Why We Don’t Twist, Crack or Pop

By Dr. Jason Slagel | October 10th, 2022

I practice under a chiropractic license, however, what I do is much different from what most people think of when they think of a traditional chiropractor. I do not do any twisting, cracking, or popping. When I say this, usually the next question is,

“So… what do you do?”

I’ll answer that, but first, let me explain what the twisting, cracking, and popping is intended for. That twisting, cracking, and popping that traditional chiropractors do is to mobilize joints that are stuck or fixated, meaning they are not moving well and need to be forcefully loosened up to move more. This does not reposition or align the spine, it simply makes it move more. There is nothing wrong with this approach when someone’s spine is in the normal position. If someone’s spine is in the normal position, then keeping the joints moving well is great. The patients that I measure and find that their spine position is within normal limits I send to a traditional chiropractor.

However, when someone’s spine is shifted out of position, then of course the joints aren’t going to be moving well, but cracking the joints to make them move more does not place the spine back in the correct position. It just makes it move more in the incorrect position, which means that those joints will lock back down again. This means that for people who have a positioning issue, traditional chiropractic mobilizations will only give them temporary relief. These are the people who typically will say things like,

“I tried chiropractic but it didn’t work.”

That’s like if your car tires are out of alignment and you take it to the mechanic and they change your oil (which is fine, but doesn’t fix the problem you actually need fixed) and then you leave the mechanic’s shop and say that you “tried mechanics” and they don’t work. In reality, they just didn’t do the intervention that was needed to fix the actual problem, but if they would’ve done the correct intervention, it would have worked out great.

So when a new patient comes into my office, the first thing I have to do is differentiate between the patients who have a positioning problem vs. a mobility problem. It is very easy to tell the difference when you simply measure them. If the head and neck are vertical, the upper body is centered, the hips are level and centered, and the legs are even, then I send them to a traditional chiropractor. If there are positional measurements that are off and need to be repositioned back to normal, then I keep those patients and fix it.

Here is where we get into more specifics about one special segment of the spine in particular. The atlas. The atlas is the top bone in the neck, called the atlas because it holds up the head, like Atlas holds up the world in Greek mythology. The atlas is the most mobile bone in the entire spine, by far. It is responsible for the majority of motion of the head, nodding up and down and turning side to side. This is very good to have so much mobility at the atlas because it allows us to move our head around to point our eyes in lots of different directions which plays a huge role in keeping us and those around us safe. However, there is a downside. Since the atlas is so mobile, it’s not very stable. This leaves it more susceptible to injury. This injury can be from many sources including C-section births, car crashes, contact sports, getting hit it the head, etc. Once the atlas has been damaged and the positioning is off, usually it effects its motion as well.

When the atlas is in the correct position, it is very mobile and moves smoothly and freely and equally from side to side. When the atlas has been shifted out of place from some type of accident or injury, it will no longer move well. This is the problem. Many traditional chiropractors will feel that the atlas is not moving well and will mobilize it (twist/crack/pop it) as if it is just like any other segment in the spine.

But it’s not.

This will make the atlas move more in the short term, but the problem is that it actually destabilizes the atlas even more. Since the atlas wasn’t moving well, we know it was shifted out of position, which made it jammed up in the first place. If you mobilize it, you are thrusting into a joint that already has damage to it, which does not reposition it back to normal. Best case scenario here is that the joint just locks down again the same as before since it is still in the wrong position. Worst case scenario is that there is even more damage to the joint and the atlas locks back down again in an even worse position. The atlas doesn’t need it’s mobility increased. It has plenty of mobility. What it needs is for the positioning to be corrected to set the atlas free to move again.

The overall takeaway here is that mobilizing the atlas the way traditional chiropractors do is actually inappropriate. The atlas moves perfectly and in abundance as long as everything is positioned correctly, so there is no need to mobilize it if the atlas is in a normal position. But if the atlas is not in a normal position, then mobilizing it is not the correct intervention, repositioning is.

Repositioning the atlas requires special training that is not offered in the traditional chiropractic curriculum and requires a post graduate board certification process to learn. Traditional chiropractors do not have this training, since they spend their time doing further education in the area of mobilization. In my office, this repositioning of the atlas is all I do, so since it has been my only focus throughout chiropractic school and in my post graduate board certification, I have been able to train extensively in it.

If you would like to be evaluated for a shift of the spine out of position, feel free to call us at (954) 842-2677.

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