Understanding Proprioception: The Secret Sense for Balance and Fall Prevention
Essential Points
Your brain integrates information from three main balance systems—vestibular, visual, and somatosensory—to maintain stability and coordination.
Each sensor provides unique feedback that your brain interprets, helping you adapt to different environments and movements.
Understanding how these systems work together can enhance your ability to train and improve balance, leading to better fall prevention and athletic performance.
Imagine this: It’s early on Saturday morning, you’re walking through a dark room, balancing your favorite mug of coffee while trying to avoid stepping on the clutter you know is there but can’t see. How are you able to navigate through the room, even with limited visibility? This ability, to know where your body is without looking, is thanks to a “hidden” sense called proprioception.
Proprioception is what allows us to control our movements with precision and coordination, helping us stand, walk, balance, and even prevent falls. In this article, we’ll take a deep dive into what proprioception is, explore how it works within the body, and discuss why it’s especially important as we age. Plus, we’ll cover practical ways to train proprioception to improve balance and prevent falls. Before we begin, it’s important to note that proprioception is an important, but smaller part, of a larger system called the somatosensory system.
What is Proprioception?
At its core, proprioception is your body’s ability to sense its own position, movement, and alignment in space. (1) Often described as the “sixth sense,” proprioception helps you know where each part of your body is without needing to look.
Imagine these everyday examples:
Closing your eyes and touching your nose.
Walking down a flight of stairs without constantly watching your feet.
Adjusting your posture while sitting to avoid slouching.
Watching athletes on TV performing high level skills without looking at their body
These actions might seem automatic, but they rely on a complex sensory network that enables you to “feel” your way through space. Proprioception is essential for every movement we make, from the tiniest twitch to an intricate dance. And here’s the thing, we all use proprioception no matter your level of balance or athletic skill. Proprioception is a critical component of daily life and becomes even more important as we age just to function normally.
Key Players in the Proprioceptive System
Proprioception relies on sensory receptors known as proprioceptors. (1, 2) These receptors are located throughout your muscles, tendons, and joints and work as the body’s internal GPS, constantly sending information to your brain about where your limbs are and how they’re moving.
Here’s a quick breakdown of the main types of proprioceptors:
Muscle Spindles: Located in the muscle fibers, these receptors sense changes in muscle length and help regulate muscle contraction to control movement.
Golgi Tendon Organs: Found at the junction where muscles and tendons meet, these receptors detect tension and help prevent muscle strain by signaling the brain to relax if too much force is applied.
Joint Receptors: These receptors are located in the joint capsules and ligaments, helping to detect joint position and movement.
Now that you understand the sensors involved, let’s explore how your brain processes this information to keep you balanced.
Proprioception and the Nervous System
The signals from these proprioceptors travel through the peripheral nervous system (nerves outside of your spinal cord) to the central nervous system (your brain and spinal cord). (1) This process happens so quickly that you don’t even notice it. Your brain integrates these signals and then tells your muscles what to do to maintain balance and coordination.
The cerebellum is a key player in processing proprioceptive information. (3, 4, 5) It fine-tunes movement, ensuring your motions are accurate and well-timed. By integrating signals from the proprioceptors, the cerebellum adjusts your body's position on the fly, allowing you to maintain balance even if you stumble. Additionally, the somatosensory cortex, located in the brain’s parietal lobe, acts like a command center. (6, 7) It receives and interprets detailed information from your proprioceptors, helping you understand where each limb is in space and what adjustments are necessary. This neural integration is crucial for the coordinated actions that allow you to navigate the world smoothly, without conscious thought.
Dive deeper on the cerebellum and parietal lobe in balance here.
Proprioception’s Place in Balance
Now, you might be wondering how proprioception ties into the larger scheme of balance. Proprioception is actually a part of one of the three foundational systems involved in maintaining balance, alongside the vestibular system (inner ear) and visual system (sight). In this trio, proprioception is an important sub-ability of the somatosensory system. Together, these three systems create what I call our Three Bodily Balance Systems.
How Proprioception Helps Us Stay Balanced
When you stand on one foot or walk on an uneven surface, it’s proprioception that helps you feel subtle shifts in your weight and adjust your stance to stay upright. (1) Your proprioceptive sense lets you feel when you’re leaning too far in one direction, and it triggers adjustments that help keep you balanced.
Without proprioception, balancing even simple movements would become challenging because you wouldn’t “feel” where your body is in space. For instance, athletes often rely heavily on proprioception to make quick, precise movements. But even for non-athletes, strong proprioception is what helps prevent falls in everyday scenarios, like slipping on a wet floor or tripping over an object. (8, 9)
Sensory Reweighting and Proprioception
An interesting aspect of proprioception is its ability to adjust, or “reweight,” with other sensory input based on the situation. This process, called sensory reweighting, allows your body to rely more on proprioception when other senses, like vision, are limited. For example, when you close your eyes, your body automatically relies more on proprioceptive and vestibular cues to maintain balance. Sensory reweighting is particularly valuable for fall prevention, as it helps us adapt in different environments and situations. In normal standing with eyes open the proprioceptive system is doing approximately 70% of the work for balance. (10)
As we age, the ability to reweight sensory input changes along with diminishing function of each system themselves. (11, 12) With diminished visual acuity and slower vestibular reflexes, older adults will often rely more heavily on proprioception to maintain balance if this system is still intact. This shift can make proprioception training particularly valuable for seniors, who might struggle in dimly lit or visually cluttered environments. For example, walking on a gravel path or maneuvering in low light requires strong proprioceptive feedback to make up for the decreased reliability of other senses. Strengthening proprioception helps compensate for these natural sensory changes, reducing fall risks in diverse environments.
Proprioception and Fall Prevention
As we get older, our proprioceptive abilities naturally decline, making balance a bit more challenging. This decline can increase the risk of falls, which are a leading cause of injury in older adults. (13) Understanding how proprioception relates to fall prevention can offer some valuable insights, and even better, some practical ways to train this critical sense.
Age-Related Decline in Proprioception
Age can bring about changes in the somatosensory system itself, as well as in the speed and accuracy of the signals the system sends to the brain. (14, 15) These changes can make it harder for the brain to detect and respond to shifts in body position, which can lead to slower reaction times and less stable movements.
For instance, studies show that older adults often lose some sensitivity in joint receptors, making it harder to detect subtle changes in movement or balance. (14, 16) Additionally, common pathologies like diabetic neuropathy (a loss of sensation in the feet due to diabetes) can impair proprioception as well. This reduced proprioceptive feedback can increase the likelihood of falls, as the body is slower to recognize and respond to balance disruptions.
For example, older adults might find it challenging to walk confidently in low-light situations or on uneven surfaces, as proprioceptive feedback becomes slower or less accurate with age. These subtle but impactful declines mean that recovering balance after a trip or slip takes a fraction of a second longer, increasing the likelihood of a fall. Research has shown that the sensitivity of joint receptors decreases over time, which contributes to slower reaction times and a greater reliance on compensatory strategies for stability. (16)
How Proprioception Helps Us React to Balance Threats
One of the reasons proprioception is so important for fall prevention is its role in corrective actions. (1, 14) When you lose your balance, proprioception allows you to detect this change and respond quickly, often before you’re fully aware of what’s happening. This quick feedback loop helps you adjust your posture, step in the right direction, or grab onto something to prevent a fall.
The good news? Proprioception is trainable, meaning you can actually improve it to maintain better balance and reduce fall risk, even as you age. (9, 17, 18)
While proprioception plays a crucial role in detecting changes in balance and triggering quick adjustments, it's not working alone. This feedback is integrated with other reflexive responses, such as the vestibular righting reflexes, to ensure you regain balance as rapidly as possible. (1) Together, these systems create a seamless and near-instantaneous corrective response, allowing your body to counteract destabilizing forces, like when you catch yourself after tripping on a curb or quickly step back after losing balance.
Exercises to Improve Proprioception
Now that we understand the importance of proprioception, let’s look at some practical ways to train and improve it. By incorporating proprioceptive exercises into your routine, you can help sharpen this hidden sense and maintain your balance over time.
Here are some exercises and techniques to get started:
Balance Drills:
Single-Leg Stance: Stand on one foot and try to hold the position for 30 seconds, then switch sides. To increase difficulty, close your eyes or stand on a soft surface.
Wobble Boards and Balance Pads: These tools create an unstable surface, making your proprioceptors work harder to keep you balanced and understand what is happening with your body.
Strength and Coordination Exercises:
Lunges and Squats with Unilateral Weight: By holding a weight on only one side of your body during exercise, you increase the balance challenge of the exercise and force your body to understand which way your body is shifted in space.
Resistance Training: Weight-bearing exercises help enhance proprioceptive feedback by improving muscle strength and stability around joints.
Functional Movement Training:
Real-Life Scenarios: Practice movements that mimic real-life situations, such as stepping over obstacles or standing up from a seated position without using your hands. Functional exercises can improve proprioception by mimicking daily tasks.
Final Thoughts: Feel the Power of Your Proprioceptors
Proprioception might not get the spotlight that vision or hearing does, but its role in balance and fall prevention is critical, especially as we age. By understanding proprioception and taking steps to strengthen it, you can improve your ability to navigate through the world with confidence and grace while feeling every inch of it.
If you’re interested in a more in-depth approach to improving your balance and preventing falls, check out the Beginner to Intermediate Balance Program. Remember taking time to work on your proprioception today, and balance overall, can mean fewer falls, better balance, and a greater quality of life tomorrow. Don’t wait! Start incorporating proprioceptive training into your routine and give your body the tools it needs to stay safe and strong.
References
Proske U, Gandevia SC. The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiological Reviews. 2012;92(4):1651-1697. doi:10.1152/physrev.00048.2011
Purves D, Augustine GJ, Fitzpatrick D, et al. Mechanoreceptors specialized for proprioception. Neuroscience - NCBI Bookshelf. Published 2001. https://www.ncbi.nlm.nih.gov/books/NBK10812/
Jimsheleishvili S, Dididze M. Neuroanatomy, cerebellum. StatPearls - NCBI Bookshelf. Published July 24, 2023. https://www.ncbi.nlm.nih.gov/books/NBK538167/
Yoo H, Mihaila DM. Neuroanatomy, vestibular pathways. StatPearls - NCBI Bookshelf. Published November 7, 2022. https://www.ncbi.nlm.nih.gov/books/NBK557380/
Professional CCM. Cerebellum. Cleveland Clinic. Published May 1, 2024. https://my.clevelandclinic.org/health/body/23418-cerebellum
Javed K, Reddy V, Lui F. Neuroanatomy, cerebral cortex. StatPearls - NCBI Bookshelf. Published July 25, 2023. https://www.ncbi.nlm.nih.gov/books/NBK537247/#:~:text=The%20parietal%20lobe%20is%20responsible,optic%20ataxia).%5B5%5D
Dieterich M, Brandt T. The parietal lobe and the vestibular system. Handbook of Clinical Neurology. Published online January 1, 2018:119-140. doi:10.1016/b978-0-444-63622-5.00006-1
Sohn J, Kim S. Falls study: Proprioception, postural stability, and slips. Bio-Medical Materials and Engineering. 2015;26(s1):S693-S703. doi:10.3233/bme-151361
Aleixo P, Abrantes J. Proprioceptive and strength exercise guidelines to prevent falls in the elderly related to biomechanical movement characteristics. Healthcare. 2024;12(2):186. doi:10.3390/healthcare12020186
Peterka RJ. Sensorimotor integration in human postural control. Journal of Neurophysiology. 2002;88(3):1097-1118. doi:10.1152/jn.2002.88.3.1097
Craig CE, Doumas M. Slowed sensory reweighting and postural illusions in older adults: the moving platform illusion. Journal of Neurophysiology. 2018;121(2):690-700. doi:10.1152/jn.00389.2018
Razzak RA, Bagust J, Docherty S. Young and older adults differ in integration of sensory cues for vertical perception. Journal of Aging Research. 2020;2020:1-11. doi:10.1155/2020/8284504
Older adult falls data. Older Adult Fall Prevention. Published May 9, 2024. https://www.cdc.gov/falls/data-research/index.html#:~:text=At%20a%20glance,common%2C%20costly%2C%20and%20preventable.
Ferlinc A, Fabiani E, Velnar T, Gradisnik L. The Importance and Role of Proprioception in the Elderly: a Short Review. Materia Socio Medica. 2019;31(3):219. doi:10.5455/msm.2019.31.219-221
Piitulainen H, Seipäjärvi S, Avela J, Parviainen T, Walker S. Cortical proprioceptive processing is altered by aging. Frontiers in Aging Neuroscience. 2018;10. doi:10.3389/fnagi.2018.00147
Ribeiro F, Oliveira J. Aging effects on joint proprioception: the role of physical activity in proprioception preservation. European Review of Aging and Physical Activity. 2007;4(2):71-76. doi:10.1007/s11556-007-0026-x
Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Frontiers in Human Neuroscience. 2015;8. doi:10.3389/fnhum.2014.01075
Yılmaz O, Soylu Y, Erkmen N, Kaplan T, Batalik L. Effects of proprioceptive training on sports performance: a systematic review. BMC Sports Science Medicine and Rehabilitation. 2024;16(1). doi:10.1186/s13102-024-00936-z
