Understanding proprioception

Proprioception provides a body map for navigation. The proprioceptive system is one of the body’s sensory feedback systems. Together with the five senses of touch, smell, taste, hearing and vision, as well as the vestibular system, proprioception processes information from the body in its environment. It creates a body map and determines how much effort should be made in movement. How clever are my joints? Do they know where my arms and legs are? How hard should I push, throw, kick to achieve the result I want? And do I have control over any of this?

Proprioceptors are located in joints, muscles and tendons. These receptors send impulses to the brain about joint position and joint movement: Where are my body parts in relation to each other and which movements are they doing? It is literally the sense of position and movement.

In adults the proprioception system get damaged with joint injury or is affected by joint surgery. Part of rehabilitation is retraining the proprioceptors to give accurate static and dynamic joint position feedback to prevent re-injury. Pro golfers have finely tuned proprioception systems. They can make tiny adjustments to their swing and are in tune with the rhythm and flow of the movement in order to achieve result.

Children’s proprioception is still being established. They are learning how to use their body and what it is telling them about their movements. Proprioceptors are stimulated by joint compression in various positions. This means weight bearing through joints. Crawling on all fours is a great developmental activity for stimulating proprioceptors. It encourages weight bearing through knees, hips, shoulders, elbows and hands.

Proprioception is also stimulated by balancing – one-legged stance, kneeling, hand stands and such are useful balancing activities. Joint distraction provides a different kind of proprioceptive stimulation, for instance pulling or lifting heavy objects or hanging on the monkey bars of a jungle gym. Proprioception should be stimulated in sustained positions – weight bearing balance; but also through resisted or weight bearing movement – squats, pushing the supermarket trolley, skiing, dragging or carrying things, etc.

Riding a bicycle is a lovely proprioception activity: Hands and arms grab onto the handlebars, so the joints are being compressed and/or distracted, depending on the effort. Legs push against a resistance. Hands and fingers work the brakes, making all these joints both strong and clever. Sitting on a ball for activities is hugely helpful for proprioceptive input from the spine and pelvis. The spine-pelvis-ribcage alignment is very important for core muscle activation. If these three are not optimally aligned, core strengthening is much more difficult. Consciously aligning one’s body parts starts with knowing where they are. This means proprioception needs to be reasonably established for core muscle work to be truly effective and for core work to spill over into everyday activities.

The vestibular system, together with proprioception, orient the child in his/her environment. Children who appear clumsy or unsure physically, often have inaccurate proprioceptive feedback. The brain continually makes tiny alterations to joint position, because of proprioceptive feedback. The receptors tell the brain where the body parts are and what they are doing, so that the brain can instruct the arms, legs and head how to balance or move. The proprioceptors tell the brain if the foot is not aligned properly on uneven surface, so the brain can send signals to straighten it. If the feedback is slow, or incorrect, the child might fall. Small corrections cannot be done if the feedback is faulty. Either the brain will discover it too late or try to overcompensate.

Vision is a function of head-on-neck proprioception. The head has to be aligned properly for the eyes to be optimally aligned. The head position provides a stable background for optimal functional vision. If small adjustments in the neck-righting reaction cannot be made with changing head positions, the eyes have to compensate. Faulty adjustments based on inaccurate feedback about the position of the head relative to the body, cause unstable vision. Head control is the beginning of the higher postural reflexes, which replace the primitive reflexes of babies.

Children with proprioceptive dysfunction have a hard time gauging how hard to press down on a pencil for drawing. They can have trouble climbing stairs. Climbing on the jungle gym is a wonderful help, but children with these struggles tend to avoid, or is cautious about physical activity. This means the situation tends to perpetuate itself. Gentle encouragement of helpful activities begin to establish better connections. On the other end of the spectrum children crave proprioceptive input. They jump wildly on the trampoline and exhaust themselves with physical activity.

Proprioceptive assessment is a good start. Therapy would include deep pressure, skin brushing, balance training, joint compression and load-bearing activities. Deep pressure can be achieved through pressure clothing, weighted blankets, elastic body socks or bean bags. Therapy should be instigated and supervised by physical therapists (physio) or occupational therapists.

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WITH SPECIAL THANKS FOR THESE LINKS

The effect of head/neck alignment on functional vision

Core stability and alignment explained

Insights into proprioceptive dysfunction