What is Proprioception?
Hands up, who's rolled the same ankle more than once? Why is it that? Obviously one of the main reasons is that certain structures have been weakened, such as ligaments and tendons...but alongside that is the damage to nerve endings and this is why re-injury can occur.
Proprioception is essentially a "feedback loop"; the nerve endings and nerve pathways originating from the joints, muscles, tendons and ligaments are processed as nerve impulses to provide information about joint position, motion, vibration and pressure to the brain and then the brain sends back information to the body part to tell it where it is in space.
When these pathways are damaged
it can result in impaired balance, decreased coordination and diminished joint position sense.
Without the appropriate integration of proprioceptive input, an artist would not be able to brush paint onto a canvas without looking at the hand as it moved the brush over the canvas; it would be impossible to drive a car because a motorist would not be able to steer or use the foot pedals while looking at the road ahead; a person could not touch type or perform ballet; and people would not even be able to walk without watching where they put their feet.
A simple test, for example, is the sobriety test in which people are asked to touch their finger to their nose with their eyes closed. Normally you should expect a error of no more that 20mm. People suffering from impaired proprioception (a symptom of moderate to severe alcohol intoxication) fail this test due to difficulty locating their limbs in space in relation to their nose.
So you can see why proprioceptive exercises should begin as early as possible in the rehab program. These exercises are not stressful to the healing tissues and enhance general coordination as well as facilitating the effectiveness of the strength and endurance exercises.
As soon as you are weight bearing you are gaining proprioceptive input, and a common Stage 1 exercise for lower limb injury is to stand on one foot. Progressions can be made gradually such as balancing with eyes closed, then adding in movement such as raising up onto toes.
Other exercises you may be familiar with are wobbleboards...this adds a degree of instability which works the nervous system a little harder.
Consistency is key with proprioceptive exercises, daily exercises can make a huge difference to your rehab.
Massage can, of course, aid the recovery of soft tissue injuries by increasing blood flow to the injury site which can speed up the healing process. Check with your therapist when this is appropriate for you.
References: Clinical Sports Medicine 3rd Edition; Brukner and Khan, & Wikipedia
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