For one, I have an exciting profession as a physical therapist, and it keeps me on my toes.  Part of the intrigue is people in our community asking me to answer questions about their ailments.  I have people asking me 2-3 x per week to feel their knee, shoulder, or ankle as they have a light click, pop, or grind in the joint.  I always smile as people feel comfortable asking me to evaluate their condition.  Most people have no concerns about this grinding/clicking/popping, but it is intriguing.

***Here is a video to help explain some of this clicking and popping too!

In today's article, we will investigate why you may have noise in a joint, what this means, and when to seek medical help.

FEEL THIS JOINT RIGHT HERE!

If most noise in the joint is benign and does not create a concern, what in the world is it?  I can break down the questionable noise into three criteria (pop, grind, click)

• 1.  Pop:  A pop in the joint is described as a loud crack once the motion passed the physiological movement.  Visualize the bending of your hands back to an audible synchronized pop of the fingers.  Typically, a parent or a mother in law will report this pop as a contributing factor to arthritis as we age; however, there is no evidence to support this. Usually, people find this annoying and use "arthritis" as a sound reason to get you to stop.   A release of "gas bubbles" or nitrogen from the joint is the most supported rationale, but new research indicates gas cavity formation when the joint is rapidly moved apart as a cause.   Either way,  the result is a benign, often annoying, pop.   

• 2.  Grind:  Grinding sounds in the joint can be found in the knee, hip, or shoulder joint.  Sometimes we experience grinding to the cervical spine as well. Grinding is typically a form of "crepitus" and is rough surfaces of a joint rubbing across each other.  Tendons with a sheath, such as the Achilles or tendons of the wrist, experience crepitus.  People describe this as a creaky door feeling.   

• 3.  Click:  A click to the joint at a consistent specific range of motion is usually cartilage disruption.  Cartilage sounds the bones of a joint or can be between the joint.  Sometimes the joint has roughening to the surface or surrounding tissues creating a palpable or audible click.  This click is accompanied by pain, usually.   

WHEN DO I NEED TO GET HELP?

• 1.  Pain: A pop, grind, or a click creating a sharp pain is the first warning.  Pain is the warning sign you have some level of disruption. Acute, intense, residual pain or numbness/tingling near the area of noise signifies a disorder to the joint.

• 2.  Locking:  A joint can have disruption creating frayed edges, a tear to the cartilage, or a bone fragment displacement.  These objects are a cause of the joint locking once a pop occurs.  Locking to the joint can be very painful, and the disruption in movement makes the individual anxious.  

• 3.  Lack of Mobility:  Disruption to the joint can result from previous trauma or current trauma related to a dislocation.  A dislocation will create a pop or click and disrupt the joint entirely.  A dislocated joint may disrupt the nerves or arteries nearby, therefore causing significant injury.  A suspected dislocation will require medical intervention.

TAKE HOME MESSAGE

People have noisy joints.  The noise in the affected joint is often benign and not a concern regarding joint pathology.  Different joint noises can mean different disruption levels and require when pain is present.  A lack of pain to a noisy joint is usually without complications.  Pain, locking, or lack of mobility are signs you will need to be evaluated by your physical therapist or physician.

• The author, Rob Sumner, is a Doctor of Physical Therapy and owner of Sumner Specialized Physical Therapy. He's happy to answer any questions about this article, wellness, fitness, or physical therapy overall by phone at (509) 684-5621 or by email at Rob@SumnerPT.com

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