We have all heard stories of athletes making amazing comebacks from injury. What happens during the rehab process? What determines success? A recent spotlight, the Cleveland Browns 2018 no. 35 draft pick Nick Chubb is a great example. Nick while playing running back for Georgia sustained a significant knee injury in 2015 tearing 3 major ligaments in his knee. Through hard work and some unconventional rehab methods, Nick successfully returned to the field 11 months after the injury. Nick’s amazing comeback has earned him the opportunity to play in the NFL.
When it comes to recovery from an injury or surgery, flexibility and strength are the obvious components most people think about. But what about proprioception or neuromuscular training? Why are these important?
Proprioception is the body’s ability to sense where it is at in space. In the limbs, proprioceptors are sensors that provide information about joint angle, muscle length and tension, which is integrated to give information about the position of the limb in space.
In addition to proprioceptors, we have sensory receptors in the eyes and ears that are in constant communication with our brain and spinal cord to allow us to perform precise complex movements.
What happens when there is injury or pain? The information highway from our proprioceptors and sensory receptors is disrupted, making movements less efficient. Examples of this may include decreased balance and coordination, feeling of instability, use of larger muscle groups as compensation predisposing to re-injury.
In addition to regaining motion and strength in the rehab process, retraining of the proprioceptors is key to successful results. Proprioception is retrained through exercises that challenge agility, balance, and coordination. Repetition of proprioceptive exercises increase the efficiency of the communication highway. Just like driving down a freshly snow covered road may be slow, but as it is plowed and cars create a pathway, the travel becomes faster. The goal being that the joint or body part involved move through its full range of motion in a controlled fashion, at a variety of speeds, with variable external stimuli while maintaining stability.
Sensory receptors related to the eyes and ears also can be retrained through exercise. This can involve head movements, eye tracking, or simply closing your eyes while you challenge your balance. Balance training specifically for the ear is called vestibular rehab.
As a Physical Therapist, each individual comes to the clinic with different goals, it is imperative to create an environment of controlled exposure to challenge the client in preparation to exceed these goals. Training at a higher level of difficulty allows for success of the less demanding activities an individual is preparing to encounter. Nick Chubb was exposed to martial arts to aid with simulating what he may see on the football field. This in addition to his hard work ethic allowed him a successful return to the football field.
Many recent videos on social media have also shown athletes like Lebron James working on high level proprioceptive exercises for injury prevention. Think about all of the times he is driving to the basket and lands awkwardly. All of the proprioceptive exercises he has incorporated has prepared his body to adjust quickly to unexpected hits and landings.
Proprioceptive training is not limited to just athletes, it is necessary for all. How do we walk down the steps in the dark without falling? Or how do we walk across the street without looking at our feet?
Can a Physical Therapist really help me with my balance? Yes, of course! In this situation the “use it or loose it” applies. Notice how children are everyday exposing themselves to proprioceptive activities on the playground or simply spinning around and trying to walk straight for fun. As we get older we tend to become less exposed to these sorts of activities and sit more. Our balance and stability then decrease. It is not lost forever though.
Clients in my clinic are prescribed individualized plans of exposure for better balance and stability. Better balance and stability decrease wear and tear on joints, risk of injury, and falls. I assess each your balance systems and identify where deficits present. Then specific focus is given to those receptors whether proprioceptors in the limbs or sensory receptors in the eyes and ears. My clients’ willingness to put the work into their programs reap the benefits and the gains can be dramatic.
“It had long since come to my attention that people of accomplishment rarely sat back and let things happen to them. They went out and happened to things” Leonardo Da Vinci
Molly Stevens PT, DPT, MTC at in the Matchworks Building in Mentor can evaluate you and your specific needs whether recent injury or if you are looking for prevention. Schedule your consult today!
8500 Station Street, #255
Mentor OH 44060