- Hi, friends, I'm Bob Schrupp, physical therapist.
- And I'm Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- Well, in our opinion, of course, Bob.
- Brad, a lot of people ask us always,
I mean, this is the question I get quite often,
is why does my neck snap, crackle, pop?
- And you're talking about patients that you're-
- Right, right, exactly.
- I get the same question.
- So today we're gonna try to answer that question.
There's three main reasons why you might hear noise
coming from your neck.
The first one, you need to have a little understanding
of the joints of the neck,
'cause there are joints in your neck.
- Right.
- And a joint is basically where two bones come together.
So here's the knee joint.
We got one bone and another bone.
And over this joint, believe it or not, is a covering.
- So we're talking about joints in the body?
- Right, joints in the body.
- Okay.
- Oh! (sarcastically) Ha ha ha.
Okay, so the joint is covered with a capsule
and in there is fluid.
- Right.
- And gases.
- Sure.
- Nitrogen, carbon dioxide.
- (agreeing) Mmhmm.
- So what happens is that fluid actually,
especially if you put stress on the joint,
it becomes a gas and it pops.
- Right. Goes from a liquid to a gas, they go (clicks).
- Yep and it's called cavitation.
- Right.
- It's like when you crack your knuckles,
that's what's happening. You're popping gas basically.
- Right.
- Do you wanna show how many joints are on the neck, Brad?
- Yeah, if we look close, here's a-
- This is gonna be a tough one for her to pick up.
- Yeah, here's the spine. You got that right up here?
This would be where your head is, of course.
In C1, C2, three, four up to C7, in between each vertebra,
there is a joint called the facet or facet,
depending on how you wanna pronounce it.
Can you get right into this thing right here?
- [Bob] I think you gotta be a little closer.
(camerawoman mumbling)
It's hard, I know.
- Can you move this spine just like that?
- [Camerawoman] Hold on there.
- [Brad] Just like that.
- [Camerawoman] Yeah. Yeah.
- [Brad] Take your yep. Rotate that there.
Pull it away.
See, there's a gap right here.
That's the facet joint.
And it's opened up at that point.
That's where you may get the pop, is when you go
from a closed position and then the joint-
can you twist it, Bob?
The joint opens up and there, the gas will go
from a liquid to a gas and you get the pop.
This is just showing it, this is not how it exactly happens,
but it gives you the right idea.
- [Bob] Right.
- [Brad] So there's four or seven joints
on each side of the cervical column, or the neck.
So that's the total of 14.
- 14 joints in the neck alone.
- [Brad] Right.
- So that's a lot of joints that can possibly
give you trouble, so.
- [Brad] And you know, You get those people that say,
(mockingly) "listen to this," and they go like this and
they get their neck to crack very consistently.
- Do you wanna grab that ligament over there, Brad?
- [Brad] Yeah.
- There you go. Okay.
The second reason you might be getting some snapping
is you actually have ligaments again, taking, going back
to this joint that hold the bone together.
So this is again crude. This isn't exactly how it works, but
there's a strand of material, basically that goes from one
bone to the other, and holds 'em together.
- [Brad] Right.
- [Bob] So you have those in your neck too.
And what can happen is - let's take the
posterior longitudinal ligament out, Brad.
- [Brad] Sure.
- [Bob] That runs all the way along the back here.
And as you turn your neck, it can snap just
basically like that.
- [Brad] It may get caught on more of the bones,
like one of the spinous processes.
- [Bob] Or on a projection, any bony projection.
- [Brad] Right.
- [Bob] Any bump.
- [Brad] Okay, let's show like - hold that Bob once.
So like, it'd be over here and then you turn your neck
and it (fabric popping along model) pops.
- [Bob] Pops off, slides off.
- [Brad] That is a very crude.
- [Bob] Yeah. Very crude is not exactly how it goes.
The third reason would be just simply arthritis.
Again, if the, you know, looking back at this joint is
this joint starts to wear out and there's discs in
between the joints, you know, between the vertebrae, too.
As they wear out, they could be giving you some degeneration
They could be giving you some noise.
That's that crunching noise you might hear.
The joints themselves are just wearing out.
They're no longer smooth like they should be.
- Right, called crepitus.
- Crepitus, yeah. And unfortunately, I hate to tell you this
but that pretty much it happens from age 20 on,
your neck is deteriorating.
- Sure.
- So, the big question, Brad: is this harmful?
I think the first thing is if you're
having sounds, and there's no pain, and it's just
while you're moving your neck, I wouldn't
worry about it at all.
- Right, exactly.
- So now the big question is, though,
is it harmful to crack your neck?
You know, is it harmful to do manipulation on your neck?
And there has been a study on this
in the British Medical Journal of medicine.
And what they found is that there was a slightly higher risk
of having a stroke from people who had been manipulated.
- You're talking about a high thrust velocity, right?
- That's right. This is not a slow-movement pull-type thing.
This is where they do the fast crack on your neck.
So they call it high velocity, right, Brad?
- Right, grade five. Technically, it's what
chiropractors do. (hesitantly) Physical services do -
- They're not supposed to do it.
I mean, as a high grade mobilization, we call it.
We don't call it cracking or manipulation.
So what happens is in what happens in that case is -
this is gonna be again, hard to pick up here.
Brad, do you want get your pen?
- [Brad] Yeah.
- [Bob] There is a vertebral artery that runs well, you can
you can see it. I can see it on the -
- [Brad] This red line is a vertebral artery that
supplies blood to the brain, and it goes right through
the facet joints, so to speak, of the bone
and it comes up, and then they come up, and...
- Yeah, you look at the torturous route it takes
right in here, and that's where I think the
problem can happen.
- [Brad] Right. And it goes up to the Circle of Willis,
but we don't really care about that.
- Right. So you do a quick twist there.
And what happens is that sometimes they actually
tear the inner lining of that artery.
And what happens is, it's not gonna be like
they're gonna do it, and you're gonna have a stroke
right on the spot, generally.
- (agreeing) Mmhmm
- More often, it might be that it forms a blood clot,
and you have a stroke later.
Now, what are the odds of that happening?
I mean, it's hard to say because the study, you know
didn't really specify, but they were guessing one in 50,000.
- Sure.
- Maybe this happens to.
- Very rare.
- Very rare. A lot less likely to happen if you're younger,
A lot of these were happening in people that were 30 to
40 to 50 years old. I guess, you know, you have to
determine, you know, what the risk is versus the
reward on that.
- Sure.
- You know what we would recommend is that if you're
having some neck pain when you first, or popping
or snapping it, rather than snapping your own neck -
which a lot of people do - I'd rather see you do
range-of-motion on your neck with end-range stretches.
- Sure.
- So we'll show that in just a minute.
The other risk: by having your neck manipulated a lot,
if you you're doing it yourself, especially, you know
several times a day, you could be stretching those ligaments
out and your neck could actually become unstable.
- Sure.
- And when it becomes unstable it leads to problems in the
future with, you know maybe increased degeneration and
stuff like that. They did find out
that manipulation does not cause arthritis though.
- Okay.
- So that can be put aside. Alright, a couple of exercises
you might want to do. Let's just talk about
a good one to do, Brad, is just real extreme rotations here,
and maybe a little stretch at the end.
- Sure.
- The same way, this way.
- Look as far as you can.
- You can stretch at the end.
- And push on the jaw bone.
- Instead of cracking your neck. Just try that one.
'Cause a lot of times that'll take the crack
out of it, okay? Chin tucks.
- Sure.
- Brad, do you wanna show chin tuck?
- Oh, over here Lonnie.
- [Camerawoman] I got it.
- She's got you.
In like this, just tuck the chin in. Not down like this,
but in and back. Very common. We've shown this on a lot
of videos for a lot of neck problems.
- And then...
- If you want a little over pressure.
- Yeah.
- A little pressure right on the chin.
(grunts)
Probably feel a little stretching back in here.
- And then wanna do some extension, Brad,
for going right with that?
- Full extension, I like to start with a chin tuck,
lean a chair that's about shoulder blade height,
and then just relax and stretch back.
There you go. And you might do that a couple, three times.
There should be no sharp pain with this or is..
- (teasingly) Your glasses pop up when you do that.
- Well, I know it's always an issue, Bob.
- Alright, the final one you might try is just go ahead
and bring your neck over like this,
and give a little stretch this way.
- Gentle.
- Yep, gentle. Trying to put the ear on the shoulder.
Really nice one to do. Just try those ones,
and you'll find a lot of times then you don't feel the need
to crack your neck. You really gotta try to get out of that
habit of...
- Right. Sure.
- ...of cracking your neck on a continuous basis, so.
Alright, Brad, it is our belief that nobody
should live in pain.
- Right.
- Unless you live in Payne, Minnesota. There's a
a place called Payne, Minnesota. Did you know that?
- Is there Payne, Minnesota?
- Those Minnesotans. (with an accent) Yeah. You betcha.
(chuckles)
- Alright. So, if you are having pain,
make sure you subscribe to us.
- Yeah. Subscribe, subscribe, and subscribe.