To Crack or Not to Crack

Have you ever cracked your back before? Or do you do it all the time, like people who pop their necks stretching in the morning? How is the feeling? Good, right? Or are you freaking out just thinking about it? There are a lot of myths and facts about this common practice.

Back crack can be helpful in specific treatments, there are a lot of studies about it (Corp, 2021). It is an old technique that people used to relieve back pain, increasing the movements when they had a lack of mobility (Kerry, 2024).

However, if you have heard some history about people who did it and got it wrong for some reason, unfortunately, it can also be true! There are specific cases of people thinking that force back crack will relieve the pain and restore the movement, but the results can be disastrous and dangerous. (Fabio, 1999).

Back crack is one of the tools that integrates the manual therapy practices. Manual therapy englobes different types of techniques that includes joint mobilizations, joint and muscle manipulation. Manual therapy, as defined by the Orthopaedic Manual Physical Therapy Description of Advanced Specialty Practice, is a clinical approach that uses specific hands-on techniques, such as manipulation/mobilization, to diagnose and treat soft tissues and joint structures. The goals of manual therapy include reducing or eliminating soft tissue inflammation, improving contractile and non-contractile tissue repair, extensibility, and/or stability, facilitating movement, improving function, and modulating pain (Johanson, 2016). Usually, physiotherapists and occupational therapists are able to apply it, but it is also used by Rolfers, massage therapists, athletic trainers, osteopaths, and physicians (French, 2011).

I have always practiced different types of sports, with friends, family and even by myself. It was very common for my family and friends to get together to watch matches, competitions and games. This was certainly one of the biggest influences on me when choosing to become a physiotherapist. Not only that, I specialized in sports physiotherapy, and during my career I took different manual therapy courses as well. One of them, I was to go to Australia to take a specific course with renowned teachers in this area. I used to be a teacher at the University in Brazil, teaching postgraduate students about manual therapy.

During my studies, both at university and in graduate school, I had different experiences with different professionals about manual therapy. Some were very good, others not so much. But the fact is that the concept changed a lot from one school to another (Gatterman, 1994), even between professionals. There were no good studies in the area either. So, I decided to seek more knowledge on the subject on my own. There were no good studies in the area either. So, I decided to seek more knowledge on the subject on my own. As I specialized and studied more, new studies were done, new evidence and high-quality guidelines came out in the last years (Silvernail, 2024), and I was able to become more confident and speak with expertise about manual therapy, its risks, and its benefits.

There are some restrictions that prevent us from performing spinal popping. Others do pose enormous and sometimes irreversible risks for patients. However, there are several techniques that work the same way with almost no risk. Manual therapy is not just about cracking. Improve your quality of life, exercise regularly, maintain your mobility, and if you need any help, seek out a qualified professional. Your spine is strong; don't be afraid to move! And if it hurts, call a physio!

Bibliography

Corp, N. (Feb de 2021). Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. Eur J Pain.

Fabio, R. P. (Jan de 1999). Manipulation of the cervical spine: risks and benefits. Phys Ther.

Gatterman, M. (Jun de 1994). Development of chiropractic nomenclature through consensus. Journal of Manipulative and Physiological Therapeutics.

Johanson, M. A. (Jan de 2016). Orthopaedic Physical Therapy: Update to the Description of Specialty Practice. Journal of Orthopaedic & Sports Physical Therapy.

Kerry, R. (May de 2024). A modern way to teach and practice manual therapy. Chiropr Man Therap.

Silvernail, J. L. (Jun de 2024). Orthopaedic Manual Physical Therapy: A Modern Definition and Description. Phys Ther.