High Velocity Low Amplitude (HVLA)

In this Osteopathic manipulative technique, there is often a joint pop sound as the release occurs and is like the techniques used by Chiropractors.  Dr. Kavieff was mentored by both Phillip Greenman, D.O. and William Wyatt, D.O., who many consider having been the best HVLA technique practitioners of their era.  The actual popping sound, known as the joint cavitation phenomenon, is caused by the escape of dissolved nitrogen gas from the joint fluid surface.  In its essence it is a glorified ‘joint fart’.  Most practitioners make the mistake of moving the body part through too great a distance, which is high amplitude rather than low amplitude, and can be associated with side effects, some of which can be serious.  Dr. Kavieff rarely uses HVLA techniques as he has found that indirect techniques give longer term results, but when truly necessary he uses a gentle approach that is very well localized and of low amplitude as taught to him by his mentors.