Is It Normal for Your Joints to Click and Pop?

We've all heard our joints pop and crack from time to time. My knees crack every time I do my first squat while warming up for a workout. And my shoulders tend to crack the first time I reach overhead in a day.

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.

Or we just feel like we're getting old.

Is there any truth behind this?

Do creaky joints indicate dysfunction?

One study found that crepitus is a poorly understood symptom for which we haven't defined a specific cause. It, therefore, creates feelings of anxiety and worry, which then create inaccurate beliefs, which then alter our behaviour. (1)

One study on patellofemoral pain (PFP) found that while kinesiophobia, catastrophism, knee stiffness, strength, and physical function are all impaired in people with PFP, this all occurred regardless of crepitus. (2)

Another study found a similar result, with no meaningful correlation found between crepitus and pain. (3)

The gap between research and cultural belief

Unfortunately, joints cracking and popping is commonly seen as something negative and even reinforced by healthcare professionals. One study showed that many patients cited a fear of crepitus that started with a professional telling them that it's a sign of damage or injury. (1)

Our beliefs and expectations about the condition of our body and how we feel can have a significant effect on our experience of pain.

If we're afraid to move because of popping and cracking noises, it can have a negative downstream effect on our overall movement, mobility, and levels of pain.

But what is crepitus?

Popping, clicking, or cracking in and around a joint generally means air is moving in the joint. All joints are fluid, and sometimes gas bubbles can form in the space between bones, ligaments, and tendons, creating these sounds when we move.

They are usually harmless. A rule of thumb I give to my clients is, if there's pain associated with a crack, that's concerning, but in the large majority of times, this isn't the case, and it's a perfectly normal phenomenon.

It doesn't appear to be a good predictor of pain because we find people who have their joints crack with zero pain, and those who experience no crepitus who do have pain.

The problem is, if you Google crepitus, you'll find statements like, "a grating sound produced by friction between bone and cartilage or the fractured part of bones". That's word for word what appears at the top of the page when you try to research crepitus.

Conveniently below that, you'll see "related" health conditions like Gout and Lupus. Seriously? It's no wonder people go down the rabbit hole while researching their health. How did we get from a harmless joint sound to Lupus, an autoimmune inflammatory disease where your immune system attacks your tissues?

Be careful on the internet.

Crepitus does not indicate dysfunction

So don't worry about your joints cracking when you move. We need people to move more, not less.

To your good health,

Coach Stephen

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📚References:

1. 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.

2. 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.

3. 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.

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Thanks for reading.

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