Snap, Click, Squeak, Thump …… Some people’s knees “talk a lot”.
These noisy noises usually occur when the knee flexes or extends, such as when squatting, standing up, walking or going up or down stairs. In most cases, knee noises are physiological and do not represent a disease, but are just “chatter” that is not relevant.
However, there are some rattling sounds that are pathological, and the “swearing” of the knee is urging you to go for an early examination and treatment, so as to avoid delaying and causing more serious injuries.
How to tell what your knee is saying, you need to listen to it like this:
It’s not enough to hear one sound.
It is not yet possible with current technology to immediately determine if there is a problem and what it is by listening to a single “click”. However, the characteristics of the sound can give us some hints to help make an initial judgement as to whether there is a serious problem behind the ringing of the knee.
Firstly, remember when your knee started to ring, can’t remember? Then it’s okay. Physiological rattles are usually not impressive and you can’t remember when they started. Pathological ringing often starts with an injury and the first ringing is often memorable, e.g. many people with torn knee ligaments remember the loud sound.
In addition, physiological rattles are usually incidental, they don’t ring again when you repeat the movement just after they have rung, there is no specific triggering position (you don’t have to make it ring if you want it to), and the rattles don’t get progressively louder or more frequent. If the ringing increases in frequency, or even occurs every time a particular posture is performed, the ringing is more likely to be pathological.
“Snap” – even knees that aren’t sick can rattle
Compared to knee snapping, people are more familiar with finger snapping. If you pull or press on a finger, the joint may make a crisp “pop”, but the same joint won’t pop again if you press on it again for a short time.
A similar sound occurs in the knee, which comes from small bubbles in the joint fluid. Scientists believe that when a joint flexes or extends, the pressure in the joint cavity changes, and the sudden formation or rupture of the air bubbles causes a ringing sound.
The sound of the vacuole itself does not cause pain, and a researcher has tried to break his fingers twice a day, each time only on the left hand and not touching the right. After breaking his fingers more than 40,000 times in 60 years, he found no difference between the joints of the two hands and was awarded the Nobel Prize for hilarity (of course, it is not recommended to break them too hard, after all, some people have broken their bones as a result).
“Thump” – nothing serious, but be careful!
Sometimes the sound is not so much crisp as a “thump” like plucking a string, and you can still feel the vibration in your hand when you touch your knee.
This kind of sound may come from the knee around the tendons and other tissues and bones between the friction, such as bending the knee process, the knee lateral iliotibial bundle by the thigh femur lateral small bump block, with the knee bending angle increases, the iliotibial bundle was pulled more tightly, until suddenly slipped through the bump, pop back to its original position to send out the “thump” sound.
In addition to this, friction between other tissues, synovial membranes or physiological creases, overactive menisci, etc., may also make a noise during movement.
If there is no pain and no obvious damage to the tissues, such noises are not strictly considered “pathological”. However, if the knee is allowed to continue to rattle, the condition may suddenly worsen with increased exercise or a certain movement, resulting in pain.
When the sound comes from an imbalance in muscle strength in the lower limbs, or from tendon slippage, stretching and strengthening certain areas may help. Common stretches target the anterior and lateral hips and the back of the calf; common strengthening exercises include elastic band side-steps, wide-spaced squats, and medial femoral muscle activation. Targeted training is more effective after professional assessment.
Swelling and pain. Something’s probably wrong.
In addition to the noise itself, the most likely indication of a “real problem” is pain or swelling in the knee joint. Severe swelling can be seen at a glance, the knee joint is obviously thicker, and even feel difficult to bend the knee, the size of the leg is difficult to tightly together.
However, when the amount of fluid is low, the change in appearance is minimal and is easier to detect in this position: sit on the edge of a chair with your legs straight, heels together on the floor, and the muscles in the front of your thighs relaxed. If the depression around the patella flattens out and the knee joint looks “fuller”, there may be an accumulation of fluid in the knee joint or an extra-articular oedema. If you are not sure whether there is swelling or not, it is advisable to go to the hospital for a more accurate examination.
A truly “sick” knee rattle, i.e. a pathological rattle, can originate from a variety of sources, including the cartilage and synovium inside the joint cavity, and the bones, tendons, and bursae outside the joint cavity. From a typological point of view, rattles can come from acute trauma, chronic degenerative changes, and systemic diseases can also affect the knee.
Among them, people often say, “If you keep doing that, you will easily get arthritis in your old age”, usually refers to osteoarthritis, and many people have concerns about knee ringing because they are worried about this disease. Osteoarthritis causes the cartilage inside the joints to become rough and the bones to become abnormally protruding, so when you move around, the bones rub against each other and against the surrounding tissues, making a “creaking and crunching” sound, and even when you put your hand on your knee, you can feel the friction between the bones.
The meniscus, the “cushion” inside the knee joint, can also get stuck and make a “clicking” sound when you move around if there is a problem, such as a congenital abnormality in the shape of the meniscus (discoidal meniscus), or if there is damage such as a tear, or if it is functioning abnormally.
In addition, rattling sounds may be produced by incomplete resorption of the internal compartment of the knee joint during development, abnormalities in the trajectory of the knee joint, extra-articular tendon sheath cysts, tendinopathies, post-surgical structural and functional changes, as well as systemic diseases such as rheumatoid arthritis.
It is important to confirm the diagnosis with your doctor and then consult with an orthopaedic, sports medicine or rehabilitation physician about what treatment is needed, such as changing previous exercise habits, relaxing or strengthening certain muscles, and medication, physical or surgical treatments, depending on your specific situation. Don’t follow the one-trick pony of “one move to eliminate knee rattles” because the source of the rattles is different and there is no one-size-fits-all treatment or rehab programme.
Knocking knees are a phenomenon that can be perfectly fine or a serious problem, so it’s important to understand the cause before deciding what to do about it.