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What Is The Difference Between Deep Pressure And Proprioception?

Rondalyn V. Whitney, PhD, OTR/L, FAOTA

December 26, 2016

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Question

What is the difference between deep pressure and proprioception? 

Answer

This is a fantastic question. That means you have been really paying attention. This is one of the most common areas of confusion in the sensory system. In my experience, and the only way I have ever been able to keep it straight for myself, is to identify the receptors. If I hear something, the receptors of my eye do not respond. They do not respond to sound. They do not fire. They do not do anything. The receptors for vision are in the visual system. The receptors for auditory are in the ear.

The receptors for deep pressure are in the skin. The receptors for proprioception are in the joint or in the muscle, not in the skin. The only way to make the receptors for deep pressure fire is to rub the skin, push down on the skin. That is where they are. They are deep down in the skin, but you do not have to move to do that. You can be sitting perfectly still.

The only way to get the receptors for proprioception to fire is to move the joints or the muscles. If I stick my tongue out and push hard on the back of my teeth, my tongue is a muscle, so my proprioceptive system is going to fire. If I pull on theraband like an isometric activity, my proprioceptive system is going to fire. In contrast, if I have a stuffed animal that is really heavy and I set it on my lap and do not move, the receptors of deep pressure will fire. I am not moving my joints or muscles so proprioception will not fire.

Let me give you another example. When working with individuals who have difficulty with modulation, if you did not know anything else to try, what activity might you try? What system did I say was a boss? The vestibular system is a very important system. It connects us to mother Earth, but if your vestibular system is freaking out and you need to modulate it, you are going to use proprioception. Proprioception is the boss. It is the strongest input. That is why exercise, running, and pushing and pulling on your joints and muscles are going to give you an overall organized effect. That is why chewing on a carrot or apple can be helpful. These are proprioceptive activities.

The tactile system is going to help calm and soothe us, and feel much more organized. However when you really are overstimulated because everything is going wrong, think about using the proprioceptive system; moving the joints and muscles. This is a very important system for you to understand, and one of the systems that we are getting less and less input, which is unfortunate.

One of the reasons I think this conversation is because there is so much information coming at us regarding healthy choices. We should do this, we should do that. If you say to yourself, "Okay, is there a place in my nervous system that that would be helpful? Do I have a receptor for that, and if I do, what will that receptor do? They are telling me I should move more. They are telling me I should eat crunchy foods. They are telling me I might want to try music. What will that give me? Do I need to be calmed? No. Well, maybe that will not work for me. That's just one person's experience."

I have seen this happen a lot. I read a study recently that said researchers have found that using a brush, like a brush that you might use in the shower, has been found to increase weight loss. I thought it was not a good reporting of a study, because they were drawing a cause and effect that do not necessarily go together. How could the use of brushing increase weight loss? Is it brushing, or is something else going on? What system is that brushing information going to? Tactile is the correct answer. What did we say about the tactile system and food? Tactile stimuli and food go together, right? Perhaps, for the people who have some sensory over-responsivity in the tactile, might not need to use food substances as a compensatory strategy. Isn't that interesting? 

Once you start to understand the individual sensory systems, you can start to evaluate research, what you are hearing in the news, and more importantly, evaluate what you are doing in order to achieve optimal health and optimal function in your life and in the life of your family. 

I worked with the child one time and she was freaking out when she had to get into the car or when they got the car seat out. I was beginning to wonder if she had been abused. It was so serious. She was about four years old. The family came to me and they were beside themselves. Obviously car seats are required, so it was a real problem. We tried lots of different things. We discovered that when she had a little bit of vanilla scent on her wrist that she could smell when she got into her car seat, she was able to modulate and mom could put her in the car seat. Here is why it may have worked. Remember we said if we can find something for our system that helps us feel calm and organized and modulate, we can deal with a challenge. Something about that car seat was probably very challenging to this little girl, I would guess tactilely, right? It was probably a tactile challenge because it was rubbing up against her. She definitely had some other tactile issues, so that is probably a good guess. Something about the scent of vanilla was very calming to her, and it gave the family just a moment of calm, organized integration of sensation. She started to learn and associate something calming with the car seat. She came to a talk of mine when she had grown up. She was 16, and she came to see me and told me about all the other ways that she used scent. She mixed all kinds of perfumes together and that was her thing. That was her modulation. Isn't it incredible? We can be detectives and help people live their lives and participate in the things that they want to do.


rondalyn v whitney

Rondalyn V. Whitney, PhD, OTR/L, FAOTA

Rondalyn Whitney’s research focuses on emotional disclosure to reduce stress and improve quality of life and family quality of life when raising a child with disabilities.  She is the author of more than 6 books, her work has been published in over 10 scholarly journals and she is a Fellow of the American Occupational Therapy Association. She serves as a reviewer for several journals.


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