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Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques

Chiro.Org Blog: High-velocity, low-amplitude thrust (HVLAT) techniques are widely used in manual therapies and nearly always produce a “cracking” noise. This is considered a cavitation event [1, 2] for the metacarpophalangeal (MCP) joint and is produced by the sudden separation, or “gapping,” of the joint surfaces. In clinical practice, the force to do this is applied manually. It is assumed that the event is the same mechanism in both spinal and peripheral joints, as it involves the same types of structures. For example, similar characteristics were found for joint noises (ie, “cracks”) in both the MCP joint and the cervical apophysial joint. [3] In addition, it was found that gapping occurred in lumbar adjusting procedures. [4] Various terms have been used for the lesion that is treated with HVLAT. [5] In this paper, the term “joint dysfunction” will be used. […]