Do you have a painful or clicking knee? You’re not alone. In this blog post, we will explain the five most common causes of a noisy, sore knee, as well as the treatments available for each of these knee problems.
If you are suffering from a meniscus tear or runner’s knee, perhaps iliotibial band syndrome, or chondromalacia patella, read on as I help you work out:
“Doc, why is my knee so clicky and painful, and should I be worried?”
Causes of clicking and painful knees:
- Meniscus tears
- Runner’s knee /patellofemoral pain syndrome (PFPS)
- iliotibial band syndrome
- ACL injury
- Knee arthritis, such as Osteoarthritis or Rheumatoid arthritis
Meniscus tears
A common knee injury, especially among athletes. The lateral and medial meniscus are crescent-shaped pieces of cartilage – shock absorbers in the knee, and when it tears, you may hear a popping sound as well as feel pain and possibly swelling.
A tear can occur when the knee is suddenly twisted or turned, causing the cartilage to rip.
[Image thanks to Andrewmeyerson, wikipedia commons]
Symptoms of a meniscus tear include pain, giving way, stiffness, and swelling, but often a meniscus tear will not exhibit swelling.
Treatment for a meniscus tear
You should try to reduce any swelling by applying an ice pack to the area, and immediately resting.
But by now, you might have had the injury for a while.
If you are wondering ‘why is my clicking’ but there is no pain, it’s less likely you have a meniscus tear.
Get to your healthcare provider as soon as possible. A physical exam can often rule out serious injury, but MRI imaging may be necessary, especially if you have pain. Learn what Doctor to see for knee pain here.
Meniscus tears are often left alone nowadays if the ‘flap’ of the meniscus is not causing locking or giving way of your knee. An effective strengthening program can get you back to sport and fitness with the help of your physical therapist.
If you’re having a more painful mechanical symptom like giving way affecting everyday activities, this type of cartilage injury may need surgery!
An orthopedic surgeon may need to shave off the meniscus flap or remove a loose body in the knee joint.
Are you also having Knee pain going down stairs?
If you are experiencing knee pain when trying to go downstairs, it could be a meniscus tear – but it could also be an issue underneath the patella or its surrounding soft tissues.
Conditions such as Chondromalacia patella, or quadriceps tendonitis should be considered.
Iliotibial band syndrome
If you are having clicking and pain on the outside of your knee, it may be iliotibial band syndrome. The iliotibial band is a thick strip of tissue that runs from the hip to the shinbone on the outer side of the leg. This band helps to stabilize and move the knee joint.
Iliotibial band syndrome is a condition where the iliotibial band becomes irritated and inflamed due to malposition and overuse, such as from running or biking.
Poor hip strength and body mechanics tend to cause and exacerbate ITB syndrome.
Symptoms of iliotibial band syndrome include clicking or snapping on the outside of the knee, pain on the outside of the knee, swelling on the outside of the knee, and/or pain with bending the knee.
Treatments for iliotibial band syndrome may range from RICE, physical therapy, stretching and strengthening exercises (especially of the glutes), orthotics, and in serious cases, surgical release.
Runner’s Knee
If you are having clicking and pain under your kneecap when you bend your knee, it may be Runner’s knee (chondromalacia patella). Chondromalacia patella is a condition where the cartilage under the kneecap breaks down and deteriorates. This can happen due to mechanical problems with your knee, such as from endurance sports, or an abnormal Q-angle [1].
Symptoms of runner’s knee include throbbing or aching pain, tenderness around the kneecap, and cracking or popping sounds when moving the knee.
Treatment options for runner’s knee include RICE, as well as exercises to strengthen the muscles around the knee joint. In some cases, orthotics may be recommended to aid with stability in your gait. If you think your flat shoes could be the issue, read the blog post here.
Symptoms of chondromalacia patella (CP) include a popping or cracking sound under the kneecap, pain under the kneecap, and/or pain with bending the knee.
Check out our guide to Hiker’s knee, which is a form of CP. There you will find at-home strengthening exercises for your knees.
As CP can be a complex issue involving degenerative changes in the hyaline cartilage of your knee, it is important to get a personalized physical therapy treatment plan, to find the underlying cause.
ACL Injury
If you have suffered a popping sensation in your knee, followed by pain, swelling, and instability, then you may have torn your ACL (anterior cruciate ligament). The ACL is one of the main stabilizing ligaments in the knee joint and when it tears, it can cause the knee to give out from under you.
A sudden change of direction or landing from a jump can cause an ACL tear. Women are more susceptible to ACL tears than men (possibly due to hormonal differences which lead to laxity in connective tissue as well as differences in muscle activation and movement patterns).
There are three grades of severity when it comes to an ACL tear:
- Grade I is a partial tear with mild symptoms,
- Grade II is a partial tear with moderate symptoms,
- Grade III is a complete tear with severe symptoms.
Symptoms of an ACL tear include pain, swelling, instability, popping or snapping sound at the time of injury, and knee giving out. An MRI will be needed to confirm the diagnosis as well as to grade the severity of the tear.
Treatment for an ACL tear may range from RICE (rest, ice, compression, elevation), physical therapy, bracing, and in some cases, knee surgery.
Surgery involves reconstruction of the ligament using a tendon graft. The type of graft used will depend on factors such as patient age and activity level.
Rehabilitation after ACL surgery can take up to nine months before you can return to your previous level of activity.
Arthritis of the Knee
Osteoarthritis (OA) of the knee is a degenerative joint disease and a common cause of a knee that is clicking and painful! There are two types of OA: primary and secondary. Primary OA is caused by aging or genetics. Secondary OA is caused by an injury or overuse of the joint.
Symptoms of osteoarthritis include pain, stiffness, clicking or grinding sensations, and swelling.
Learn about what others are doing for bone-on-bone knees in our full guide.
Treatment for OA may range from conservative measures like weight loss if you are overweight, physical therapy including exercises to strengthen the muscles around the knee joint, orthotics, and in some cases joint replacement surgery.
Physickle Tip:
Should I get a knee x-ray?
Yes, if you suspect you might have osteoarthritis. OA is the most common cause of painful and clicking knees for older people. But you shouldn’t just settle for having joint pain! A knee X-ray can give a lot of clarity about your knee situation. Start there with your health care provider.
Total knee replacement is a major surgery that should be considered as a last resort. It involves replacing the damaged joint with an artificial joint (prosthesis). The type of prosthesis used will depend on factors such as patient age and activity level.
Why is my Knee clicking when I am bending it?
If you are wondering why your knee is making an unpleasant clicking noise when you bend it, one of the following things is likely happening:
- Knee crepitus, as with osteoarthritis of the knee
- Nodules behind the kneecap (Chondromalacia patella)
- Meniscus Tears
- ACL injury
What is Knee Crepitus?
Knee crepitus is a knee condition characterized by a grating, grinding, or crackling noise that you may hear when you move your knee. The noise is caused by the roughness of the cartilage surfaces rubbing against each other.
Crepitus can be either articular or periarticular. Articular crepitus occurs when the cartilage in the knee joint rubs together. Periarticular crepitus happens when tendons, ligaments, or muscles rub against each other or bone.
The most common type of knee crepitus is articular crepitus and it is generally not painful. However, periarticular crepitus can be painful as it is often the result of an injury.
Knee crepitus is more common in older adults as the cartilage in the knee joint deteriorates with age. However, it can also occur in younger adults and children due to knee injuries.
While knee popping can be worrying, in many cases it is not a serious issue and will resolve with conservative treatment. However, if you are experiencing pain, swelling, or instability in your knee, it is important to seek medical attention to get an accurate diagnosis and appropriate treatment plan.
Especially if you are noticing a popping noise, or suspect a torn meniscus!
If you are suffering from a painful or clicking knee, don’t despair! There are many treatment options available that can help you get relief.
Do you have a clicky knee? Describe it in the comments below, and we might be able to point you in the right direction.
Author Bio
Dr. Jason Whealing is a Chiropractor with extensive experience across the UK and Australia. He is passionate about family care and injury management. The cases Jason works with daily include back pain, neck pain, jaw pain, sciatica, knee pain, shoulder pain, headaches and migraine.
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