Joint issues
Why do my joints pop, click and grind and should I be concerned?
Our bodies can create a wide range of unusual and at times perplexing noises. A common question presented to physiotherapists is: Is it normal for my joints to click, pop or grind and is it bad? Fortunately, many of these sounds are not problematic and will simply come and go without causing pain or problems. In this blog we will discuss some of the different types of sensations and/or sounds that the joints of the body make and whether or not they should be of concern.
Harmless POPs
Everyone has heard another individual “crack” their knuckles and for some the sound alone makes them cringe. This same “cracking” can also occur with exercise when the joints are moved through rapid loaded movements at the beginning of an exercise or body movement. The physiology behind this sound is the rapid release of energy in the form of sudden vibratory energy (Protapapas and Cymet, 2002). Rapid pressure changes in the joint result in cavitation and formation of a gas bubble within the joint fluid (Protapapas and Cymet, 2002). The mechanism believed to cause the sound associated with a “popping” joint is due to the production of a momentary partial vacuum produced by joint separation. The contents of this vacuum are thought to contain water vapour, nitrogen, oxygen and carbon dioxide under reduced pressure. Once the gas bubble has formed within the joint a period of time is required for it to be resolved into the synovial fluid resulting in a delay in the ability to “re-pop” the joint.
Popping and joint fluid bubble formation is common and fortunately is not a cause for concern. There is no evidence to associate it with increased arthritic changes within the joint and the only detrimental impact it could have is increased joint laxity (joint looseness) which could predispose you to joint instability and injury (unlikely given that most joints clicked habitually are the knuckles).
Grinding
Grinding sensations and noises are associated with causes other than synovial fluid bubble formation. Typically grinding is referred to as crepitus and is often reported as stemming from neck joints and knees. Grinding is often associated with more degenerative type changes within joints that are experiencing cartilage wear and tear. The fissuring and thinning of cartilage reduces the smooth gliding surfaces and hence grinding becomes noticeable. As much as most of us don’t like to hear it, it’s often simply a fact of us getting old.
Periodic grinding can also be associated with inflammation and swelling within a joint which can affect the joint arthrokinematics (just a big, complicated sounding word used to describe joint surface movements). Additionally, increased muscle tension around joints can also affect their movements and create grinding sensations or sounds (especially in the neck facet joints which due to their proximity to the ear are often heard reverberating through the bones of the skull).
If you are suffering from muscle tension and/or joint inflammation it is important that the underlying reason/s are established in order to prevent further complications. As physiotherapists at Central Baldivis Physiotherapy we can provide education and guidance for this.
Clicking
Clicking (especially sharp clicks) tend to be associated more with fibrocartilaginous pads or rings within joints called menisci or labrum. When they become frayed or torn it is possible for them to catch and create a clicking sound (could also be grinding or grating though) which may or may not be associated with pain. If there is also locking of the joint associated with the click then it would be best to get it checked out by a physiotherapist here at Central Baldivis Physiotherapy.
Tendon Noises
Just to cause more confusion, tendons and the sheaths they slide in can also be a cause for crepitus (grinding). When joints and the tendons that help move them are overloaded swelling can develop in the tendon sheaths resulting in tenosynovitis and a grinding sensation. This is another reason for seeking assistance from us at Central Baldivis Physiotherapy as we will be able to help guide your recovery from this type of condition. A good starting point is reducing your exercise/joint movement load and to use ice and anti-inflammatories to help calm the swelling down.
I’m sure after reading this blog you will suddenly notice more pops, grinds and clicks emanating from your body than ever before. Generally, a good rule of thumb is that if there is no pain associated with the joint sounds you are hearing or sensations you are feeling than you shouldn’t be too concerned. If you are unsure, or begin to notice pain developing, than come visit us as Central Baldivis Physiotherapy and we will provide expert advice and guidance for your particular situation.
References
Protapapas M.J. and Cymet T.C. (2015). Joint cracking and popping: understanding noises that accompany articular release. Journal of the American Osteopathic Association, 36(4), 811-816.
