Balance, Co-ordination and Proprioception for Injury Prevention

Balance, co-ordination and especially proprioception are terms that generally are used synonymously, but we are here to help clear them up so that you have a better understanding of your body, how it works and how you can help it to help you stay younger and fitter for longer.

Balance is the body’s co-ordinated interaction of nerves and muscles to maintain a defined position in response to our ever changing environment.

Probably one of the most important roles of balance in humans is that it helps us maintain our upright posture, which in turn helps us to perform all our activities of daily living for survival. To maintain balance, there needs to be a combination of information coming from a number of systems, namely, vision, vestibular (from the inner ear), and proprioception. For most healthy adults, the preferred sense for balance comes from proprioceptive information, which we will look at a little further down. It becomes easy to understand that if we have an alteration in any of these senses; visual, auditory, tactile, kinesthetic or proprioceptive, that balance will also be altered. Although maintaining balance while standing may seem to be a rather simple skill, this feat cannot be taken for granted, especially for people with muscular problems. Muscular weakness, proprioceptive problems or range of motion difficulties can cause a person to lose balance. Balance is the single most important element dictating human movement. Individuals need to know that the maintenance of balance is a vital part in the rehabilitative process of injuries and disorders, and should not be overlooked.

Coordination refers to the body’s ability to execute smooth, fluid, correct and controlled movements. Simple movements such as combing hair, involves a complex muscular interaction using the right speed, distance, direction, rhythm, and muscle tension to execute the task. Coordination can be divided into 2 categories:

  • gross motor movements involving large muscle groups, used for standing, walking, skipping and running,
  • and fine motor movements using small groups, which are seen in precise actions, particularly with fingers, such as picking up a coin off a table, clutching an opponent’s jersey, or picking up a ground ball with a glove.

Proprioception means “one’s own” and perception, is the sense of the relative position of neighbouring parts of the body. It is the sense that indicates whether the body is moving with the required effort, as well as where the various parts of the body are located in relation to each other. This sense has receptors in the skin, muscles, tendons, ligaments, and joints, and provides information to the brain on what the muscles are doing when we move to perform activities. The eyes and ears also give information to the brain about body position and balance. Proprioception is the awareness of the precise position of body parts.

As one may see, if any of the above are altered there is going to be an alteration of the other 2 modalities. Each cannot function efficiently without the other. For balance to occur effectively there needs to be co-ordination of muscles and nerves and for co-ordination to occur effectively there needs to be proprioception, information about what is happening so that the correct muscles can be engaged and co-ordinated so that balance is maintained. When an injury occurs and the limb is immobilised, sensory input from proprioceptors and motor commands are disrupted, resulting in an alteration of co-ordination which in turn alters balance. It is important to get moving as quickly as possible after injury and follow a rehabilitative program to regain effective proprioception, coordination and balance, so as not to allow for another injury to creep in.

One last important aspect to remember, is that it’s not just injury that alters these senses of ours, so does the aging process. The changes that come with age are:

  • a reduced sense of movement around us,
  • a slowing in the speed at which information is received,passed on a captured through the brain to elicit appropriate actions, a decrease in skin receptors,
  • deterioration of visual function

This all leads to postural instability, decreased balance performance which leads to falls. Our entire neural system slows down with age, with loss of balance being perceived more slowly and corrected less efficiently. What is of vital importance to note, is that these changes can all be slowed down with proper assessments and treatment programs in place.

Article Sponsored by Health International.


Article by Kristy Delport. Kristy is a qualified Biokineticist with a BSc. Med. (Hons.) Sports Science (Biokinetics). She works at Kingsmead Physiotherapy and Rehabilitation Centre in Borrowdale, Harare.  You can ask her questions in the comments section beneath the article.