For once, forget the cereal usually associated with the title of this piece. This time around we’re referring to the snap, crackle and pop sounds our bodies sometimes make. These sounds are known technically as crepitus, and there are many myths associated with them, despite scientific evidence to the contrary. As much as these sounds can be distressing and sometimes an indicator that something could be wrong, most times they are normal—unless accompanied by pain, swelling and decreased movement.
Snap – Have you ever heard a snapping sound in your hips and knees as you stand up, bend down or take a step? Sometimes the sound comes from your shoulder
joint as you raise your arm. This is usually caused by tightness in the area, which causes the muscle or tendon to rub over the bone. (Tendons are fibrous bands that attach muscles to bone.) Quite often athletes tend to be affected, especially dancers, gymnasts, track and field specialists and horse riders. The noisiest snapping sounds tend to come from the shoulders, because the stability of the shoulder is maintained by lots of muscles rather than a deep socket.
Crackle– Cracking their joints is something people do because it helps them loosen up and move easier, but there are many who say this can lead to arthritis. In any case, for most people the instant relief it brings far outweighs the possibility of arthritis. So who is right? To crack or not to crack, that is the question. Well science is divided on the cause: one suggestion is that the popping is caused by compression of nitrogen bubbles that occurs in the spaces of joints and the cracking sound is the gas being released. Others believe the sound is made from the recoil of ligaments and tendons. So, regardless of which reasoning you follow, science tells us that the assumption that cracking joints can lead to long-term joint problems is false and may actually be good for us. But cracking the joints constantly is only a temporary solution to the tightness and discomfort that demand relief. If the tightness is caused by improper movement of bones or tight muscles, then visiting a physiotherapist may be best in the long run.
Pop – Popping can often be heard at the knee and can be a sign of damage or degeneration. When a joint is injured it may be accompanied by a popping sound. In the knee a popping sound may be a sign that a ligament of the meniscus has been damaged. These types of injuries are usually accompanied by inflammation, instability and loss of function. Inflammation, for other reasons such as arthritis, can also cause popping as the ligaments and tendons are overstretched as they move over the bone. The important factor is pain and function. A sudden injury with a popping sound and immediate swelling and pain requires an assessment by a doctor to rule out a tear to soft tissue structures like ligaments, tendons and menisci. And there’s more—crunching knees and creaking joints are also sounds unique to the body. Crunching knees can be heard when bending or climbing stairs. The sound is caused by rubbing of the cartilage or other soft tissue.
Creaking joints, on the other hand, are a completely different scenario and are often experienced as we get older. The creaking sound is caused by the friction of bone on bone. Bone is covered in a spongy layer called cartilage which is responsible for cushioning and lubricating our joints. Each time we move and the bones are compressed, the action causes fluid to be pushed out of the cartilage so that our movements are smooth. However, as we age, or sometimes after an injury, our cartilage wears out or is damaged, reducing the amount of fluid produced and increasing bone on bone surface.
For some there is no pain but for others there is also loss of movement; the key here is to keep moving. Each time we move, fluid is released into the joint, so being active is the message. Resting creaking joints will only lead to more creaking. If there is no sign of injury and no accompanying pain or swelling then the best action is exercise, to stretch and strengthen muscles.
Identifying short, weak muscles can help to implement a programme aimed at balance and symmetry. It is common to have a more dominant side which can put undue stresses on the body. Balance and symmetry are the key to a stronger and more efficient body, reducing the risk of injury and unwanted sounds. However, if an injury is suspected, the first step is to use RICE: Rest, Ice, Compression and Elevation.
If there are no signs of an obvious injury then a rehabilitation programme to restore strength, increase flexibility, improve balance and proprioception and promote stability is recommended.
A physiotherapist can determine problem areas and help you to develop a programme that will aid recovery. In cases where a torn ligament, muscle or meniscus is suspected, a thorough assessment from your doctor will ensure that you get the right treatment and interventions.
