Early drum brakes (before about 1955) required periodic adjustment to compensate for drum and shoe wear. If not done sufficiently often long brake pedal travel ("low pedal") resulted. Low pedal can be a severe hazard when combined with brake fade as the brakes can become ineffective when the pedal bottoms out.

Self adjusting brakes may use a mechanism that engages only when the vehicle is being stopped from reverse motion. This is a traditional method suitable for use where all wheels use drum brakes (most vehicles now use disc brakes on the front wheels). By operating only in reverse it is less likely that the brakes will be adjusted while hot (when the drums are expanded), which could cause dragging brakes that would accelerate wear and increase fuel consumption.

Self adjusting brakes may also operate by a ratchet mechanism engaged as the hand brake is applied, a means suitable for use where only rear drum brakes are used. If the travel of the parking brake actuator lever exceeds a certain amount, the ratchet turns an adjuster screw that moves the brake shoes toward the drum.

The manual adjustment knob is usually at the bottom of the drum and is adjusted via a hole on the opposite side of the wheel. This requires getting underneath the car and moving the clickwheel with a flathead screwdriver. It is important and tedious to adjust each wheel evenly so as to not have the car pull to one side during heavy braking, especially if on the front wheels. Either give each one the same amount of clicks and then perform a road test, or raise each wheel off the ground and spin it by hand measuring how much force it takes and feeling whether or not the shoes are dragging.