Crack! Did you know physical therapists can perform joint mobilizations on your spine?
Have you heard your back pop, felt better, but are curious as to what’s going on when that happens?
Spinal mobilizations are not actually your “bones cracking”; your physical therapist is actually performing what’s called a high velocity low amplitude (HVLA) thrust to encourage movement within the joints of the spine, specifically the facet joints. With the HVLA thrust, a gapping of the joint occurs; this gapping causes a partial vacuum and creates a small pocket of an air bubble with the resultant “burst”, resulting in the popping noise you hear. Often, patients will find that they have newfound mobility shortly after the HVLA thrust.
Spinal mobilizations are partially effective in treating many low back conditions. Thoracic mobilizations have been shown to be moderately effective in relieving neck pain1 and lumbar mobilizations have been shown to be moderately effective for acute low back pain, and weak evidence for improving chronic low back pain.
In essence, these mobilizations are good for short-term relief, but the most important role they play is to allow you to use that relief and short-term mobility to perform exercises and stretches to bring stability and mobility for long-term relief in your back. Importantly, in combination with specific corrective exercise, these mobilizations have been shown to be much more effective and reduce both neck and lumbar spine pain. Some exercises for neck and thoracic pain include chin tucks, rows with a barbell, prone A,T,Ys.
As you build a stronger base, you want to incorporate more functional, compound movements into your exercises. This allows your body to progressively strengthen the right way; plus the neuromuscular re-education benefits from this allows your body to recognize how to use its newfound stability during all types of movements.
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References
Cleland JA, Glynn P, Whitman JM, Eberhart SL, MacDonald C, Childs JD. Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Phys Ther. 2007;87(4):431-440. doi:10.2522/ptj.20060217