By Kerry Glendon, Clinical Specialist at Perform at St. George’s Park
Proprioception is the ability of your body to know where your limbs are in space. This is achieved by a complex system of nerves feeding back information and the nervous system controlling how the body responds to these messages. Proprioception assists with joint stability, postural control and motor control. It is split into three entities: your body knowing what position your limbs are in, the ability of your body to detect movement and the ability for it to sense force. If these three mechanisms do not work in unison, the correct balance of muscle contraction around a joint or body area results in the joint or limb not having the correct amount of support or control. This increases the risk of injury.
There are small monitors in the muscles, ligaments and joint capsules, which send messages or impulses along the nerve back to the brain. These monitors are called mechanoreceptors. If the muscle is stretched the mechanoreceptor generates an impulse which is sent along the nerve to the spinal cord, and then on to the brain. The spinal cord, brain and other areas within the brain are called the central nervous system. When the impulses arrive at the central nervous system, they’re compared to what our other senses are telling the nervous system. This complex system then integrates these impulses and sends an impulse or message back down the nerve to tell the muscles what to do. If the impulses travelling to or from the muscles are not a true representation of what position the joint or limb is in or what forces are acting on the area, this could cause the wrong muscles to be contracted.
The shoulder complex is comprised of three joints, the arm bone connecting to the shoulder blade (glenohumeral joint), the collar bone connecting to the shoulder blade (acromioclavicular joint) and the collar bone connecting to the chest bone (sternoclavicular joint). The only bone to bone joint that connects our arm to the body is the collar bone attaching to the chest bone. The shoulder blade is surrounded by muscle which keeps the shoulder blade firmly fixed to the chest wall. The socket for the arm bone to fit into is very flat and small, this allows a lot of movement but this means the muscles surrounding the shoulder are more responsible for controlling the movement.
If messages from the nerves around the shoulder do not give an accurate account of what position the joint is in or the amount or direction of force that is acting on the joint, the shoulder is at risk of injury. Common injuries seen at the shoulder are dislocations, tendon impingement and rotator cuff injuries. Furthermore, long standing pain or shoulder problems can make the proprioception in the area worse. But, exercises to improve proprioception can reverse this issue. In the lower limbs this is done by practising your balance. For the shoulder, this is done by weight bearing through the joint and improving the control of the muscles surrounding the joint, particularly the rotator cuff.
Here at St. George’s Park we have clinicians who are experienced in treating shoulder and upper limb pain. Call 01283 576333 to discuss how we can assess and treat shoulder injuries, or to book an appointment.