Photo by Faith Davis on Unsplash

 

One of the most common questions and concerns I hear in clinic has to do with the music that your body makes. I am talking about clicking and popping around your joints! My grandfather is a mechanic, and my favorite line of his always followed the question, “why is my car making this sound.” He always replied with, “do you hear that noise when you aren’t in the car?” Every now and then I love to joke with people when they show concern regarding these noises. In reality, this really does freak people out and not completely grasping why your body creaks, pops and clicks could actually be a HUGE ROAD BLOCK in your quest for health.

I love the following quote from a patient interviewed in a research study regarding her “joint noises.” I love it because she perfectly states what most people are thinking (Robertson, 2010).

“I didn’t know whether it would click more or click less, whether I should push through it, whether I should stop if something aggravates the clicking, but nobody offered up anything, any explanation about it at all.”

Let me start by saying that there is no correlation between clicking or popping noises and arthritis. Despite some of the articles put up on the internet.

How you perceive these noises is more of an indicator of how well you will progress in therapy. If there is fear, anxiety and stress related to these noises, it is likely that your outcomes will be poor. Many people will avoid activities because they are concerned that they are causing more “damage.” Please do not do this.

I am not telling you to just ignore it. No one likes making joint music when entering a quiet room. But try your best not to fixate on it. Do not convince yourself that you are slowly churning up a fresh batch of arthritis. It only makes the matter worse and it is not true.

Here are some cool facts from various research articles:

• One study found that clicking and popping at the knee was common in 99% of people. Noises were blamed on a “slip-stick phenomenon” where movement between the kneecap and femur are “sticky” (Beverland, 1986). Likely because of reduced flexibility and joint lubrication.
• Another hypothesis is that noise is secondary to tendon rubbing against bone (Hutton, 1967).
• Popping around the spine is thought to be secondary to a release of nitrogen from the joint. This is often a source of relief when receiving joint manipulations from a chiropractor, osteopathic doctor, physical therapist or your fraternity brother (Ouch!). It is not to say that this noise needs to occur to get relief, but people often associate this noise with actual change. It is funny how our brains work. Often times seeing or hearing something results in better outcomes. We love certainty.

“Is it ok to “crack” my joints? It feels pretty wonderful.”

The honest answer: I don’t know.

A study found no correlation between “self –cracking” and arthritis or degeneration (Castellanos, 1990). However, if this is an obsessive habit I would advise you to slow your roll! With anxiousness related to stiffness in a certain area of the body or suspected injury, many people will adopt habits like “self-cracking.” If you regularly feel stiff, or tight this may require a visit with your PT to see how they can help.

 

The Big Takeaway

• The tendency for tendons and all of your bits to rub together can be a result of reduced flexibility and joint/muscle lubrication. MOTION IS LOTION.
• In many cases, people report less clicking and popping after warming up or taking a nice walk in the morning.
• In some cases noises may also be a result of strength, stability or alignment issues during the day. Bringing some of your concerns to a skilled PT may be the fix that you need.
• Don’t forget… these noises are normal in people with and without pain, in the old and the young.

 

Just a reminder. Don’t neglect the basic pillars of health. 

Eat well, drink lots of water, exercise, sleep and think good thoughts. Trust that everything else will fall into place.

 

Dr. Michael Infantino, DPT

 

References

Beverland DE, McCoy GF, Karnohan WG, Mollan RAB. What is patellofemoral crepitus? The Journal of Bone and Joint Surgery (British volume) 1986; 68-B: 496.

Blodgett WE. Auscultation of the knee joint. The Boston Medical and Surgical Journal 1902; 146: 63–66.

Castellanos J, Axelrod D. Effect of habitual knuckle crack- ing on hand function. Annals of the Rheumatic Diseases 1990; 49: 308–309.

Crossley KM, Barton CJ, Menz HB. Clinical predictors of foot orthoses efficacy in patellofemoral pain syndrome. Medicine and Science in Sports and Exercise 2010; 42 (5): 687.

Department of Work and Pensions. Glossary of terms. 2010. (Available at http://www.dwp.gov.uk/publications/ specislist-guides/ medical-glossary) (Accessed 11 August 2010).

Garry JP, McShane JM. Postcompetition elevation of muscle enzyme levels in professional football players. Medscape General Medicine 2000; E4: 2.

Heuter C. Grundriss der chirurgie (third edition). Leipzig: FCW Vogel, 1885.

Hutton S. Manipulative treatment. The Medical Journal of Australia 1967; 25: 1274–1280.

McConnell J. Management of patellofemoral problems. Manual Therapy 1996; 1 (2): 60–66.

McCoy G, McCrea JD, Beverland D, Kernohan G, Mollan RB. Vibration arthrography as a diagnostic aid in dis- eases of the knee. The Journal of Bone and Joint Surgery (British volume) 1987; 69-B (2): 288–293.

Robertson, CJ. Joint Crepitus- are we failing our patients? Physiotherapy Research International. 15, 4, 185-188. Dec. 2010. ISSN. 13582267