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The audible release associated with joint manipulation

R Brodeur1

  • 1Department of Biomechanics, Michigan State University, East Lansing 48824, USA.

Journal of Manipulative and Physiological Therapeutics
|March 1, 1995
PubMed
Summary

The audible release from joint manipulation, known as cracking, is caused by joint cavitation. This process, involving gas release in synovial fluid, increases joint motion and may initiate beneficial reflex actions.

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Area of Science:

  • Biomechanics
  • Physiology
  • Musculoskeletal System

Background:

  • The audible release during joint manipulation, often termed
  • is a common phenomenon.
  • Understanding the mechanism behind this sound is crucial for comprehending the physiological effects of manipulation.

Purpose of the Study:

  • To review existing literature on the audible release associated with joint manipulation.
  • To explore the underlying mechanisms, particularly joint cavitation.

Main Methods:

  • A literature search was conducted using MEDLINE database.
  • Keywords included: joint, joints, cartilage, crack, cracking, cavitation, crepitus, and noise.
  • Relevant articles were selected and all available data was synthesized.

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Main Results:

  • Audible release results from joint cavitation, a process where dissolved gases (primarily carbon dioxide) release from synovial fluid due to decreased intracapsular pressure.
  • Cavitation increases joint range of motion and alters the force-displacement curve.
  • Habitual joint cracking correlates with grip strength loss and soft-tissue swelling, but not arthritis.
  • The rapid joint distraction during cracking occurs faster than stretch reflexes.

Conclusions:

  • The rapid joint distraction during cavitation likely imparts a high impulse on surrounding ligaments and muscles.
  • Cavitation may initiate beneficial reflex actions, potentially explaining positive outcomes of manipulation.
  • Without cavitation, achieving therapeutic forces without causing damage would be challenging.