By Hashim Saifuddin
Most of us will have heard a crack emanate from somewhere in our bodies at some point in our lives! The causes of these sounds are many: a stiff joint in the spine, and a tendon or ligament rubbing over a bony prominence are relatively minor causes; right through to a fracture of a bone being a major cause!
This article will focus on a technique that osteopaths (as well as chiropractors and some physiotherapists) carry out in order to restore normal function to a joint – be that in the spine, or the upper and lower limbs.
The technique, in full, is known as a high velocity and low amplitude thrust – HVLAT or HVT for short. You may have heard your clinician refer to it as a click or crack of the joint. The full name explains exactly what is happening when this technique is applied – high velocity (meaning a quick technique) low amplitude (meaning a small force technique). When applied correctly to a restricted joint, often an audible sound can be heard, which is what the clinician may refer to as a ‘click’ or ‘crack’.
So what is actually happening to cause this sound? Is bone being broken? This is a common misconception among patients, the answer to which is no! (Hopefully! Which is why you should only allow a qualified practitioner to HVT/manipulate your joints!) The sound is caused by synovial fluid cavitation and/or the release of gas bubbles from the joint to which the technique has been applied to.
In simple terms…when the HVT is carried out, the force applied separates the surfaces of the joint. The sound is thought to occur when gas bubbles are released from the joint, which varies from person to person. The contents of the resultant gas bubbles are thought to be mainly carbon dioxide.
Now, let’s finish off with a question I’m always asked…”If I crack my knuckles, will I get arthritis?” The answer to this question is that there is no evidence to suggest this will cause arthritis. In fact, a medical doctor called Donald Unger regularly cracked the knuckles of his left hand for over 60 years, whilst not cracking those of the right hand. No arthritis or other disease formed in either hand (and in 2009 he was awarded the 2009 Nobel Prize in Medicine!). So there you have it!
Find and book an Osteopathy appointment at triyoga
Hashim works as an associate osteopath alongside Nav Bhandher as a part of Guy Gold’s Osteopathic Practice at triyoga.
Hashim Saifuddin M Ost., D.O, N.D, MSc SMEH, qualified from the British College of Osteopathic Medicine in 2009 with a Masters in Osteopathy. He went on to complete an MSc in Sports Medicine, Exercise and Health at University College London in 2010. He has been practicing as a full time Osteopath since 2010 alongside some of London’s most highly regarded osteopaths.
Hashim has had a wealth of experience working with top football and rugby clubs, the GB Paralympic tennis team, as well as the prestige of being selected as one of the 25 Osteopaths making up the medical team for London 2012 Olympic Games.
