Joint manipulation

Manipulation of joints is often referred to as "cracking" by many people. Physiotherapists, 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 malpositions of joints

A blockage of a joint is an example of a malposition. Malpositions of joints are incorrect joint positions. When there is a blockage, damage is done to the articular cartilage. Various types of malpositions are possible:

• Static malpositions; reduced mobility of a joint.
• Dynamic malpositions; during movement, the two bones do not move correctly in relation to each other. This is also called instability.
• Reversible malpositions; blockages that can be resolved without surgery.
• Irreversible malpositions; blockages that cannot be treated without surgery. Think of a fracture that heals misaligned.

Manipulations for blocked joints

A manipulation is performed on static reversible malpositions. A manipulation removes the blockage. A manipulation can produce a cracking sound due to pressure changes in the joint, similar to popping bubble wrap or pulling off a suction cup.

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

Correct loading of articular cartilage

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

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

Causes of static malpositions or blockages

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

• Maintaining the same posture for a long time.
• Prolonged immobilisation (cast).
• Not using a certain body region, which 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, joint capsule or loose body.
• Accident causing a malposition. Examples are overstretching, damage to the capsule or contusion.

Effects of joint manipulations

By performing a manipulation on joints, influence is exerted on tissue around the joint. In and around a joint there are many structures that affect mobility. Manipulations give an impulse to the joint fluid, cartilage, capsule and muscles. This stimulates natural recovery.

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

Treatment with manipulations

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