This is a request that osteopaths hear regularly in their practice: “Please don’t break me. I hate that ! » For some, it has even become a criterion of choice when making an appointment. Osteopaths have understood this well, and specify, more and more often, “without cracking” on their business card. But what is it exactly? In reality, it is not a question of “cracking the bones”, but the joints. As for the noise, this “crack” which often surprises by its sound intensity, it comes in fact from the bursting, under the effect of the pressure, of gas bubbles contained in the synovial fluid, a kind of lubricant which lodges between the joints.
“Always ask for consent”
«Le “cracking”, it is less a subject for us than for the patients, because in general, it is not a very pleasant moment for them, agrees Ai-Jee Youn, freshly installed in a practice in the Paris region with her companion, Léo Guérin. But afterwards, it can do a lot of good. Moreover, the patients often start laughing immediately afterwards, they are suddenly very happy, a sign that the impact has released something. »
→ INVESTIGATION. Osteopathy, a “young” profession in search of scientific legitimacy
Nevertheless, these young osteopaths rarely resort to cracking – also called cracking or thrust. “This technique has the advantage of being able to treat the joint precisely, but there are other ways to restore mobility to a blocked joint, says Léo Guérin. We can also have a more global approach: treat the joint remotely, for example by working on the adjoining muscles. » In any case, a golden rule: “Always ask the patient’s consent before cracking them. » No question of imposing anything on him, “He shouldn’t be uncomfortable”. At the risk of seeing him leave the cabinet more contracted than he entered.
A method that must be adapted to the patient
Solène Chavane has chosen to banish this manipulation from her consultation, in favor of gentler techniques. “We learn all the approaches at school and everyone, once they graduate, practices with what they enjoy the most. A bit like a cook who, to cook food, can use an oven, a frying pan, a fryer or even steam, compare this Parisian osteopath. In fact, there is no right or wrong technique, the important thing is that it is well mastered. »
Above all, it must be adapted to the patient. Indeed, if it can turn out to be useful in certain cases, cracking is not essential; it is even not recommended for some. “There are places in the body, the cervical ones in particular, that it is better to avoid cracking, especially if you do not know the patient’s pathologies, warns Corinne Le Sauder, general practitioner and osteopath in Olivet, in Loiret. Cracking a patient at the site of an injured joint or a metastasis, for example, can be devastating. »