This technique is a therapeutic procedure applied to the patient’s spine with an aim to restore ‘normal’ movement. The manipulation involves taking a joint past its normal end range of motion, but not past its anatomical end range of motion. There are different types of manipulations that can be used, however at DAHM a ‘short lever manipulation’ also known as high-velocity low-amplitude manipulation may be chosen to utilise.
Often people associate manipulations with a ‘clicking’ or ‘popping’ sound, which may or may not occur. The most widely accepted explanation for the production of the ‘crack’ sound, is an event called ‘cavitation’, which occurs within the affected joint’s synovial fluid (SF) (Evans and Breen, 2006). The term ‘cavitation’ refers to the formation and activity of gaseous bubbles (or cavities) within the SF of the joint, which are created in a local decline in pressure (Evans and Lucas, 2010).
There are many suggested benefits relating to manipulations that can be categorised into three sections:
– A Biomechanical Reaction – a release of entrapped synovial fluid and/or the unbuckling of motion segments resulting in improved ranges of movement.
– Muscular Reflexogenic Reaction – a modulation of alpha and gamma motor neuron activity resulting in the relaxation of hypertonic (sensation of tightness) muscles.
– Neurophysiological Reaction – Activation of the descending inhibitory systems, and stimulation of Beta endorphins resulting in a reduction in pain.