Joints are regions of the human skeleton where two or more bones meet and move with one another. Your body has over 360 of them!
It’s not uncommon to hear or feel a pop click, snap or other form of noise within a joint when moving. This noise which is formally known as crepitus might not be painful, but may perhaps cause some concern.
What is this caused by, how dangerous is it, and can you get rid of it? I am going to explain three common scenarios from a scientific perspective.
Scenario 1: No Pain & Occurs Infrequently
If crepitus is not painful and occurs infrequently (once or twice a day), there’s a good chance you are experiencing cavitation within the joint. Cavitation occurs when air bubbles accumulate in the joint capsule over time, and then are expelled when the joint moves a certain way. Think of it like morsels of bubble wrap making their way into the joint and then getting popped via contact from the bones.
Cavitation is normal and there’s no need to try and prevent or fix this.
Californian physician Dr. Donald Unger conducted an experiment where he went 1 year cracking only one set of his knuckles every day [1]. Follow up X-rays showed no significant difference in Arthritis between his hands.
So whether it’s your knuckles, toes, knees or elbows, let cavitation do its thing!
Scenario 2: No Pain & Occurs Frequently
This is probably the most common situation that I get asked about and arguably the most complex situation to answer. Why is that you ask?
Well just because the noise is heard and felt at a specific joint, that doesn’t necessarily indicate that specific joint is source of the problem. For example, crepitus at the ankle doesn’t always mean the problem is at the ankle. It could be at the knee, hip, torso or somewhere else.
Simply put, the noise is a symptom indicating a problem (at your joint or elsewhere) that likely requires your attention. As your joint moves, many muscles and tendons slide over bones, which produces some noise, but typically not enough to be heard or felt. Some of these muscles cross several joints and may span across multiple bones of the body.
If there is scar tissue built up from a previous injury or you have certain muscles that are under trained, or neglected, they might become weak and stiffen. This causes an increase in muscle tension which may shift certain bones out of their optimal working position. All of this will likely initiate more aggressive contact between the bones and tendons during movement which often translates into louder crepitus.
So is this dangerous?
Short term, I wouldn’t worry to much about it. Usually after a good warm up, added blood flow to the area is enough to muffle a lot the noise.
But just because you are able to quiet crepitus, that doesn’t mean the problem is completely solved. You should still address the muscle weakness or imbalance by performing appropriate exercises and mobility drills.
If you choose to ignore the noise, your odds of developing an acute injury, and pain increases.
Scenario 3: Pain & Occurs Frequently
At this point you’re likely dealing with something a little more serious.
If the pain develops somewhat gradually (over several weeks/months) and tends to get worse when performing moderate to intense physical activity, this may be indication of early stage Osteoarthritis. This is the result of articular cartilage breakdown due to excessive wear and tear on the joint. Parts of your bone become unprotected and rub together which creates noise and inflammation. A pretty common occurrence in older individuals and those who have played high level impact sports for many years.
The most common treatments for Osteoarthritis involve medication, physical therapy and cortisone injections in an attempt to manage pain levels. But if none of these work, surgery will likely be required and the joint may have to be replaced entirely.
If the onset of pain was somewhat quick (over hours/days) and it is similar whether you are physically active or not, chances are you are dealing with some sort of acute tissue damage. This may have been triggered by a sudden increase or change in your activity level, or by some sort of injury from sudden movement or impact during exercise or sport.
Maybe one day you decided to try and break the world record for a mile run without warming up. Or perhaps you were playing a sport, fell, and landed on your knee or elbow but were so focused on the game that you didn’t even notice. Whatever the case may be, there are many types of tissues that may have been damaged within or around the joint including, ligaments, cartilage, tendons, or the actual bones themselves.
It is not easy to pin point the exact problem but the good news is that in a lot of these situations, your body will heal itself over time. If you’re looking to speed up the process, I highly recommend consulting with your doctor or physical therapist so they can properly assess you and provide an individualized plan for you to get you on the road to recovery.
Summary
There’s no one-size-fits-all solution for joint clicking. Each case is unique and should be treated as such.
Hopefully this article helps you make the most informed decisions possible moving forward.
Work With A Pro
At Stephen Fitness & Rehabilitation, we offer personal training and physiotherapy services specifically designed for individuals experiencing crepitus.
Our mission is to improve the strength, mobility and independence of each and every client in a friendly, empathetic, and non intimidating atmosphere.
Contact us to learn more about how we can help you or your loved one become stronger more mobile and independent in the comfort of their own home!
References
[1] Unger, D. L. (1998). Does knuckle cracking lead to arthritis of the fingers?. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 41(5), 949-950.
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