Proprioception: What It Is, Problems, Diagnosis, Treatment & More

Proprioception is basically a continuous loop of feedback between sensory receptors throughout your body and your nervous system.

Sensory receptors are located on your skin, joints, and muscles. When we move, our brain senses the effort, force, and heaviness of our actions and positions and responds accordingly.

Normal proprioception lets you move freely without giving your movements a second thought. Abnormal proprioception causes symptoms that can interfere with even the simplest activities.

what to watch out for

A proprioception disorder or injury could cause a number of signs and symptoms, including:

• balance issues, such as having trouble standing on one foot or frequent falls while walking or sitting
• uncoordinated movement, such as not being able to walk in a straight line
• clumsiness, such as dropping or bumping into things
• poor postural control, such as slouching or having to place extra weight on a table for balance while sitting
• trouble recognizing your own strength, such as pressing on a pen too hard when writing or not being able to gauge the force needed to pick something up
• avoiding certain movements or activities, such as climbing stairs or walking on uneven surfaces because of a fear of falling

Proprioception dysfunction can be caused by injuries and disorders that affect any part of the proprioceptive system between the sensory receptors that send the signals to the parts of the brain that receive and interpret them.

The risk of proprioception loss increases as we age due to a combination of natural age-related changes to the nerves, joints, and muscles.

Examples of injuries and conditions that can cause proprioceptive deficit include:

• brain injuries
• herniated disc
• arthritis
• multiple sclerosis (MS)
• stroke
• autism spectrum disorder (ASD)
• diabetes
• peripheral neuropathy
• Parkinson's disease
• Huntington's disease
• ALS (amyotrophic lateral sclerosis), or Lou Gehrig's disease
• joint injuries, such as an ankle sprain or knee sprain
• joint replacement surgery, such as hip replacement or knee replacement
• Parkinson's disease

If you have symptoms of proprioception disorder, such as balance issues or a lack of coordination, your doctor will ask about your medical history, including any preexisting medical conditions and recent injuries or surgeries.

A healthcare professional, such as a doctor, physical therapist, or occupational therapist, will perform an examination, including a neurological exam. They may also use one or more proprioception tests. The type of test used will depend on the area of the body affected.

Some proprioception tests include:

• Romberg test. This is the most commonly used diagnostic test for proprioceptive abnormalities. To do the test, you stand unsupported for 30 seconds with your heels together and your eyes closed. If you lose your balance during that time, it's considered a positive result.
• Field sobriety test. This may involve one or a series of tests often used by police officers to evaluate suspected drunk drivers. One such test involves closing your eyes and touching your nose with each of your index fingers. The standardized field sobriety test (SFST) is a battery of three tests. It includes the horizontal gaze nystagmus (HGN) test, which involves following a slowly moving pen or other object with your eyes; the walk-and-turn (WAT) test, in which you walk a few steps in a straight line with one foot in front of the other; and the one leg stand (OLS) test, which is simply standing with one foot raised off the floor.
• Thumb finding test. For this test, the tester will place one of your hands in a certain position. Then, you'll be asked to touch the placed thumb with your other thumb and forefinger while your eyes are shut.
• Sequential finger touching. This test is often used on children and adults. To perform the test, touch each of your fingers to your thumb, starting with your forefinger.
• Distal proprioception test. The tester will hold the sides of your big toe and perform up and down movements while you watch. You then have to repeat the same movement with your eyes closed.

A physical therapist can assess proprioception with special equipment that controls and measures movements of other body parts, such as your arms, back, legs, and feet.

Your doctor may order other diagnostic tests if an underlying medical condition or injury is suspected. These may include one or more of the following:

• blood tests
• X-rays
• CT scan or MRI scan
• electromyography
• nerve conduction velocity

Proprioception treatment depends on the underlying cause, and it may require treating a medical condition or injury.

Along with treating any underlying condition, successful proprioception treatment also involves other therapies and exercises to help gain strength and improve balance and coordination.

There's evidence that proprioception training can also be used as a preventive measure to reduce the risk of injuries, such as sprains.

Treatments options include:

• physical therapy, which can be catered to any underlying injury or condition and involves activities to improve motor skills, strength, and balance
• occupational therapy to learn how to manage daily tasks while living with proprioception dysfunction
• somatosensory stimulation training, such as vibration therapy
• exercises, such as balance exercises
• tai chi, which improves lower limb proprioception, according to recent research
• yoga, which improves balance and muscle strength

Proprioceptive training has been shown to be effective in treating proprioception caused by a number of conditions and injuries. Results vary from person to person, depending on a variety factors, such as the cause, your age, and overall health.

See your doctor if you're worried that you have abnormal proprioception. Your doctor can work with you to develop a treatment plan best suited to your situation.

Proprioception plays a role in every move you make, from walking to eating. Your doctor may perform tests to help determine if you have an abnormality. Proprioception training can help you improve your motor skills, muscle strength, and balance.