Proprioception is very closely linked to your ability to adapt to changes in the environment. It allows you to move with confidence, knowing that you can cope with whatever comes your way. When pain of injuries limit your proprioception, you will also lose some of the confidence moving that body part. Unfortunately, your brain learns a bad habit very quickly, so proprioception will only improve up to the limit that you push yourself. If your arm was in a sling for 6 weeks it would naturally adapt to that position. You’ll be good at keeping your arm in a comfortable position close to your body, but that doesn’t leave much room for getting cups out of the cupboard on the top shelf not even stretch out if you trip over a rock.
Retraining proprioception is crucial to get rid of these bad habits and get your confidence back. Initially, we will start retraining in comfortable, stable positions. Over time, your rehabilitation program will start to include more challenging exercises and unstable positions to prepare you for sudden changes. This ensures that you can control movement in different positions, different directions and speeds where necessary. Even more importantly, you should be able to adapt to these changes effortlessly and without thinking. Like jumping onto a wabble board.
All the manual (in other words “hands-on”) techniques used by your physiotherapist will fall have an effect on your proprioceptive system. As we work on specific joints, muscles and movements, the special receptors in these structures will constantly send information to your brain. This information can help your brain to reorganise and retrain movements and motor control of muscles. This is conditioning the nerve pathways to re-act faster and regulate force with precision.
Techniques we use with the specific aim of improving proprioception include:
Static balance exercises – you need to maintain a position of a part of your body. For example, standing on one leg.
Dynamic balance exercises – similar to static balance, but now we add movement of another body part. For example, throwing a ball while standing on one leg.
Rhythmical stabilisation – in this technique you need to keep a part of your body in a certain position, while your physiotherapist applies forces in different directions. For example, you hold your arm out at shoulder height and the practitioner tries to push your arm up, down, left or right.
Joint mobilisation – an external force is applied by your physiotherapist on a peripheral joint or your spine. These are usually small, controlled movements and can also be applied in different directions. How we apply force will depend on your symptoms and the stage of healing of your injury.