Interpreting the Clicking of Your Knees

Like a baby’s different types of cries or noises coming from your car’s engine, knee clicking can run the gamut from normal sounds that cause no worry to signs of major problems. By considering the three most common knee noises and their causes, hopefully we’ll be able to distinguish whether your knees should have you shrugging your shoulders or running (but not literally) to your nearest physical therapist.

1. Sudden loud snapping noises

If such sounds occur when you stand up, climb stairs, or bend or straighten your knee, they probably aren’t anything to worry about. They may be high in pitch and possibly accompanied by pain. Basically, the clicking (and pain) is caused by the position of the patella, or kneecap, in relationship to the trough underneath it made by the femur bone. Instead of resting in an ideal relationship to the femur, the kneecap can move to the side and possibly unevenly contact the underlying femur bone. Even slight misalignment can cause the patella to snap back into place, causing a cracking noise.

The cause of such misalignment is usually connected to weakness in the legs or imbalanced muscles. As long as this kind of clicking is not accompanied by pain, it’s really nothing to worry about. However, if performing basic initiating movements causes you to be in pain, you should probably have a healthcare professional take a look.

2. Grinding noises lasting for several seconds

If you continually hear high-pitched grinding similar to the sound of sandpaper when squatting and returning from a squatting position, you’ll probably want to have a doctor take a look. Basically, what’s happening is that the cartilage coating the underside of the patella is unevenly contacting the tissue and bone. When you squat, the rigid kneecap cartilage grinds against the bone. Unlike the kneecap’s tracking off to the side (see #1), the grinding noise is caused by the kneecap’s downward movement.

The cause of such grinding is typically related to tight hip flexors and quads that tether the patella, causing it to move downward. Alternatively, the cartilage under the kneecap could be unusually soft, allowing for greater movement. If squatting is accompanied by this grinding sound on an occasional or short-term basis, there’s no need to worry; however, if it plagues you over months or years, you should have it checked out.

3. Deep pitched grinding sounds coming come from deep in the knee joint

When deep grinding sounds accompany weight-bearing movements of the leg, such as sitting or standing, pain is often part of the equation. The cause is usually joint arthritis in either the patella or the femur, typically the combined effect of years of repetitive stress and age. X-rays typically show less space between the joints due to a lack of cartilage. Without the cartilage that usually provides lubrication and shock absorption, bone-on-bone contact causes pain as well as grinding sounds. A doctor visit should certainly be on the agenda.

PhysioDC of Washington, D.C.

Daniel Baumstark and his professional team of physical therapists operate a boutique physical therapy office in downtown Washington, D.C. From athletes to government officials, and from ballerinas to corporate executives, PhysioDC helps people recover, strengthen and return to healthy living. Visit their website at www.PhysioDC.com or call them at 202-223-8500.