What’s that clicking creaky noise?

Are you worried about the noises that your knee makes? Some call it a clicking sensation. Others describe this as a creaky, cracking or scratching noise. This usually happens when the knees move about, especially under pressure. Is this truly a dangerous condition? What are the reasons behind these types of noises?   

Before understanding this creaky feeling, let’s find out what comprises the knee. The thigh has a long bone called the femur which ends up on top of a lower leg bone called the tibia. The exact site where these two bones meet is called the knee joint. Imagine balancing one long bone on top of another. This would be a very difficult task if not for the structures which fix the bones. There are several muscles which pass in front of and behind the knee. One huge muscle is your quadriceps and another group is named the hamstrings. There are also tight bands called ligaments which hold the joint steady. In front of the knee joint proper there is this small bone named patella(knee cap). Ideally this should slide over the knee joint during all movements. If sliding is hindered, pain is the result, especially when using the stairs.   

The knee is called a hinge joint because it moves only in one plane. You can bend the knee and straighten it out. Although termed a hinge joint the exact situation is much different. The knee joint involves a bit of rotation as well. All these factors predispose to lots of injuries.   

Returning to the clicking knee, mainly three conditions may give rise to this. Clicking is medically termed crepitations.   

The first reason is the passage of air bubbles mixed with joint fluid from one compartment of your knee joint to another. This is usually painless. Your knee has several compartments or rooms. When you move about the knee, the tiny amount of fluid meant to lubricate the inner surface of joint and some small air bubbles, pass under pressure from one place to another. This makes a noise. No treatment is necessary.   

The second reason is rubbing of bands called tendons and ligaments that surround any persons knees. As mentioned before these bands are meant to hold the knee in place. When these ligaments or tendons rapidly slide on top of each other, the cracking sensation can be felt. Then again this is painless and no treatment is required.   

The third reason is worn out cartilage inside the knee. The cartilage is a spongy slippery surface covering the two huge bones of the knee. It also covers one side of the knee cap (oval shaped bone at the front of the knee). The role of the cartilage is to protect the underlying bone from friction damage. The cartilage can be damaged because of many reasons. Osteoarthritis is one key reason. Previous injury to the knee might be another. Then, engaging in strenuous sports like rugby or football for many years can damage the cartilage. The movements are painful to do and continuous clicking/ creaking is felt when the knee is bent (or extended).   

Contrary to the popular belief there are methods to prevent cartilage wear and tear in western medicine. There is also treatment available to prevent pain. If we strengthen the muscles, this would stabilise the knee and prevent unnecessary movement. The patients who have osteoarthritis need motivation in abundance to continue exercising till benefits are achieved.