At Mike Squirrell Physiotherapy and Sports Injury Clinic Harley Street you will receive the best care for your back, neck and spine. Mike Squirrell is a specialist in spinal manipulation and mobilisation for back pain, neck pain, sciatica and scoliosis and postural problems. All our practitioners are registered with the Health Professions Council and Chartered Society of Physiotherapy and have post-graduate certification and training in manipulation, X-ray and MRI diagnosis.
Joint manipulation is a type of passive movement of a skeletal joint. It is usually aimed at one or more ‘target’ synovial joints with the aim of achieving a therapeutic effect – i.e. a decrease in pain, increased flexibility, improved spinal alignment and posture.
Joint manipulation is characteristically associated with the production of an audible ‘clicking’ or ‘popping’ sound. This sound is believed to be the result of a phenomenon known as cavitation occurring within the synovial fluid of the joint. When a manipulation is performed, the applied force separates the articular surfaces of a fully encapsulated synovial joint. This deforms the joint capsule and intra-articular tissues, 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 solution creating a bubble or cavity, which rapidly collapses upon itself, resulting in a ‘clicking’ sound. The contents of this gas bubble are thought to be mainly carbon dioxide. The effects of this process will remain for a period of time termed the ‘refractory period’, which can range from a few minutes to more than an hour, while it is slowly reabsorbed back into the synovial fluid.
The clinical effects of joint manipulation have been shown to include:
* Temporary relief of musculoskeletal pain.
* Shortened time to recover from acute back sprains.
* Temporary increase in joint range of motion.
* Positive physiological effects upon the central nervous system.