Do "Noisy" Joints Indicate Dysfunction?
We've all heard our joints pop and crack from time to time. I know I've heard my knee while getting up after sitting for a while.
This phenomenon is known as "crepitus" which describes a popping, clicking, or crackling sound in a joint.
The common belief is that if we hear these sounds, it's an indicator that something is wrong, possibly that the joint is tight or that there is some underlying pathology that could affect us down the line.
However, this is not true.
One study on patellofemoral pain (PFP) in women found that while kinesiophobia, catastrophism, knee stiffness, strength, and physical function are all impaired in women with PFP, this all occurred regardless of crepitus. (2)
In saying that, the same study showed that those who were pain-free with crepitus had poorer objective function overall. (2)
Another study found a similar result, with no meaningful correlation found between crepitus and pain. (3)
But this doesn't tell the whole story.
One study found that crepitus is a poorly understood symptom that we haven't defined well in terms of a specific cause. It, therefore, creates feelings of anxiety and worry which then creates inaccurate beliefs, which then alter our behaviour. (1.)
Our beliefs and expectations about the condition of our body and how we should feel can have a significant effect on our actual experience of pain.
If we're afraid to move because we're afraid of hearing any popping and cracking noises, then it can have a negative downstream effect on our overall movement, mobility, and levels of pain.
You can see how it can create a negative feedback loop of pain and dysfunction.
What's worse is that this feedback loop is reinforced by many healthcare professionals, with many patients citing that this fear of crepitus started with a professional telling them that it's a sign of damage or injury. (1)
There's still a lot we don't know about the source of crepitus, but we do know that it's a completely normal phenomenon and not something you should be worried about. We've found people in pain with and without crepitus as well as those who are pain-free with and without it.
At best we can describe it as a pressure release within a joint, usually of air or other gases within the joint space.
Crepitus does not indicate dysfunction., so don't worry about your knees or shoulders cracking when you move. We need people to move more, not less.
To your good health,
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Claire J.Robertson, MichaelHurley, FionaJonesPhD. People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study. Musculoskeletal Science and Practice. 2017. 28: 59-64.
Danilo de Oliveira Silva, Christian Barton, Kay Crossley, Marina Waiteman, Bianca Taborda, Amanda Schenatto Ferreira, Fábio Mícolis de Azevedo. Implications of knee crepitus to the overall clinical presentation of women with and without patellofemoral pain. Physical Therapy in Sport. 2018. 33: 89-95.
J. J. Stefanik, R. Duncan, D. T. Felson, G. Peat. Diagnostic Performance of Clinical Examination Measures and Pain Presentation to Identify Patellofemoral Joint Osteoarthritis. Arthritis Care and Research. 2017. 70(1): 157-161.