Proprioception and Maintaining Balance

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Proprioception, also known as kinesthesia, is the sense of knowing your body's relative position in space. Often referred to as our sixth sense, proprioception allows us to move and navigate environments as we inherently "know" where our limbs, weight, and center of gravity are at any moment in time.

What is Proprioception?

The ability to move through space without the need to see or feel every aspect of that movement is called proprioception.

Proprioception is a coordinated neurologic and physiologic response aided by specialized nerves known as proprioceptors. These are the sensory receptors located on the nerve endings of the inner ear, muscles, skin, joints, tendons, and other tissues. They relay information about our body's spatial position and movements to the brain.

When you perform movements like walking, throwing or kicking a ball, or going up steps, all without looking, you are using proprioception. Some things can affect your ability to use proprioception, such as alcohol, aging, and certain conditions or injuries that affect the brain and nervous system.

Thanks to proprioception, we can move without consciously focusing on where we are in space. Without it, we wouldn't be able to type, dance, jump rope, or steer a bicycle or car.

Biology of Proprioception

The proprioceptors are a special type of mechanoreceptors, which are nerve endings that respond to stimuli such as touch, pressure, and vibration. Various types of proprioceptors in the muscles, tendons, and joints detect stretching and movement of the muscles and joints. They then deliver millions of signals to the brain, which translate those signals into a map of the body's position.

The proprioceptors of the body are found primarily in the muscles, tendons, and skin. Among them:

  • Muscle spindles, also known as stretch receptors, are sensitive to changes in muscle length. These allow you to know when and how far to stretch your legs while walking or your arms when reaching.
  • Golgi tendon organs, found in tendons, are sensitive to changes in muscle tension. They sense how much tension a muscle is exerting and what is needed to effect a movement with the appropriate amount of energy.
  • Pacinian corpuscles are situated in the skin and are responsible for detecting changes in pressure, which the body reads as texture, temperature, and other sensations.

Proprioception also relies upon a coordinated response between the muscles and the inner ear, which is central to balance, motion, and orientation. The inner ear contains structures that are sensitive to whether you are speeding up, rotating, and where you are orientated.

Specifically, the inner ear contains the vestibular system, which is dedicated to balance. This system contains two labyrinths that have fluid and hair-like sensors inside that detect movement, such as going up and down in space and the position of your head relative to gravity.

Proprioception and Reflexes

Besides providing information about movement and position, proprioceptors can trigger certain protective responses such as the stretch reflex. This is the reflex in which a hyperextended muscle will automatically retract to protect itself. These reflexes happen when the muscle spindles give information about the muscle length and limb position.

There are also reflex arcs in which one movement will compensate for another to prevent injury, such as the flexor reflex (or withdrawal reflex).

One such example is stepping on something sharp like a nail or piece of glass. While the pain reflex will cause the injured foot to pull away, the body will counteract by shifting the center of gravity to the other foot while stabilizing your position with your arms. The complex reaction is sometimes referred to as a human antigravity reflex arc.

The knee jerk reflex is one you may be familiar with from a visit to your doctor's office. When a quick tap is given to the patellar tendon, sensory information is sent from the quadriceps muscles in the thigh to cause leg extension.

The Achilles reflex (ankle jerk reflex) entails a contraction of the muscles in your calf when the foot is pointed downward.

Causes of Impaired Proprioception

Proprioception can become impaired or reduced for many reasons, either temporarily or permanently. Some causes of impaired proprioception, such as aging, are unavoidable, although improvements can be made. Illnesses and disease conditions that are neurological, muscular, degenerative, or sensory can also limit proprioception. Here are a few reasons why proprioception might become reduced:

  • Aging
  • Stroke
  • Brain injuries
  • ALS (amyotrophic lateral sclerosis)
  • Parkinson's disease
  • Diabetes
  • Autism spectrum disorder (ASD)
  • Huntington's disease
  • Peripheral neuropathy
  • Multiple sclerosis (MS)
  • Tendinopathy or arthritis
  • Joint injuries or replacement surgeries

Improving Your Proprioception

While vision and hearing also contribute to movement and balance, those senses are not considered proprioception components since you don't necessarily need them to be oriented in space.

Different people have different levels of proprioception in the same way that some people have better eye-hand coordination, making them better at typing or playing video games. Another such example is standing on one foot with your eyes shut. Some people can do this without impediment; others fall immediately.

You can improve proprioception—up to 52% in some cases—by training it in specific ways. This applies to any activity for which you may be less coordinated, such as catching a ball or playing tennis. With practice, your body can adapt and expand its proprioceptive response to specific tasks.

The same is true if you have reduced proprioception due to a hip or knee replacement. Proprioception and balance training can improve your functional abilities.

Certain practices can help sharpen one's proprioception. Among them:

  • The Alexander technique is a practice designed to retrain habitual movement patterns and posture by gaining awareness through mindful movements.
  • T'ai chi requires awareness about your posture and center of gravity as you slowly shift from one movement to the next.
  • Yoga also relies on balance and awareness of your core, which provides you with your center of balance.
  • Juggling and slacklining (walking on a slack tightrope) can finely tune proprioception to an extraordinary degree.
  • Gym workouts with an exercise ball can improve proprioception by forcing you to constantly readjust your position to perform exercises usually done in a stable position.

Proprioceptive exercises are commonly used for rehabilitation therapy, helping you relearn how to control the position of a joint after a serious injury.

A Word From Verywell

Everyone’s level of proprioception is different. You can improve proprioception if you make it a fitness goal and spend time practicing it. If you have impaired proprioception, know that there are ways of boosting it through therapy, balance exercises, and practice.

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