Proprioception,
the body's ability to react appropriately to external forces, is the
keystone to a functional rehabilitation program. When a joint is injured,
there is a decrease in mechanoreceptor function and proprioceptive feedback
to the brain. This deficit inhibits properly coordinated muscular effort
and results in an altered perception of body-space relation. Without
reestablishing proprioception, the other components of the rehabilitation
program (flexibility, strength, and endurance) cannot be orchestrated
in the goal of the athlete's return to participation. This may result
in chronic problems.
Lower extremity deficits in proprioception are easily determined by
using static and dynamic balance. Some clinicians recommend having the
athlete stand single-legged or hop in place, or both, while others use
a mini-tramp and watch for loss of balance or compensatory shoulder
motion.
Proprioception exercises should begin early in the rehabilitation process.
They are designed to restore the kinesthetic awareness of the athlete
and to form the basis for the coordination, agility, strength and endurance
required for return to participation. Their performance is simple, and
they place minimal stress on healing tissues. Early implementation of
proprioceptive work enhances the development of muscular strength and
endurance, since the athlete gains better control by performing these
exercises
