My (insert body part) cracks every time I… Is that bad?

July 30, 2019
July 30, 2019 foxphysical

Does your body often make cracking, popping, clicking, and grinding noises when you move?

By: Dr. Ashley O’Rourke

This is one of the most frequently asked questions I get daily. A patient will be on the table and say to me “my shoulder cracks every time I raise my arm…is that bad?” or “I feel a click in my knee every time I extend it…how do I get it to stop?”. The reality is that there are many explanations for these sounds- most of which are often entirely harmless if not accompanied by pain. There are, however, some cases in which the sounds should be addressed, with the general rule of thumb being: any of these sounds occurring in a joint that is not accompanied by pain are typically nothing to worry about.

Let’s Differentiate the Noises:

Popping: all joints are surrounded by synovial fluid. Think of this as your body’s natural oil. It lubricates the joints to decrease friction between the surfaces. Changes are pressure- which can occur with movement- can cause gas bubbles to form within the fluid. When these bubbles implode or “pop” the sound associated with “cracking your knuckles” is produced. To physical therapists and chiropractors, this sound is known as a “cavitation.” They are painless, do not cause damage, and often even relieve symptoms (at least temporarily). It takes time for this gas to build back up, which is why you cannot repeatedly crack the same joint repeatedly. While one should not be worried about cracking their knuckles from time to time, repeated attempts over a short period should be avoided as this can eventually cause changes in the joint capsule or train the brain into thinking they “need” to perform this activity over and over again (forming a habit) when in fact it is not necessary.

That being said, a “popping” sound coming from the lower leg that occurs after landing from a jump shot while playing basketball or in the knee after cutting/pivoting on the soccer field could indicate serious injuries such as an Achilles rupture or ACL tear- both of which would most often be heard/felt in conjunction with pain.

Snapping: Other sounds are not serious but, over time, could lead to chronic injury. An example of this could be snapping in the outside of the knee. Initially, this snapping sensation may be annoying but not cause pain. It is by no means an emergency; however, with repetitive motion and frequent activity, this friction that occurs as the connective tissue (iliotibial band) rubs against and snaps over the thigh bone can cause inflammation and irritation of the tissue leading eventually to pain. Similarly, people can experience a like feeling in the hip known as the “snapping hip phenomenon.” This can be due to tightness in the muscles/tendons rubbing over the bone.

Clicking: this sound can sometimes be problematic due to connective tissue abnormalities such as a torn meniscus in the knee or torn labrum in the shoulder/hip. These would both be typically associated with pain. Additionally, sometimes a clicking sensation can be felt in the knee cap, indicating a tracking issue where the knee cap does not stay ideally in the groove it is meant to stay in. While this may not cause additional symptoms in the short term, it too could cause pain in the long term, like patellofemoral pain syndrome (PFPS) or generalized knee pain caused by muscular imbalances that lead to abnormal stresses to be placed upon the knee.

Shift/Clunk: This sound/sensation can be a little more concerning and indicative of instability or laxity in the joint, leading to subluxation or full dislocation. People with “too loose” joints may experience clunking when the two joint surfaces rub together. Seeking treatment would be indicated to work on the joint’s stability by strengthening the tissue around it to prevent dislocations that could result in tissue damage, such as torn ligaments/joint capsule damage, etc.

Grinding: This type of sound is often associated with general degeneration of cartilage within a joint, such as osteoarthritis, and occurs when bone-on-bone contact. This sound may increase over time as it is normal for joint surfaces to change with age.

Other Noises: sometimes, a painful or non-painful “pop” can be heard during manual therapy- perhaps while a PT moves a knee after surgery. This sound can indicate the breaking up of scar tissue and may be beneficial if it improves mobility.

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If you are uncertain whether you are experiencing a typical joint sound or something problematic, let the qualified doctors at Fox Physical Therapy assess the tissue to determine whether intervention is warranted. Give us a call today for a free consultation.