Joint manipulation

Joint Manipulation


If, like me you want to know everything about what you will experience during a treatment, then following is a fairly in depth explanation of what happens when you have a joint manipulated/adjusted/clicked.


If you are not interested, here is the short version.


You have a joint restricted or ‘stuck’. The reason it’s stuck is because the muscles around the joint are in a spasm. when I ‘click’ the joint using a HVT (high velocity thrust) Which is exactly the same as if you crack your finger joints, then these muscles will relax, allowing the joint to move more naturally. This will take stress off the joint tissues relieving your pain.


For those of you with more enquiring minds, read on………


There are some important facts to be aware of about joints, before we consider what happens with a manipulation or ‘click’ of the joint. There is a commonality between all joints in the human body in that they are all composed of two very slippery surfaces of bone separated by a thin layer of Synovial fluid. Synovial fluid is possibly the most slippery substance known to man! NASA wishes it could reproduce something like it!


All joints are held together with ligaments. Ligaments are a powerful non stretchy dense material that blend with the lining of your bones holding them together, often completely enveloping the whole joint making a kind of capsule around it.


Your skeleton, is a collection of bones joined together with ligaments. This bone collection would be nothing more than an inanimate pile of sticks, if not for your muscles!


Muscles are what hold the bones up and move them around each other. Every conceivable movement of a joint is controlled by muscles. Muscles are joined to your bones by tendons. Tendons are a natural extension of the stretchy contractile muscle fibres. They are denser, less stretchy and again blend into the lining of the bone. When a muscle contracts, (shortens) it pulls one part of a bone towards another, with the outcome perhaps bending your arm.


So that’s the anatomy, but what happens when you manipulate/adjust/click, a joint?


Firstly joints are rarely ‘out of place’, what usually happens, particularly in the spine, is that the muscles surrounding the joint become irritated for any number of reasons, from trauma to sustained poor posture, and they go into a spasm, then, if you stretch them, as you turn your neck for instance. They react by going into a stronger spasm. This restricts the movement of the joint and creates pain., possibly even irritation and inflammation of the joint surfaces. Remember, that joints are inert and can do nothing unless a muscle acts upon them.


So in reality what we are dealing with are the muscles surrounding the joint! Often they are too small and too deep to physically massage. This is where the joint manipulation comes in. read carefully on...


Within the tendons of your muscles are microscopic apparatus that report back to your brain. They tell the brain how much tension is being applied from the muscle contraction.


They play an important role in protecting your muscles and joints from trauma in 2 different ways.


If excessive stress is applied to the muscle or joint slowly, the tendon apparatus report this to the brain, which in turn sends a signal back telling the muscle to contract, counteracting the stress.


If a sudden stress is applied, the body will cleverly, protectively and completely, relax the muscle, so that it can stretch further without damage to the tendon, muscle or joint. It is this protective mechanism that joint manipulation takes advantage of.


In osteopathy a joint manipulation is known as a high velocity thrust or HVT. High velocity means ‘fast’, basically a fast thrust initiates the body’s natural protective mechanism to relax the muscles surrounding the joint. However there is another extremely important factor to consider… Low amplitude.


Low amplitude means ‘little movement’ so in essence what we have is a fast thrust through a small amount of movement. This is were the safety factor comes in. A skilled practitioner will ‘lock’ the joint before performing the HVT. This means taking all available movement out of the joint usually by rotating, side bending and forward or back bending it. At this point, there is almost no movement left, a quick but short thrusting movement in the correct direction will stretch the tendons around the joint, often leading to the characteristic ‘pop’ in the joint as it slightly separates. If there is any pain at the point of locking then the HVT should not be used. There should also be no pain when performing the HVT. Although many people still find the ‘pop’ disconcerting, it should be painless. In skilled hands a high velocity low amplitude thrust is painless and very, very safe. After the pop and the subsequent relaxation of the surrounding muscles, the joint is more able to move freely leading to sometimes dramatic reduction in pain symptoms.


Of course its much easier to say “I’ve just put your joint back in”!


What is the ‘pop’? The most ‘pop’ular theory about the pop or crack that occurs during a joint manipulation concerns the fluid between the joint surfaces. As the joint is separated gas is sucked out of the fluid by the negative pressure, this gas forms into bubbles which ‘pop’ as the joint continues to open, you can create a simiar effect by wetting the palms of your hand and pulling them directly apart quickly. Because bone is very conductive to sound, the crack or pop can sometimes seem very loud. Sometimes it is almost inaudible.
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