“Did you hear that?” “Oh no, there it goes again!” - These are common phrases I hear all the time when a patient’s joint begins to make noise. We normally refer to this noise as crepitus, which is a sound that comes from a joint due to friction or a release of gas. The most common joint that this occurs in is the knee, but it can also be heard in other areas. Crepitus or noise doesn’t mean joint damage or pain. Let me repeat this, there isn’t an association between loud or noisy joints and pain. When we hear this noise, it can be multiple things: gas leaving the joint (like cracking your knuckles) or tendons/muscles rolling over each other.
A study conducted in 2018 by Pazzinatto et al. investigated the clinical implication of crepitus in individuals with knee arthritis. They found that individuals who had arthritis of the knee with crepitus had lower self-reported function compared to individuals with knee arthritis without crepitus. This means that the group with crepitus (which is joint noise) believed they had less function than those without crepitus. However, there was no difference in the knee strength and performance between the two groups based on the activities they performed. The authors concluded that knee crepitus does not impact knee strength, range of motion, or pain in individuals with arthritis. It's important to become educated and not self-limit your abilities based on joint noise!
The one exception is if you notice new joint noise and pain after an acute injury or trauma. This would indicate damage and should be assessed by a medical health professional immediately.
I’ve found that if you notice crepitus, stop whatever you’re doing and perform a general range of motion movement - like rolling your shoulder around in a circle or bending your knee for 10-20 seconds. This will typically reduce the amount of shoulder or knee noise that is occurring. If you go back to your exercise and still notice joint noise, my general rule of thumb is, “Do you have pain with this activity or movement that is associated with the crepitus?” If the answer is no, then you’re normally fine continuing the exercise. If you’re still unsure or want to be certain that you’re not damaging your joint, contact your medical profession for advice on addressing this issue!
- Dr. Colten Sullivan
Bull City Physical Therapy
1. MF, de Oliveira Silva D, Faria NC, Simic M, Ferreira PH, de Azevedo FM, Pappas E. What are the clinical implications of knee crepitus to individuals with knee osteoarthritis? An observational study with data from the Osteoarthritis Initiative. Brazilian journal of physical therapy. 2018 Nov 16.
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