Joint manipulation

Manipulation of joints is often referred to as ‘cracking’ by many people. Physical therapists, manual therapists, chiropractors, and osteopaths perform this procedure. It is a technique used to restore proper movement to joints. A joint can have movement problems for many reasons.

Blockages or positional faults of joints

A blockage of a joint is an example of a positional fault. Positional faults of joints are incorrect positions of joints. When a blockage is present, damage is done to the articular cartilage. Various types of positional faults are possible:

• Static positional faults: reduced mobility of a joint.
• Dynamic positional faults: during movement, the two bones do not move correctly relative to each other. This is also called instability.
• Reversible positional faults: blockages that can be resolved without surgery.
• Irreversible positional faults: blockages that cannot be treated without surgery. Think of a bone fracture that does not heal in proper alignment.

Manipulations for blocked joints

A manipulation is performed for static reversible positional faults. A manipulation lifts the blockage. A manipulation can produce a cracking sound due to pressure changes in the joint. Think of popping bubble wrap or pulling off a suction cup.

The cracking sound is the reason the treatment is often called 'cracking', but that sound does not come from the displacement of vertebrae or other bones. By removing a blockage, the normal function of the joint is restored.

Loading articular cartilage correctly

Normal loading of articular cartilage is an absolute requirement for maintaining good cartilage quality. When a joint does not move well, damage can occur.

During movement, nutrients, water, and oxygen are brought to all cells. Waste products are removed through movement. When a joint cannot move fully, increased pressure occurs. Cartilage depends on the right pressure in joints. How this works exactly, you can read here.

How static positional faults or blockages arise

A blockage arises from forms of underuse, overuse, or incorrect loading:

• Maintaining the same posture for a long time.
• Prolonged immobilization (cast).
• Not using a particular body region; this can be due to an incorrect movement pattern or inactivity.
• Not being able to move joints fully. This can be due to impingement of, for example, a meniscus, the joint capsule, or a loose body.
• An accident that causes a positional fault. Examples include overstretching, capsular damage, or a contusion.

Effects of joint manipulation

By performing a manipulation on joints, influence is exerted on the tissues around the joint. In and around a joint there are many structures that affect mobility. Manipulations provide a stimulus to the synovial fluid, cartilage, capsule, and muscles. This stimulates the body's natural recovery.

Synovial fluid and cartilage need movement and pressure to take up nutrients and remove waste products. The joint capsule, ligaments, and muscles around a joint must also be able to move well. These structures provide stability to a joint.

Treatment with manipulations

For treatment with manipulations, it is best to make an appointment with a manual therapist. This is a physical therapist with additional training who, among other things, focuses on manipulating joints.