Proprioception Exercises for Balance and Strength - Dr. Axe

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4 Proprioception Exercises to Improve Balance and Strength

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Proprioception - Dr. Axe

How is it that professional dancers can glide across the room, without looking where they are going and not bump into each other along the way? It’s called proprioception.

How can we walk down a flight of stairs at night when the lights are off? That’s right, proprioception.

Proprioception, simply put, means sense of self, specifically self-movement. The proprioceptors are sensors that provide information about joint angle, muscle length and muscle tension, which gives the brain information about the position of the limb in space at any given time.

While I do not claim to be a great dancer, I have seen some amazing footwork that seems impossible to most. This includes ballroom dancing as well as ballet and any other type of dancing — or even a barre workout.

Of course, proprioception goes beyond dancing — to all types of athletes who are able to make movements with their arms and legs and know exactly what support those arms and legs will give them without even thinking about it.

Somehow, most of us are able to execute body movements that require proprioception without much worry, but developing high-level proprioceptive abilities not only will improve your athletic performance, such as footwork, but simply make you more lithe and agile no matter what you do.

Let’s learn how.

How Proprioception Works

Proprioception refers to the body’s ability to sense movement within joints and joint position. This ability enables us to know where our limbs are in space without having to look and the reason ballet dancers are able to have such awareness of their bodily movements without looking at the action as it occurs.

It is important in everyday movements but especially so in complicated sporting movements when precise coordination is essential.

The International Association for Dance Medicine defines proprioception metaphorically as the sixth sense, extending the classical five senses to include the body. This body sense is more than just a feeling of movement. It is intimately tied to our feelings of muscle tone, perception of effort and, most importantly, our perception of balance.

Specialized nerve endings originate in our muscles, fascia, tendons, ligaments and joints, and some scientists even include the skin. These sensory receptors perceive the amount of pressure and speed at which a movement is occurring and the rate at which the speed is changing, the direction of the movement as well as any pain associated with the movement.

Massive proprioceptive input from sensory nerves embedded in muscles and joints enters the spinal cord and is carried toward subcortical and cortical parts of the brain, which provides us with both a conscious and subconscious sense of where we are and how we are moving. We are aware when we are moving and can usually turn our attention to the fine details of this movement at any given time, something often required to help refine movements within a sport or activity.

Our subconscious sense of embodiment is essential for timely, appropriate neuromuscular coordination. Just as your foot is aware of the location of the step beneath it, an athlete’s quadriceps and hamstrings know just when and how to contract to stabilize around the knee to perform a specific athletic movements.

Without this inner sense of timing and accuracy, the rate of injury would be incredibly high, causing simple movements to require an enormous amount of cognitive energy.

Types of Proprioceptors

We have a system of receptor nerves, or proprioceptors, located in the muscles, joints and ligaments. These receptors can sense changes similar to how other receptors monitor pressure, sound, heat and light passing signals to the brain.

The brain then sends a message to the muscles telling them what to do. This can happen so fast that it’s, at times, referred to as a reflex rather than a reaction, but there are a few components that make up this action as a whole.

Kinesthetic Awareness

Proprioception and kinesthetic awareness are often used interchangeably. However, it is important to note the difference.

Kinesthetic awareness is a conscious effort to react to the situation, while proprioception is an unconscious or subconscious process. Ultimately, the brain sends the signal so fast that it is an automatic response.

However, the two work together to allow a smooth, efficient and safe platform for everyday movement and athletic performance. A great example is when a skier acts subconsciously, through proprioception, to stay vertical yet the person’s mind, kinesthetic awareness, processes what needs to happen in order to ski over slopes, moguls, around trees and anything else needed to make necessary adjustments to the body to successfully accomplish the motion at hand.

Proprioception is an inner sense, the central nervous system, while kinesthetic awareness is an external sense, the body in space and time.

Golgi Tendon Organ

Another type of proprioceptor is the Golgi tendon organ, which provides information about changes in muscles tension. When the muscle contracts, the collagen fibrils are pulled tight, and this activates the Golgi tendon organ.

Because changes in muscle tension will provide different degrees of pull on the tendon, the Golgi tendon organ provides information about muscle tension to better assist the muscle in performing an action.

Muscle Spindle

The muscle spindle is also a type of proprioceptor that provides information about changes in muscle length. When the muscle lengthens, the muscle spindle is stretched, triggering specific actions within the muscle fibers.

Who Can Benefit from Proprioception?

Athletes, accident-prone or clumsy individuals, the elderly, those with diseases, and even children can benefit from proprioception training — everyone can benefit from proprioceptive work.

Because proprioceptive signals from the joints, muscles, tendons and skin are essential for movement, the loss of proprioceptive awareness may affect the control of muscle tone, disrupt reflexes and severely impair voluntary movement. Numerous neurological and orthopedic conditions are associated with proprioceptive and kinesthetic impairment, such as stroke, Parkinson’s disease, peripheral sensory neuropathies, or injuries to ligaments, joint capsules and muscles.

It makes sense that proprioception training could be beneficial to anyone that has been affected, whether due to injury, birth defects or disease.

As studies reveal, there are ways to improve proprioception, no matter if you’re an athlete or someone who has experienced a stroke.

People have varying degrees of proprioception awareness. A professional athlete has a high degree of proprioception awareness, but you may know someone who is accident-prone — and this could mean that person’s proprioception awareness is not as developed as it could be.

While one’s proprioception may not mirror a professional athlete’s, working on your proprioceptive skills will make a difference in your day-to-day activities.

It is understood that the brain uses sensory information to accurately produce motor commands. In contrast, studies have begun to investigate how sensory and perceptual systems are tuned based on motor function, specifically motor learning.

For example, in a study published in the Journal of Neurophysiology, sensitivity to small displacements of the hand was measured before and after 10 minutes of motor learning, during which subjects grasped the handle of a robotic arm and guided a cursor to a series of visual targets randomly located within a small workspace region. The study showed that the proprioceptive acuity improved following motor learning.

The findings support the idea that sensory changes occur in parallel with changes to motor commands during motor learning.

Another study investigated the link between motor learning and sensory function in arm movement control, and the findings were consistent with the idea that motor learning is associated with systematic changes to proprioception. This study focused on testing whether motor learning could be improved by providing subjects with proprioceptive training on a desired hand trajectory.

Subjects who experienced the additional proprioceptive demonstration of the desired trajectory showed greater improvements during training movements than control subjects who only received visual information. This benefit of adding proprioceptive training was seen in both movement speed and position.

These findings support the idea that the addition of proprioceptive training can augment motor learning, recognizing that the brain uses sensory information to accurately produce motor commands.

In terms of athletes, a study was reported by the British Journal of Sports Medicine that followed two professional female handball teams for one season. The intervention team used a prescribed proprioceptive training program, and the results of the intervention and control teams were compared.

The proprioception sensory function of the players in the intervention team significantly improved between the assessments made at the start and the end of the season. This was the first study to show that proprioception training improves the joint position sense in elite female handball players.

This may explain the effect of neuromuscular training in reducing the injury rate.

Exercises to Enhance Proprioception

There are a number of exercises that can be performed to help train your proprioception. It is always best to work with a physical therapist or licensed trainer to ensure that you are selecting the right exercises to help enhance your desired performance.

Balancing Exercises

Good exercises for proprioception development are activities that challenge balance and equilibrium. Balance exercises help teach your body and brain to control the position of a deficient or an injured joint.

A common example of a balance exercise that can help improve proprioception is the use of a balance board. You may need to begin holding on to the wall until you have gained a stronger sense of the intended use of the muscles in order to balance on the board.

You can also try balancing on one leg as a simple starter exercise, which has been tied to better overall health.

Exercises While Closing the Eyes

As you become stronger, you can gain the ability to inform and trust your muscles to perform standing activities with the eyes closed. This enhances the communication between the brain and the muscles so you are able to perform activities properly without watching the movement take place.

Strengthening Exercises

Knee strengthening exercises like leg presses, squats and lateral movements with the arms are examples of ways that you can help establish the connection between muscle fibers by building strength. As you build strength in the muscles, the brain begins to understand the request of this strength more and more.

As strength builds, it helps improve proprioception awareness with the mind and body and also allows you to continue/hold a movement or action in place far longer with proper form.

Plyometric Movements and Drills

Plyometric exercises involving coordination and movement patterns can greatly enhance the kinesthetic awareness. Vertical jumps, running figure-eight patterns, change of direction drills and crossover walking are other routines that help establish the connection between muscles and nerves.

As you are asking the body to perform certain movements, it trains the brain to respond to these movements. Over time, it becomes easier to perform these exercises without much thought as a natural connection becomes a part of the routine.

Training Routine

Table Top

Using a mat to protect your knees, get on all fours on the floor in table top position. Make sure the back is flat and the neck is aligned with the spine.

While looking at the floor, raise and extend your right arm and your left leg at the same time. Keep a tight core.

Hold for three to five seconds, and repeat on the other side. Do 10 reps on each side.

Advanced: Hold for 20 seconds with eyes closed. Really focus on a tight core and perfect balance, keeping the arm and leg parallel to the floor.

Single Leg

Stand with feet hip-distance apart. Raise your right knee to a 90-degree angle, and hold for three to five seconds. Return foot to the floor, and repeat five times on each leg.

You may need to hold on to the wall or a chair at first. Work toward not needing the extra support.

Advanced: Perform this exercise with eyes closed, no support and holding for 10 seconds, 10 times on each leg.

Crossover Walk (Karaoke)

Stand with feet hip-distance apart. Begin walking to your right, crossing your left leg over the right, then back to starting position. Continue stepping sideways in a constant motion for about 15 yards.

Repeat in the other direction, five times each direction.

Advanced: The advanced option is the same but much faster and with a high knee raise as you cross over the leg, naturally twisting the hips back and forth while moving and crossing over in the same direction. Repeat in the other direction for 25 yards, five to 10 times each side.

Squat Jump

Stand up straight with your knees slightly bent and feet shoulder-width apart. Squat down until your thighs are parallel to the floor by pushing hips back, keeping back flat and head facing forward — with weight on heels rather than the balls of your feet.

Immediately explode upward, reaching as high as you can with your hands as your feet leave the floor. Land in the same position you started in. Swing your arms back, and jump again right away.

Repeat five to 10 times on each side.

Precautions

It is always important to seek expert training support whenever possible. Work with a fitness professional or physical therapist with these types of exercises, as they will be able to individualize a program for your specific needs, whether elderly and wanting to gain better sense of balance and basic day-to-day functions or an athlete wanting to enhance performance and prevent injuries.

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