What is proprioception?
Proprioception, sometimes referred to as the "sixth sense," is the sense of the body position and movement. Our body is impressive in collecting information such as pressure, touch, vibration, pain, temperature, balance, and joint proprioception (which refer to the position and movement sense of our joint and limb). After collecting the information, sensory organs transmit the message to our big boss, the "central nervous system," which includes our spinal cord and the brain. The big boss gathers information, makes decisions, and instructs our muscles to react to different daily life situations.
How does proprioception relate to daily activities?
Proprioception is extremely important to us in daily living. Let us take an example of driving; the proprioception sense allows our foot to press on the pedals and our hands to steer the helm without looking at them. Therefore, our visual attention can focus on the road ahead. Another example is typing; remember when we first practice typing, we have to look at the keyboard. When our practice becomes perfect, our fingers can be coordinated and type without looking at the keys.
The most common example is walking. Toddlers have to look at their feet while walking because their sense of proprioception has not developed fully yet. So they have to depend on their vision to know the positions of their limbs.
You may find out from the above examples that proprioception sense is vital to acquire new skills. It is crucial for us in learning and training, as it allows us to control our limbs without relying solely on visual information.
How does proprioception relate to sprained ankle injury?
Ankle joint proprioception
We mention proprioception sense in the overall situation previously; now, we narrow it down to the ankle joint. Let us do a simple experiment: close your eyes, move one of your ankles to a certain degree you like, followed by moving another ankle to the exact angle. Simple right? We call this the joint proprioception (joint position sense): the ability to know your joint position after it is moved either passively or actively.
Who calls for the action during our body movement?
For normal proprioception during movement, all sensory organs in the joints, including muscles, ligaments, and the skin, react to the joint's change in position and send signals to the upper control center, our big boss. The upper control center will command for action. After the body adjusts to a new position, feedback will transmit to the upper control center for a further action call, forming a continuous feedback loop during movement. The feedback loop allows the joints, central nervous system, and muscles to communicate and perform the action we intend to do.
What happens to the ligament after a sprained ankle injury?
The mechanoreceptors located in the ankle ligament that play a role in the normal proprioception sequence are damaged. It will disturb part of the feedback loop and negatively impacts the smoothness of action; thus, people complain about poor balance control. If not fully recovered, people may suffer from repetitive sprain after the first ankle sprain injury.
What are mechanoreceptors?
They are the sensory cells that respond to mechanical pressure changes or distortion and play a proprioception role. There are four types of mechanoreceptors found in ankle ligament:
Type l (Ruffini) is the mechanoreceptor that fires in a static movement like standing. It is responsible for giving the postural sense.
Type II (Pacini) senses the initiation of ankle joint movement.
Type III (Golgi like ending) is active in the extreme joint movements and can probably act to alert the central nervous system for impending danger to the ankle. It resembles the Golgi tendon organs and is believed to protect the joint by reflex action.
Type IV (Free nerve endings) is responsible for pain sensation.
What should we do after the accident happens?
Yes, the ligament(s) tear, proprioception, and balance are compromised. However, it is not the end of the story. Researches prove that the ankle's balance can be restored through proper rehabilitation exercises, and proprioception training is crucial in preventing subsequent injuries.
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