The Biggest Stability Training Myth

We have all seen the AirEx pad or BOSU ball being used in the rehab or gym.

Most people will claim that they are working on training “stability” and encouraging “proprioceptive activity” in their clients….

Which in my opinion is just a big fat lie!

When going through physical therapy school, everyone learns a test called the “foam and dome” test.

This is considered a clinical test for sensory integration.

Balance is composed of the visual system, vestibular system, and sensory/proprioception from the feet. During the foam and dome test we use an AirEx pad to impede one's ability to use their feet for proprioception. This way we can test how well the visual and vestibular systems are operating.

Yet when it comes to training, we use these same objects that IMPEDE proprioception to magically improve proprioception of the feet.

Consider that logic for a moment…..

It would be like me telling a client that we can improve your vision by impeding your vision using a blindfold. We all know that would be a bunch of malarkey! So why is it any different with proprioception?

Now I will give the benefit of the doubt and say that maybe the client will improve their hip righting strategies for balance because the ankle strategy is being impeded. The problem though is the ankle strategy should be the dominate strategy in keeping ones balance and a hip righting strategy should only be secondary to a failure in ankle strategy for balance.

Research has shown that after an injury, people tend to shift towards a visual proprioceptive strategy as opposed to a sensory proprioceptive strategy from pressure in the foot or limb/joint angle awareness. This mechanism was discussed in “Neuroplasticity following ACL injury: A framework for visual-motor training” by Grooms and colleagues. 

A better way to go about “stability” training and working the proprioceptors of the feet would be to have the client close their eyes as they stand on solid ground. This would challenge the proprioceptive system by taking away the visual system. The client could balance on one foot, perform an exercise such as a squat, lunge, RDL, or even a low level plyometric that you would deem safe for the athlete with eyes closed.