To crack or not to crack?

There are whole industries built on the concept of cracking the spine and a ‘release’ or cracking of joints. While this is considered by many to be quackery the idea of being ‘realigned’ is a seductive idea that seems to resonate with people. I asked Alexander Hunter, Clinical Director at one of London’s top physiotherapy clinics if cracking joints is helpful or not.

“When you adjust/manipulate a joint you’re essentially stretching it apart so far that the vacuum inside is released and you get a ‘pop’. I always explain it like the sound you get when opening a jam jar. We know from radiological studies it’s not ‘putting the joint back in place’, except if you’ve got a specific ligament injury. 

It tends to ‘feel’ good at the time, because you get a big mechanoreceptor stimulus and lots of pain gate mechanisms going full steam. 

But long term it tends to have a negative effect. Most joints that are painful, are this way because they’re already moving too much/overloaded e.g: facets in lower back being overloaded because the core/glutes are not working properly. So repeatedly doing aggressive stretching to such joints makes them worse and worse. Especially without appropriate strengthening around them.

Most people with chronic neck issues have overloaded facet joints. They all crack their own neck at least 2-3 times a day, so the first conversation I usually have is about stopping this!! If they manage to stop this bad habit, the urge to do it goes away in a few weeks and they always feel better for it. “

Alexander Hunter - Clinical Director

So what is a better option? If we can all agree that a ‘cracking joint’ is a dysfunctional joint, do we want to stretch and put force through a joint that isn’t moving correctly? Probably not! A better option is to strengthen around that joint and look upstream and downstream of the cracking joint in question and make sure forces acting on that joint are moving optimally. For example, underlying causes of knee cracking can be traced back to hip and ankle mobility/strength causing dysfunction, so mobilising these joints, then strengthening the knee in the space this creates, is a better long term solution to cracking joints.

You can’t go wrong getting strong.