So what is Proprioception?
It is the awareness of our joints in space, or should i say lack of awareness of our joints in space and the end range of movements. This is partly why we get into the situations that we do and are so unaware of how 'bad' our alignment looks because we cannot sense it.
Due to the collagen laxity in people with EDS-HT there is continual movement into an extra range of joint movement and means we are more prone to injury because of the poor sense of spatial awareness of joint proprioception. Proprioception is determined by the spatial awareness of one's joints. For people with EDS-HT this judgement is impaired due to their poor joint proprioception, particularly at the end range of movement into their hyperextension.
People have questioned whether or not EDS is a problem of the neurological system? I think not. EDS-HT is a connective tissue disorder, this affects the connective tissues that will indirectly affect the neurological system because there is connective tissue and collagen surrounding the neurological pathways but this does not mean it is a neurological disorder. Poor proprioception is as a result of lax tissues which result in the nervous system not getting the feedback from the joints or the tissues. The nerves cannot sense the end range because they are not getting the feedback required from the soft tissue.
A poor sense of proprioception could explain why people with EDS-HT are more prone to accidents and injuries, because they are not aware of there end range of movement. In females the onset of menstruation can cause symptoms of joint pain and instability to worsen, This is because menstruation increases the release of the hormone progesterone, which further relaxes collagen further impairing proprioception.
Poor proprioception is very debilitating because the proprioceptive system is such a basic system in being human and in most people it just comes naturally but if this system is not working properly, the sense of not knowing where your joints are in space is basically eroding a sense of identity.
This can result in a whole list of difficulties which are linked into EDS-HT. These difficulties can be, overuse, dislocations, subluxations, soft tissue injuries and poor healing due to constant re-injury.
So it is thought that people with EDS-HT are prone to have poor proprioception because of tissue laxity of the soft tissues.
Motor coordination is reliant upon accurate proprioceptive feedback, so as a result of poor proprioception there can be a delay in motor development. This means that children with EDS-HT tend to learn to walk alot later than a child without EDS-HT and may experience problems with coordination.
So how do we manage proprioception?
It is possible to improve proprioception through exercise and exercise will also improve muscle tone which is why it is important for EDS-HT patients to be gently and slowly rehabilitated with exercises because improving proprioception and muscle tone may potentially reduce the number of ongoing traumas.
The following things can help with the management and improvement of proprioceptive dysfunction:
- Joint stabilising exercises
- Avoiding hyperextending joints
- Reversing the deconditioning of muscles which is as a result of muscle disuse
- Enhancing fitness and stamina through appropriate aerobic exercise ( please do not attempt these exercises without speaking to your physiotherapist first )
- Improving your core stability
- Using coping mechanisms and managing pain by pacing
It is no wonder that people with EDS-HT that are experiencing poor propriception also suffer from anxiety. It is like a constant battle of stability and can be very difficult being in a body that feel chaotic and out of control. It is thought that EDS-HT shares some of the genetic bases of anxiety but surely poor proprioception and physical instability caused by tissue laxity must also contribute to this.
I myself have poor proprioception and it is not as easy as said to just 'put it right' or 'improve it'. I wear a lycra suit as seen in my braces post, this helps support my joints but it also helps with proprioception because it is tight to the skin and therefore gives immediate sensory feedback regarding the misalignment of my joints when moving. It also helps me to hold myself in a better position because with the suit on i am aware of where my body is.
Using KT tape can also aid you. I use tape on my knees, shoulders, elbows, wrists and hips, to help support my joints but because the tape will pull on skin during movement it also gives immediate sensory feedback.
I hope you find this post useful. I have taken alot of information I have read in Isobel Knights Living with EDS book and just conveyed it in my own words. The book is very informative and a good read :)
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