• Dr. Daniel Keadle

What is a Chiropractic Adjustment?

Many people go to the chiropractor to get their neck, back, and hips “popped” or “cracked.” While we definitely do make our career out of “cracking backs,” we much prefer the term “adjustment” or “manipulation.” Chiropractors and other physicians may disagree about which of those terms is more appropriate (or accurate), but that’s purely an argument over terminology more than anything else. For the sake of consistency, today we’ll be referring to those pops and cracks as an “adjustment.”

So, the big question is, what actually IS a chiropractic adjustment??

The main goal of most chiropractors is to restore and/or increase joint motion. This applies to individual segments as well as larger regions. For example, a patient may be able to rotate their head to the right only 45 degrees, but normal range of motion is actually 90 degrees. If the patient can’t rotate their head that far, that means that they’re experiencing restriction from either the soft tissues or the joints or potentially both. That restricted range of motion is often accompanied by pain, tightness, etc and can lead to other problems (bad posture, tension headaches, etc). So, our goal with the adjustment is to slowly aid in the restoration of more normal range of motion.

Now, how does the adjustment actually work?

All of your joints have a defined range of motion. Active range of motion (what you do to yourself) is actually the smallest. Then you have passive range of motion, this is when our muscles are totally relaxed and someone else moves the joint for you (like a puppet). And finally we have the paraphysiological space which is a small window of motion just short of where you would surpass the physical limits of the joint itself. This image below displays that pretty well.



An adjustment works by pushing a joint into the paraphysiological space with a high speed, low intensity “thrust” (either by hand or with a tool). When we forcefully push that joint into the paraphysiological space, we’re able to slowly increase the available range of active and passive motion while “breaking down” restrictions. While science has a long way to go with regard to the specific mechanisms behind why this happens, we know that this type of adjustment has a positive effect on the physical structure of the joint, it’s range of motion, the tension of the surrounding soft tissue, and even the neurological feedback loops created between that joint (or joints) and your brain.

Well what’s the popping noise?

The popping noise you hear is actually coming from inside the joint. The joints are filled with fluid that’s under a certain amount of pressure. When we deliver the adjustment, it creates negative pressure within the joint and the fluid bubbles up, just like when you pop the top on a fresh soda. This also explains why different people “pop” more or less than others. The quality and quantity of the joint fluid will determine how much of a noise the adjustment creates. It’s also important to understand that the popping noise isn’t the only thing that determines whether an adjustment was effective or not. As my teachers in chiropractic school used to say, “Don’t get addicted to crack!”

I hope this sheds some light on what is actually happening when you go to the chiropractor. Don’t get caught up in the difference between manipulations and adjustments and mobilizations. 99 times out of 100, they’re probably all describing the same type of treatment that chiropractors have been delivering since 1895. If you’re in the Raleigh, Cary, or Wake Forest area, I’d love to show you in person what an adjustment looks and feels like…if not, I hope you’ll find a chiropractor near you!

As always, you can contact me through our website, email, Facebook, or Instagram if you have questions!

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