Proprioceptors 101:
How to Really Get On Your Clients’/Patients’ Nerves
By
Will H. Stewart CMT, FAFS
In Applied Functional Science, one of the Principles of Function that we anchor to is that Function is three‐dimensional (3D). With this Principle, we include tri‐planar movements as well as the “3D‐ness” of mind, body, and spirit. When we look at the body, we take into consideration the trio of nerves, muscles, and bones that is the NeuroMusculoSkeletal (NMS) System. As I work with many of my athletes and post‐rehabilitation clients, I tend to focus my attention on the real and relative joint motion of the bones, as well as the eccentric, concentric, and econcentric actions of the muscles. However, I am missing out on the “Spirit of Function” if I do not take into the consideration the proprioceptors of the NMS System.
The proprioceptors are truly the “Spirit of Function” as every movement we make in our day‐today lives utilizes them. Moreover, as we look at the proprioceptors, we see that they definitely have a complexity to them, but there is also an amazing simplicity to them.
When we work with our clients/patients, it is vital to keep in mind that each proprioceptor has a different response to stimuli. This will effectively allow us to take our patients/ clients to their full 3D potential.
This summer, I worked with one of my athletes in a post‐rehabilitation situation after he had a sports hernia surgery. Tommy is a wide receiver on his high school football team. He is a highlevel athlete, but, unfortunately, this injury kept him out of competitive sports for about six months and limited him to very moderate training to stay in shape. He had an “open” surgery to repair the injury in his lower rectus sheath. Working closely with his rehabilitation therapist, we focused on having Tommy not only heal properly but also get him back in top shape so that he would able to make all of the dynamic overhead catches, jumps, runs, and dives that he would need to contribute to his team.
Our progression, starting 17 days post surgery per doctors’ orders, was just to start him in a very easy 3D Common Lunge Matrix to initial range without any hand drivers. (The 3D Common Lunge Matrix is “Alternate Feet, Anterior/Same Side Lateral/Same Side Rotational, Lunges.”) We checked in daily to make sure the he was not experiencing any residual pain from the rehab and started to progress him. Over the course of the summer, his progression was as follows:
• 3D Common Lunge Matrix to Initial Range (without Bilateral Hands as a Driver); • 3D Common Lunge Matrix to Initial Range with Bilateral Hands at Knee Reach; • 3D Common Lunge Matrix to Mid Range with Bilateral Hands at Knee Reach;
• 3D Common Lunge Matrix to Mid Range with Bilateral Hands at Ankle Reach &
• 3D Common Lunge Matrix to End Range with Bilateral Hands at Ankle Reach.
Because we needed to ensure the proper healing process of his abdominals, as well as the econcentric action, we also incorporated Posterior Lunges. The progression was the following:
• Posterior Lunge to Initial Range (without Bilateral Hands as a Driver);
• Posterior Lunge to Initial Range with Bilateral Hands at Shoulder Reach
(Elbows Flexed);
• Posterior Lunge to Initial Range with Bilateral Hands at Shoulder Reach
(Elbows Extended);
• Posterior Lunge to Initial/Mid Range with Bilateral Hands at Overhead Reach;
• Posterior Lunge to Initial/Mid Range with Bilateral Hands at
Sagittal/Frontal/Transverse Plane Reach.
After Tommy had no pain, and with clearance from his physician, we were able to move into an enhancement program where we tweaked lunge distance, width, speed, drivers, and artificial loads.
A workout progression where we were able to illicit responses from all proprioceptors was as follows:
Movement: 3D Common Lunge Matrix + Posterior Lunges
Drivers: Bilateral Arms
Speed: Variable
Distance: Initial to Mid to End Ranges
Artificial Load: 5‐10 lb. Dumbbells
The sequence utilized was the following:
Slow Pace to Mid/End Range
3D Common Lunge Matrix + Posterior Lunge with Bilateral Hands
at Ankle Reach
3D Common Lunge Matrix + Posterior Lunge with Bilateral Hands
at Overhead Reach
3D Common Lunge Matrix + Posterior Lunge with Bilateral Hands
at Ankle to Overhead Reach
Next, we would do a medium pace set in mid range, concentrating on loading the posterior muscular complex with the “Bilateral Hands at Ankle Reach” lunges, then focusing on the econcentric action of the abdominals, groin, and hip flexors of the anterior muscular complex.
Finally, we would finish with a fast pace set at initial/mid range focusing on really “getting there and back” using the hand drivers to move us in and out of the Transformational Zones.
Another Principle of Function is that Function is enhanced via Tweakology. Tweakology is the study of choosing and managing the most effective functional variables to create the optimal functional environments for analysis, rehabilitation, prevention, and performance training and conditioning. Using Tweakology, we were able to take Tommy into various Transformational Zones of the Lunge Matrices for proper real and relative joint motion, econcentric action of the muscles, and finally stimulation of all the proprioceptors. Ideally, because Tommy is a football player, we wanted to take him to into as many movements as possible so that his body would be able to have “already been there” and could make a functionally sound movement that not only prevented another injury, but ensured that he was successful.