Yoga, Body Awareness, & Balance – Slowing the Age-Related Loss of Proprioception

By: 
Eva Norlyk Smith, Ph.D.

Can yoga help us improve balance—and thereby reduce the risk of falls and injuries over time? In this article, we explore the answer to this question by exploring how yoga can help slow the loss of proprioception—i.e. the faculty most involved in retaining balance and complex movements—over time.

A few summers back, my sister and I visited the summer house where we spent most summers growing up. It was on a remote island in the Baltic with a rocky coast line, where we as kids spent hours jumping from rock to rock looking for the salamanders that lived in puddles between the rocks.

So, of course, the first thing we did when we arrived, was to head down the rocky path leading to the Baltic Sea. However, only a few steps down, I made an unwelcome discovery: To my dismay, the light-footed jumping from rock to rock was a thing of the past. Most notably, my ankles felt unsteady, and I no longer had the same sure sense of how much force was needed to carry my body from rock to rock, nor how to position my feet to land safely on the opposite side.

As we gingerly picked our way down the rocks, using both hands and feet, the contrast after almost five decades was striking. Despite years of yoga practice and steadily growing overall muscle strength, I had still lost a great deal of the ankle joint proprioception that enabled me to, as a kid, move effortlessly from rock to rock without a second thought.

After picking our way on the rocks down to the ocean for 30 minutes, we rested for a while on the hot rocks, looking out over the shimmering ocean. As we turned to make our way back, however, I noticed something curious: Already, on the return my ankles felt just a tad more steady. It was an almost imperceptible difference, but even though small, it was a definite improvement in my ability to navigate the varying inclines of the rocks and get a firm foothold with each new step.

It was a sobering firsthand lesson in just how much we lose our proprioceptive abilities over time, i.e. our ability to feel the position of our limbs and overall body in space. At the same time, however, it was an encouraging reminder of just how quickly the body responds to challenges to rebuild proprioception and thereby our overall balance.

What is Proprioception and Why Should You Care?

Proprioception is a term originally coined by the English neurophysiologist Sir Charles Sherrington in 1906. It refers to the collective input from neural receptors in our joints, muscles and tendons, which in turn enables us to know where parts of the body are located in space.

In other words, without proprioception you wouldn’t know what position your limbs and joints are in at any given time in relation to the trunk. People who lack proprioception are unable to undertake more complex movements, while people with a high level of proprioception often excel as dancers and athletes.

How Loss of Proprioception Impacts Balance and Joint Health

As we age, proprioception naturally declines. This decline has two significant impacts on our aging bodies: Firstly, motor control and balance decline as a result of deteriorating proprioception, because knowing where the body is in space is essential for balance. In fact, according to researchers, proprioception contributes to our sense of balance more than visual inputs.

Loss of proprioception also results in the deterioration of joint health. This second effect may be more surprising, but when we lose proprioception, we also lose our sense of the specific position of our joints, and whether they are properly aligned. The sense of the position of the knee and ankle joint, for example, are both negatively affected by aging. This in turn can lead to abnormal joint biomechanics during normal daily activities like walking. Once joint biomechanics get disturbed, we become more predisposed to degenerative diseases in the joints, a.ka. arthritis.

In short, the loss of proprioception is closely linked to two of the major risk factors of age-related decline: Falls, which often lead to fractures or other serious injuries, and joint degeneration, which leads to the chronic pain of arthritis. In other words, to maintain mobility and independence over time, it is crucial to work on maintaining as much proprioceptive functioning as we can over time.

Why Do We Lose Prioprioception As We Get Older?

How can we retain greater levels of proprioception over time? To answer that question, it’s important to first understand why we lose proprioception.

Advancing age causes a decline in proprioception on both a central and peripheral level, i.e. on the level of the central nervous system as well as in the limbs, i.e. muscles and joints.

At the peripheral level, studies suggest that proprioception decreases with aging  in part because of changes in muscle spindle function.  Muscle spindles are the mechanoreceptors in muscles that sense changes in the length of the muscle.

Muscle spindles communicate information about the length of a muscle to the central nervous system via sensory neurons. This is one important pathway through which the brain is able to determine the position of various parts of the body in space. As muscle spindles decrease in number and efficiency, the brain gets less input about the position and movement of muscles, and proprioception decreases.

Advancing age also leads to less effective processing of sensory input and a decline in neuromuscular performance. Older adults have fewer motor units, and the ones that remain are larger and slower. A  motor unit consists of a motor neuron and the skeletal muscle fibers innervated by that motor unit. Groups of motor units work together to coordinate the contractions of a single muscle.

The age-related alteration of the number and function of motor units affect both how much force the muscle can produce and the degree of control we have over the muscle. This lack of control in turn also leads to a decline in our proprioceptive ability.

In addition, aging leads to a reduction in the number of neurons and receptors that process motor information, as well as other changes that affect the brain’s sensitivity to muscle spindle activity.

The relative contribution of the changes on the central and peripheral level is not known, but we do know that loss of proprioception is linked to both. The good news is that you can compensate for the declining proprioception in muscles and joints by increasing the brain’s ability to sense and process proprioceptive input, thereby reducing perceptual proprioceptive errors during balance control.

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Can Yoga and Physical Activity Help Preserve Proprioception Over Time?

We still know relatively little about the effects of regular physical activity on the preservation of proprioception during aging, but initial studies are encouraging. Studies indicate that while proprioception is diminished with age, regular activity may slow the decline.

Not all exercise has the same effect, however. Researchers have found that regular exercise of a more proprioceptive nature is particularly beneficial to retain or regain balance. For example, long-term practice of Tai Chi, which puts great emphasis on the exact joint position and direction, has been linked to increased proprioception.

There is also preliminary evidence that a regular yoga practice can help improve balance, although more research is still needed.

How does exercise improve joint proprioception? We don’t know, but researchers believe that improvements in both central and peripheral levels of proprioception are involved. Peripheral improvements in proprioception are thought to be linked to alterations in muscle spindle structure and activity stimulated by exercise.

Physical activity that improves muscle strength can also improve proprioception. Increased muscle strength generally yields better control of movement, which in turn can enhance joint proprioception during weight bearing.

At a central level, physical activity is thought to induce  changes in the central nervous system, by building new and stronger connections among neurons. The brain changes in response to repeated stimuli, so the repeated positioning of body and joints in specific positions, such as demanded during yoga practice, might well increase cortical representation of the joints, and in turn lead to enhanced joint proprioception.

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Yoga Practices to Improve Joint Proprioception

Based on what is known so far, it can be speculated that yoga is likely have a powerful impact on the development and preservation of joint proprioception. Alignment-based yoga practices that put great emphasis on developing awareness of the alignment of joints in space are precisely the kinds of activity found to be most effective in developing or preserving proprioception over time.

Based on the research, the following three types of yoga practices will be helpful to improve joint proprioception and balance.

1. Strengthen the Joints. Many people get frustrated with balancing yoga postures because they can’t stay in balancing poses for more than a few seconds. However, you don’t need to balance to improve joint proprioception. Simply standing on one leg while holding on to e.g. a chair or wall will improve the strength in the joint. That in turn will improve muscle strength and lay the foundation for better movement control.

2. Add Neuromuscular Education. To improve the brain’s processing of proprioceptive signals and add an element of neuromuscular education to your practice, play with moving in and out of small, manageable versions of balance poses. For example, try this Grand Canyon variation of Warrior III: With the hands on your hips, step your right foot forward.

Gradually shift your weight to the front foot and tip slightly forward with the spine and back leg in a straight line until the back left foot lifts slightly off the ground.

Imagine you are peeking out over the edge of a cliff to look into the bottom of Grand Canyon.

Pivot back and forth playing with going deeper into the pose, perhaps, if your balance allows it, ending up with your torso parallel to the ground.

3. Pick a Few Favorite Balancing Poses. As a last step, pick one or two favorite balancing poses and play with those for 3-5 minutes a day while watching TV or talking on the phone.

As you work up to longer and longer holds, you’ll be surprised just how much your joint proprioception – and hence your balance – improves.

 

Resources 

Jeter, P. E., Nkodo, A., Moonaz, S. H., & Dagnelie, G. (2014, April 01). A Systematic Review of Yoga for Balance in a Healthy Population. 

Ribeiro, F., & Oliveira, J. (2007, August 07). Aging effects on joint proprioception: the role of physical activity in proprioception preservation. 

 

To read the entire study on physical activity and proprioception please click here.