Stick Your Neck Out

I have always wanted to write something about patients who "crack" their own necks. All practicing DCs have encountered this phenomenon, so I had mentally put it on a "back burner" of topics that desired editorial comment someday. However, a recent image on TV, of a 13-year-old boy cracking his neck, really caught my attention.

The boy was standing in a politically loyal background crowd, during a speech by President Bush. The rumor has it that he was tired, bored and (as it turned out) somewhat of a smarty-pants. Since the kid was cracking, yawning, nodding off, etc., the humor-savvy media jumped on him, and soon he ended up on The David Letterman Show.

But as funny as the reality of this kid's antics were, the neck-cracking was probably "lost in translation" to most viewers - except chiropractors. After all, what do you tell your patients who frequently crack their own necks? It seemed to me that the quest for a mature and appropriate consultation regarding this displeasing habit deserved a judicious inquiry among my peers. That's why I recently posed the question to one of my DC colleagues at a social gathering, after she had downed a few cocktails.

"I tell 'em it's a disgusting habit, like picking your nose in public," she retorted. "I explain that if they keep it up, hair will grow on their palms, their eyes could pop out, and their spinal cord could explode into their mouth." Her lips began to quiver, and she gave me a hard look, while offering a rhetorical question: "It is gateway-type cracking, isn't it?" she queried. "This is how it starts! Soon, they will be cracking their thoracic spines over a chair in a cafeteria, and then attempting some twisted-up lumbar roll in the morning before getting out of bed. At that point, the only hope for these people is some kind of 12-step program."

Obviously, this doctor had some strong feelings on subject. I can understand. We are supposed to be the experts concerning specific and competent adjustments of the spine. So, it is a bit disconcerting when one of our patients demonstrates how he or she routinely releases the "pressure" with a good neck crack. Many times over the years, I have had patients come in because "I just couldn't get it to crack by myself this time, doc."

I take pride in my skills with diversified adjustment techniques, but I remember one occasion when I failed to release a particularly stubborn cervical segment, and the patient sat up and "cracked" his own neck, to show me how it should be done. Then, he laid down again, with the expectation that since I now understood how to go about it, I would be successful in "setting" the joint, as only a real chiropractor knows how to do.

When I was in chiropractic school, I used to practice my sitting cervical adjustment on neighbors and old college friends. One of those college people was my friend Chopper, who worked at a mental hospital. He was good at mimicry, and consequently, began "adjusting" the necks of several of the hospitalized mental patients on his ward. This became a problem when a few of the paranoid patients asked for manipulations hourly, since they "just knew" they had a bone out of place in their necks. (Good thing I wasn't a resident in proctology during those years!)

I do have advice for chiropractors on this topic: Don't be intimidated by patients who crack their necks; just discourage them from doing it in the waiting room in front of other patients. And don't make the mistake of lecturing them about how only you, the DC, can give a real adjustment. These folks know they usually feel better after cracking their own necks. Besides, they are coming in to see you anyway, in search of a "better" adjustment.

Last of all, don't be smug. (Hanks Corollary: The value of the adjustment can be directly proportional to the satisfaction the chiropractor experiences after giving that adjustment, or "It was good for me ... so it must have been good for you!") "My hands sensed a good joint and myofascial release, so you must feel better now, right?" Maybe, but the patient is the final judge. The proof of the pudding is in the tasting, and the patient holds the spoon.

I have never come up with a good answer for the frequent neck-cracker, but I do understand the problem. And I do have some advice for this type of patient:

1. Don't ever adjust your own neck better than I do.
2. When your ligaments get thick and loose, don't blame me.
3. When your thick and loose ligaments cause your joints to slide around like a goose on a greased floor - call me anyway. Maybe I can still "set your bone just right."