Joint cracking

Joint cracking is the manipulation of joints to produce a sound and related "popping" sensation. It is sometimes performed by physical therapists, chiropractors, osteopaths, and masseurs in Turkish baths pursuing a variety of outcomes. The cracking of joints, especially knuckles, was long believed to lead to arthritis and other joint problems. However, this is not supported by medical research. The cracking mechanism and the resulting sound is caused by dissolved gas (nitrogen gas) cavitation bubbles suddenly collapsing inside the joints. This happens when the joint cavity is stretched beyond its normal size. The pressure inside the joint cavity drops and the dissolved gas suddenly comes out of solution and takes gaseous form which makes a distinct popping noise. To be able to crack the same knuckle again requires waiting about 20 minutes before the bubbles dissolve back into the synovial fluid and will be able to form again. It is possible for voluntary joint cracking by an individual to be considered as part of the obsessive–compulsive disorders spectrum. For many decades, the physical mechanism that causes the cracking sound as a result of bending, twisting, or compressing joints was uncertain. Suggested causes included: Cavitation within the joint—small cavities of partial vacuum form in the synovial fluid and then rapidly collapse, producing a sharp sound. Rapid stretching of ligaments. Intra-articular (within-joint) adhesions being broken. Formation of bubbles of joint air as the joint is expanded. There were several hypotheses to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it. When a spinal manipulation is performed, the applied force separates the articular surfaces of a fully encapsulated synovial joint, which in turn creates a reduction in pressure within the joint cavity. In this low-pressure environment, some of the gases that are dissolved in the synovial fluid (which are naturally found in all bodily fluids) leave the solution, making a bubble, or cavity (tribonucleation), which rapidly collapses upon itself, resulting in a "clicking" sound.

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Related concepts (2)

Physical therapy

Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries. The career has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography.

Joint cracking