Click, crackle, pop! Why do my joints make noises?

Dr. Chelsea Moehlenbrock Author

You can find many dancers popping their joints. Some of the noises can be quite alarming if you’re not used to it. But why are our joints so noisy?

First off, there is good news! The noises that our joints make are not associated with the degeneration of our joints and do not necessarily mean that the joint is going to be painful with movement. Actually, joints that have degeneration can be less likely to make noises.

There are two questions I ask when it comes to noisy joints:

1. Does it hurt when it makes a noise?

2. Does it limit the range of motion?

If the answer to both of these is no, then there is no need to worry. Your tissues are gliding and sliding as they need. If the answer to either of these is yes, then it is time to seek some advice from a dance physical therapist or other dance medicine specialist, since there might be something else going on.

So then why are your joints making weird noises? There are various reasons:

1. Pressure changes and fluid movement in a joint. All of our major joints are synovial joints. This means they have a viscous fluid in them that supplies nutrients and lubricates the structures of the joint making sure everything glides nicely as we move. Sometimes there are gas bubbles in this fluid and when we start moving, those gas bubbles form or pop and make a noise. Tribonucleation is why the bubbles form and the pop is called a cavitation - if you want to get all science-fancy with your vocabulary!
2. Tendons rubbing over other structures. Our bodies are made to move and that means structures will be gliding over each other. There are small sacs of fluid around all of our joints called bursae that reduce friction between structures as they are moving, but sometimes tendons still rub over another structure and make a popping or clicking noise. Some dancers get a consistent clunking noise from the front of their hip when they are doing grand battement or bringing their leg down from a développé. This is commonly referred to as Snapping Hip Syndrome. Often it is annoying and only painful when those movements are done repeatedly. Many times this is the iliopsoas tendon rubbing along the front part of the pelvis or a bursa and an exercise program focused on strengthening the muscles all around the hip can improve this.
3. Stretched ligament or joint capsule. Ligaments and joint capsules do not have much give or stretch like muscles and tendons. When the joint capsule or a ligament has been over stretched, it cannot support a joint as well. This causes the joint to have more movement and can cause the bones to glide more than they typically would otherwise. This is often seen with hypermobility syndromes. In these cases, it is important to strengthen the muscles that support the joint since the ligaments and/or capsule isn't providing as much support.
4. Bony changes, extra bones in a joint. This is less common, but there may be some bony changes in a joint that are making it more noisy, such as having extra bones in a joint. This is typically seen in the ankle, called os trigonum. This presents differently in every dancer. Some never know they have the extra bone, while others have to get it surgically removed because it causes pain and limits their ability to do releve and pointe work. It is also possible to have a bone fragment in a joint, but this is typically related to trauma.

Many people ask if their noisy joints mean that they are going to have arthritis in the future. Let me explain arthritis a bit further, though, because there are some outdated narratives that explain arthritis as "wear and tear". Good news! More recent research has shown that this concept of "wear and tear" is false. Some research has found that the cartilage in the knee (meniscus) adapts and recovers really well after running. So the theory that the cartilage wears down over time is less likely, but we definitely need more research on this.

I think of arthritis like a dried out dirty sponge. The sponge is your cartilage and the dirt in the sponge is the cellular waste products, which build up when we don't move our joints for extended periods of time. When a dirty sponge is dried out, all the gunk in it cannot escape. If you add water to the sponge, it is much more malleable and you can squeeze out the dirt. That is what motion does to our joints. 

Have your knees ever been sore after sitting on a plane for a long time? They've been stuck in the same position for a while and the fresh synovial fluid hasn't had the chance to move through the joint because the joint isn't moving. This is why movement is crucial to our joint health. New synovial fluid can get to the cartilage and push the waste products out. 

So if that dried out sponge is an arthritic joint, the best way to get that gunk out is to do gentle movement to get the fresh synovial fluid in there. It's just like putting water on a dirty sponge and wringing it out. Typically once a joint is painful from arthritis, movement is painful. However, it is still beneficial to get some consistent GENTLE movement so those joints can get the nutrients they need. 

So, do noisy joints mean you are bound to get arthritis? Most likely not. 

One last thing to keep in mind: most of the time when our joints make noise we are NOT experiencing a dislocation, subluxation (partial dislocation), or a moving in/out of alignment. These kinds of things may be happening if you have a diagnosed hypermobility disorder, but this does not happen in the majority of the population.

So, the next time you hear a weird noise come from your joints, don’t be too alarmed. As long as it is not painful and you can still move through a full range of motion, then your body is moving as it should. The noises from our joints just add to the symphony of other noises that come from our bodies: breath, heart beat, gut noises, etc.

References:

Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation. PLoS One. 2015 Apr 15;10(4):e0119470. doi: 10.1371/journal.pone.0119470. PMID: 25875374; PMCID: PMC4398549.

Khan MCM, O'Donovan J, Charlton JM, Roy JS, Hunt MA, Esculier JF. The Influence of Running on Lower Limb Cartilage: A Systematic Review and Meta-analysis. Sports Med. 2022 Jan;52(1):55-74. doi: 10.1007/s40279-021-01533-7. Epub 2021 Sep 3. PMID: 34478109.

McCoy GF, McCrea JD, Beverland DE, Kernohan WG, Mollan RA. Vibration arthrography as a diagnostic aid in diseases of the knee. A preliminary report. J Bone Joint Surg Br. 1987 Mar;69(2):288-93. doi: 10.1302/0301-620X.69B2.3818762. PMID: 3818762.

Robertson CJ, Hurley M, Jones F. People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study. Musculoskelet Sci Pract. 2017 Apr;28:59-64. doi: 10.1016/j.msksp.2017.01.012. Epub 2017 Feb 2. PMID: 28171780.

Song SJ, Park CH, Liang H, Kim SJ. Noise around the Knee. Clin Orthop Surg. 2018 Mar;10(1):1-8. doi: 10.4055/cios.2018.10.1.1. Epub 2018 Feb 27. PMID: 29564040; PMCID: PMC5851845.

Vincent TL, Wann AKT. Mechanoadaptation: articular cartilage through thick and thin. J Physiol. 2019 Mar;597(5):1271-1281. doi: 10.1113/JP275451. Epub 2018 Jul 29. PMID: 29917242; PMCID: PMC6395418.