Grinding: This type of sound is most often associated with general degeneration of cartilage within a joint, such as osteoarthritis, and occurs when there is bone on bone contact. Seeking treatment would be indicated to work on the stability of the joint through strengthening the tissue around it in order to prevent dislocations that could result in tissue damage such as torn ligaments/joint capsule damage etc. People with joints that are “too loose” may experience clunking when the two joint surfaces rub together.
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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. 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. Additionally, sometimes a clicking sensation can be felt in the knee cap which can indicative of a tracking issue where the knee cap does not stay perfectly in the groove that it is meant to stay in. These would both be typically associated with 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.Ĭlicking: this sound can sometimes be problematic if it is a result of connective tissue abnormalities such as a torn meniscus in the knee or torn labrum in the shoulder/hip. 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. In the beginning, this snapping sensation may be quite annoying, but not cause any pain. An example of this could be snapping in the outside of the knee. Snapping: There are other sounds that are not serious, but over time could lead to chronic injury. 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 injury such as an Achilles rupture or ACL tear- both of which would most often be heard/felt in conjunction with pain. While one should not be worried about cracking their knuckles from time to time, repeated attempts over a short period of time 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. It takes time for this gas to build back up, which is why you cannot repeatedly crack the same joint over and over and over again. They are painless, do not cause damage, and often even relieve symptoms (at least temporarily). To physical therapists and chiropractors, this sound is known as a “cavitation”. When these bubbles implode or “pop” the sound associated with “cracking your knuckles” is produced. Changes are pressure- which can occur with movement- can cause gas bubbles to form within the fluid. It lubricates the joints to decrease friction between the surfaces. Think of this as your body’s natural oil. Popping: all joints are surrounded by synovial fluid.
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. The reality is that there are many explanations for these sounds- most of which are often entirely harmless if not accompanied by pain. 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?”. This is one of the most frequently asked questions I get on a day-to-day basis. Does your body often make craking, popping, clicking, grinding noises when you move?
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