Proprioception: An Overview

Proprioception is a medical term that describes the ability to sense the orientation of your body in your environment. It allows you to move quickly and freely without having to consciously think about where you are in space or your environment. Proprioception is a constant feedback loop within your nervous system, telling your brain what position you are in and what forces are acting upon your body at any given point in time.

Examples of proprioception include:

• Being able to tell that an arm is raised above our head, even when your eyes are closed
• The ability to sense the surface you are standing on, even when you are not looking at the surface
• Adjusting to a change in surface, such as walking along the sidewalk and then turning to walk on a grassy surface

This article discusses how proprioception works, problems with proprioception, and how to improve it.

Anatomy of the Proprioception System

Proprioception comes from sensory nerve endings that provide our brain with the information to sense movement and action. There are specialized nerves in your muscles and joints that communicate with your brain and tell it what position your joint is in and how much stretch or strain is on the muscles surrounding a joint. The nerves surround each muscle bundle, creating a system of communication with your brain about what is happening to the muscles and joints of your body.

What Happens When Proprioception Is Impaired?

If you have poor proprioception after an injury or surgery, you may not even notice. But sometimes, impaired proprioception results in difficulty with basic functional mobility. For example, when walking on unsteady surfaces, you may feel like you are about to lose your balance. If your proprioception is really off, you may even fall.

People with Parkinson's disease have impaired proprioception that is only partially restored with medications or deep brain stimulation.

Upper extremity injuries may also result in loss of proprioception. You may have difficulty reaching properly, and you may have problems with fine motor tasks that require precision of movement.

Proprioception Exercises

Many people perform balance and proprioception exercises after an injury or surgery. After a total knee replacement, your physical therapist may work with you to help you regain your sense of your knee's position. They may have you perform balance exercises, such as:

• The T-stance balance exercise
• Single-leg stance
• BOSU steps
• BAPS board
• Upper-extremity functional practice and movement

Progression of proprioception exercises can be done by altering the surface you are standing upon. Try standing on a pillow or piece of foam. Standing with your eyes closed, thus eliminating your visual system, can also challenge your proprioception.

One small study found that people with mild to moderate Parkinson's disease improved balance when they received proprioception training or a yoga meditation program.

When you visit a physical therapist, they may assess your balance and proprioception and prescribe exercises to help improve it. These exercises may challenge your balance, creating situations where you feel unsteady. This unsteadiness is necessary; it helps to improve your balance and proprioception.

Understanding how proprioception affects your balance and your ability to navigate through your environment may be a key component to your successful rehabilitation after an injury or surgery.

Summary

Proprioception is a complex series of muscle and nerve communications that tell your brain where your body is in space. If you have been injured, have surgery, or have certain conditions like Parkinson's disease, your proprioception system may become impaired, leading to an altered ability to function properly. Working with a physical therapist may help improve your proprioception and your overall functional mobility.