Posts Tagged ‘Pain’

Have you ever had someone tell you that before? I get asked questions like this all the time in my practice. People who crack their hands, spine, knees, feet etc ask me if they are causing damage to themselves by cracking their joints. I always ask them if there is any pain/numbness/tingling associated with the crack. If they say no, I tell them not to worry about it as there is no evidence that says cracking is bad for you or will give you arthritis. (Authors note: The studies I am referring to were only conducted on the hands and I don’t know of any literature that addresses this question for any other part of the body).

In short, there are a few reasons why joints “crack”. It could be because of a tendon snapping over a bone (snapping hip syndrome). Or it could be a bone moving over another bone (snapping scapula syndrome). A true joint crack occurs when joint surfaces of an encapsulated joint (say a facet joint in the spine) are separated. This 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,,which rapidly collapses upon itself, resulting in a “clicking” sound. This process is known as a cavitation and is the same sound you hear when a physiotherapist, chiropractor etc manipulates your spine.

The common advice that “cracking your knuckles gives you arthritis is not supported by any evidence to date. A 2011 study from the Journal of the American Board of family Physicians examined the hand X-rays of 215 people (aged 50 to 89) and compared the joints of those who regularly cracked their knuckles to those who did not. The study concluded that knuckle-cracking did not cause hand osteoarthritis, no matter how many years or how often a person cracked their knuckles. “The prevalence of OA in any joint was similar among those who crack knuckles and those who do not”

In 2009 a doctor by the name of Donald Unger won a Nobel Prize for a study of one participant…HIMSELF! He cracked the knuckles of his left hand every day for more than sixty years (that’s dedication), but he did not crack the knuckles of his right hand. In the end, no arthritis or other ailments formed in either hand after 60 years of cracking his left hand.

So all in all, cracking the hands is not a problem, and there is nothing that would lead me to say stop doing it. However (and it’s a big one)…If you have ANY pain or limitation with joint cracking, it is best to seek consultation with a health care professional. You may have a joint instability or hypermobility which may cause you problems down the road if not properly addressed.

Have a great week!

Jesse Awenus B.A Hons (Kin), MSc.PT
Registered Physiotherapist

DeWeber, Kevin, and Rebecca Ortolano. “The Journal of the American Board of Family Medicine.” Knuckle Cracking and Hand Osteoarthritis (2011): n. pag. Knuckle Cracking and Hand Osteoarthritis. Web. 22 July 2012. <http://www.jabfm.org/content/24/2/169&gt;.

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Ok, here it is…part 2 of it’s all in the hips. In my last post I discussed the importance of strong gluts for the prevention of knee pain. I explained what the glut muscles do and what happens when they go wrong. Suffice to say, there would be a lot less “pattelofemoral” pain patients in the world if we all worked on strengthening our hips!

Before I begin I want to say that the following exercises are for beginner to intermediate athletes and for those who have knee pain that COULD be attributed to the hips. Like I said in my last entry, there are other factors to knee pain but in any case, there is nothing wrong (or unsafe) about training the hips so I’m confident I wont hurt anyone by giving them some tips and videos. PLEASE note: don’t assume that these exercises will “cure” you of knee pain. I will always always always recommend getting a specific assessment by a trained professional such as a physiotherapist or chiropractor to determine the exact cause of your problem…you knew that was coming lol

Here is a list of exercises I like to give my patients with weak hips that are causing knee and low back pain:

1) The single leg bridge:

This exercise is great for 2 reasons. First and foremost, it strengthens the glut max (butt muscle) on the weight bearing side very well if done correctly. Secondly, this exercise is single leg and as such, the glut medius and minimus are working to control the non weight bearing hip from dropping down to the side. If this exercise is too hard to do..i.e you cant lift up high enough to make your hips level, you can do the double leg bridge…same idea as this, but you use 2 legs to bring your butt up instead of just one.

2) The “telephone” book exercise:

This exercise is tricky and is hard to explain in writing. Basically, you stand on a step (or telephone book lol) with one foot. You drop the other foot that is not on the step down my lowering the hip on that side. You then have to focus on contarcticing the glut med muscle on the weight bearing side to hike up the hip on the non weight bearing side. It’s best to hike the hip up higher then the hip on the weight bearing side for maximal benefit…don’t bent the knee on the weight bearing side much because that is cheating

3) Side lying hip abduction:

This one Is self explanatory…but here are a few key points to know:
a) When raising the leg up, do NOT let the hips roll back. You must try and keep the shoulder, hip and knee parallel. Keep your hand on your hips to sense if they are falling back or not…or do the exercises in front of a mirror if possible.

b) People with weak gluts will cheat in this exercise by using the hip flexor muscle tensor fascia lata (TFL) to raise the leg up instead of using the glut med. You will know this is happening because instead of keeping the leg straight out beside you (or even a little bit extended is best) the leg will come forward…you will flex the hip while abducting the leg because the TFL will do the work for the lazy gluts!

In the video, he uses a plastic band around the ankles to increase resistance. That is a good idea, but poorly executed. The band should ideally be just below the knees for maxiaml effect…having the band around the ankles is a) too hard and b) promotes the use of the TFL over the gluts

4) The Bird Dog:

The dude in this clip actually does a good job of explaining the exercise and common mistakes that are made. Just watch the clip and do what he says 😉
I know the video says this is a killer abs exercise (and it is)…BUT, this exercise is also a great glut max exercise and glut med stabilization exercise. It’s kind of advanced but I thought I’d throw it out there.
To make it easier—Don’t involve the arms. Just extend the legs out one at a time. Hold the leg out in an extended position for 10 seconds, bring it back down, and then do the other leg. This will still target the gluts but won’t do as much for the abs or back..

Do each of these 4 exercises 10 times. That is one set. Do 3-4 sets per day of each. If you develop pain while doing ANY of these exercises, STOP right away!! No need to hurt yourself here haha

As always, feel free to ask any questions you want. There are many more great glut exercises out there (squats, deadlifts etc), but these are the ones I find work well for the majority of people I see. For a personalized exercise program see a trained professional!

Thanks for reading!