Manual adjusting is the most common technique the chiropractor may use and it involves using their hands to perform the adjustment. Many times you will hear the typical "cracking" sound, which is the response of air being forced out of the joint. It is the same concept as when you crack your knuckles. Instrument-assisted adjusting, such as Activator, involves the use of a hand-held device to perform the adjustment. Both techniques are equally effective and their usage is determined by the chiropractor's evaluation of each patient's condition. Our chiropractors utilize both techniques.