The Role of Proprioception in Idiopathic Scoliosis Our sense of proprioception is critical to maintaining proper posture

Those of us with scoliosis have issues with proprioception. This means we don’t accurately know where their body is in space. This simple test will show how good is your sense of proprioception. Close your eyes and try to touch your nose with your index finger.  Unlike normal people, those with scoliosis, are unable to correctly do this – will be off-center, at least an inch away.

Through an interplay of signals from our connective tissues, feet, vision, and our vestibular system we receive proprioceptive feedback. This is critical for motor control, proper balance, and posture.

Without accurate integration of proprioceptive inputs, one wouldn’t be able to do even simple activities like putting food in one’s mouth or be able to walk without watching. It goes without saying that the greater the skill required the better your sense of proprioception needs to be. Top athletes, dancers, musicians have a high level of proprioceptive acuity.

Impaired proprioception shows up as clumsiness, proneness to falls/accidents,  a lack of awareness of body position in space, odd body posturing, and of course scoliosis.

Proprioception Deficits In  Idiopathic Scoliosis
One-leg balance exercises help improve proprioception

Proprioception – The Body’s  Sixth Sense

Proprioception comes from a Latin word meaning unconscious perception of movement.

It is via proprioception, also called our sixth sense, you instinctively know where your body parts are, relative to other body parts. Sensory nerves, called proprioceptors in our joints, muscles, and fascia, communicate with the brain which then makes the required body adjustment is needed for movement.

The fascia which is our largest sense organ has 10 times more proprioceptors than muscle.

Sensory information is usually transmitted to the brain,  in a split second, beyond our conscious awareness.  However, this is not the case when there are proprioceptive deficits or when one has scoliosis. With the twisting of our spines, the myofascial tissue becomes taut and rigid which could lead to impaired transmission of nerve impulses.

Proprioception and Kinesthesia

Kinesthesia is another term that is often used interchangeably with proprioception. However, the big difference is that proprioception is concerned with position while kinesthesia is concerned with movement. Proprioception includes your sense of balance, while kinesthesia does not.

Proprioception is the result of sensory input throughout the body (skin, fascia, muscle, joint receptors), which then sends feedback to the spinal cord and brain.  Kinesthesia however is more behavioral in origin, and your body is more actively involved in assessing movement patterns and making adjustments.  In movement disciplines like yoga, tai chi, dancing, etc. we need both our proprioceptive sense and kinesthetic abilities to execute tasks.

You don’t consciously think about proprioception. It is the unconscious perception of movement and spatial orientation

While kinesthesia is more of conscious behavioral acclimatization. You learn how to dance/play golf through kinesthetic awareness. Muscle memory is a kinesthetic concept.

Knowing The Different Senses

  • Exteroception –  Perception of the environment via sight, hearing, smell, taste, and touch.
  • Interoception – The sense of our internal organs and feeling our emotions.
  • Proprioception – The sense of our body in the space around us
  • Vestibular – The sense of balance and spatial awareness when combining movement with balance.
  • Kinesthetic awareness  – refers to our ability to navigate space and the awareness of how we move. Kinesthetic awareness and proprioception work as partners to get us through the movements of our lives from the inside and the outside of the body.

We perceive the environment – exteroception, which causes bodily reactions- interoception, this, in turn, affects how our body adapts in that situation – proprioception and vestibular (balance) and how we can move through this situation with ease and agility – kinesthetic awareness.

From perception to making optimal choices is a dynamic process, a dance of our senses working in synchrony.

Kinesthetic Awareness and Self-Awareness

Kinesthetic/body awareness is critical in knowing how we feel. Attunement to these sensations is a building block of self-perception. Disconnection from our felt sense due to body armoring diminishes our ability to know who we are, what we want and need. This results in difficulty in traversing through life. We are constantly filled with anxiety and self-doubt.

In order to feel grounded and emotionally regulated, we need to cultivate the skill of self-observation and tune into our visceral bodily sensations or interoception.

According to the podiatrist and human movement specialist, Dr. Emily Splitchal:

Emotional awareness is the dance between proprioception and interoception

We represent our body from within with interoception. By contrast, we represent how our body is relating to the outside world – through proprioception.

 Proprioceptive Deficits Causes Scoliosis? Or…

Here again, it is the chicken-egg dilemma. Do proprioceptive deficits cause scoliosis? Or is it scoliosis causing impaired proprioception?

At least, in my case, it is the former – I used to be quite agile and nimble-footed right up to age 11,  the time my mother. I remember regularly running along a narrow wall without thinking or even once falling down.

However, I slowly became a klutz whenever I was in the kitchen helping out. Was it because my violent father was always dictatorially ordering me around.

As I theorize, my slow degradation into my scoliotic stance, occurred as a result of being chronically in a defensive armored state. It slowly shut down my body’s natural ability to feel alive and act with spontaneity. I was constantly gauging the situation so as not to incur my father’s wrath.

Armoring Affects Interoception and Proprioception

Having to shut down emotionally affected my sense of interoception – my body’s internal feeling system. This in turn affected my proprioception. Both interoception and proprioception are two sides of one coin. We need to truly feel to accurately respond to the world.

Armoring is a chronic pattern of involuntary body tension. It helps us cope by dampening or blocking emotional feelings. To protect itself from a perceived threat, the body takes a defensive stance – tight and tense, bracing for danger.

Body armoring inhibits the functioning of the somatic-visceral feedback loop. It disconnects different parts of the body from awareness. Shutting off emotionally invariably shuts off awareness of our body. We feel numb and frozen. This in turn affects how we move and interact with the world around us.

One point to keep in mind though,  the body doesn’t differentiate between bracing for a car accident, a hurtful word from our parents, or the abandonment of our caretakers as children. All feel dangerous and our body reacts accordingly.

Armoring as a defense response happens involuntarily and most often outside awareness.

Body Schema

Body schema is a type of integrated internal brain map of how we perceive the world in relation to our body. Our brain is constantly updating through exteroceptive, interoceptive, proprioceptive signals in order to preserve a kind of internal homeostasis.

We humans need internal models for anticipating/predicting interaction with external environments/situations. That is why living in an inconsistent toxic environment can be so damaging to forming an integrated sense of self.  Our brain is unable to form a coherent map viz the unreliable world.

Scoliosis and Faulty Body Schema

Growing up feeling unsafe physically or emotionally keeps the fascia in a state of impeded constriction. It is not allowed to relax and stretch.

When our emotional brain is stuck in a hypervigilant state while our cognitive brain goes about daily life there is a structural dissociation in our personality. The right brain is stuck in the past while the left brain struggles to operate in the present. Our conscious mind tries its best to stay upright the unconscious part pulls us down. Over time, the muscles and fascia act like a vice to twist and pull the spine in a distorted manner.

Our body adapts, it perceives the body position as straight even when it is already slightly off-center. Our body adjusts to the change in our internal representation. That becomes our new body schema – the sensorimotor brain map has adapted to our environment.

And unless one can alter the internal body perception, correcting scoliosis will be limited.

Changing our body schema requires working on our interoceptive and proprioceptive awareness. Learning to process and release our stuck emotions while concurrently working on our physical selves.

Improving Proprioception

The bottom-up approach of starting with our bodies is the best way to help our dysregulated system become more regulated. Studies have shown that activities rich in proprioceptive sensory input quickly change how we feel in our bodies. Furthermore, our movement, posture, balance improves.

Improving proprioception helps us become more aware and truly embodied in our psyche. It also helps mitigate the distortions created by trauma.

Below are the numerous ways one can sharpen our proprioceptive sense:

1) Juggling trains reaction time, spatial location, and efficient movement.

2) Standing on a wobble ball or balance board increases proprioception abilities.

3) Slacklining and tightrope walking improve balance and proprioception.

4) Walking in the dark /blindfolded, walking backward.

5) Standing on one leg (stork standing) and similar body-position challenges in yoga, martial arts, and tai chi improve proprioception and neuromuscular control. Regularly practicing the horse stance has helped me improve my reflexes.

6) Spinning, twirling, and even simply swinging helps enhance the vestibular system which is key to proprioception.

7)  Exercise ball, workout also helps in strengthening  the abdominal and back muscles

8) Stimulating the soles of the feet with a plastic fork or standing on an acupressure mat or wearing special proprioception insoles. (Please note I have not used this product so cannot vouch for its efficacy) helps too.

Below is one simple foot exercise which will help improve proprioception.

 Proprioception Balance Challenge

Changing How We Feel From Inside Out

Changing scoliotic body patterns requires that we change faulty sensory messages. Improving our proprioception is an effective way to tune up the mind-body continuum.

Proprioceptive exercises help improve balance, coordination, postural stability.  Just a minute or two every 2-hours is better than a 20-minute workout done every alternate day. The science of neuroplasticity indicates that tiny intervals of repetition are what rewire the brain and change it.

Secondly, the brain thrives on novelty, slight movement variations are also good for proprioception. Challenge your body to move in non-familiar movement patterns and non-linear planes. Doing things differently helps keep our thoughts focused on doing the action. Instead of our thoughts running amuck while doing mindless repetitive action.

Our mind-body is one interconnected looping system. Improving proprioception changes how we feel in our bodies. This in turn affects our thought patterns which influences how we hold ourselves, head held high or downcast,  defensive or assertive.

Image Source: Pixabay

Ref: Do Adolescent Idiopathic Scoliosis (AIS) Neglect Proprioceptive Information in Sensory Integration of Postural Control?
Scoliosis and Proprioception
Proprioception revisited: where do we stand?
The Bodily Senses

Further Reading:

Body Mind Movement -Jennifer Pilotti

Biological Learning and Control: How the Brain Builds Representations, Predicts Events and Makes Decisions – Reza Shadmehr and Sandro Mussa-Ivald

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