CMC Balance and Proprioception

Ever tried to walk through a doorway and end up clipping your arm on the door? This is due to adysfunction in one of our bodily senses known as proprioception. Proprioception can be described as a “bubble of awareness” around your body. This sense is what allows you to perform 3D movements without constant banging into objects. It relays your body’s position, movement, surface stability, and many other sensations to your brain. It is similar to your awareness of where your car is while backing up or parking.

Our overall sense of proprioception can decrease from not being active, disease, and naturallyas we age. While just bumping your arm on a door frame isn’t too serious, further loss of this sense can lead to falls or other accidents. Each year 3 million older Americans are treated inemergency departments for injuries resulting from a fall 1. A fall even from ground level caneasily result in fractures or concussions which can progress into more serious conditions.

As our sense of proprioception becomes impaired we will commonly compensate by becoming over reliant on our vision. This will help with your bodily awareness, however, this is not aseffective in low-light situations or when you are unable to look down at your feet (such ascarrying bulky objects). It is important to incorporate balance training with eyes closed tominimize this compensation.

With some simple exercises, this sense of proprioception and your balance can be improved and maintained. Doing so will not help to prevent falls, but can improve your ability to performdaily tasks such as walking on uneven surfaces or carrying in groceries.

Below are some examples of exercises that can help with balance and proprioception. When performing any balance exercises it is important to have something sturdy nearby to use for support if needed. Try and use your arms as little as possible while performing to really challenge the muscles in your feet and ankles.

Single Leg Stance

Single leg stance is one of our most used balance exercises. While you are walking there is astage where your entire weight is supported by one leg alone. Insufficient balance in this phase combined with momentum or unstable footing can easily result in a fall. Pivoting or stepping in adifferent direction also relies on single leg stability.

To perform a single leg stance, first find a stable object to use for support. Next, stand with feet about shoulder width apart, and lift one leg enough to clear the ground.

Don’t let your free foot touch the other leg, doing so will help your body stabilize. Try and holdthis position for as long as possible for a 30 second duration. Use your arms as needed throughout, but try and do so as little as you can.

Rhomberg Stance

As our proprioception becomes impaired one common compensation is to become over relianton our eyes. To combat this, it is important to practice balance exercises with your eyes closedto more accurately challenge the systems for balance and proprioception. The Rhombergstance is a good exercise to use for this as it is safe to perform, but still challenging.

Start by standing with both feet together, and posture upright. Keep your hands either at yourside or crossed across your chest, depending on how much support you need. Try and hold thisstance as long as possible over a 30 second duration. Next try with your eyes closed for anadditional challenge. You will likely feel yourself sway during, this is your body balancing and isnormal.

Tandem Stance

Decreasing your base of support will put more demand on the stabilizer muscles in your anklesto stay balanced. Start with a feet slightly offset from each other and slightly apart. Bring yourfeet closer together and more in line with each other to further challenge your ankles. Alternatewhich foot is in front, and which is behind.

Once you become comfortable with performing this with eyes open, progress to eyes closed.Start with a wider stance again, and then slowly make your stance more narrow as you improve.

Try to hold this position for 30 seconds at a time, 2-3 times with each leg in front.

These exercises are only a few examples of many. Find more exercises that you can safelycomplete, and are challenging to keep progressing your balance. Like with strength training,consistency is key. Performing exercises only 3-4 times per week can help to improve yourbalance, and reduce your fall risk.