In my previous Blog, The Physical Benefits of Recess we discussed the various sensory systems of the body that relate to physical therapy and gross motor movement…. visual, vestibular, tactile, and proprioception! Physical therapists do not often directly treat sensory issues or dysfunctions as this is typically the role of occupational therapists. However, I want to dig into how physical therapy supports those systems.
Our sensory systems send constant information to our brain about our body including its position in space, its position in relation to objects or people in its surroundings, its orientation to different planes or directions of movement, the amount of force we need to generate to complete a task, etc. These systems are developed & strengthened by gross motor movement & gross motor play. Ultimately, physical therapists facilitate the development of these various sensory systems for children & adolescents through our role & expertise with gross motor movement.
So how exactly do we do this?
One of the best ways to support the visual system is through ball skills & ball play! Throwing involves the ability to visually fixate on the person or target you’re throwing to as well as utilizes depth perception to judge the distance in order to know how far & hard to throw. Catching is also a great way to support the visual system as it involves hand-eye coordination and tracking (following a ball with the eyes & head) in order to successfully catch it. Kicking a ball or trapping it (stopping a ball with your feet), striking a ball with a bat, and hitting a ball with a tennis racquet are also great sports specific ways to support the visual system. Walking and running, especially across uneven and/or graded terrain (holes, bumps, hills, inclines, etc.) is another fabulous way to support the visual system as it forces us to visually scan our environment and attend to obstacles in our path. Balance activities also support our visual system as one of the main components of balance is vision. Stationary balance activities such as standing on one leg challenges & strengthens our ability to visually fixate on a still target. Dynamic balance activities such as walking across a balance beam or hopping on one leg, challenge our ability to visually accommodate which involves our visual system to change focus back & forth from near to far as we look down to watch our leg/foot position and then back up to attend to our environment & surroundings.
There are many different ways to support the vestibular system! The receptors for the vestibular system are located in our inner ear. They receive input when we move our head and send information to the brain about the position of the head and the body’s movement through space. Walking, running, swinging, riding a bike or scooter, spinning, obstacle courses and hanging upside down are all terrific ways to support this system as they involve movement of the head & body as well as typically involve changes of direction & speed. Remember the larger, faster, stronger the movement is the more vestibular input will be received.
The tactile sensory system has receptors located in the skin & joints that respond to the sensations of pressure, vibration, temperature, pain, and movement/position. Utilizing different textures in therapy activities such as with balls (soft/squishy balls, spikey balls, heavy/hard balls) or bean bags during throwing & catching activities can be a great way to support the tactile system. Performing animal walks (bear crawls, crab walks, etc.) and/or balancing activities barefoot in the grass, sand, dirt, etc. is also a great way to experience different textures & sensations. Water play such as running through the sprinklers or jumping in puddles is another terrific way to incorporate tactile sensory play & support this system. Water play is also a great way to develop sensation & awareness with different temperatures which is imperative for the development of this facet of the sensory system as it relates to safety.
The proprioceptive sensory system sends subconscious information to our brain about the body’s position in space. It provides information about where each part of the body is and how it is moving, especially in relation to other people or objects. This sensory system also informs the body about how much force to use when performing a task. The receptors for our proprioceptive system are located in our muscles & joints. One of the best ways to challenge & support this system is through heavy work activities. Heavy work activities are activities that are challenging to the body & provide significant resistance to the muscles & joints. Examples include climbing, pushing/pulling heavy objects, lifting & carrying weighted objects, running, jumping, etc. Remember the harder the activity the harder the muscles & joints will have to work which will send more feedback to the brain about the position of the body.
Again, the purpose of these sensory systems is to provide information to us about our body & environment. This information helps us grade our physical movement, problem solve, and keeps us safe. Remember that these systems do not work alone but constantly in conjunction with each other to provide the most accurate information and feedback for precise, skilled movement which contributes to body awareness & body scheme. When there is a dysfunction in one or more of these systems it can significantly impact a child’s body awareness, strength, balance, and coordination which in turn significantly impacts their gross motor skills. If you suspect that your child may have a deficit or dysfunction in one or more sensory systems please seek professional help from an occupational therapist. If gross motor skills are also impacted then physical therapy services may also be warranted.
Catherine C. Skelton, PT, DPT
Pediatric Physical Therapist