Reasons Not To Worry About Your Clicking Knees:
Many of our physiotherapists are dual trained as musculoskeletal sonographers. This means they use diagnostic ultrasound as part of their clinical assessment to look inside the body to assess the joint and surrounding soft tissue structures such as ligaments and tendons.
Diagnostic ultrasound is a dynamic imaging technique. Unlike static imaging techniques such as an X-ray or MRI, ultrasound can assess the structures whilst the patient can carry out a specific movement that reproduces the click. This makes it the perfect assessment to accurately identify the structures that are causing the clicking and the specific reason for your pain.
If you are worried about your clicking knees and would like to book an appointment or for more information please email or call 0207 482 3875.
Anatomy Of The Knee Joint
The large femur sits atop the tibia, much like two pillars stacked on top of each other. The smaller fibula bone is on the outside of the tibia in the lower leg. The fibula provides some weight bearing, but not nearly as much as the tibia does. At the end of the femur are two large condyles with rounded edges that allow for the rocking or hinging motion associated with knee movement.
In between the femur and the tibia are fibrocartilage shock absorbers, or meniscus. Several large stabilizing ligaments on the inside and outside of the knee prevent excessive forward and backwards movements. These stabilizing ligaments include the Anterior Cruciate Ligament and Posterior Cruciate Ligament .
The patella bone sits in front of the femur and slides in a groove. The backside of the patella is covered with hyaline cartilage along with the front side of the groove on the femur, which minimizes the friction as the patella slides. The patella is a large sesamoid bone, which means it is surrounded in muscle or tendon. Sesamoid bones act as a pulley system to change the direction of forces, in this case from the quadriceps muscle to the tibia.
Experts In Finding Joint Pains Cause And Its Solution
Joint problems are very common, especially as you get older. The team at Aurora Health Care has advanced expertise in pinpointing the cause of crepitus and joint pain so that you can move freely again.
As one of Wisconsins largest regional health care systems, we offer:
- Expert diagnosis: With extensive experience in joint care, we provide a thorough diagnosis. Many times, we can find the cause of crepitus without invasive treatment.
- Advanced testing and imaging: Youll have access to advanced diagnostic technology like magnetic resonance imaging , 3-D computed tomography scans and diffusion tensor imaging . DTI is an innovative tool that helps us analyze the condition of cartilage, the smooth, white material that cushions the ends of bones.
- Noninvasive and surgical treatment options: Choose from a variety of proven treatments, including bracing, physical therapy and total joint replacement.
- Convenient locations: With clinics and hospitals across eastern Wisconsin and northern Illinois, you can see a doctor and find physical therapy close to home. See our locations.
- Seamless care: Our health system is fully integrated. That means physical therapists, rehabilitation specialists, orthopedists and primary care doctors work closely together on a care plan thats right for you.
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Understand Your Clicking Knee
It can be unnerving to hear a clicking sound in the knee. In particular, doctors often hear complaints from patients who have noticed their knees clicking when walking or when walking up stairs. Most often, knee clicking is not a cause for concern.
- Other benign reasons for knee clicking include the rolling of tendons, ligaments, or other connective tissue across each other with certain motions. In the knee, this is most common with a deep knee bend.
However, there can be more serious underlying causes of knee clicking, particularly if it is associated with pain or swelling.
Real Worry: Loud Pop At Time Of Injury Followed By Swelling Instability And Giving Way
When a patient says to me, Doc, I heard a pop and my knee swelled, it is definitely a cause for concern. If there is a pop at the time of injury, the knee has almost certainly been damaged. You have most likely injured either your ligaments anterior cruciate ligament, posterior cruciate ligamentor medial collateral ligament or the meniscusor articular cartilage. The knee will usually swell up after these kinds of injuries.
If there is pain, swelling, or giving way of the knee, we will do a careful exam, history, X-ray, and MRI. By studying the cartilage and soft tissue within the knee, we can determine which tissues need to be repaired. Sometimes careful physical therapy, combined with injections, can fix the problem and help you avoid surgery.
So remember: If you hear clicks and pops in your knee but feel no pain or swelling, dont worry. It is normal. If you have pain, instability, or swelling, make sure you check it out to avoid further damage to the joint. The philosophy on this has changed from rest your knee and wait until you are older for a joint replacement to fix the problem ASAP by repairing, regenerating, or replacing the missing tissue and cartilage so that you may never develop arthritis or need a knee replacement.
While it is always best to hear the sounds of silence, snap, crackle, and pop sometimes need to be listened to as well.
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Is It Normal For My Knees To Crack All The Time
Many people experience popping or cracking in their knees when squatting, and while this can sound concerning, it is actually very common. As long as you dont have pain or swelling associated with your knee popping, you most likely dont have anything to worry about. There are a few reasons why your knees may develop these sounds. As we get older, the cartilage in the knees can develop uneven areas due to wear and tear. The ligaments in the knee joint could also be tightening or shifting as you move, creating an audible sound.
If the popping or cracking in your knees is painful or leads to swelling, you should schedule an appointment with your doctor to be evaluated. An injury or chronic condition in the knee may require treatment to alleviate your pain and restore your range of motion. If the cartilage in your knee has undergone excessive wear and broken down, such as from arthritis, you will likely be recommended conservative therapies to manage your symptoms. Osteoarthritis, the most common type of arthritis, can gradually damage the cartilage in your knee and make it difficult to move normally without pain. In these cases, knee replacement surgery may eventually become necessary if other treatments do not provide adequate relief.
Why Does My Knee Pop When I Walk
Why does my knee pop when I walk? That is the most common question asked by young athletes. Although its natural to here cracking and popping sounds in the knee from time to time, you shouldnt take those sounds for granted once they occur frequently. The knee popping sounds that are accompanied by pain could be an indication that you have an underlying health condition that is yet to manifest.
For people who are asking Why does my knee pop when I walk?, there could be several answers to your question. An injury may have caused some parts of the knee to become loose, thus creating the unnecessary sounds. Another reason could be torn ligaments and tendons due to a recent extreme physical activity. Whatever the reason may be, its important that you apply basic remedies even during the first signs of pain. This will prevent your knees from getting worse, before you can even ask for a doctors advice.
Why does my knee pop when I walk, when in fact I am a sedentary person? That is another question commonly asked by young people. Although an active lifestyle exposes you to risks of knee pain and injuries, it doesnt mean people who lead sedentary lives cant get the same condition. There are knee pains that are not associated with physical injuries, but rather and underlying health condition. To get an accurate diagnosis, its always best to consult a doctor.
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Possible Causes Of A Knee Pop
Some associate a knee pop with solely one condition, when actually this can point to a number of knee conditions. Below is a list of possible causes and a few knee conditions in which the afflicted might hear or feel a knee pop:
Crepitus: Crepitus describes the popping, grating, or creaking sensations and sounds within the joint. A buildup of gas bubbles in the surrounding areas of the joint and the sudden release of the gas may cause these noises. While crepitus is typically painless and of no concern, any accompanying symptoms such as swelling or discomfort indicate the affected person should take precautionary measures and see a specialist.
Meniscal tear: The combined symptoms of a pop in the knee and swelling are associated with a meniscal tear. Some patients, however, may not experience these symptoms after a certain amount of time of inactivity but still have a tear.
Knee arthritis: Several types of arthritis can form in the knee, such as osteoarthritis or inflammatory arthritis. Because general symptoms of these conditions include stiffness, swelling, and instability of the knee joint, the knee may pop as a result.
Ligament injuries: The four ligaments that stabilize the knee are the anterior cruciate posterior cruciate medial collateral and the lateral collateral An impact injury or abrupt tear in any of these ligaments may cause the knee to pop, depending on the circumstances of the injury.
What Can I Do About It
This can be a quite frustrating injury for people to deal with, because they often feel that their knee will get better over time on its own. This depends on the type of meniscal tear and the extent of the tear. Some minor tears can be left alone and managed with physical therapy, knee braces, strengthening/stretching exercises. However serious tears may require surgery.
Resting the knee. I advise people to avoid putting much pressure on the leg for the first few days, at-least until the swelling goes down. Avoid running, jumping, squatting, twisting, or any movements that cause pain.
Ice. Use Ice to get the inflammation and swelling under control. Ice every few hours for 15-20 minutes at a time.
Knee brace. If you still need to move around due to your job or other requirements, you can wear a knee brace to help support the leg and prevent any more damage being done to the knee. I will post a link to the knee brace I often recommend to my patients in my clinic.
Another option is stem cell or PRP injections. These injections are very promising for meniscal tears, and can actually help heal the tear. Consult with your physician on possibly receiving these injections.
Physical therapy. I recommend seeing a physical therapist who can evaluate your knee, and determine if you indeed have a meniscus tear. The physical therapist can go over your options, and design a plan of care to get you back to enjoying life as fast as possible!
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What Is The Clicking
The clicking could occur for a few different reasons. Although the noise can be quite alarming on occasion, they are seldom a reason to worry.
Believe it or not scientists first studied the clicking or popping noise in 1947! There was much debate initially but in 2015 a real-time medical imaging study of joint spaces revealed the answer!!
The noise occurs because tiny air bubbles accumulate within the fluid inside your joints and when you move, they collapse due to the changes in pressure inside the joint. The noise occurs when the gas bubbles collapse. When the bubbles burst this is called cavitation. It is the same process as when you click your knuckles !
In the knee this can occur from either the knee joint itself between the tibia and the femur , known at the tibio-femoral joint or the joint on the front of the knee between the patella and the femur , known as the patellofemoral joint.
This mechanism is why you hear the clicking noise if your physiotherapist or osteopath applies a short, sharp movement to one of your spinal joints. It also explained why you cannot keep clicking the same joint in quick succession. It takes approximately 20 minutes for the gas bubbles to reform.
Here are the other reasons for clicking at the knee that we see in clinic:
Both these conditions are often pain free and are often nothing to worry about.
Osteoarthritis Of The Knee
If crepitus occurs with pain, this can be an early sign of osteoarthritis of the knee. OA is normally a result of wear and tear, and it tends to develop and worsen with age.
In OA, the cartilage that covers the ends of bones in the joints gradually wears away. Bones rub on this increasingly rough surface, resulting in pain and mobility issues. It is more likely among people with obesity or those who have had an injury in the past.
A study published in the journal Osteoarthritis and Cartilage found that women aged 45 to 60 years who had both crepitus and patellofemoral pain had a 72 percent chance of developing OA, although they did not yet have a diagnosis of OA.
The Centers for Disease Control and Prevention estimate that of adults aged 65 years and above were living with a diagnosis of arthritis between 2013 and 2015.
Tips and treatment
If a person has an early diagnosis of OA, the Osteoarthritis Foundation suggest using nonsurgical options to slow the progression, maximize mobility, and improve strength.
- lifestyle modifications, such as weight loss and exercise
As OA progresses, treatment through medication or even knee replacement surgery may be necessary.
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You Experience Greater Than Normal Movement
If you feel like your range of motion in the knee is higher than usual, something might be out of place or injured. This is known as joint instability.
You may feel like your knee will buckle or fold with walking, twisting, or weight-bearing.
The sensation of the knee giving away may occur with simple daily activities or upon return to sport following what was thought to be a minor injury, explains Dr. Brown.
Additional episodes of joint instability may worsen the condition of a knee after an injury. Tears of the ACL or MCL and patellar dislocations could also create joint instability, he says.
Hundreds of thousands of exercise injuries occur each year. Among these, knee injuries are the most common.
The best plan of action is to make an appointment with an orthopedic surgeon.
Wear a compression-sleeve-type brace or a knee brace with hinges in the interim, says Dr. Brown.
This may provide some comfort or level of support. Use crutches if you feel like you could fall and suffer additional injury because of knee joint instability.
Another type of hypermobility can occur when the kneecap moves out of place. This condition is called a patella dislocation. Its usually painful when it happens, and it might be sore the next day. If it pops back in by itself, the injury might not be serious. The true test is whether you feel confident that you can resume regular activity later that day or the next day.
Consult With A Physical Therapist If
- The knee pain increased progressively or it affects your daily activities.
- The noise is like a creaky door. It could indicate an early stage of knee osteoarthritis, best treated with exercises and physical therapy.
- The noise appeared suddenly, with or without pain. This could be a sign of patellofemoral pain syndrome or arthritis.
- If any of the sounds in the normal section suddenly become painful.
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Improve Movements To Eliminate Knee Pain
The lower extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and during recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.
Many therapeutic exercises can help restore proper strength and endurance to the leg muscles. Isometric exercises are often the initial treatment exercises, followed by single plane rubber band exercises for the hip, knee, and ankle: flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, an exercise ball, and BOSU balls can be performed on the floor. The more unstable of the surface, the more effort and stabilization is required of all the lower extremity muscles.
Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.
Crepitus Following Surgery Or Trauma
published in Clinics in Orthopedic Surgery shows that up to 18 percent of people who have a total knee arthroplasty , or knee replacement, will experience crepitus. This may due to the design and fit of the new knee.
This type of crepitus usually resolves without intervention.
However, if problems persist, a doctor may recommend debridement, a minor surgical procedure to remove debris from around the joint.
Another reason for crepitus after surgery is arthofibrosis, or the development of scar tissue. This can lead to pain and stiffness in the joint. It can also happen after a traumatic injury.
If the person experiences pain and stiffness after an injury or surgery, they should see a doctor. The doctor may recommend monitoring the knee, and it may need treatment.
Often, however, crepitus that follows an injury or surgery is not serious. Doctors , for some people, the crepitus may have been there before, but an increased awareness how the joint is reacting makes it more noticeable now.
Often, say the researchers, reassurance and rehabilitation are enough.
Treatment may not be necessary. If it is, the options will depend on the cause, as outlined above.
If crepitus occurs with exercise, the person should not stop exercising but modify the exercise.
Precautionary measures include:
When exercising, people should always listen to their body. If there is pain, they should stop. Always exercise in moderation and stretch before exercising.
Other ways to protect the knees include: