Proprioception is the body's awareness of where it is in nature. Jennifer A. Stone of the Sports Medicine Division of the U.S. Olympic Committee writes, "Proprioception training is an essential part of any rehabilitation program to return an athlete to pre-injury performance." Shoulder proprioceptive training is an important tool for athletes and non-athletes in the prevention and rehabilitation of upper body injuries.
Proprioceptive feedback is sent to the body's central nervous system, the brain and spinal cord, via receptors in the muscles, tendons, joint capsules, ligaments and outer lining of the bone called the periosteum. The receptors located in the muscles exist in larger quantities in body areas where greater skill is required, such as the hands. Shoulder proprioception is vital because of the shoulder's working relationship with the hand.
The Journal of Athletic Training reports proprioception exists in two manners. The first is the body's ability to vary contractile forces of muscles in immediate response to outside forces. The second positions the limb at any moment in time. To satisfy both of these key components, shoulder proprioceptive training needs to be executed while weight-bearing and non-weight bearing.
General Proprioceptive Training
Exercises designed to increase cardiovascular health, power, strength, flexibility, range of motion, endurance and fitness provide general proprioceptive training. Exercises performed on the unstable gymball and balance ball surfaces incorporate greater proprioceptive feedback than training on a flat surface. Dumbbells and kettlebell exercises provide more proprioceptive training than a barbell. Running and cycling outdoors supplies greater proprioceptive feedback than treadmills and stationary bikes. Plyometrics and sport specific training are great proprioception exercises. These general exercises are starting points for shoulder proprioceptive training.
Shoulder proprioception training needs to be specific for the upper extremity. The best programs work the entire arm-trunk mechanism through various planes in functional motions. Start with non-weight bearing exercises, especially if recovering from surgery, immobilization, lack of strength, limited range of motion or illness. Start at your own level and progress gradually. Stand with your eyes closed and move both your arms in identical motions through pain free ranges of motion of the shoulders, elbows, wrists, hands and fingers. Pinch your shoulder blades together without shrugging your shoulders, close your eyes and move both your arms in identical motions through a pain-free range of motion. Stand on one leg and perform this exercise, then switch legs and repeat. This will train the parts of the body to work as a team and build balance, stability and awareness in the shoulder joints.
Weight-bearing shoulder exercises should be started gradually and should progress gradually. Begin by holding a push-up position on both hands and knees from 15 to 60 seconds. Progress to a push-up position balanced on both hands and feet, then move to a one-handed position. Advance in increments from the floor to a mini trampoline to a small exercise ball to a gym ball to two gym balls. These exercises develop greater proprioception, strength and balance in the shoulders.