The spine is one of the strongest and most resilient structures in the human body. It takes over 3,000 newtons of force to fracture the cervical spine, comparable to a 500-pound car crashing into a wall at 30 mph. While spinal injuries can happen, they typically occur only when the body fails to engage muscles that protect the spine during high-velocity trauma. So, does your spine really “pop out” during everyday movements? What really happens during spinal adjustments for athletes? And, can a chiropractor, physio, osteopath, or other rehab-based manual therapist “pop it back in”?

👉Spinal Adjustments For Athletes: Ruling Out the Subluxation Theory

The subluxation theory claims that spinal joints misalign and cause pain or other health issues, and that spinal adjustments realign these vertebrae. But for this to hold true, practitioners would need to:

• Agree on which vertebra is “out of place”,
• Deliver targeted interventions to correct it,
• And show clear evidence that these adjustments restore proper alignment and improve symptoms.
  

Research paints a different picture. A 2015 study revealed poor agreement between expert examiners in identifying dysfunctional spinal segments by touch. Another investigation found no reliable connection between the location of the “pop” sound and the intended adjustment site. Moreover, systematic reviews conclude that spinal manipulation does not meaningfully change vertebral motion or alignment.

Adding to this, leading chiropractic organizations and international health bodies have declared the vertebral subluxation as a cause of disease to be unsupported by scientific evidence. In 2015, they recommended that teaching the subluxation concept should be limited to historical context only. Despite this, many clinics still promote subluxation-based care, raising valid concerns about misinformation and regulatory oversight.

🧐A Brief History of Subluxation Theory

While spinal manipulation has ancient roots in places like Greece, China, and Egypt, the formal field of chiropractic care and the subluxation theory were founded much more recently and much closer to home. In 1895, D.D. Palmer performed what’s considered the first chiropractic adjustment in Davenport, Iowa, launching the chiropractic profession as we know it today. Though inspired by age-old manual therapy practices, chiropractic is a uniquely American creation, built on early theories like spinal subluxation that modern research has increasingly called into question

🔊What Causes the Joint Cracking Sounds?

So, if the spine isn’t “popping back in,” what causes those familiar cracking or popping noises during adjustments?

Research led by Kawchuk et al. (2015) sheds light on this. The joint cracking process involves three phases:

• Resting Phase: Joint surfaces sit closely together; minimal force separates them.
  
• Rapid Separation Phase: With greater force, the joint surfaces suddenly pull apart, creating a bubble in the joint fluid — this is the cracking sound.
  
• Refractory Phase: After cracking, the joint cannot produce another pop for about 20 minutes, as the bubble remains until it dissipates.
  

This bubble forms due to a drop in joint pressure that causes dissolved gases in the fluid to come out of solution. Importantly, the sound arises from bubble formation, not from bones snapping back into place or bubbles collapsing. Imaging confirms that joint orientation remains unchanged before and after cracking.

😌Why Do Adjustments Feel Good?

The popping sound during spinal adjustments for athletes isn’t bones realigning but bubbles forming in the joint fluid, as explained above. The relief you feel is largely neurological, a reset in your pain perception, rather than a structural fix. This effect tends to be short-lived but can provide meaningful symptom reduction.

👤What About X-Rays and Spinal Alignment?

Can X-rays reveal misaligned vertebrae?

Yes and no. X-rays can detect serious spinal injuries or gross misalignments after trauma. However, in non-specific or gradual cases, X-rays often show variations in spinal curvature caused by factors such as:

• Patient positioning during imaging,
• Muscle spasms or guarding
• Temporary pain responses.
  

Studies highlight that these variations often lack clinical relevance and should not solely guide treatment decisions. Moreover, unnecessary spinal imaging exposes patients to radiation risks without clear benefits.

🏅What This Means for Athletes

Your spine is incredibly strong and rarely “goes out of place” during routine activities or sports. The fear of a fragile back “out of alignment” only undermines confidence and recovery.

Understanding the true cause of joint sounds and the limits of spinal adjustments for athletes can empower you to focus on what really matters.

Interested in what to prioritize before and after common sports injuries?
Check out our free resource for athletes [here] to guide your rehab journey with science-backed advice.

Author: 

Dr. Dillon Caswell, PT, DPT, SCS

Hope Evangelist | Top-Selling Author & Speaker | Human Performance Expert