Why do I hear a ‘Click’ during spinal manipulation?
Osteopaths use a technique called High Velocity Thrust (or HVT). This is a safe, relatively gentle spinal manipulation to restore normal movement and function in the joints of the spine. It takes the joint just slightly further than it is used to going.
Although it can sometimes feel as if force is being used, the joint is not taken further than it is capable of moving. Sometimes you hear a clicking or popping noise. However, the noise is perfectly normal is not the sound of a bone crack!
So what is actually happening to cause this sound?
The sound is believed to come from the release of gas bubbles from the joint to which the HVT technique is being applied. Joints are the meeting point of two separate bones. They are held together and in place by connective tissues and ligaments and surrounded by synovial fluid. Just like when you stretch or bend your finger to pop the knuckle, the bones of the joint are pulled apart. The connective tissue capsule that surrounds the joint becomes stretched.
This stretching rapidly increases the volume and decreases the pressure in the joint cavity. As a result this causes the gases dissolved in the synovial fluid to become less soluble and form bubbles. When the joint is stretched far enough, the pressure in the capsule drops so low that these bubbles burst. This produces that ‘pop’ that we associate with joint manipulation. See this demonstration.
Does the popping sound always occur?
Patients often listen for the tell-tale noise as a sign that the HVT has worked. However, a pop or click noise will not always be heard – even if a joint has been released. The relaxation of the surrounding muscles and increased movement in the joint are far more important signs of the technique having worked.
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Poor footwear, especially high heels, cause problems from the big toe right up to the spine causing back pain.
The first area we see problems are painful lumps (called bunions) on the outside of your big toe. Typically a bunion forms from pressure on the front of the foot causing a deviation in the bones of the big toe. It creates painful pressure contact on the bunion, looks unsightly and the big toe can get stiff.
Another issue with high heels are tight calf muscles. Because as your heels are elevated, it shortens the calf muscle. This shortened muscle can have a biomechanical impact on the legs. Constant wear also applies pressure to the shin bone and added stress to it can lead to issues such as ‘shin splints’ – pain on the front of the shin, which is common in runners.
You can also get calluses, hard patches of skin, under the front and ball of the foot.
Although there is a force distribution going through the hip joint, while wearing high heels, it may not directly causes specific hip problems but it does cause stress on the area!
What to do about poor footwear and back pain? The best way to avoid these conditions is to give the feet a rest!
- Limit the amount of time in high heels if you need to wear them to work.
- Always commute in flats and trainers to take the stress away from hips and knees.
- Those who frequently wear heels should do calf stretches.
- There are self help remedies you can do to deal with pain, such as standing on the edge of a step and letting the heel drop towards the next step, allowing the feet to stretch
- Massaging the sole of the feet can help – try using a golf ball or a rolling pin.
- Other remedies include a hot bath and mobilisation, such as drawing circles or the alphabet with your foot.
- Walk properly in comfortable shoes. Why not try Nordic Walking!
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