Having a "healthy balance"

It's largely about proprioception! Proprioception- what’s that?

Each time you get into the car to drive, your body is able to comfortably sit down, operate the foot pedals, direct the steering wheel, switch on the indicators or wipers, speed the car up, slow it down, change gear (for the manual car drivers amongst us) all whilst keeping our eyes on the road in front.

How does our body to do all this so fluidly?

The answer proprioception. Proprioception is the ability to sense stimuli arising within the body regarding position, motion and equilibrium or in other words knowing what a part of your body is doing when you are not looking at it!

Try this activity

Sitting comfortably, close your eyes and raise both of your arms upwards to shoulder height. With one hand, reach to touch your nose with your index finger, then reach your hand back out. That ability to “know” where your hand was in relation to your nose and bring the finger to touch your nose without looking is what our body is designed to do.

This is proprioception.

So why is proprioception important?

Throughout our busy daily lives, we demand our bodies to split attention to many tasks (yes, men can multi task!) and carry these tasks out to a high and meaningful level. Car driving is one example, playing a musical instrument is another.

Also, think about how often you are walking along a street in town, carrying bags, talking on your phone, watching the other half and avoiding stumbling on the uneven pavements. But what happens if you do step onto one of those uneven surfaces? How does your body deal with it? How do you avoid ending up on the floor in a heap? This is where proprioception comes in!

As we place our foot on an uneven surface, (or as in the picture a painful surface), our body reacts immediately. As the foot's anticipated position is compromised, the proprioceptors around the small joints, and in the muscle fibres, detect a change to this plan.

This results in the sensory nerve (sensory neuron) sending a message up the spinal cord, via ascending pathways, to inform the brain (the control centre) of this sudden imbalance in the foot position, and subsequently its ability to take the body’s weight for balance.

The brain responds by sending a message back, via the reverse route, to inform the muscles surrounding the foot and leg to move and respond and place the foot in a different place or position, to maintain ability to stay upright. You might call this a reflex. We will blog more on this in the future, on righting reactions.

Great, so what is the problem?

The problem arises when our proprioception system becomes sluggish, and “out of practice”. In our day to day lives we have come to rely heavily on our vision to help tell our brain whether we are approaching uneven surfaces, and together with our vestibular system (the body’s spirit level), if we end up off balance.

This anticipation gives our body the heads up and we can prepare for any changes we need to make to our activity before we get there.

What is the problem with that?

The issue occurs when this anticipation is predominant. This is because the ability to detect and respond to those changes proprioceptively slows down. This in itself is not always a problem until there is a problem with one of the two other systems.

Anyone who has had the misfortune to experience an ear infection, labrynthitis, menieres disease or similar will know how difficult it can be to maintain balance when that “spirit level” is compromised. Similarly a change to vision and ability to see is equally limiting. Clinically one of the questions asked to people who have fallen is in relation to any changes in their vision or the environmental light.

This may be when in darkness. For example:

nipping to the toilet in the night without putting lights on ambulating outdoors in poorly lit areas,

Or when moving from extremes of light and dark. For example; opening the door to a bright sunny day and being dazzled. At these times our body cannot safely rely on our vision and requires the proprioception to jump into action to help protect the body.

So what can I do to make sure my proprioception is working?

There are several things that can be done to help if you notice a problem. Our body is great at re-awakening sluggish systems. If you have limited movement in joints or too much movement in lower limb joints, then this can affect proprioception. Increasing the range of movement can help, together with ensuring a good strength and control around the joint musculature.

Making sure muscles are working with both strength and reaction together, contribute to a system ready to respond to changes identified strongly and quickly. Re training balance can be key to proprioception limitations. Try being aware of challenging your body to undertake simple tasks without looking.

try brushing your teeth whilst your eyes are closed or whilst stood on one leg

try typing an email without looking at the keyboard

If you struggle it may be time to ask a physiotherapist to guide you further.

Accidents do happen and some as hard as we may try, are unavoidable. For those that can be avoided, prevention is often the key.