Proprioception training – reduces injury risk 

There is an increasing amount of evidence that show proprioception to improve athletic strength, co-ordination, muscular balance and muscle reaction times. Proprioception is highly linked to improved recovery from injury as well as preventing injury.

 As you carry out overall muscular activity the range of motion at your joints, and posture are all products of your sensory nerve activity which is received, coded and acted upon by your brain and spinal cord.

 Here are some links to some great research studies that show proprioception training to improve sensory feedback and reduce injury;

 1) http://www.sportsinjurybulletin.com/archive/proprioceptive-training.htm - “proprioceptive exercises training programme”

2) http://sportsinjurybulletin.com/archive/proprioceptive-exercises.html - proprioceptive training and injury prevention”

3) http://www.bodyblade.com/index.cfm?pages=articles_Oscillatory

4) http://www.brucebrownlee.com/coaching/fitness/proprioceptiontraining.htm

5) http://www.pponline.co.uk/encyc/rotator-cuff-rehab.html

Many injuries in sport occur due to instability around the joint and loss of proprioceptive feedback. This can be caused by previous injury, muscle imbalance/weakness, which can lead to poor posture control, poor balance, and altered perception etc.

 Brief description of sensory systems

The somatosensory system can detect touch, pressure, pain and joint motion and position. Physical actions are picked up by mechanoreceptors, by sensing muscle length and tension. The visual system provides visual clues for use as reference points in orienting the body in space. The vestibular system picks up information to help with maintaining overall body posture and balance. The visual system also helps in balance this can be tested by standing on one leg with yours eyes open and then closed. Many will loose balance as by closing your eyes you are loosing your reference points of your surroundings

 When injury occurs damage is not just to the ligament or muscle but to the mechanoreceptors if you train to be stronger and faster, then it makes sense to enhance your joint-position sense, balance co-ordination, muscle reaction times and overall muscle strength.   

Proprioception can be put in any body’s programme starting easy from just standing with eyes open and then closed, moving on to one leg balances, uneven surfaces. Lower body proprioception has been shown to reduce ankle sprains, knee injuries (ACL, dislocation) it is also important to include upper body proprioception.

 As with all training it is important to add challenge in to your programme. It’s not much point having a workout that is too easy. Proprioception training can make strength training more challenging. An example would be taking a normal squat, progress this to a one leg squat; this will then strengthen your lateral stabilisers as well as quads and hamstrings. The one leg squat brings in balance. To challenge this further you can swing the other leg, stand on an uneven surface, make it a plyometric hop, this is particularly beneficial for tennis players to improve dynamic balance, and you can hop in different directions to make it more sport specific.

 The ankle joint is open to inversion and eversion sprains, the foot has to be able to detect what is under foot and react quickly to changes. Orthotics has become the norm for many athletes to control the position of the ankle particularly when stressed in running. The higher the impact the higher the chances of the ankle rolling on to the outside or inside of the foot. Orthotics and the design of trainers may reduce symptoms of pain but it is equally important to strengthen the foot mechanics to cope with change. Trainers tend to allow the foot muscles to become lazy and slow to react. Orthotics can help to re train the muscles to bring about a good posture; proprioception can help keep the improvements.

 The shoulder .is very complex as it allows a large amount of movement in many directions. Poor mechanics and posture are very common and cause adverse strain and stresses on the scapula and rotator cuff muscles. Again the loss of joint sense leaves it open to injury. The Bodyblade and Swiss ball are great ways of training the shoulder. Instead of a normal push up why not try this on the Swiss ball. It’s important to start off with easy exercises and progressing to more dynamic exercises when ready. As you build the difficulty you will notice your strength improving. http://www.sportex.net/newsite/common/mainframe.asp - Shoulder Instability - Part 3,by Jo Gibson, MCSP,Treatment and rehabilitation of shoulder instability

When injury occurs it is important to begin proprioceptive exercises as early as possible into the rehabilitation programme. Proprioceptive exercises are not stressful to the healing tissue and enhance general co-ordination as well as facilitating the effectiveness of the strength and endurance exercises.

Below is a lower limb proprioception programme which would go along with your injury exercises.

It is taken from Brukner and Khan, clinical sports medicine 2002, page 175.