Proprioception training has a role in improving performance output not only in a context of rehabilitation process but even for a general improvement in movement quality and in the early stages of cognitive/learning skills process.

Proprioceptive function in an athlete is the result of proper integration between kinesthetic awareness, neuromuscular control, neuromuscular coordination and proper muscle sequencing: especially at the beginning of a new general preparation phase (GPP), when proper muscle balance and sequencing can be impaired due to the specific training and loading demands of the previous competition phase, the use of EMS as a means of proprioceptive training can support the improvement of overall movement quality and general muscle patterning.

Muscle action and movement start with the brain receiving the proper information from specific proprioceptors about the position of the body into space, speed and direction of movement: we are aware of the position of our body segments thanks to the function of the proprioceptive sensitivity and the integrated action of some mechanoreceptors located into skin cells (Ruffini), joint receptors and muscle receptors (i.e. muscle spindles and Golgi tendon organs) which all transmits informations from the peripheral nerves up to the spinal cord.

Stuart McGill, professor of spine biomechanics at University of Waterloo, once stated that the main difference between top performers and low-profile athletes lies in the ability of elite pros to use mental imagery in order to activate the right muscles at the right moment during competition: practical applications were already showing the benefits since the early years of EMS in sport but research is very clear now in supporting the benefits of using EMS in association with voluntary contractions to improve neuromuscular outcomes.

The way EMS can support proprioceptive function is by the modification of the order of motor unit recruitment as well as neural adaptations through reflex inputs to the spinal cord and supraspinal centers (Vanderthommen & Duchateau, 2007); also, it seems that CNS activation induced by EMS is due to the activation of sensory neuronal axons that send proprioceptive signals to the brain (Muthalib et al., 2017).

The muscle contractions induced by EMS are spatially fixed in terms of recruitment (Gregory CM et al., 2005), allowing a very high level of activation useful as a sort of biofeedback stimulus for re-training the ability to voluntary activate specific targeted muscles.

The table below (from Seyri et Maffiuletti, 2011) shows the main difference between voluntary and EMS contractions:

3 BASIC PAINPOD PROTOCOLS TO IMPROVE PROPRIOCEPTION AND KINESTHETIC AWARENESS

I used to work in 3 main areas for proprioceptive function training in sports performance, usually the most problematic areas of dysfunctions in athletes looking to rebalance and reprogram the neuromuscular system and the sensory input: feet, hamstring/glute medius and neck/upper back.

Feet represent the point in which all the neuromuscular compensations end up and the main interface that distributes our body weight to the ground through the complex interaction between 28 bones and 25 joints; hamstrings and glute medius muscles are key in the origin and transmission of force and power and the neck/upper body is the anatomical zone in which all the present muscular tensions can create inhibition and lack of activation.

Below you can find the foot protocol whereas the hamstrings and upper body protocols will be outlined in my next articles.

The protocol follows 3 steps and it is important to use it when the neuromuscular system is still fresh, as a part of the warm-up or during recovery days.

FOOT PROTOCOL

PainPod Mode: 8

STEP 1

Pad placement: A channel (left plantar fascia), B channel (right plantar fascia)

Intensity: no more than 8 (as tolerated)

Exercise: (30” stimulation + 6 reps reverse lunge) x 3

STEP 2

Pad placement: A channel (left tibialis anterior), B channel (right tibialis anterior)

Intensity: no more than 8 (as tolerated)  

Exercise: (30” stimulation + walkout push up) x 3

STEP 3

Pad Placement: A channel (left gastrocnemius), B channel (right gastrocnemius)

Intensity: no more than 10 (as tolerated)

Exercise: (20” stimulation left + 3 squat jumps + 20” stimulation right + 3 squat jumps) x 3