Proprioception

Proprioception is defined as the body’s ability to sense stimuli with regard to position, motion and equilibrium. It is the sense of the orientation of one’s limbs in space; the ability to know where a body part is without looking at it.  Therefore, the body is able to sense the position of its parts, analyze it, and react with proper movement. Without proprioception, we would have to constantly watch our feet while we were walking.

Balance and proprioception are not the same things. The sense of balance originates from the fluids in the inner ear. Proprioception is provided by proprioceptors, which are sensory receptors. These nerves are located inside the body and transmit information from the muscles, joints, tendons and skin to the central nervous system.

Proprioceptors control balance, coordination and agility, and by training proprioception, we can improve balance, coordination and agility. Balance is a basic skill needed in practically every activity.  The key to efficiency is changing your center of gravity to match your moves. Agility is what allows us to move gracefully without wasting motion.  It allows our joints to move through the full range of motion smoothly and confidently. Proprioception also reduces the risk of injury. For example, ankle sprains are a fairly commonly injury for athletes.  These are often caused by a lack of balance or proprioception.  Even if a runner has strong lower limbs and good endurance and flexibility, slight deviations in the terrain during running require adjustments in balance. If the athlete has not trained the neuromuscular system to react appropriately when running on uneven ground or when they have a misstep, they may be injured.

Just like any other motor activity, proprioceptive ability can be trained. Any new motor skill that involves precise movement of our arms and legs– from baseball to painting to skiing – involves training our proprioceptive sense. And just like any new skill or exercise, it requires a progression during training. Start with simple exercises and make them more complex as the individual improves.

Proprioception can be tested by standing on one leg for 30 seconds with both eyes open and then standing on one leg with both eyes closed. Beginners should start with static balance activities and advance to agility and coordination activities. Balance exercises should start on the floor and progress to unstable surfaces, such as stability trainers or wobble boards. On the stability trainer, you can perform lunges, mini-squats, etc and progress to using a resistance band and then further progress to one leg. Wobble boards are good for static balance training and can be made more difficult by using a weighted ball. Be sure to exercise caution when using unstable surfaces.

After mastering balance, you can move on to more advanced proprioception for agility and coordination. Activities used to improve agility and coordination including pivoting, twisting, jumping and cutting. Progress jumping from two legs to one leg.

It is important to use correct technique when performing proprioceptive exercises. Reduce the intensity or level of activity if you cannot perform the exercise with proper technique. In order to reduce the risk of injury, perform these exercises before you are too fatigued. It is important to consider age and body weight when engaging in proprioceptive exercises. Performed correctly, this type of core stabilization or stability training is an invaluable tool to enhance overall fitness.

Exercise As You Age

As we get older, we are finding it harder to adhere to a healthy, active lifestyle. This is especially true for those in Corporate America . Anyone, from the receptionist answering phones to the CEO closing 7 figure deals, can have terrible eating habits, less time to exercise, and more stress than they are meant to endure. These environmental stresses speed up the aging process and contribute to the deterioration of the body. Throw in a crazy travel schedule and bad sleeping habits, and you have your average American. It is because of these stressors that 1 in 3 Americans is considered obese and struggles with weight issues.

Our lack of activity is actually killing us, and the older we get the more important exercise becomes. So, why do people refuse to exercise? There are too many reasons to list, but often I hear, “I don’t know where to start.”  In a sea of misinformation and in an unregulated fitness industry, it is almost impossible to know where to begin. The gym can be a dangerous place if you do not know how to use the equipment or where to begin. As an expert witness, I have seen improper form and misuse of equipment that leaves me speechless. My advice to those confused about what to do is to start by finding a reputable professional, who has an accredited certification and who can list doctors as references.

Recovering from injury can take longer as we get older. For this reason, err on the side of caution when starting a program. Regardless of age the most common injuries occur in the lower back and shoulders. Very often, these injuries are simply a result of poor exercise form or performing the wrong exercise. Starting out at a high intensity and doing complex exercises may seem like the best avenue for fast results, but more often than not, it results in injury. It is crucial to take a person’s daily activities and orthopedic issues into account before prescribing exercise. For example, if you sit all day and have lower back pain or discomfort, sit-ups and leg raises may actually make your condition worse. Planks, chops and deadbugs are safer and more effective exercises for the core. In addition, some machines are not designed properly and can contribute to injury. For instance, some seated leg presses can stress the lower back and cause pain and/or injury. For the lower body, it is safer to start with a ball squat or step-up instead of using a machine, so as not to disrupt natural movement patterns.

As we age, we lose muscle mass and flexibility and our overall balance degrades. Posture is a major problem, especially for those in Corporate America, because they sit for so many hours, often without taking a break.  It is important to create a solid foundation for an active lifestyle and focus on exercises that attain personal goals. Performing balance exercises, stretching and correcting postural distortions are critical to participation in daily activities. Without these exercises, the likelihood of daily pain and injury is markedly increased. Stretching and core strengthening will eliminate most of common everyday aches and pains.

Balance, mobility, postural training, and circuit training with weights at a 50-60% intensity are a great start for the older, sedentary population. It might sound easy but if you haven’t been exercising for a long time, it will be very challenging. It is important to remember that we are all individuals with different strength and weaknesses, so what may be easy for one person may be impossible for another person. Do not just copy exercises that surround you in the gym! Remember that you are a unique individual and your workout needs to be tailored to your specific needs. A majority of older clients who were not athletes or workout buffs in their youth have no interest in looking like a fitness model or a bulging Adonis on the beach. They just want to feel better and live longer. More than half the battle is the training consistency, not the training intensity. If a client does a low to moderate level workout and follows a fairly healthy diet, he/she will feel better and have health benefits, even if he/she is only exercising a couple of days per week. The bottom line is that some exercise is better than no exercise.

I have worked with many older clients. In fact, my oldest client was 90 years old. In my experience, I found that many exercise programs do not include enough flexibility training and intensity is often too high. Many professionals believe that you must train at a high intensity to get any substantial results. There is plenty of reputable research that shows higher levels of intensity can be a better use of time compared to low to moderate levels of exercise. The majority of these professionals will insist that regardless of your age, you need to build your workouts up to intensities beyond 80-90%. While there is truth to the science behind this theory, the experts fail to explain that working out at lower levels is still extremely beneficial. They don’t take into account that at higher intensities, not only is injury risk is increased but a majority of older individuals are not interested in exercising at that level. As a result, they will never stick to that sort of program. Others cannot train at that level because of orthopedic injuries or some other health limitations. If a client’s goal is to eliminate back pain, to increase balance and to be able to play with their grandchildren, plyometrics and intense sprinting is probably unnecessary. They will get more benefit from full body circuit training with active rests and with sets that include therapeutic exercises and stretching. When we look long-term, consistency is king because the most consistent person regardless of intensity will reap the most rewards of exercise.

The fact is low to moderate intensity workouts will produce significant results and keep your client healthy and pain free. If a person is capable of more and wants to work up to a high intensity program, I am not against it and agree that it works for some people. I believe the average person does not have an athletic history and is frequently deconditioned. In my personal experience, it seems that the people who need low intensity exercise the most often believe it is a waste of time to work out if they aren’t “dying” during a workout, and therefore they won’t engage in lower intensity training. The truth is that most Americans just need to move and do low-level exercises to remove stress and to keep them healthy.  For some people, exercise is a stress outlet, it helps them stay healthy, and it keeps their eating habits on track.  Lower intensity exercise is also important for those who need to recover from their active lifestyle. For example, clients playing 2 hrs. per day 4-5 times per week or those who are avid runners training 25 miles per week should focus their training on flexibility, recovery and exercising when they are in the gym. The goal should be to increase efficiency and to increase the longevity of participation in that activity.

My advice it to focus on the fundamentals and to get the client moving better and feeling good. Once you achieve this, then you and the client can decide what is next. Individualize the workouts and encourage them to meet their individual goals. Start with a solid foundation, and if high intensity is their goal, gradually build up to those type of workouts at a pace that works for the client physically and mentally.

How To Do A Step-Up

Emphasis – The concentric action is hip and knee extension. The primary muscles used during hip extension are the gluteus maximus  and hamstrings (semimembranosus, semitendinosus, and biceps femoris). During knee extension is quadriceps (vastus lateralis, vastus intermedius, vastus medialis and rectus femoris).

Starting Position – Begin the upward movement by stepping up with one leg. Keep trailing foot at start position and shift weight to the leg on the box. As the hip and knee extend on the box stand tall while simultaneously bring the opposite foot next to the starting foot.  The downward movement starts with shifting the body weight to the same start leg and stepping off the box with the opposite leg. Shift the body to the the opposite leg and the start leg will follow to starting position.

Movement:

Training Tips:

  • Keep torso erect and parallel to the tibia
  • Initial contact of lead foot with top of the box must be made by the entire foot
  • During upward extension push through the heels and squeeze the glutes
  • Maintain hip flexion, knee flexion, and dorsiflexion of ankle at top of movement

Warning Tips:  Do not allow the heel to hang off the edge of the box

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