Proprioception - Fact Sheet
Try the following trick (not recommended for
people with a balance or movement disorder): Stand up. Close both
your eyes. Balance on one foot (this part is optional, if you
prefer) and then touch the tip of your nose with both index
fingers. Did you fall over? If you did, you may have a problem with
proprioception. If you didn't, proprioception is why not.
The word "Proprioception" is a combination of the Latin
proprius, meaning "one's own", and "perception." It is a perception
of self or, more accurately, a perception of where your body is and
what it's doing; the sense you have of where your limbs are in
relation to each other. The traditional senses (sight, smell,
touch, taste and hearing) are essentially external: They collect
information from the outside world. Other senses, such as balance
and proprioception, collect information from the body*.
Proprioception occurs because the nerve pathways that travel
from your brain to your muscles are two-way: Orders go out along
one set of nerves, and proprioception goes back along another.
Proprioception allows you to pick up a remembered object without
looking at it, to walk without looking at your feet, to move in the
dark without falling over, and to accurately kick a football while
looking at it and not your feet (although that may depend upon how
much training you've had!)
Many people have experienced temporarily impaired proprioception
as a result of moderate to severe alcohol poisoning. The above
trick, minus the standing on one leg, is called the Field Sobriety
Test in America and is used by police officers to assess degree of
drunkenness. Subjects with impaired proprioception due to a high
blood-alcohol level are more likely to stab themselves in the eye,
provided they stay upright.
Permanently impaired proprioception can impact upon every aspect
of your life, and may require rigorous retraining as
The reason proprioception is so important is that it is not just
limited to the large skeletal muscles, as the above examples might
suggest: In order to speak, your brain needs to use proprioception
to keep track of where your jaw and tongue are and what shape your
throat is. In order to drive, you need to be able to move the
steering wheel, the pedals and all the other controls without
looking at them. Touch-typing or playing any musical instrument
requires you to move without looking at your hands.
Even holding an object - a pen, a cup, a spoon, your partner's
hand - uses proprioception as well as the sensation of touch.
Walking requires accurately moving hips, legs and feet and without
proprioception becomes impossible without monitoring those limbs
with your eyes, sending a continuous stream of corrections on the
basis of what you can see, rather than the much faster and more
accurate basis of what you "know". The consequences for dancing
should by now be obvious!
Nerve or neuron damage
Damage to proprioception can occur from a traumatic brain injury
and other kinds of brain disorders. The injury can be anywhere from
the nerve sight where the "sensing" occurs through to the regions
of the brain where proprioception is received and interpreted, and
can occur through any form of nerve damage: viral infections,
multiple sclerosis, absence of blood, absence of oxygen in the
blood, physical damage through puncturing, cutting, twisting or
hyper-extension, poisons, and the list goes on.
When impaired proprioception is due to nerve damage and not a
short-term problem such as alcohol poisoning or short-term
restriction of blood to the muscles and nerves, treatment is
necessarily limited to preventing further damage, microsurgery to
resplice nerves if possible and physiotherapy in the hopes of
stimulating nerve or muscle repair.
Where treatment can not be total, the individual with impaired
proprioception must learn management strategies. Looking at your
limbs is one of the most fundamental strategies employed. Where
voice is impaired, feedback can be obtained through the ears, or
even by pressing your fingers against your throat while speaking,
providing the sense of touch is intact. If you can not judge how
tightly you are holding something (or someone), try looking for the
skin to change colour with increased pressure.
Environmental modifications may also be necessary, such as
clearing pathways through the home, changing cupboards and shelves
so that you can also see the contents, keeping torches in useful
locations, adding more light fixtures and sleeping with a night
light that is sufficiently powerful to allow the eyes to compensate
if you need to go to the toilet in the middle of the night.
Most of the compensatory strategies do of course require
training, and the best way to do that is to challenge what you can
do and then increase the challenge. Standing on a wobble board can
improve the use of vision to maintain balance. Juggling can improve
the relationship between the hands and the eyes, as well as
improving spatio sensory abilities. Tai Chi or Yoga are good for
strengthening remaining proprioception and promoting alternatives,
and any training or diet that improves visual acuity or your
capacity to use your peripheral vision will of course aid any use
of the eyes.
If you have impaired proprioception and have not yet been given
adequate assistance, the best people to speak to are neurologists,
physiotherapists and occupational therapists. Speak to your
hospital or your GP about a referral.
References and further information