Proprioception is a sense that we often overlook because it is only subtly distinguished from movement. And, unlike sight or hearing or taste, we rarely experience the absence of proprioception (dead arm being a rare exception). Yet, a total loss of proprioception might be even more devastating than going blind or deaf. Without sensory information coming in from our muscles, we would be unable to monitor and correct our paths of motion. Imagine trying to walk, gesture, or eat if you had no sense of where your limbs were without looking at them.
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In humans, it is provided by proprioceptors (muscle spindles) in skeletal striated muscles and tendons (Golgi tendon organ) and the fibrous capsules in joints. It is distinguished from exteroception, by which one perceives the outside world, and interoception, by which one perceives pain, hunger, etc., and the movement of internal organs.
How Does Proprioception Work?
Proprioception is guided by receptors in the body (skin, muscles, joints) that connect with the brain through the nervous system so that even without sight, a person knows what his or her body is doing. Vision plays a key role in the ability to sense one’s body in space. However, vision is not necessary for a person to understand body ownership. Only proprioception is necessary for the development of body awareness and may already be present in newborns.
Like most physiological processes, proprioception can be improved with challenging practice, and can also be impaired by disease or disuse. A concert pianist can play incredibly complex music with their eyes closed because they have trained the proprioceptive sense of their fingers to be precise enough for the task. If that same concert pianist tried to play a piece they have never seen before, they would have to look at their hands to master a complicated section.
By contrast, patients who suffer from stroke often have difficulty with balance and coordination during their recovery. Proprioception is also impaired by diseases or injuries affecting the musculoskeletal system, like an ankle sprain or diabetic neuropathy. Patients suffering from these types of conditions are predisposed to falls and repeat injuries, which compounds problems. For this reason, physical therapists can work with patients on proprioceptive training to help gain a stronger position sense.
Training usually consists of working on uneven or irregular surfaces, and balancing on affected joints with a blindfold to remove visual confirmation. Although these exercises are demanding, patients can usually see functional benefits within a few weeks.
This ability enables us to know where our limbs are in space without having to look. It is important in all everyday movements but especially so in complicated sporting movements, where precise coordination is essential.