Walking the Tightrope: The Mysterious World of Proprioception.
Dr. Thomas Patavino of Thoracic Park Alternative Health 

    Proprioceptors. They sound like something that might be aboard the mother ship in some science fiction movie. Actually, proprioceptors are tiny little nerve endings in our bodies that help with balance, performance and setting muscle tension.  Chances are you never heard of proprioceptors. Very few people have unless they were injured and it was discovered that there was room for improvement in this neuromuscular system. If you made it this far in the article, please continue because it will all make sense in the end.

     When we walk, we take for granted all the little things that must take place to get from point A to point B without falling. The eyes play a major role along with our vestibular system (fluid system in our inner ear that regulates balance) in helping us maintain balance. What most people don't realize is that we have little nerve endings in our hands and feet that tell our muscles and the rest of the body exactly where we are in position, space and time. In English, that means you can close your eyes and touch your nose with your finger because of proprioceptors. Those little nerve endings know where your arm is in space allowing you to perform the desired action. Now, the real test; Try standing on one foot and get your balance. Not too hard for many, but impossible for some. Now close your eyes while standing on one foot. (Please don't fall, this is supposed to be educational and not harmful). Once the eyes are closed, you are relying only on proprioceptors for balance. You might feel your foot shaking from side to side.  That shaking is coming from the little nerve endings firing away to maintain balance.

         Whenever we step, the nerve endings are performing just like when your eyes were closed, but we fail to notice this because of our visual and vestibular input. We don't fall over because those nerve endings recognize that we are on solid ground and our muscles adjust appropriately. Why is this relevant?              The elderly. When we get older or have an injury, our proprioceptors become less reactive. More often than not, when we hear of someone older falling it wasn't because they got light headed, but rather due to the proprioceptors failing to communicate properly. If they fail to fire when they are supposed to, the body can't tell the difference from flat ground versus uneven ground. More injuries occur this way because the body reacted like it stepped in a pothole or the floor suddenly moved beneath unstable feet.

  Proprioceptors act like the balance poles used with walking a tightrope. It helps maintain a stable center of gravity. If we are falling to the right, the pole balances the left and vise versa. Poor proprioceptive activity leaves the body walking a tightrope without a pole. Unfortunately, for many people there aren't safety nets to catch us when we fall. This leads to fractured bones and other various injuries.

      The young aren't exempt either. An injured area loses the acuity of proprioceptors.  A common display of this is a sprained ankle. Did you ever experience or know someone who had his or her ankle just turn in or give out long after the original sprain was healed? That was because proprioceptors failed to provide stability and even ground appeared to be a dangerous unstable environment. With each step, certain muscle fibers have to relax and contract due to the surface beneath it. This happens automatically, unless we have flaws in our neuromuscular system. All it takes is slight misfiring and we can lose balance or have a joint suddenly give way making us prone to injury.

       Now that good news, Proprioceptors can be retrained at any age and improved upon. Specific balance training and exercise can improve proprioceptors in a very short time. Athletes have noticed a distinctive edge in performance by adding proprioceptive training to their routines. Reoccurring incidents of old injuries can be dramatically reduced by treating the proprioceptors in the injured area. Finally, probably the most important indication is with our seniors. I can't stress the importance enough to have a proprioceptive evaluation. It doesn't take long and it can easily detect if you could benefit from improving proprioceptive activity for injury prevention.  A simple phone call to your health care provider can inform you if they offer proprioceptive evaluation and retraining. Prevention remains our best medicine in healthcare.