Joint Cracking- What does it mean? Ask a Physiotherapist!

Written by alphahealth

16 August 2018

*Pop… Crack…Click*

These are some noises our body can make when moving. Have you ever heard them? Joint noises can be very common and often are not cause for alarm. Joints represent the place between two bones. Highlighted below are some of the possible causes for these noises:
1) Joint cavitation is a process that occurs when a joint is stretched and a negative pressure change occurs in the joint. This creates air bubbles in the fluid that lubricates the joint. This fluid is known as synovial fluid. Recent literature supports the theory that joint noises are caused from the collapse (or partial collapse) of these air bubbles. Contrary to popular belief, there is not substantial evidence in the literature that cracking knuckles leads to future osteoarthritis (joint damage). However, it has been postulated that consistent cracking may lead to hypermobility (more movement) in the joint, making it susceptible to injury if proper strength is not maintained.
2) Muscles or ligaments moving may create a snapping/popping or clicking sound. When a muscle is tight, it can create sound as the tendon goes over a bony prominence. This can sometimes occur when doing repetitive movements, such as exercises at the gym. A proper warm up and stretching out affected muscles may help reduce or eliminate the clicking/popping sounds! Rapid stretching of ligaments can also create noise. A sound in the knee may occur when we are sitting for a while and then suddenly straighten our legs. However, there are times when this popping sound may continue to irritate the muscle as it goes over a bony prominence (e.g. IT band friction syndrome – see a previous blog post on this condition published April 27, 2017). This can create local inflammation in the tissue and cause pain and/or swelling if continually aggravated. Ligament injuries and meniscus injuries may also cause similar clicking sounds and can be accompanied by pain and swelling in the joint.
3) Cartilage (lack of) may cause sounds like creaking, grinding or clicking in a joint. This can result from our bones rubbing against one another. When there is less cartilage, the bone surfaces are rougher and may create noise when rubbing together. For example, those with knee osteoarthritis may experience a grinding in their knee when walking or going up stairs. Joints surfaces change as we age and as a result, more joint sounds may be noticed.
4) Improper position of our body/limbs as we are performing an exercise can contribute to clicking or cracking. Bones are meant to glide on adjacent surfaces in an optimal way. When our knee position is slightly off, or when our shoulders aren’t positioned correctly for example, we may experience some clicking during movement. This clicking may result from the surfaces not gliding properly. This could be due to anatomical misalignment or another condition. However, it could also be due to muscle imbalances in the body and deviation from ideal body position during movement. If we know how to position our limbs correctly and have the strength in specific muscles to maintain this position, joint sounds will decrease. This plays a huge role in patella femoral pain syndrome, where addressing the muscles around the knee/hip/ankle, and focusing on alignment during movement, can decrease or eliminate knee pain and clicking! Stay tuned for more to come on this syndrome in a later blog.
No matter the cause of your joint sounds, know that some are okay and some can be an indication of injury. When sounds are accompanied by pain and/or swelling or discomfort, it is important to get it assessed by a healthcare professional, such as a physiotherapist, to determine the cause and get it treated accordingly. If ever in doubt, get it checked out!
By Olivia Skrastins
Physiotherapist

Physiotherapy Yonge and Eglinton


References:
 
Protapapas MG, Cymet TC. Joint cracking and popping: understanding noises that accompany articular release. The Journal of American Osteopathic Assocation.  2002;102(5);283-287.
 
Suja VC, Barakat AI.  A mathematical model for the sounds of produced by knuckle cracking. Scientific Reports. 2018;8(4600);1-9.

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