Manipulative therapy is used to create neurophysiological changes which helps to improve range of motion, alter pain signals and reduce neural tension i.e. "tightness".

It involves specific positioning of the patient's body and a specific movement is performed by the practitioner which tends to lead to a cavitation or 'pop' of the underlying joints.

The 'pop' heard during the manipulation is a change in pressure in the joint capsule and nothing more which leads to alterations in the peripheral and central nervous system.