The Importance of Sensibility and Joint Position Sense
by Jonathan Blood Smyth
Our sensory system conveys the information we need to our
brains so we can make the right decisions in daily life.
Huge amounts of information flow in to our brain at all
times and we must decide the importance or otherwise of
this. Hearing, touch and sight are clearly used by use to
manage our responses to the challenges of normal life but
there are other sensory modalities which are just as
important in our mobility. The feelings coming in from all
our bodily structures such as our muscles, ligaments, discs
and joints are very important for normal movement function.
Joint position sense is more specifically related to our
joints and is also called proprioception.
Have you ever woken up in the night to find you have a numb
and dead arm? I woke up on my back to find an arm laid
across my chest so I lifted it off to the side. Very soon it
came back. I moved it again, this time with a bit more
speed. It came back. Gradually waking up I felt up the arm
until I got to my shoulder. It was my own arm! Since I had
laid on my arm, cutting off the blood supply to the nerve or
compressing it, all sensory input to my brain from the arm
had been cut off. My arm did not exist as far as by brain
was concerned and when I gripped and moved my arm I had no
sense that it was mine. As far as I was concerned the lack
of feeling coming in meant that the arm had to be someone
else's.
Compression of the nerves in the arm or cutting off their
circulation in the same manner can completely interrupt the
incoming messages to the brain, making the brain think that
the area of the body does not exist at all and therefore has
no movement function. The brain is unable to picture the
limb and its position so is cannot plan any useful movement
for the limb either. Working as a physiotherapist for over
twenty years has left me with a clear view of the importance
of sensory input in our management of normal movement.
Sensory input, the constant incoming signals to the brain
from the various parts of the body, informs us what is going
on and where we are in space. This is much more important
than we realise. Losing muscle power is difficult but people
adapt and manage well but losing sensory information from a
body part makes it extremely difficult or impossible to use
the part. Losing sensibility is more troublesome than losing
muscle power, although both are important.
In stroke we see the lack of movement easily, what we don't
see is the underlying sensory abnormality which may be
partly or wholly responsible for the disability. Joint
position sense (JPS), also called proprioception, is the
body sense which indicates to our brain where our joints are
at all times. The sense also tells us what state our joints
are in such as what angle they are at, what muscular effort
is being exerted and in which direction the effort is being
expended.
The brain is always monitoring the position of our joints so
it can plan the movements we want to achieve. Without the
position sense for our joints coming in normally to our
brains we are unable to understand where our joints are and
therefore we can't predict what to do next. Without accurate
joint position sense we cannot plan the next movement we
need to do and so cannot move effectively.
The loss of the ability to feel any part of our body
accurately can have profound consequences, reducing our
functional independence in many normal daily activities.
Typical conditions include stroke, paraplegia and direct
nerve damage but more surprising injuries can reduce JPS
input. A sprained ankle or ruptured anterior cruciate
ligament reduces the accuracy of joint position sense and
requires rehabilitation. Physiotherapists are skilled in the
rehabilitation of proprioceptive ability in multiple
conditions. - 15668
Jonathan Blood Smyth is a Superintendent of
(http://www.thephysiotherapysite.co.uk) Physiotherapy at an
NHS hospital in the South-West of the UK. He specialises in
orthopaedic conditions and looking after joint replacements
as well as managing chronic pain. Visit the website he edits
if you are looking for
(http://www.thephysiotherapysite.co.uk/physiotherapy/physiotherapists/uk/south-yorkshire/sheffield)
physiotherapists in Sheffield.
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New Unique Article!
Title: The Importance of Sensibility and Joint Position Sense
Author: Jonathan Blood Smyth
Email: david.ravech@googlemail.com
Keywords: Back pain,injury management,sciatica,Piriformis Syndrome,pain management,sciatica,back injury,back pain relief,Frozen Shoulder,Alternative medicine,physiotherapists,physiotherapy,Health,physical fitness,advice
Word Count: 673
Category: Health & Fitness:Alternative Medicine
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