Previously in this blog we’ve covered the basics of proprioception, and how it effects sports performance. If you haven’t read this yet, you can check it out here. This article touched on the use of proprioceptive training during rehab and return to play, but the influence proprioception has on sports injury in general reaches much further beyond the scope of that article.
The cost of injury in elite sport
Let’s start with a simple statement. Injuries are not 100% preventable in any sport. However, the impact of injury across elite sport is substantial. In team sports, injuries not only cost clubs money through lost wages, but also directly influence league points, finishing position, and ultimately income.
In the English Premier League, it is estimated that injuries cost clubs a staggering £221 million in salaries alone for the 2018/19 season, with each club suffering an average of 1410 player days lost to injury. These figures are even more pronounced in the NFL, with the estimated cost of injuries reaching $521 million. Within individual sports, injury can be even more impactful, with time off substantially reducing the performance and earning potential of an athlete.
As a result, clubs and organisations spend a significant amount of time, resource, and money on injury prevention strategies, considering everything from training and workload management, to physiotherapy, recovery, nutrition, and technical optimisation. Any impact in this area can save clubs or athletes money, and directly improve their chances of winning.
Proprioception and injury prevention
Before we start, let’s have a very quick recap on proprioception. If you’ve recently read our previous article on proprioception you can probably skip this bit.
In its simplest terms, proprioception is a conscious or subconscious awareness of your body position and movement. An individual with well developed proprioceptive skill is better able to control their body and adapt movement in reaction to the ever-changing environment around them. Sport is inherently a varied environment, with constantly changing stimuli that direct action. As we discussed in our previous article, this ability to adapt is a key performance differentiator between elite and non-elite athletes.
These ever-changing environments and stimuli that we find to some degree in all sports, also bring with them instability, which in itself is one of the greatest causes of injury. Instability can either be caused by impact, for example with another player, or by a lack of strength, muscle imbalance, or joint instability. In many sports, where the loading is high and athletes reach towards the end of their natural range of motion, the risk of injury caused by instability is significantly increased.
I imagine at this point the link between proprioception and injury prevention in sport is becoming clearer. In performance terms, highly developed proprioceptive skill may help a gymnast perform an athletic dismount, transitioning seamlessly from beam to floor without having to even think about the changes in position required to land on the new surface. This same skill also helps that same gymnast deal with instability better, allowing them to adapt to an off-balance landing, both making minor adjustments to maintain a high level of performance, and reducing the risk of picking up an injury in the process.
This link is sufficiently strong that enhanced proprioception, developed through training, has been explicitly linked to reductions in knee, ankle, and overall injuries amongst athletes. A recent study in basketball found that incorporating proprioception-specific exercises, along with targeted balance and strength training, decreased the risk of ankle and knee sprains by a staggering 81% and 65% respectively. The authors suggest that this reduction in injury rates can be attributed to two factors. Firstly, the improved movement control that allows athletes to better manage stress on muscles and joints during high-impact motions. Secondly, the adaptations and increased plasticity seen in muscles, ligaments, and tendons minimising force due to enhanced proprioceptive control.
Unsurprisingly, this reduction in injury corresponded with a 76% reduction in missed games and practice, as well as reduced reliance on strapping and braces. Although the severity of sprains that did occur remained consistent even following the intervention. Whether this magnitude of injury prevention could be reproduced with other athletic groups remains to be seen, but this one study clearly shows the potential significance of proprioception in injury prevention.
Proprioception during rehab and return-to-play
As we’ve discussed, you can be as strong, flexible, and equipped to deal with instability as you like, but injuries will still occur. Unfortunately, any injury that causes damage to soft tissue where proprioceptors are located, results in some loss of proprioception. This loss of proprioception, along with a weakening of the structures supporting a given area of the body, can lead to both injury recurrence and cumulative damage over time. Although injury can cause individuals to avoid exercise altogether, it is critical that you work to restore strength, range of movement, and proprioception in the injured area.
Studies in US collegiate baseball found proprioceptive defects to be a significant mechanism for shoulder instability amongst pitchers, and that shoulder pain was linked with reduced proprioceptive sensation in that area. Athletes who do all they can to maintain and quickly restore proprioceptive skill are likely to experience reduced pain and enhanced control during return-to-play.
Fortunately, you can quickly rebuild your proprioception, balance, and ability to deal with instability through targeted exercise. The use of wobble boards during static and dynamic activity is a common place to start particularly for lower body injury, working to improve the feedback between muscles and your central nervous system, and training your body to more efficiently react to the instability created without conscious thought. This instability becomes slightly harder to manufacture for upper body injuries, although the use of resistance bands and some creativity in exercise prescription normally does the trick. A simple Google search will help you find plenty of ideas for targeted exercises that may help you.
How Exosuit can help with injury prevention and return-to-play
All Exosuit products are designed with athletes in mind, specifically to help support, stabilise, and power performance. For those of us suffering instability, there are a number of ways that Exosuit could be of benefit:
Exosuit interacts with your body to enhance proprioception
As we now know, an acute awareness of motion and body position can help reduce the risk of sustaining injury during exercise. By interacting with your skin via silicone panels at key anatomical locations, Exosuit garments enhance awareness of position, movement, posture, and muscular activation during exercise. We will never claim that this awareness prevents all injury, but it does give your body a better chance to adapt to unexpected perturbations, and therefore to avoid some instability and reduce the risk of injury.
Patented PowerFlex Technology stabilises key muscles and joints
Exosuit garments all come with our patented integrated flexible support, designed to stabilise key joints and muscles during exercise. The EXO1 for example, actively supports the shoulders and upper back, assisting the surrounding muscles in providing joint stability particularly for upper body focussed and overhead activities. You can check out more about how this technology works via our features page.
The unique cut of Exosuit garments supports dynamic posture
Many people neglect correct posture as a direct influencer on both athletic performance and injury, however this is definitely not a factor you should ignore. The unique cut of the EXO1, in combination with the integrated flexible support, works to draw the shoulders back and straighten the spine into a strong neutral posture. We will cover this in more detail in future articles, but in short this can reduce loading on vulnerable muscles and joints, directly reducing the risk of pain and injury.
Exosuit is not a magic pill. It will not solve all your problems with sports performance or injury. But for many of us, enhanced awareness and additional support around vulnerable areas can make a substantial difference. This is where we are focussing our research and development – apparel that is specifically designed to interact with the body to support and power performance, and that makes a genuine difference to athletes at all levels.
You can read more about the science behind Exosuit here.