Whether you’re standing up from the couch or in the middle of an intense workout, cracking knees can be an unpleasant sensation.
The good news: if you don’t experience pain in addition to cracking, said physical therapy expert Harshvardhan Singh, there’s probably nothing to worry about. He’s an assistant professor at the University of Alabama at Birmingham.
“Typically, there’s no concern if there’s no pain associated with knee cracks,” Singh said. “The intensity of the sound of knee crack also follows the same principle.”
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Circumstances change slightly if you’ve had recent trauma to your knee.
“If your knee started to crack after that event, you should see a doctor even in the absence of pain,” Singh said.
Some people worry that cracking knees can be an indication of arthritis, but that’s not the case.
“A knee crack may mean your joint is mobile and lubricated.”
Singh emphasizes that, typically, cracking knees are normal and shouldn’t stop you from doing activities you enjoy.
“Do not allow these sounds to make you feel abnormal or be mentally stressed or limit your functional activities,” he said. “A knee crack by itself does not indicate presence of any disease.”
Why knees crack
Cracking knees can mean a lots of things, Singh said.
The kneecap moves around in a groove located within the knee joint to accommodate movement, especially during activities such as walking, running or squatting.
If your knees crack without pain, there could be a number of things going on, including:
- A large-sized kneecap which doesn’t fit well in the groove and thus produces cracking during activities such as running and jogging
- A too-tight thigh muscle, which can pull the kneecap and affect its free-gliding movement, leading to cracking
- Degeneration of various soft tissues such as cartilage and the meniscus, which can result in the loss of a smooth cover for the knee joint and cause cracking
“The degenerative changes can also lead to pain and locking of the knee joint,” said Singh. “Typically, degenerative changes are common in older people.”
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During physical activity, it’s “absolutely normal” for knees to crack — especially when you’re ascending or descending stairs, walking, jogging, running or squatting.
“If you have no pain during these activities, then you shouldn’t be worried about the cracking sound during the performance of these movements,” Singh said.
“A cracking sound during these activities could simply mean that your kneecap (also called a patella) is mobile and moving.”
Treatment
If cracking knees bothers you, you can seek treatment from a physical therapist.
“If the knee cracking is due to any misalignment of the kneecap, then there’s (a) technique … that can be useful,” Singh said.
This typically involves “taping or correcting the alignment of the kneecap (in addition to) exercises.”
“A physical therapist may also be able to help you determine if there are specific movement patterns or any bio-mechanical alignment which may be leading to (cracking) and prescribe you certain exercises to help improve it,” Singh said.
What can we do to protect our knees?
Dr. Paul Wong, chief of orthopaedics at Michael Garron Hospital in Toronto, previously told Global News that knee complications in Canada are becoming a “quiet epidemic.”
“When people think of disease, they think of heart problems or diabetes, but they’re kind of stabilized,” he previously told Global News. “What we see in the practice is that arthritic problems keep growing higher and higher each year … much higher than what we expected.”
Wong added that following C-sections, knee replacements are the most common inpatient surgery in Canada, and as a practicing knee surgeon for more than 20 years, he has seen these surgeries double.
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While Wong can’t explain why more Canadians are getting more knee-based surgeries or experiencing more knee pain as a whole, he says it could be multiple factors.
About 80 per cent of his patients who are getting knee-replacement surgeries or dealing with knee pain are immigrants, he said, and for Asians, for example, it could be cultural as many Asian communities kneel to pray.
Other factors can include genetics and obesity but also trends in society.
He added that more people take part in marathons now than they did decades ago, or play sports like soccer and tennis. This is often when you see injuries related to the knee, he said.
But this is not to imply that working out will cause knee pain. Dr. Najam Mian, a physical medicine and rehabilitation specialist in Vancouver said there are numerous muscles around the hip, knee and ankle that strengthen and support the knee joint.
“It is extremely important to maintain conditioning of these muscles in order to prevent injury and to rehabilitate after a knee injury,” he previously told Global News.
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“Often, when people develop chronic knee pain, their natural reaction is to stop exercising… unfortunately, this leads to further weakness and psychological fear of movement, which in turn leads to increased chronic pain.”
This cycle can become difficult to break so regular exercise is important.
“In general, we should always maintain some combination of aerobic, strength-based and stretching-based exercises a few times a week,” Mian said.
— With files from Global News’ Arti Patel
Meghan.Collie@globalnews.ca