How Loss of Mobility and Proprioception Can Raise Your Risk of Falling + What to do about it!

As we get older or deal with certain injuries or conditions, it’s common to feel a little less steady on our feet. But have you ever wondered why? Two reasons are loss of mobility and loss of proprioception, and the two are closely linked.

Let’s break it down.

What is proprioception?

Proprioception is your body’s ability to sense where it is in space, without needing to look. It helps you balance, move smoothly, and react quickly if you trip or slip. For example, proprioception helps you put your foot on the next stair without watching it, or recover if you start to wobble (Brumagne et al., 2000).

How does the loss of mobility affect proprioception?

If your joints or spine don’t move well, the sensors (called mechanoreceptors) in those areas don’t get used as much. Over time, this can “dull” the feedback your brain gets about where your body parts are (Pai et al., 1997; Hassan et al., 2001).

What can cause loss of mobility?

• Sedentary lifestyle – Sitting too much means joints and muscles don’t go through their full range of motion often (Sturnieks et al., 2004).
• Injury – After a fall or joint injury, we get swelling and immobilisation of an area as it heals. The loss of mobility and lack of use can lead to altered deposition of collagen fibres and fibrosis. Even if rehab goes well, we can be left with some altered proprioception, one of the reasons why people tend to repeatedly re-injure the same ankle over and over. Injury can also lead to fear and apprehension when reintroducing movement to that area, so the process of returning to full form is often slow.
• Degenerative changes – Conditions like hip or spine arthritis can stiffen joints and alter the way we move, which affects proprioceptive input (Hassan et al., 2001; van Dieën et al., 2019).

When we stop moving fully and freely, we don’t just get stiff — our ability to sense movement and position can fade too (Pai et al., 1997).

How loss of proprioception (and other factors) can increase fall risk

When proprioception is reduced, it’s harder to:

• Keep your balance, especially on uneven surfaces
• React quickly if you start to fall
• Adjust your posture to stay upright

Poor proprioception has been shown to contribute to greater postural sway and poorer balance (Hassan et al., 2001). But proprioception isn’t the only factor in falls. Falls often result from a mix of issues that tend to feed into one another, rather than being stand-alone issues:

• Muscle weakness
• Slower reflexes
• Poor vision
• Inner ear (vestibular) problems
• Pain and fear of falling (Sturnieks et al., 2004)

That’s why addressing balance problems usually means looking at the whole picture.

 What can you do?

1. Stay active: Regular movement keeps your joints and sensors working. Walking, gentle stretching, tai chi, yoga, and strength training all help maintain mobility and proprioception (Menz et al., 2003). You don’t need all of these inputs, but try to include a few.
2. Challenge your balance safely: Try standing on one leg (near a counter for support if needed) or walking heel-to-toe along a line. Try incorporating more single-leg or arm movements when training. Play sports that challenge your balance.
3. Address pain or stiffness: Seek help for joint or back pain so it doesn’t lead to significant reductions in your mobility (van Dieën et al., 2019).
4. Get assessed if concerned: Manual therapists like osteopaths or chiropractors and the like are trained to evaluate mobility issues, strength imbalances, and movement control issues. If you have pain or a loss of mobility, it could be an excellent idea to start getting some regular hands-on care. Spinal adjustments are shown to help stimulate these mechanoreceptors and improve this proprioceptive feedback. They can be used as an adjunct to rehab and mobility training to speed up recovery and aid in preventing further losses (Haavik and Murphy, 2012,Hillermann et al., 2006; Solecki, 2017).

References

Brumagne, S., Cordo, P. and Verschueren, S. (2000). Proprioceptive weighting changes in persons with low back pain and elderly persons during upright standing. Neuroscience Letters, 273(1), pp.63–66.

Hassan, B.S., Mockett, S. and Doherty, M. (2001). Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Annals of the Rheumatic Diseases, 60(6), pp.612–618.

Menz, H.B., Lord, S.R. and Fitzpatrick, R.C. (2003). Age-related differences in walking stability. Age and Ageing, 32(2), pp.137–142.

Pai, Y.C., Rymer, W.Z., Chang, R.W. and Sharma, L. (1997). Effect of age and osteoarthritis on knee proprioception. Arthritis & Rheumatism, 40(12), pp.2260–2265.

Sturnieks, D.L., St George, R. and Lord, S.R. (2004). Balance disorders in the elderly. Neurophysiologie Clinique/Clinical Neurophysiology, 34(6), pp.417–428.

van Dieën, J.H., Reeves, N.P. and Kawchuk, G. (2019). Motor control changes in low back pain: divergence in presentations and mechanisms. Journal of Orthopaedic & Sports Physical Therapy, 49(6), pp.370–379.

Haavik, H. and Murphy, B. (2012). The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22(5), pp.768–776.

Hillermann, B., Gomes, A.N. and Groenevald, H.T. (2006). The effect of sacroiliac manipulation on postural control. Journal of Manipulative and Physiological Therapeutics, 29(8), pp.582–586.

Solecki, T.J. (2017). Immediate effects of sacroiliac joint manipulation on postural sway in patients with non-specific low back pain: a randomized controlled trial. Journal of Bodywork and Movement Therapies, 21(2), pp.345–351.