NOTE: technical blog!!
What Is Proprioception?
It’s said that we have five basic senses: touch, smell, hearing, sight, and taste. Yet there’s a sixth sense (and more!) that’s often recognised as such because it’s just as important as those other five. It’s known as proprioception.
What is proprioception?
Proprioception, also sometimes referred to as kinesthesia, is a sense that affects our body positioning and self-movement. Joint, tendon, and muscle neurons known as proprioceptors drive the movements dictated by this sensory system.
Perhaps this issue exists as a reminder of something that is always present but is not seen, yet is extremely powerful and important. Just like it is such a human tendency to forget about God until we need Him, we tend to forget about proprioception until we have issues with it! This secret sense is part of God’s design that touches so many parts of our daily lives. But what does it mean when things aren’t working typically?
Many of us are blessed enough to not have to think twice about the sixth sense that is proprioception, but unfortunately, not the case for everyone. Let’s go in this journey of discovering these greater things that go unseen as we talk more about proprioception, the disorders that can affect one’s self-movement, as well as which treatments and therapies are available.
What Is Proprioception?
Kinanesthesia or proprioception is the way your body detects your actions, movements, and location. For example, when you woke up this morning, did you have to think about how you got out of bed? No, of course not. You may have struggled a bit because you were tired, but you didn’t risk hitting the bed or falling to the floor because of your proprioception.
Within your body are proprioceptors. These mechanoreceptors and located in the joints, tendons, and muscles. Not all proprioceptors activate the moment you move various parts of your body. The others gauge what’s going on around you to inform the limits of your limbs, how much limb load you can handle, and the movement and velocity of your limbs.
The group of proprioceptors that monitor your limb movement and velocity are called type la sensory fibres. Sometimes, they’re referred to as primary afferent fibres as well. The proprioceptors that track your static muscle length (for the limbs when they’re at rest) are group II neurons.
Some proprioception we do is considered conscious, while the rest is non-conscious. Reflexes, which we can’t control, are a form of non-conscious proprioception. Take the righting reflex, for example.
Referred to also as the labyrinthine righting reflex, when your body begins tilting, you automatically move your head so your eyes are at the horizon level through the righting reflex. You don’t have to think about it doing this. It just happens. The same is even true in infants, so the righting reflex is not taught.
Any proprioception that occurs between the cerebrum and the dorsal column-medial lemniscus pathway is conscious.
What Part of the Brain Controls Proprioception?
In conscious and non-conscious proprioception, one of two parts of your brain are involved. For non-conscious proprioception such as the righting reflex, the cerebellum mandates this automatic reaction. The cerebellum also oversees other non-conscious proprioception through communication with the ventral spinocerebellar tract and the dorsal spinocerebellar tract.
What is the cerebellum? The term comes from a Latin word that means “little brain” because it’s not as big as your cerebrum. The cerebellum’s main job is dictating motor control, but it’s also thought to be somewhat involved in pleasure and fear responses, language learning, and attention.
Thanks to our cerebellum, we can do things in our lives with the correct timing, precision, and coordination. The spinal cord and sensory systems feed input to the cerebellum, which is then converted into motor activities.
Your spinocerebellar tracts include both ventral and dorsal tracts. These send proprioceptive data to the cerebellum.
With non-conscious proprioceptive activity managed by the cerebellum, that leaves conscious proprioceptive activity to the cerebrum. As we had mentioned, the cerebrum outsizes the cerebellum.
This part of our brain is also known as the telencephalon and is actually the largest portion of the brain in general. The cerebrum is broken up into four areas or lobes: the temporal lobe, the occipital lobe, the parietal lobe, and the frontal lobe.
The temporal lobe takes sensory input and uses it towards our association with emotions, our comprehension of languages, and our visual memories. Your occipital lobe acts as a visual processing centre, as it’s responsible for our perception of colour properties, spatial frequencies, and local orientation.
Your parietal lobe takes inputs such as pain receptors, temperature, and touch to ensure we react appropriately. Finally, the frontal lobe has neurons and pathways that trigger our motivation, planning, short-term memory, attention span, and need for rewards.
Proprioception in Those with Autism, ADHD, and Dyspraxia
If your child struggles with conditions such as autism, attention-deficit/hyperactivity disorder (ADHD), or dyspraxia, will these diagnoses affect their proprioception? Or rather – does their proprioceptive processing affect their diagnoses?
Yes, indeed. This may cause children to not understand another child’s physical boundaries, or the child may also have a hard time determining the location of their own body.
Proprioception and Coordination
Above, we talked about how the cerebellum is what allows us to have coordinated movements. A Science Direct writeup on proprioception mentions that our proprioceptors provide us with three elements known as the proprioception ABCs. These are agility, balance, and coordination. When our muscles work in conjunction with one another, coordination is possible.
One of the main symptoms of a proprioceptive disorder or dysfunction is ataxia, or dyspraxia – another word sometimes used for lack of coordination. This may make movements appear clumsy, sudden, and unplanned.
Why Is Proprioception Important?
As one of our bodily senses within our sensory system, proprioception dictates the body’s ability to determine its positioning in the space around it. Without having a sense of proprioception, be that consciously or non-consciously, it’s hard to do simultaneous activities.
We’re not simply referring to multitasking, but basic activities you’d do more than one of at a time. For instance, if you’re playing basketball, you need the ability to both run towards the basket and dribble the ball. A proprioceptive deficit or disorder would cause difficulties with both activities, whereas someone else can do these activities at the same time with ease, and, even more so, without thinking about it.
Proprioception also affects our coordination and movement fluidity. Even if your child doesn’t dream of being a star athlete someday, you still want them to have both fluidity and coordination. This prevents them from hurting themselves by bumping into every last little thing as well as invading personal space and damaging relationships with others.
In short, this sense that is not thought of much unless there are issues with it is much of what makes everyday life doable.
Examples of Proprioception
So how exactly does proprioception affect you in your day-to-day life? We already mentioned one example in the last section, which is a person’s ability to run while dribbling a ball simultaneously. What about…
Can you tell when you’re walking on concrete versus walking on grass if your eyes were closed? Would you have a hard time doing that with shoes on? No – probably not. Yet someone with a proprioceptive integration difficulty might not be able to discern between standing on concrete or grass, even though the two feel very different.
If you throw something, such as a ball, do you have to look at the arm that’s doing it? Again, probably not. You feel confident in your ability to throw ahead of you without staring at your arm during the throw. Someone with a poor proprioception would probably have to watch their arm as they made the throw, and even then, their throwing accuracy may still be impacted.
The classic example of standing on one leg is something that those with proprioceptive issues often struggle with. That’s not to say balancing on a single leg is easy, but lots of people can do it, at least momentarily.
Close your eyes and try to find your nose using only your index finger. Simple, yes? For you, perhaps, but if you tasked this same activity to someone with proprioceptive issues, they would struggle and struggle to find their nose, especially with their eyes closed.
What Are the Signs of a Proprioception Deficit?
Asking your child to perform the above tricks is not necessarily a gauge for whether they have a proprioception deficit or disorder. Instead, you want to keep your eyes peeled for a slew of symptoms that can manifest individually or together.
Unnecessary Fear of Falling
Your child may not have had any difficulty climbing the stairs to get to the second story of your house at one point, but they won’t do it anymore. They’re too afraid they might fall down the stairs. Even small sets of stairs, like those leading up a front patio, may cause your child to express fear and look for an alternate way to get in.
When your child writes with a pencil, do they press down on the tip until it snaps? Do they also forcefully grab things, including fragile items? It’s not necessarily that your child is throwing a temper tantrum, but rather, they might not realise how strong they actually are.
Teaching proper posture in children is paramount, but if your child just isn’t getting it, you may have to ask if it’s a proprioceptive issue that’s causing the postural problems. Children with these deficits may slouch more often and even use items to balance themselves.
For some children, their clumsiness is something to pay attention to. If your child bumps into things all the time, even very obvious things like open doors or tables you’ve never moved, that’s possibly indicative of a proprioceptive issue. The same is true if they can’t hold onto things, such as pens, toys, forks, and seemingly anything and everything else without dropping these items.
Lack of Coordination
Since un-coordination is so closely associated with proprioceptive issues, this is another sign to really watch. If your child especially has difficulties with maintaining their coordination, including simple tasks like walking along a straight line, it’s worth getting in touch.
Falling a Lot and Other Balance Issues
As the B in the ABCs of proprioception, balance or lack thereof is another overt signal of proprioceptive / vestibular issues. Your child cannot stand on one foot, and if they try, they fall over almost immediately. Even on two feet, your child may have difficulty staying upright. They can fall when sitting, and they tend to trip a lot when walking too.
Therapy for Proprioception
Both children and adults can have proprioceptive processing issues. Adults can develop difficulties with proprioception, although these are not sensory processing issues, such as Parkinson’s disease, knee or hip replacement surgery, joint injuries, Lou Gehrig’s disease, Huntington’s disease, peripheral neuropathy, stroke, multiple sclerosis, arthritis, herniated discs, for example.
An occupational therapist, physiotherapist, or doctor will administer tests to determine the patient’s level of proprioception. Examples include the field sobriety test, the Romberg test for balance, and sequential finger touching, as well as Ayres Sensory Integration specific tests.
Upon being recognised with a proprioceptive issue, your doctor or therapist will suggest at least one form of therapy, perhaps even multiple. With occupational therapy, integrating with sensory stimuli is recommended so the patient develops a healthy framework for day-to-day life with their proprioceptive functioning.
Physiotherapy can improve the patient’s balance, use of strength, and motor skills.
How to Improve Proprioception – Powerful Proprioception Activities
Remember this verse:
“For we walk by faith, not by sight.”—2 Corinthians 5:7
This means that no matter what your perception is of the world, or the distortion that comes with proprioception issues, faith in God is still above it all. And with prayer, consistency, and faith you will find a treatment that works.
Besides the treatment your child will receive through their therapists, they may also be advised to engage in proprioceptive activities at home or at school. These activities are desirable in two scenarios. The first is when your child is sensory-seeking or under-responsive, and the second is when they’re over-responsive and need to be calmed down or have their energy redirected. Here are some activities you can teach your child with a proprioceptive issue, either with your supervision or that of a teacher and other students.
Passive Proprioceptive Activities that Join with the Tactile System.
The use of weighted gear, such as a weighted vest or jacket, a weighted belt, or a weighted blanket may help with some passive activities. For instance, weighted gear can be substituted for a tight, firm hug from an adult if your child is in school. All weighted equipment needs to be used under definite conditions however.
Any means of inducing deep pressure is considered a passive proprioceptive activity for your child because of the way the tactile and proprioceptive nerve tracts combine. You can make these activities into a game. The steamroller game involves your child lying down flat on their stomach. A second child, such as a friend, neighbour, or classmate, would take an exercise ball and roll it along your child’s back and legs.
The sandwich game entails your child lying on a mat yet again, either facedown or face up, and then having another child or two put a second mat over your child. The hot dog game is similar. This time, your child lies down on a large blanket while someone else rolls them up and pretends they’re a hot dog, adding faux toppings.
Oral Proprioceptive Activities
These activities can improve a child’s oral proprioceptive abilities:
- Consuming a heavier beverage like yogurt or a milkshake through a straw
- Blowing up and tying a balloon
- Learning a wind or brass instrument
- Using a chewy tube
- Find chewy or crunchy food
- Sipping a bottled beverage with a sports cap through a straw
- Blowing bubbles
Functional Proprioceptive Activities
The following activities work for over-responsive children and are helpful to boot.
- Cleaning up a classroom or an at-home playroom
- Stacking up chairs at the end of the day
- Putting piles of books away on the bookshelf
- Tidying up toys and moving them to the toy chest
- Holding a door open for somebody
Over-responsive Proprioceptive Activities
You can also suggest these activities to your child, although the availability of such activities will differ depending on if they’re at home or at school.
- Playing a game of tug-of-war with a classmate, neighbour, sibling, or friend
- Enjoying gym equipment or even doing cartwheels and handstands outside
- Going through an obstacle course, especially one that requires crawling rather than running
- Playing with a weighted ball, such as tossing it back and forth
- Climbing up ropes, typically in gym class
- Jogging in one area / on the spot
- Doing push-ups
- Lifting light weights such as books or tins
- Playing with a stress ball
- Doing wall pushes
Thanks to this sensory ability, we can understand the world around us and act appropriately, keeping our distance, our balance, and our coordination. Children and adults with proprioceptive issues should strongly consider Christian Occupational Therapy Support for addressing and treating any dysfunction.
Isaiah 41:13 says, “For I, the Lord your God, hold your right hand; it is I who say to you, “Fear not, I am the one who helps you.”” As we move forward with treating proprioceptive issues, remember that we are hands of God to represent His loving guidance in times when it is hard to see His glory. While living with or caring for someone with sensory related issues can be a daunting challenge, the engagement of this sixth sense might just be the reminder we need to interact with the world we don’t too often consider: the world of the spirit. Look at this as an opportunity to praise His name in the storm, and His magnificent creation into the light. He has provided you with this opportunity as a part of His grand plan!