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Joint cracking

May 04, 2024

Joint cracking is the manipulation of joints to produce a sound and related "popping" sensation. It is sometimes performed by physical therapists, chiropractors, osteopaths, and masseurs in Turkish baths[1] pursuing a variety of outcomes.

Cracking finger joints makes a distinct cracking or popping sound.

The cracking of joints, especially knuckles, was long believed to lead to arthritis and other joint problems. However, this is not supported by medical research.[2]

The cracking mechanism and the resulting sound is caused by dissolved gas (nitrogen gas) cavitation bubbles suddenly collapsing inside the joints. This happens when the joint cavity is stretched beyond its normal size. The pressure inside the joint cavity drops and the dissolved gas suddenly comes out of solution and takes gaseous form which makes a distinct popping noise. To be able to crack the same knuckle again requires waiting about 20 minutes before the bubbles dissolve back into the synovial fluid and will be able to form again.[3]

It is possible for voluntary joint cracking by an individual to be considered as part of the obsessive–compulsive disorders spectrum.[4][5]

Causes edit

MRI of a cracking finger joint depicting cavitation between the bones
 
Static images of the hand in the resting phase before cracking (left). The same hand following cracking with the addition of a post-cracking distraction force (right). Note the dark, interarticular void (yellow arrow).

For many decades, the physical mechanism that causes the cracking sound as a result of bending, twisting, or compressing joints was uncertain. Suggested causes included:

  • Cavitation within the joint—small cavities of partial vacuum form in the synovial fluid and then rapidly collapse, producing a sharp sound.[6][7]
  • Rapid stretching of ligaments.[8]
  • Intra-articular (within-joint) adhesions being broken.[8]
  • Formation of bubbles of joint air as the joint is expanded.[9]

There were several hypotheses to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it.[10] When a spinal manipulation is performed, the applied force separates the articular surfaces of a fully encapsulated synovial joint, which in turn creates a reduction in pressure within the joint cavity. In this low-pressure environment, some of the gases that are dissolved in the synovial fluid (which are naturally found in all bodily fluids) leave the solution, making a bubble, or cavity (tribonucleation), which rapidly collapses upon itself, resulting in a "clicking" sound.[11] The contents of the resultant gas bubble are thought to be mainly carbon dioxide, oxygen and nitrogen.[12] The effects of this process will remain for a period of time known as the "refractory period", during which the joint cannot be "re-cracked", which lasts about 20 minutes, while the gases are slowly reabsorbed into the synovial fluid. There is some evidence that ligament laxity may be associated with an increased tendency to cavitate.[13]

In 2015, research showed that bubbles remained in the fluid after cracking, suggesting that the cracking sound was produced when the bubble within the joint was formed, not when it collapsed.[9] In 2018, a team in France created a mathematical simulation of what happens in a joint just before it cracks. The team concluded that the sound is caused by bubbles' collapse, and bubbles observed in the fluid are the result of a partial collapse. Due to the theoretical basis and lack of physical experimentation, the scientific community is still not fully convinced of this conclusion.[3][14][15]

The snapping of tendons or scar tissue over a prominence (as in snapping hip syndrome) can also generate a loud snapping or popping sound.[8]

Relation to arthritis edit

The common claim that cracking one's knuckles causes arthritis is not supported by scientific evidence.[16] A study published in 2011 examined the hand radiographs of 215 people (aged 50 to 89). It compared the joints of those who regularly cracked their knuckles to those who did not.[17] The study concluded that knuckle-cracking did not cause hand osteoarthritis, no matter how many years or how often a person cracked their knuckles.[17] This early study has been criticized for not taking into consideration the possibility of confounding factors, such as whether the ability to crack one's knuckles is associated with impaired hand functioning rather than being a cause of it.[18]

The medical doctor Donald Unger cracked the knuckles of his left hand every day for more than sixty years, but he did not crack the knuckles of his right hand. No arthritis or other ailments formed in either hand, and for this, he was awarded 2009's satirical Ig Nobel Prize in Medicine.[19]

See also edit

References edit

  1. ^ Richard Boggs, Hammaming in the Sham: A Journey Through the Turkish Baths of Damascus, Aleppo and Beyond, 2012, ISBN 1859643256, p. 161
  2. ^ Shmerling, Robert H. (14 May 2018). "Knuckle cracking: Annoying & harmful, or just annoying?". How do we know that knuckle cracking is harmless?. health.harvard.edu. Retrieved 19 July 2019. One study published in 1990 found that among 74 people who regularly cracked their knuckles, their average grip strength was lower and there were more instances of hand swelling than among 226 people who did not crack their knuckles. However, the incidence of arthritis was the same in both groups.
  3. ^ a b Dvorsky, George. "Simulation May Finally Explain Why Knuckle Cracking Makes That Awful Sound". Gizmodo. Retrieved 30 March 2018.
  4. ^ Abouhendy, Wa-il; Jawad, Sudad (4 July 2013). "Compulsive Joint Clicking on the Obsessive-Compulsive Spectrum: A Case Report". The Primary Care Companion for CNS Disorders. 15 (4): PCC.13l01513. doi:10.4088/PCC.13l01513. PMC 3869608. PMID 24392256.
  5. ^ Johnson, A.; Linse, A.; Novoa, K. C. (6 April 2022). "A Tough Case to Crack: Diagnostic, Ethical, and Legal Considerations in Treating Compulsive Neck Cracking". Cureus. 14 (4): e23875. doi:10.7759/cureus.23875. PMC 9076044. PMID 35530890.
  6. ^ Knapton, Sarah (15 April 2015). "Why knuckle cracking makes a popping sound, and why it might be beneficial". The Daily Telegraph. London. Retrieved 17 December 2016.
  7. ^ Sample, Ian (15 April 2015). "Cracked it! Scientists solve puzzle of why knuckles pop when pulled". The Guardian. London. Retrieved 20 September 2016.
  8. ^ a b c Protopapas M, Cymet T, Protapapas M (1 May 2002). . J Am Osteopath Assoc. 102 (5): 283–7. PMID 12033758. Archived from the original on 27 September 2007. Retrieved 2 March 2007.
  9. ^ a b Gregory N. Kawchuk; Jerome Fryer; Jacob L. Jaremko; Hongbo Zeng; Lindsay Rowe; Richard Thompson (2015). "Real-Time Visualization of Joint Cavitation". PLOS ONE. 10 (6): 384–390. Bibcode:2015PLoSO..1019470K. doi:10.1371/journal.pone.0119470. PMC 4398549. PMID 25875374.
  10. ^ Brodeur R. (1995). "The audible release associated with joint manipulation". J Manipulative Physiol Ther. 18 (3): 155–64. PMID 7790795.
  11. ^ Maigne, Jean-Yves; Vautravers, Philippe (September 2003). "Mechanism of action of spinal manipulative therapy". Joint Bone Spine. 70 (5): 336–341. doi:10.1016/S1297-319X(03)00074-5. PMID 14563460.
  12. ^ Unsworth A, Dowson D, Wright V (1971). "'Cracking joints'. A bioengineering study of cavitation in the metacarpophalangeal joint". Ann Rheum Dis. 30 (4): 348–58. doi:10.1136/ard.30.4.348. PMC 1005793. PMID 5557778.[1]
  13. ^ Fryer, Gary; Jacob Mudge & McLaughlin, Patrick (2002). "The Effect of Talocrural Joint Manipulation on Range of Motion at the Ankle" (PDF). Journal of Manipulative and Physiological Therapeutics. 25 (6): 384–390. doi:10.1067/mmt.2002.126129. PMID 12183696. (PDF) from the original on 21 September 2017.
  14. ^ "Why Does Cracking Your Knuckles Make So Much Noise? Science Finally Has an Answer". Time. Retrieved 30 March 2018.
  15. ^ Chandran Suja, V.; Barakat, A. I. (29 March 2018). "A Mathematical Model for the Sounds Produced by Knuckle Cracking". Scientific Reports. 8 (1): 4600. Bibcode:2018NatSR...8.4600C. doi:10.1038/s41598-018-22664-4. ISSN 2045-2322. PMC 5876406. PMID 29599511.
  16. ^ Rizvi, Asad; Loukas, Marios; Oskouian, Rod J.; Tubbs, R. Shane (August 2018). "Let's get a hand on this: Review of the clinical anatomy of "knuckle cracking"". Clinical Anatomy. 31 (6): 942–945. doi:10.1002/ca.23243. ISSN 0897-3806. PMID 30080300. S2CID 51920825.
  17. ^ a b Deweber K, Olszewski M, Ortolano R (2011). "Knuckle cracking and hand osteoarthritis". J Am Board Fam Med. 24 (2): 169–174. doi:10.3122/jabfm.2011.02.100156. PMID 21383216.
  18. ^ Simkin, Peter (November 1990). "Habitual knuckle cracking and hand function". Annals of the Rheumatic Diseases. 49 (11): 957. doi:10.1136/ard.49.11.957-b. PMC 1004281. PMID 2256753.
  19. ^ "2009 Winners of the Ig® Nobel Prize". August 2006. Retrieved 27 November 2011.

May 04, 2024
joint, cracking, manipulation, joints, produce, sound, related, popping, sensation, sometimes, performed, physical, therapists, chiropractors, osteopaths, masseurs, turkish, baths, pursuing, variety, outcomes, cracking, finger, joints, makes, distinct, crackin. Joint cracking is the manipulation of joints to produce a sound and related popping sensation It is sometimes performed by physical therapists chiropractors osteopaths and masseurs in Turkish baths 1 pursuing a variety of outcomes Cracking finger joints makes a distinct cracking or popping sound source source The cracking of joints especially knuckles was long believed to lead to arthritis and other joint problems However this is not supported by medical research 2 The cracking mechanism and the resulting sound is caused by dissolved gas nitrogen gas cavitation bubbles suddenly collapsing inside the joints This happens when the joint cavity is stretched beyond its normal size The pressure inside the joint cavity drops and the dissolved gas suddenly comes out of solution and takes gaseous form which makes a distinct popping noise To be able to crack the same knuckle again requires waiting about 20 minutes before the bubbles dissolve back into the synovial fluid and will be able to form again 3 It is possible for voluntary joint cracking by an individual to be considered as part of the obsessive compulsive disorders spectrum 4 5 Contents 1 Causes 2 Relation to arthritis 3 See also 4 ReferencesCauses edit source source source source source source MRI of a cracking finger joint depicting cavitation between the bones nbsp Static images of the hand in the resting phase before cracking left The same hand following cracking with the addition of a post cracking distraction force right Note the dark interarticular void yellow arrow For many decades the physical mechanism that causes the cracking sound as a result of bending twisting or compressing joints was uncertain Suggested causes included Cavitation within the joint small cavities of partial vacuum form in the synovial fluid and then rapidly collapse producing a sharp sound 6 7 Rapid stretching of ligaments 8 Intra articular within joint adhesions being broken 8 Formation of bubbles of joint air as the joint is expanded 9 There were several hypotheses to explain the cracking of joints Synovial fluid cavitation has some evidence to support it 10 When a spinal manipulation is performed the applied force separates the articular surfaces of a fully encapsulated synovial joint which in turn creates a reduction in pressure within the joint cavity In this low pressure environment some of the gases that are dissolved in the synovial fluid which are naturally found in all bodily fluids leave the solution making a bubble or cavity tribonucleation which rapidly collapses upon itself resulting in a clicking sound 11 The contents of the resultant gas bubble are thought to be mainly carbon dioxide oxygen and nitrogen 12 The effects of this process will remain for a period of time known as the refractory period during which the joint cannot be re cracked which lasts about 20 minutes while the gases are slowly reabsorbed into the synovial fluid There is some evidence that ligament laxity may be associated with an increased tendency to cavitate 13 In 2015 research showed that bubbles remained in the fluid after cracking suggesting that the cracking sound was produced when the bubble within the joint was formed not when it collapsed 9 In 2018 a team in France created a mathematical simulation of what happens in a joint just before it cracks The team concluded that the sound is caused by bubbles collapse and bubbles observed in the fluid are the result of a partial collapse Due to the theoretical basis and lack of physical experimentation the scientific community is still not fully convinced of this conclusion 3 14 15 The snapping of tendons or scar tissue over a prominence as in snapping hip syndrome can also generate a loud snapping or popping sound 8 Relation to arthritis editThe common claim that cracking one s knuckles causes arthritis is not supported by scientific evidence 16 A study published in 2011 examined the hand radiographs of 215 people aged 50 to 89 It compared the joints of those who regularly cracked their knuckles to those who did not 17 The study concluded that knuckle cracking did not cause hand osteoarthritis no matter how many years or how often a person cracked their knuckles 17 This early study has been criticized for not taking into consideration the possibility of confounding factors such as whether the ability to crack one s knuckles is associated with impaired hand functioning rather than being a cause of it 18 The medical doctor Donald Unger cracked the knuckles of his left hand every day for more than sixty years but he did not crack the knuckles of his right hand No arthritis or other ailments formed in either hand and for this he was awarded 2009 s satirical Ig Nobel Prize in Medicine 19 See also editCrepitus sounds made by jointReferences edit Richard Boggs Hammaming in the Sham A Journey Through the Turkish Baths of Damascus Aleppo and Beyond 2012 ISBN 1859643256 p 161 Shmerling Robert H 14 May 2018 Knuckle cracking Annoying amp harmful or just annoying How do we know that knuckle cracking is harmless health harvard edu Retrieved 19 July 2019 One study published in 1990 found that among 74 people who regularly cracked their knuckles their average grip strength was lower and there were more instances of hand swelling than among 226 people who did not crack their knuckles However the incidence of arthritis was the same in both groups a b Dvorsky George Simulation May Finally Explain Why Knuckle Cracking Makes That Awful Sound Gizmodo Retrieved 30 March 2018 Abouhendy Wa il Jawad Sudad 4 July 2013 Compulsive Joint Clicking on the Obsessive Compulsive Spectrum A Case Report The Primary Care Companion for CNS Disorders 15 4 PCC 13l01513 doi 10 4088 PCC 13l01513 PMC 3869608 PMID 24392256 Johnson A Linse A Novoa K C 6 April 2022 A Tough Case to Crack Diagnostic Ethical and Legal Considerations in Treating Compulsive Neck Cracking Cureus 14 4 e23875 doi 10 7759 cureus 23875 PMC 9076044 PMID 35530890 Knapton Sarah 15 April 2015 Why knuckle cracking makes a popping sound and why it might be beneficial The Daily Telegraph London Retrieved 17 December 2016 Sample Ian 15 April 2015 Cracked it Scientists solve puzzle of why knuckles pop when pulled The Guardian London Retrieved 20 September 2016 a b c Protopapas M Cymet T Protapapas M 1 May 2002 Joint cracking and popping understanding noises that accompany articular release J Am Osteopath Assoc 102 5 283 7 PMID 12033758 Archived from the original on 27 September 2007 Retrieved 2 March 2007 a b Gregory N Kawchuk Jerome Fryer Jacob L Jaremko Hongbo Zeng Lindsay Rowe Richard Thompson 2015 Real Time Visualization of Joint Cavitation PLOS ONE 10 6 384 390 Bibcode 2015PLoSO 1019470K doi 10 1371 journal pone 0119470 PMC 4398549 PMID 25875374 Brodeur R 1995 The audible release associated with joint manipulation J Manipulative Physiol Ther 18 3 155 64 PMID 7790795 Maigne Jean Yves Vautravers Philippe September 2003 Mechanism of action of spinal manipulative therapy Joint Bone Spine 70 5 336 341 doi 10 1016 S1297 319X 03 00074 5 PMID 14563460 Unsworth A Dowson D Wright V 1971 Cracking joints A bioengineering study of cavitation in the metacarpophalangeal joint Ann Rheum Dis 30 4 348 58 doi 10 1136 ard 30 4 348 PMC 1005793 PMID 5557778 1 Fryer Gary Jacob Mudge amp McLaughlin Patrick 2002 The Effect of Talocrural Joint Manipulation on Range of Motion at the Ankle PDF Journal of Manipulative and Physiological Therapeutics 25 6 384 390 doi 10 1067 mmt 2002 126129 PMID 12183696 Archived PDF from the original on 21 September 2017 Why Does Cracking Your Knuckles Make So Much Noise Science Finally Has an Answer Time Retrieved 30 March 2018 Chandran Suja V Barakat A I 29 March 2018 A Mathematical Model for the Sounds Produced by Knuckle Cracking Scientific Reports 8 1 4600 Bibcode 2018NatSR 8 4600C doi 10 1038 s41598 018 22664 4 ISSN 2045 2322 PMC 5876406 PMID 29599511 Rizvi Asad Loukas Marios Oskouian Rod J Tubbs R Shane August 2018 Let s get a hand on this Review of the clinical anatomy of knuckle cracking Clinical Anatomy 31 6 942 945 doi 10 1002 ca 23243 ISSN 0897 3806 PMID 30080300 S2CID 51920825 a b Deweber K Olszewski M Ortolano R 2011 Knuckle cracking and hand osteoarthritis J Am Board Fam Med 24 2 169 174 doi 10 3122 jabfm 2011 02 100156 PMID 21383216 Simkin Peter November 1990 Habitual knuckle cracking and hand function Annals of the Rheumatic Diseases 49 11 957 doi 10 1136 ard 49 11 957 b PMC 1004281 PMID 2256753 2009 Winners of the Ig Nobel Prize August 2006 Retrieved 27 November 2011 Retrieved from https en wikipedia org w index php title Joint cracking amp oldid 1208284204, wikipedia, wiki, book, books, library,

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