Do you worry about your knees ‘clicking’?

Why do they make that noise? Is it worth noticing or it’s just a “hoax” alarm?

One of the most common questions we get in clinics is ‘why does my knee click?

So, if you have ‘clicky’ knees you are certainly not alone!

Often the questions are-

Why do my knees click when I walk?
Why do my knees click when I squat/ kneel down?
Why do my knees click when I go upstairs or downstairs?

Joints make a variety of noises which patients describe as “popping, snapping, cracking, catching, grinding and clunking!”

Believe it or not, this was first described in 1947.

The noise occurs because tiny air bubbles (nitrogen) accumulate within the fluid inside your joints and when you move, they collapse (or burst) due to the changes in pressure inside the joint. The noise occurs when the gas bubbles collapse. It is the same process as when you ‘click your knuckles’

Here are the other reasons for the clicking the knees that we see in the clinic:

• If the clicking occurs on the outside of the knee it is often related to the iliotibial band (ITB) known as ‘Runner’s knee’
• If the clicking occurs at the back of the knee then it may be due to swelling at the back of the knee, called Baker’s cyst. Both these conditions are often pain-free and are often nothing to worry about.
• Another type of clicking that can occur at the front of the knee can be due to an anatomical structure called a plica. The plica is a fold in the thin tissue (called the capsule) that surrounds the knee joint.

This can cause ‘clicking’ or a flicking or catching sensation clicking when you bend the knee or squat. Most of the time this is pain-free, but if it is painful it is called Plica syndrome.

Why not worry about the ‘painless clicking’ of knees?

It is normal for knees to click since they are moving parts with structures that move and glide next to each other when you bend and straighten the knee, for example when going up or down the stairs.

Interestingly, most knee issues I see in my clinic that are painful, have no clicking or clunking!

Here are some noteworthy facts to debunk myths related to the clicking of knees and other joints-

1. There is no evidence that clicking gets worse as you get older
2. There is no evidence it will ‘wear out your joint’ and lead to osteoarthritis (OA)
3. Painfree clicking is unlikely to stop you from carrying out the activities you love doing, be it hiking, running, cycling, or jogging
4. There is no correlation between the amount of clicking and levels of pain.
5. There is no evidence it will progress into a painful joint. It is not a predictor of any joint pathology!

Dr. Mohit M Kukreja
Consultant – Orthopedic Surgeon
Wockhardt Hospitals, Mumbai Central