Grind, Crack, Creak – Why are my knee’s noisy?

I see a lot of clients in the clinic who come to me for knee pain or in fact I am seeing for something different and state their knee’s make noise, like a crack, or a creaky sound. I’m sure I speak on behalf of our team and in fact many health professionals we get asked this a lot.

So let’s consider the below info-graphic…have a look

So the real take home message is the majority of people without any knee problems have noisy knees, so lets consider this to be actually normal. Noise does not mean arthritis and neither does pain for that matter.

Even researchers and clinical people are undecided really whether this noise (known as crepitus) signals the beginning of arthritis.

So what exactly is joint crepitus? Most importantly does crepitus really matter? We need to determine what this cracking, grinding, creaking, clicking, clunking, popping and other adjectives used for the phenomena of joint crepitus is.

Loud isolated cracks and pops.

These are often seen during warm ups and activities involving crouching down. Some people even feel better after the knee has cracked. This will either be bubbles of gas popping, just like when someone cracks their knuckles, (which by the way does not lead to arthritis!), or the patella locating into the groove underneath as the muscles warm up. Neither are a case for any concern whatsoever, and should be seen as entirely normal.

Pathology

People will very often associate their joint noise with a diagnosis of osteoarthritis (especially if someone in their family has osteoarthritis). A true osteoarthritic joint creak almost resembles a creaky door. This is indicative of bone on bone advanced osteoarthritis. This noise is quite different from the fine grating that often originates from a non-arthritic patellofemoral joint. Ironically clients with advanced degenerative disease rarely complain of this as their pain, deformity and or functional loss is normally a much bigger problem.

It is much more likely that many of our clients will have fine crepitus of a non-arthritic origin. Some of these people may have chondromalacia patellae,(CMP) of the patellofemoral joint, an extremely common finding indicating fissuring of cartilage on the back of the patella but not a loss of vertical cartilage height.

So if you are concerned about your crepitus or noisy knees then for sure it is of interest to us the physios. Though a really good assessment looking at you thoroughly we hope to empower you and alleviate your concerns.

Atif is one of our senior physiotherapists working out of our clinics in Porirua.