Chiropractic Myths and Misconceptions
What makes the "cracking" sound when I get adjusted
There are many misconceptions around what that “crack” or popping sound during an adjustment means. The most common we hear from our patients are
- It’s the sound a joint makes when it goes back into alignment
- It’s the sound of the bones rubbing together
Well, neither is true. Synovial fluid in a joint has gases dissolved in it. Because joints are sealed hydrostatic environments when they are decompressed, negative pressure builds and a gas bubble is formed making the popping sound, called a cavitation. The cavitation is not sensitive to the direction in which the joint is decompressed. That is where the skill of a chiropractor comes into play.
Does an adjustment put the joint back in alignment?
Chiropractors don’t push joints back into alignment, your brain, nervous system and retraining does this for us, we just wake it all up!
A chiropractic adjustment, as opposed to a manipulation (a more generic approach to gapping a joint) is a usually a high velocity, low amplitude thrust delivered to a joint to restore motion that has been lost. For any joint in the body there are a multitude of planes in which it can become restricted or stuck. Actually you can have a joint that is
Misaligned and not “stuck”
A joint that is stuck and not “misaligned”
& everything in between
What we now know, is that the adjustment delivered with specificity wakes up neurological pathways (i.e. proprioceptive pathways) to the brain. When a joint is “stuck” certain pathways and areas of the brain that fire in response to that movement effectively go to sleep. It’s basically a neurological blind spot, in much the same way that you would lose a field of vision if you plucked an eye out. When a joint gets stuck, your brain is deprived of the sensory information that would normally come from joint receptors firing in response to that movement. These sensory pathways from joints and the information they carry are so very important. It is with this information that the brain can know where each of your joints are, what they are doing and hence where you are in space. This allows your brain to then go on to regulate not just muscle and joint function like keeping you balanced on 2 feet but also every other system in the body.
So by helping to restore joint motion that has been lost and waking up dormant pathways to the brain the adjustment helps to assist in changing muscle tone at the spinal level (the reflex effect from the brain down of restoring lost movement) which in turn assists in bringing the joints into better alignment.
Why does my back feel “out” and then after the adjustment feel like it is back “in” after an adjustment?
When your back feels out often what you are feeling is a joint that has been restricted and lost the ability to move freely through all the planes of motion. For example, your lower neck should be able to move freely in 6 planes, forward and back, side to side, turning right and left and all the combinations in between. When something feels out it means that you are noticing a loss of freedom to move in a particular way. As a result the resting position of the joint and the way in which you hold that body part can also change. So in the case of your neck you may be left holding your head with a slight tilt. Many other times you may not see a change in position rather that you can’t move well in a certain direction, or that you can move that way but it hurts.
Worse still, is when you have stuck joints that you don’t feel. This is really common given how efficient our bodies are at compensating. Usually we don’t feel “stuck” until we have run out of ways to compensate. Actually, we don’t often notice the early stages of joints being restricted which means by the time we do the wear and tear process can be quite advanced.
When treating, it’s not enough to just find the joint that is stuck. You also have to figure out specifically which plane of motion or direction it is stuck in and adjust it in that direction. That is where years of training and skill comes in. Then with a high velocity, low amplitude thrust we drive the joint through the plane of motion that has been lost. Once that lost motion has been restored (either with one or many corrections) reflex muscle activity changes in a way that brings the joint back towards its ‘ideal’ or normal resting position.
Why do I need more than one adjustment?
That’s a bit like saying why would you need to stretch a tight hamstring more than once. How many adjustment you need depends on
- How long the joint has been dysfunctional
- How much damage there is to the joint and surrounding tissues
- Whether the things you were doing in the first place to cause the problem have changed or not
- And how adherent you are the prescriptive exercises given to support the chiropractic adjustments
So because adjustments are a way of restoring lost motion to stiff and restricted joints, we need to repeat and support that process for as many times as it takes for that new movement to be retained, strengthened and incorporated back into your normal daily life.
The deeper joint structures are extremely resilient and in the same way that damage often happens slowly over time so too does healing.