What Happens with an Adjustment

Our bodies are made for movement and without it we will definitely experience ill health. Every cell in our body is stimulated by movement and it enhances the performance of every organ. Movement occurs at joints, which are made up of bones that come together in a complex of tissues allowing for movement and stability. For this to happen easily, the ends of the bones are covered in a silky smooth material called cartilage. The joint is encased in a fibrous material called a capsule and the inside lining of the capsule produces a thick fluid material that lubricates and nourishes the joint cartilage. The bones are held in place by thick fibrous elastic material called ligaments. The ligaments end up forming the outside walls of the capsule. Movement of the joint is made possible by the contraction of muscles that are attached to the bones near the joint by tendons. Other structures often found in or around joints include nerves, blood vessels, and cartilage structures called menisci, bursae and fat pads. Collectively these structures other than bone are known as soft tissues. It is also important to know that structures around the joint, especially the capsule and ligaments are well endowed with nerve endings making them very pain sensitive and also very important in posture, balance and coordination.

What Happens?

The adjustment is a painless, short amplitude, high velocity thrust that causes the bones to separate or move through a normal physiological range of motion. Essentially it is a way to bring about stretching without eliciting the stretch reflex. The stretch reflex occurs whenever a muscle is stretched. It involves contraction of the muscle that you are trying to stretch. In many cases the stretch ends up being counterproductive because the muscle that you are trying to stretch tightens up to resist the stretch. There are other ways to circumvent the stretch reflex but the adjustment is the quickest way and has many other benefits.

The Benefits

The chiropractic adjustment may provide the following benefits:

  • Pain relief.
  • Improved range of motion.
  • Decreased muscle spasm.
  • Improved coordination.
  • Improved balance.
  • Improved posture.
  • Improved strength.
  • Improved nerve function.
  • Improved circulation.
  • Improved health of the joint.

How Does This Happen?

All these benefits occur because the adjustment affects the joint in two major ways

1. Mechanical:

  • Separation of the bones of the joint means less contact between them and less friction in movement.
  • Separation of the bones of the joint results in a rapid stretch of the local muscles that causes them to relax.
  • Ligaments, capsules and fascia of the joint are stretched which can restore normal movement to the injured joint.
  • Joints that have menisci or meniscoids (cartilage discs) such as the knee, jaw or vertebral joints, may have these structures repositioned restoring normal motion and reducing pain.
  • Restoring the normal movement pattern in a joint helps to maintain normal pressure on the joint cartilage, which helps to keep it healthy.
  • Restoring the normal movement pattern in a joint helps to keep the synovial fluid moving within the joint so that it can lubricate and nourish all structures within the joint and prevent early degeneration.

2. Neurological:

  • The adjustment stimulates nerve endings in the soft tissues of the joint (mechanoreceptors), which in turn inhibit pain receptors.
  • The stretch reflex is short-circuited allowing muscles to relax.
  • Spasm and trigger points (knots in muscles) are deactivated resulting in less pain, improved muscle strength and function, better posture, balance and coordination.
  • Reduction in muscle hypertonicity improves blood and lymphatic circulation.
  • Slowing down the conduction of nerve impulses from the injured tissues results in normalizing impulses in the autonomic nervous system which can have far reaching effects such as a reduction in pain, improved tonus of smooth muscles in blood vessels and organs improving circulation and organ function.

What is the Crack?

The joint space is surrounded by the capsule and is filled with joint fluid that has the consistency of raw egg white. The chiropractor positions the patient to take out the “joint slack” with the joint near its limit of normal range of motion. He then imparts a very quick, low amplitude thrust which takes the joint into the safe para-physiological range of motion. This happens so quickly that the soft tissues and the patient are unable to resist the movement of the bones of the joint. Separation takes place and a gap in the joint is created. The joint fluid that normally fills the joint space cannot fill the gap quickly enough, so a relative vacuum is created in the gap. Instantly gases that are normally present in the joint fluid will form gas bubbles that pop when they are drawn into the vacuum of the gap. The cracking sound is not the bones being put back into place such as when a joint is dislocated, but a gas bubble popping. A dislocated bone being repositioned makes a clunking sound. It takes from 30 minutes to 2 hours for the gases to be reabsorbed into the joint fluid and by this time the original space in the joint has been reinstated. That is why you can only get a crack out of your knuckles every hour or two.

How safe is an adjustment?

When performed by a trained and licensed practitioner, the adjustment is an extremely safe procedure. Very few complications occur from the adjustment. If any do occur, it is usually joint irritation and localized muscle soreness that resolves quickly with the appropriate care. There are definite precautions that have to be taken with certain patients and chiropractors are well trained to either modify the procedure or refrain from adjusting in these instances. There has been controversial press coverage in the last few years about the possible risk of damage to the vertebral arteries in the neck after neck manipulation. Epidemiologists who study the incidence of diseases find it very difficult to put a number on the incidence of stroke like symptoms following neck manipulation because it is so rare. When pressed for a number they usually say that it ranges between 1 million and 3 million adjustments to give rise to stroke like symptoms, which can resolve within hours or days in most cases without any complications. Recent studies at the University of Calgary found that the action of turning your head fully puts twice the amount of stress on these vertebral arteries than does a neck adjustment. Although the risks when adjusting are infinitely less than the risks involved in taking anti-inflammatory drugs, chiropractors are always very careful to minimize the side effects. This is one of the reasons why chiropractors have one of the lowest mal-practice insurance premiums in health-care.

How about self-manipulation?

Although this practice is socially unacceptable, it is relatively safe. The adjustment is essentially a stretching maneuver and as long as you position yourself properly and don’t overstretch the soft tissues, no damage is done. If you do exceed the limits of the soft tissues you will feel pain and are not likely to want to do that again. Most people that self manipulate do so because they feel better afterwards. It is more dangerous to let an untrained person manipulate you than doing it yourself. Although it is likely that you will irritate the people around you when you crack your knuckles it is a myth that it will cause you to develop big knuckles and arthritis in your fingers.

How often do I need to be adjusted?

The answer to this question varies from person to person. If your joint mechanics are relatively sound and corrections are made early then very few treatments are needed and joint health can be maintained through an appropriate exercise program. If however you are unfortunate enough to be endowed with poor body alignment, have developed disorders which cause damage to joint structures or you have suffered injuries which have changed the architecture of your joints, you will require more treatment and in some cases constant care to prevent further deterioration. Individuals who place extra stress on their bodies by either being overweight, adopt poor posture or continuously subject themselves to repetitive strain are also likely to need extra care. It is always best to take care of these problems early and not wait until the condition has deteriorated. If you do, you can minimize the damage and the care required to correct it and you can keep it under control with proper exercise and health habits. What makes management of these problems more difficult is that people don’t always feel discomfort at the outset of these problems. By the time pain develops extensive tissue changes may have taken place. It is more prudent to have a physical checkup before problems arise, similarly to having your car alignment checked before your tires and bearings start to wear out.

If you have any questions about he adjustment and how it can help you, feel free to contact us.