What is the click?!

Ever wondered what the clicking sound is when a joint is manipulated? And why does it help? Read on to find out. 

Many osteopaths, and other manual therapists, use joint manipulation techniques to bring about therapeutic change. The aim is to restore normal function of the joint which, hopefully, brings about a reduction in reported symptoms. 

Before manipulating osteopaths will gauge whether the technique is suitable for the individual patient, if it is then they will carefully assess the range of movement of a joint and if it is restricted then they may chose to manipulate. The osteopath will gain consent before using this technique as some patients may not like it and very occasionally they may suffer associated side effects. 

All manipulatory techniques involve creating tension within a given joint; using either short or long levers. This tension is created by the structures within the joint (capsule, cartilage) and outside of the joint (muscle, ligament). The tension brings about the formation of a gas bubble within the joint (synovial) fluid. When an external force is applied (a high velocity low amplitude thrust) the gas bubble pops creating the audible 'click', 'pop' or 'crack'.

So what is the point of doing this?

There are many theories to what happens during and after joint manipulation, these include: 

• relaxing tight muscles that are related to the joint by causing a sudden stretch to them that affects there nerve supply
• releasing adhesions within the joint which cause restriction
• releasing any trapped material within the joint such as folds of joint synovium or cartilage

These factors all contribute to bringing about an improved function of the joint which many people find to be an effective technique in osteopathic treatment. 

If you like to find out more on this subject please read this paper http://www.ncor.org.uk/wp-content/uploads/2012/12/Audible_sounds_sm.pdf. 

Manipulation, along with other osteopathic techniques, may be able to help you! If you want to find out more don't hesitate in getting in contact with Rockingham Forest Osteopaths. 

Osteoarthritis (Wear and Tear)

There are many types of arthritis but by far the most common type that osteopaths see in practice is osteoarthritis, which affects around 8.5 million people in the UK.

So what is it?

Osteoarthritis, commonly referred to as wear and tear, is a condition that affects joints and usually develops over a period of time. In a healthy joint there is cartilage on the bony surfaces to aid joint movement, prevent bony damage and provide shock absorption, in osteoarthritis this is the first thing to be affected. The body’s constant maintenance of the cartilage slows and it begins to thin until eventually the joint ends up as bone on bone. The body tries to compensate by growing bone (osteophytes) in places where there should be cartilage.

This whole process is painful! The irritation of joint surfaces causes inflammation and swelling, also the muscles associated with the joint tighten up in order to try to protect it.  Wear and tear in one joint (or a few joints) can cause you to move differently and cause problems elsewhere.

What joints does it affect?

Osteoarthritis can occur in any joint but most commonly it affects joints that have been overused, suffered trauma or are weight bearing. In practice the areas that I see most commonly affected are the neck, low back, hips and knees.

Who does it affect?

Usually osteoarthritis develops in people over 50 however it may be earlier if a joint has suffered a trauma or overuse. It is also to do with your genetics, more common in women and if you are overweight.

What can be done about it?  

Unfortunately osteoarthritis cannot be reversed, however it can be managed and prevented from getting dramatically worse. Standard medical treatment may involve pain management, lifestyle changes, exercise programmes, steroid injections and perhaps eventually joint replacement.

Osteopaths can help manage symptoms of osteoarthritis with manual treatment by loosening tight muscle around the joint, improve fluid drainage away from the joint, improve joint mobility and ensure that other areas are functioning properly so that the affected joint does not have to overwork.

A diagnosis of osteoarthritis or wear and tear does not have to result in a down hill path! Don’t let pain stop you doing what you love; we can help!

Please get in contact: 07977367222 charlotte@rockinghamforestosteopaths.co.uk

Case study: Pain across both shoulders, arms and hands.

Note –  this is based on a real patient that has been seen at the clinic and all facts are true apart from the patient name which has been changed.

A 50 year old gentleman (let’s call him Paul) came to see me complaining of pain across both shoulders that spread into random areas of his arms, forearms and hands. The pain would usually start in the right side and then be mirrored in the left a short time afterwards. He also suffered from regular headaches and occasional tingling in his hands. The pain would occur randomly and would, at times, be debilitating and interfere with his job.

Paul had been in pain for 11 years; tried painkillers, had treatment from physiotherapists and even minor operations on both of his shoulders. All treatments had made a bit of a difference but the pain just seemed to come back.

On examination Paul’s nervous system was working normally and his shoulder movements were good however he had a small curve in his thoracic spine (mid back) and the joints and muscles in this area were tight, not functioning properly and tender to the touch, especially the T4 vertebrae.

I diagnosed Paul with T4 syndrome, which is where the T4 vertebrae stops functioning properly and causes all of the tissues associated with it to be compromised; in Pauls case this involved nerves travelling down into his arms and muscles attaching to his shoulders.This was causing his neck to overwork and get very tight at the top, possibly creating his headaches. A previous lumbar spine disc injury was creating altered pulls through his spine and maintaining his problem.

Treatment involved freeing up the area between the shoulder blades using soft tissue, articulatory techniques and manipulation (particularly to T4). I also worked on his lumbar spine, around his disc injury, and used cranial osteopathy techniques to release his upper neck. But how did he respond…

After 3 treatments Paul was virtually pain free and was suffering from far less headaches! As you can imagine he is extremely happy about this, as am I!

To find out more about T4 syndrome please read this paper http://www.physio-pedia.com/T4_Syndrome

If you have similar symptoms to Paul find out what the real cause is and start your road to recovery with us!