Chiropractor Chandler AZ

Why Does My Knee Pop

knee model patella labeled

All joints in the body can produce a popping sound. Most of the body's joints are synovial, or contain a synovial fluid filled cavity within the joint. Muscle spasms and certain positions pressure increases within the knee joint, which pushes small gas molecules into the synovial fluid. When the pressure is relieved within the joint cavity, decrease pressure allows the gas bubbles to escape from the fluid and into the air filled cavity of the knee. As the gas bubbles cross the liquid air barrier it releases energy and produces a popping sound.

Knee popping is similar to when you open up a pressurized can of Coke. CO2 bubbles are pushed inside the coke, when you open the top of the can pressure is released. Gas bubbles escape from the liquid phase and into the air, and that energy released produces the familiar popping sound.

In the body joint popping occurs whenever the pressure increases inside the joint and then is quickly released; such as with stretching or pulling the joint apart. Whenever volume is decreased pressure is increased. Likewise as volume increases the pressure decreases inside the cavity. When people pop their knuckles they are increasing the volume of space inside the joint cavity; which decreases pressure and results in the popping sound.

Soft Tissue Damage Causes Increased Knee Popping

The knees are more likely to pop because they are under constant pressure from our body weight. In addition we can have muscles spasm which further compress and increase the pressure within the joint cavity. Muscle spasms are jamming the joints together, which decreases volume and increases pressure.

Damage to muscles, tendons, ligaments, and joints cause muscles to spasm in protection. The knees absorb a tremendous amount of force with every step. Over time the accumulation of forces produces micro tearing and damage to the muscles and tendons. More on soft tissue damage later in the article.

Patella Tracking Causes Clicking and Popping

knee model lateral view labeled

Another source of knee popping is when the patella bone is improperly sliding along the femur. The patella should slide in a cartilage groove along the front surface of the femur. With muscle damage and imbalance the outside aspect of the quadricep is pulling the knee cap toward the outside of the knee. The inside aspect of the femur cannot pull hard enough to keep the patella sliding properly in the patella groove.

The improper sliding of the patella causes damage to the hyaline cartilage underneath the knee cap and on the surface of the patella. Damage to the cartilage underneath the patella is called chondromalacia patella. While damage to the surface of the femur is called patellofemoral syndrome. Both of these knee conditions commonly occur with patella tendonitis.

A deep sharp internal popping and stabbing pain can be associated with meniscus tears. The sharp pain occurs whenever the meniscus tear is flipped as the condyles rotate across the meniscus.

Is Popping A Sign Of Serious Problems?

Not all knee popping is a sign of serious problems. Meniscus flap tears are less common than people think, but they do occur. If the pain is sharp and consistent every time they squat, then an MRI would be useful to evaluate the internal structures of the knee.

Most times extra knee popping and clicking are a sign of microtearing and damage to muscles and tendons. The muscle fiber damage is producing mild pain and causing the muscles to spasm. Soft tissue damage can be properly treated with conservative treatment.

Home Treatments

knee model posterior labeled

At home the first step is always PRICE. Protect, rest, ice, compress, and elevate. Reduce the stress and strain to the knee. Over the counter NSAIDs as recommended by your doctor can help reduce pain and inflammation. Ice helps blocks the knee pain and reduce inflammation.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.

Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

GT therapy

Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. Specific knee exercises are given to increase strength and endurance. Proprioception exercises help teach the muscles how to work together again to stabilize the knee during walking or running.

When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Video: Scar Tissue Treatment with Graston Technique for Muscle Pain

Improve Movements to Eliminate Knee Pain

The lower extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.

vibration squat exercise

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for hip, knee, and ankle; flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable of the surface the more effort and stabilization is required of all the lower extremity muscles.

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.