spine has such a high density of proprioceptors, rotating the head to follow

the correct drishti will often make us feel as though we are off balance. Again,

with practice, this will become easier and with an associated enhancement

of balance.


In this sort of training, it is important to ensure that the muscles are as free

as possible of both scar tissue and trigger points as they can alter the ability

to perform appropriate muscle firing patterns.


To read her entire article, and for more from Gaia, visit: https://www.gaia.com/article/yoga-and-developing-proprioception


Whether you are wanting to improve performance, reduce risk of falls or injury, rehabilitate an injury, reduce hip, lower back, or neck pain, improve your posture, or just learn more about proprioception and how it can help you, we are happy to help!

To book one of our services, visit us here!



Sources:


https://www.healthline.com/health/body/proprioception


https://www.webmd.com/brain/qa/what-are-the-types-of-nerves-in-the-body


https://www.sciencedirect.com/topics/neuroscience/proprioception


https://helix.northwestern.edu/article/proprioception-your-sixth-sense


https://www.gaia.com/article/yoga-and-developing-proprioception

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