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The Sound of a Joint Release

February 23, 2019


I thought that, over the next few weeks,  I would address a few common questions I am often asked by our patients. Let’s start with the most common one!




The most common question that patients ask me is about joint manipulation, “What is that cracking or popping sound I hear when you adjust my back, and are you sure it is ok”? The answer to this question is surprisingly simple.  


  • The sound that you hear during joint manipulation comes from the release of accumulated gas (80% carbon dioxide) within the joint. In fact, about 15% of our joint volume (where the synovial fluid is located) is made up of gases. (1)

  • Secondly, that sound you hear during joint manipulation is NOT harmful — no matter what your mother may have told you.



Joint cavitation (releasing the joint) has several benefits.


  • The most immediate benefit that you will notice is an increased range-of-motion in the joint.

  • In addition, you will find some very beneficial neurological effects. Essentially,  cavitation of the joint is a very effective way of initiating a neurological response known as a Reflex Action (from the periarticular receptors - which are the neurological receptors surrounding the joint).


Let me explain. Most back problems involve both the joints and the soft-tissue structures that surround the joint (paraspinal muscles, ligaments, tendons, fascia, joint capsules, etc). Essentially, when you are injured, the neurological receptors around your joints (mechanoreceptors and nocieptors) cause your joints and muscles to become very hypertonic  (increased capsule tension, increased nerve ending sensitivity, and tight restricted muscles) —all of which causes pain.(2)



  • When a spinal joint is manipulated, it creates a reflex action in all the surrounding neurological joint receptors (mechanoreceptors and nocieptors). (2)

  • This in turn cause the surrounding joint capsule to release, allows hypertonic muscle to relax, and allows the nerve endings to become less sensitive

  • The end result is decreased levels of pain.


So, you should consider the sound of joint cavitation to be a very positive occurrence. Joint cavitation is an indication that the “Neurological Reflex Response” has been activated. With this sound, you know that you will now have increased range-of-motion in the joint, decreased soft-tissue tension and best of all, a decrease in pain.



As a musculoskeletal practitioner, my success rate would be greatly reduced if I did not address spinal joint restrictions. In fact, none of the many soft-tissue techniques that we use in practice (MSR, Graston, ART,  etc.) can activate the periarticular “Neurological Reflex Reponses” the way that joint cavitation can. Nothing frees up a restricted joint, and restores joint function like joint manipulation.


Joint manipulation in the hands of a trained practitioner is a highly effective and safe form of therapy.

Bottom Line…Take Care of Your Joints

Your spinal and peripheral joints make up a key component of your body’s kinetic web.  Joints restrictions make up a significant component of most injuries and should not be overlooked. 


At Kinetic Health, we are always talking about the importance of working with the fascial connections that exist between different muscle groups, and about how it is important to recognize that the whole body acts as a single functional unit. Spinal joints form a key component in your body’s kinetic web.


So remember, most musculoskeletal problems are not just a soft-tissue problem, or just a joint problem — they usually involve both types of structures.  Joint manipulation, in the hands of an experienced Chiropractor provides safe, evidence-based therapy that can achieve great results. This is especially true when combined with soft tissue therapy (such as Motion Specific Release) and a functional exercise program (such as those we provide at Kinetic Health).


So, the next time you have an injury, make sure your practitioner addresses both joint and soft-tissue issues. You will be much happier with the final result.



  1. The audible release associated with joint manipulation. J Manipulative Physiol Ther. 1995 Mar-Apr;18(3):155-64. Brodeur R. .

  2. Spinal manipulative therapy and somatosensory activation. J Electromyogr Kinesiol. 2012 Oct;22(5):785-94. doi: 10.1016/j.jelekin.2012.01.015. Epub 2012 Feb 19. Pickar JG1, Bolton PS.  .



Dr. Abelson believes in running an Evidence Based Practice (EBP).  EBP's strive to adhere to the best research evidence available, while combining their clinical expertise with the specific values of each patient.


Dr. Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 10th publications which will be available later this year.



Dr. Abelson is the owner of Kinetic Health, a partner in BKAT Motion Specific Release, and a partner in Rowan Tree Books.