Have you ever heard someone say their “hips are out of place” or their “neck needs to be adjusted”? What does this mean…and when we go to a trained healthcare provider to get a spinal manipulation or HVLAT are we actually re-aligning bones? The short answer…no. While we may hear or feel a “crack” or “pop” as the technique is performed, this audible sound is not what you may think…
There are three primary therapeutic benefits associated with spinal manipulations or HVLAT techniques; biomechanical, muscular reflexogenic, and neurophysiological (PT G. High Velocity Low Amplitude Thrust, 2023). These movements are very common in trusted healthcare facilities and performed by highly skilled professionals. Most people think of it as back cracks, pops and bone realignment, but let’s discuss the true benefits and different mechanics of this skilled movement.
- The biomechanical effect of HVLAT is gapping (or spacing) between the associated facet joints. Distraction of these joints provided by the quick stretch mechanism can cause a cavitation (“crack” or “pop”) which allows for greater range of motion (ROM). While this audible sound can be mistaken for bone realignment, the sound is actually the product of gas bubbles shifting or popping within the joint capsule itself.
- The muscular reflexogenic effect associated with HVLAT is thought to produce a reduction muscle hypertonicity (muscle tightness). This decrease in “muscle tightness” then leads to further increases in ROM as well as a likely reduction in associated pain.
- The neurophysiological effect associated with HVLAT may alter our pain perception by modulation of the pain gate mechanism. Simply put, by gapping the facet joints the mechanoreceptors within/near the affected area are activated and act as a ‘bouncer’ towards painful signals attempting to reach the central nervous system.
The combination of these three effects allows HVLAT to act as a quick relief technique to allow a short window of opportunity to optimize movement. It is the correct exercises prescribed we follow-up with that will create long-term benefit and lead to a pain free life! To learn more about how we can help you be pain free, request an appointment with us.
Source:
PT G. High Velocity Low Amplitude Thrust (HVLAT) – Get Well Physical Therapy. Accessed April 19, 2023.
