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How many senses do we human beings have? The obvious answer is five - we were all taught about sight, hearing, taste, smell and touch at school - but we have many more. Other senses include theromoception (hot/cold), nociception (pain) and proprioception (body position). All our senses contribute to our health and well-being but proprioception is of particular importance to everyone who participates in sport or likes to keep active. Good body awareness will not only improve sporting performance but is also known to reduce injury rates.

So, what is proprioception and how do we train to improve it?
Specialized sensory receptors are located in our joints, muscles and tendons. These organs, which can collectively be known as "proprioceptors", send information in the form of nerve impulses to our conscious and subconscious central nervous systems. They relay information about our limb positions, joint movement, vibration and pressure. This allows any sequence of movement to be continually monitored and then modified if necessary.
However, after acute injuries such as muscle pulls or joint sprains and after over-use injuries such as tendonitis, these nerve endings and nerve pathways can be damaged. The proprioceptors become slow to respond to changing position and this resulting decrease in joint position sense causes decreased co-ordination, poor balance and can lead to a tendency for joints to give way. This means that after any lower limb injury, proprioception should be re-trained.
However, researchers suggest that 75% of people with an ankle sprain have had previous injuries which have not been fully rehabilitated. This is a huge statistic and represents unnecessary injuries as proprioception can be easily improved. Remember that minor injuries now long forgotten may have left you with proprioception that is less than perfect.

How good is your proprioception?
Proprioception Training Exercises. Can you work through these exercises and feel confident and stable at each level?

The following exercises will help retrain proprioception but, as with any training programme, it must be safe and suitable for you. Only try this if you can fully weight bear through your leg - starting too early after injury can cause problems.
Always think about safety. Start balance work near a wall or between a doorframe so that you can hold on if you lose your balance. Practice barefoot or in shoes - avoid slippy socks on slippy floors. Never work into pain and always seek advice from a sports medicine specialist if you have any concerns.

The exercises here are in order of difficulty so don't move on until you are happy you have mastered the previous one.

  • Stand on one leg - you should be able to stand still for 30 seconds up to 1 minute. Always aim to stand straight with good posture.
  • Stand on one leg plus arm movement - wave, bounce ball, throw/catch ball.
  • Stand on one leg plus other leg movement - trace out the alphabet in the air with your free foot.

The above sequence can then be repeated on a more difficult surface such as a foam mat, cushion or pillow.
Once mastered on a static surface, training can move onto a dynamic surface such as a rocker board which rocks side to side, a wobble board which can move in any direction or a mini-trampoline.

These are examples of basic balance exercises and training can be progressed and developed to suit individuals and their sport. If you feel you would like some help with these exercises please contact the clinic for a tailored personal exercise programme.

The above exercises will help to ensure that you have good body position awareness. Ensuring that you retrain your sense of proprioception after lower limb injury will help you return safely to activity and help prevent further injury. These are very big rewards for investing 10 minutes every evening practising a few simple exercises until confidence in your balance returns.

PS   In answer to the very first question - the number of senses we have - depends on which neurologist or psychologist you ask. There are defensible answers for 3, 9, 21 or 33 depending on the definition of "Sense". The only wrong answer appears to be 5!

This article was written by the McNaughton Physiogrange Team and first appeared in the June 2009 edition of 702 Gazette

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