Proprioception... Things you learn from your PT

Normally I don't find time to write as much as I am writing, but information keeps coming at me that makes me do research. So I thought I would share. Maybe others have heard of this and its no big deal but I find this fascinating and worrisome.

I took Bruce to his PT yesterday and he went from doing well 2 weeks ago to becoming inflamed and walking in with an air-cast on his left foot. I looked like hell, my hands hurt so bad. It was just funny..Yes Funny Haha because we just looked a mess. I had so much running through my mind yesterday plus I had to do the laundry, sweep the floors and paint the house...Just kidding on painting the house.

Anthony, Bruce's PT listened about Bruce's constant falling. We then moved onto his back becoming stiff throughout the day. By 3 pm his back was tight. Last night he slept in his anti gravity chair (yes the outside lounger) then moved himself to his bed. Anthony looked at his ankle and felt that it wasn't fractured or broken but the constant rolling and tripping has messed with his tendons. He cannot flex the foot, it stays at 0 degrees. He said that the constant falling will probably continue and then you get into more trouble and more problems with the ankle. He said to keep the boot on for 2 weeks because hes hurt the ankle plus with the arthritis/enthesitis we don't want that area to become even weaker. He did say that he thought he had proprioception. I have never heard of this word. He explained that the word means sense of perception of the relative parts of the body. It is knowing where various body parts are in relationship with how they are moving and how much energy is being used to move it. Specialized Nerve Cells called proprioceptors are found in large numbers in the tissues that hold joints together (tendons, muscles, ligaments, fascia). Propreceptors sense things like the amount of stretch, movement and pressure of or on these various tissues. When the proprioceptors are stimulated by stretch or movement, the nerve movement is fed to the brain via the spinal cord and nerve system. When in the brain it is integrated into something your body can understand. This is continual and thus your brain interprets the information and sends the messages back to parts of the body over motor nerves. When this system doesn't work properly a lot of problems can arise. Maybe this is why Bruce keeps falling.

Every time a proprioceptive nerve ending is not being stimulated usually due to a loss of normal joint range of motion, 30 returning motor responses from the brain to the body are not being stimulated. This causes degeneration of the restricted joint and thus causing loss of normal joint motion. This is a big problem in Juvenile Arthritis and Ankylosing Spondylitis and kids with lower extremity arthritis. So loss of range
and balance causes proprioception.

As strength and balance are related, children and adults with arthritis and lower extremity arthritis need exercise that enhances balance.

Bruce cannot stand for a long time...but put him on one foot and he is all over the place. He has impaired balance. I think I was in awe of my PT.

OH I did borrow some of what I wrote, ok most of it. It was a mouthful. My PT has been working with Bruce on balance. His left leg is much weaker than the right so we will try to build that muscle, fatigue and balance as we progress forward and hopefully the left ankle will get stronger.

I thought this was very interesting...I don't know if it means anything for Bruce long term and will try to gain more knowledge of this. This also can be due to sensory processing issues which Bruce doesn't have. I only read about proprioception in kids who have Juvenile Arthritis and Ankylosing Spondylitis. The swelling and inflammation have more to do with this for Bruce. Bruce doesn't swell much but there is inflammation which makes those neurons not work properly. Just another piece of the puzzle.