Do you know about your body's "sixth sense"? (Proprioception) Let's talk about this!

Have you ever wondered how we know exactly where our hands and feet are, even with our eyes closed? Or how we can walk in the dark without bumping into anything? The amazing ability that we're going to talk about today is called 'Proprioception.' It's like a 'sensor' system in our own body.

What is "Proprioception"?

Simply put, proprioception is your body's innate sense of its own position and movement. It's something that happens automatically, not something we think about. It's what allows your brain to know where your body is and how your limbs are positioned, even when you're not looking. It's also important for maintaining our balance.

Now there's another word related to this, and that's 'kinesthesia.' 'Kinesthesia' is the ability to combine 'proprioception' and other processes to create movements in our bodies and to practice various physical skills. 'Kinesthesia' is a behavioral process. That is, it helps our body recognize a certain movement and learn how to do that movement better.

Just think, even simple tasks like throwing a piece of paper in the trash or eating with a spoon require both proprioception and kinesthesia. Not only that, but even complex skills like doing a backflip on a balance beam require both. In fact, without these complex sensory experiences, our lives would be very different.

Examples of Proprioception in everyday life

Now let's look at some examples of how 'proprioception' and 'kinesthesia' work in everyday life.

Things that happen spontaneously (Automatic Proprioception):

• Imagine you're walking on a gravel road, on an uneven surface with large rocks. Your body, your legs, and your soles are changing their muscle tension, helping you maintain your balance and walk without stumbling. This happens without you even realizing it.
• If you scratch your nose, your brain and body know to move your hand and fingers closer to your nose. You don't even need to look at your hand or look at your nose in a mirror.
• When you're lifting something heavy, your body knows how much force is needed to hold it, and how to maintain balance throughout your body.

Things that happen through habit and learning ('Kinesthesia' - Learned Movements):

We sometimes call this 'muscle memory.' These things require a little conscious effort and practice.

• When learning to ride a bike, you need to develop a variety of coordination skills (such as pedaling and steering) and maintain balance.
• A skilled pianist can play a song by moving their fingers precisely without looking at the keys.
• Soccer players learn to control and kick the ball by using specific muscles and a specific amount of strength in their legs and soles.
• Bowlers learn how to catch, throw, and spin the bowling ball, and how to knock down different pin patterns.
• A skilled gymnast knows exactly where they are when they do a tumbling or spinning in the air and can land correctly.

What body systems are involved in "proprioception"?

Proprioception is a very complex process, and it happens without you even realizing it. There are several parts of your body that are involved in this:

• Your Brain: Several parts of your brain work together to process this sensory information. Specifically, the cerebellum , brainstem, and sensory cortex . The way you feel your body's position is how your brain interprets that information and acts on it.
• Peripheral Mechanoreceptors: These mechanoreceptors are located in your skin, muscles, ligaments, tendons, and around your bones and joints. They can detect a variety of stimuli, including touch, pressure, pull, vibration, and movement. They sense the forces acting on your body and send that information to your brain.
• Peripheral Vestibular System: There are five sensory organs in your inner ear. These sense information about your posture, position, and movement that you need to maintain balance. This information is also sent to the brain.
• Eyes: Through your vision, your eyes send information to your brain about your position and the things around you. However, proprioception can function well even without vision. For example, someone with good proprioception can move their finger right up to their nose even with their eyes closed.

What are the symptoms of impaired proprioception?

Well, now let's see what symptoms appear if this ability called 'proprioception' becomes weak, or if there is some problem with it.

• Balance issues: This can cause frequent falls, making it difficult to stand or walk properly.
• Carelessness/Clumsiness: This may include frequently bumping into things around you or making mistakes when trying to reach for something.
• Dizziness: Sometimes you may feel dizzy.
• Issues with spatial awareness: Reduced awareness of things like where they are and how far they are in relation to the things around them.
• Uncoordinated movements: When the limbs are moved, they move in a chaotic manner, without any connection to each other.
• The amount of force applied to an action decreases or increases: For example, when writing, the pen is pressed down hard, or the writing is done very slowly and softly.
• Under- or over-doing actions: When you reach out to grab something, your hand either goes before or after the object.

These symptoms can affect anyone of any age. However, as we age, our joints, muscles, nerves, and brain naturally weaken, increasing the risk of problems with proprioception.

What conditions affect proprioception?

There are various injuries, medical conditions, and situations that can affect this sense of 'proprioception.' Let's look at a few of them:

• Alcohol intoxication: When you're drunk, you can't control your body, right? That's another example of this.
• Ataxia: This is a condition in which movements cannot be coordinated.
• Autism Spectrum Disorder (ASD)
• Joint-related injuries or diseases: For example, sprains, diseases like arthritis, and joint hypermobility syndrome.
• Joint replacement (Arthroplasty): When things like the hip or knee are replaced.
• Amputation: When an arm or leg is lost, such as in an accident.
• Neurodegenerative conditions: For example, multiple sclerosis (MS), Parkinson's disease, and Huntington's disease.
• Neuromuscular conditions: For example, 'Amyotrophic Lateral Sclerosis' (ALS), 'Muscular Dystrophy'.
• Peripheral Neuropathy: Damage to the peripheral nerves.
• Sensory Processing Disorders: For example, 'Dyspraxia', 'Postural Disorder', 'Sensory Under-Responsivity' (SUR).
• Traumatic Brain Injuries (TBIs) and Stroke.
• Vestibular disorders: For example, vertigo, Ménière's disease.

These conditions can cause proprioception problems that can be temporary or chronic .

How is "Proprioception" tested?

Doctors and sports therapists use several tests to assess different aspects of this 'proprioception' ability. Let's look at a few of them:

• Romberg test: This is a very simple physical test. It helps to find out if the dorsal column pathway in your brain and spinal cord, which controls proprioception, is working properly. In this test, you are asked to stand with your legs together and your arms either hanging down at your sides or folded across your chest. One part of the test is done with your eyes open, and the second part is done with your eyes closed. The doctor will observe you and look for any loss of balance, such as swaying.
• Heel-to-toe test / Tandem gait: In this test, the doctor asks you to walk in a straight line with the toes of your back leg touching the heel of your front leg as you take one step. It's like walking on a tightrope.
• Heel-to-shin test: In this test, you place the heel of one leg on top of the shin of the other leg, then move the heel down toward the foot in a straight line.
• Finger-to-nose test: The doctor will ask you to reach out and touch his finger, then touch your nose with the same hand/finger. You may need to do this several times.

Physical therapists and sports therapists may use specialized equipment to assess the 'proprioception' of specific joints. Some of these tests include:

• 'Threshold to detection of passive motion' (TTDPM)
• 'Joint position reproduction' (JPR) , also known as 'Joint position matching' .
• 'Active movement extent discrimination assessment' (AMEDA)

Are there exercises that can improve proprioception?

You may be an athlete looking to prevent injury or improve certain skills. Or you may have a medical condition that affects your sense of proprioception. For either of these, physical therapists can provide specific exercises to improve this sense.

Proprioception involves many body systems. In fact, every skeletal muscle and joint in our body contributes to it. Therefore, physical therapy exercises that improve proprioception target specific joints and muscles. They also help strengthen your sense of balance. For example, standing on one leg (one-legged balance), or walking in a straight line (like on a balance beam).

However, some proprioception problems may not be helped by physical therapy. For example, if you have permanent brain damage. If proprioception problems are affecting your daily activities, an occupational therapist can help you find new ways to do those activities.

Finally, things to remember

When we think of our senses, we often think of only the five senses: sight, smell, hearing, touch, and taste, right? But 'proprioception' is also a very important sense that makes life easier and more enjoyable. It's like our sixth sense.

Without effective proprioception, we wouldn't be able to easily do things like scratch our noses or ride a bicycle.

Many conditions and injuries can temporarily or permanently affect this important sense of proprioception. If you notice any changes in your balance or the way you perform physical activities, be sure to see a doctor to discuss it. They can perform a few simple tests to assess your proprioception. Remember, the sooner it's diagnosed, the easier it is to treat!

` Proprioception, kinesthesia, balance, body sensation, sixth sense, nervous system, movement coordination