Dear Alice,

When I bend down my knees make a cracking sound? How do I get them to stop?

Dear Reader,

The whole “snap, crackle, and pop” thing is less fun when it comes from your joints rather than cereal, huh? The most common causes of these joint-cracking sounds are gas escaping from the synovial fluid inside the joints, a tendon or ligament changing positions, and rough surfaces moving against one another in the case of cartilage loss. Unfortunately, there aren’t any proven lifestyle modifications to stop the cracking sound from happening. The good news is that popping sounds are usually not cause for concern — unless pain accompanies the pop. If you do feel pain along with the noise, it’s possible that you might be dealing with chondromalacia (a.k.a., runner’s knee), pigmented villonodular synovitis (try saying that three times fast!), or another condition all together. Whatever the cause might be, a trip to your health care provider can help get to the root of the pain and any proper treatment you may need.

Runner’s knee — when the kneecap moves across the thighbone in the wrong place — can be caused by overuse, misalignment of the kneecap, tight or weak muscles, foot issues, or knee trauma. Check out What is chondromalacia? for more information about runner’s knee. The good news is that this condition is usually treated with rest and self-care, which you can remember with the acronym RICE:

  • Rest — keep weight off of the painful knee
  • Ice — but keep the ice wrapped in a towel or cloth before putting on the skin
  • Compress — try wrapping you knee in a bandage or try a knee sleeve from the drug store
  • Elevate — prop up your knee higher than your heart while lying down

Remembering to RICE, in combination with taking anti-inflammatory pills, investing in arch supports, and completing stretching and strengthening exercises can help the symptoms of runner’s knee dissipate. In some cases, however, surgery is needed to treat extreme cases of runner’s knee — only a health care provider will be able to determine the best treatment for a particular case.

Though not as common as runner’s knee, pigmented villonodular synovitis (PVS) is still a possible explanation for painful knee popping. It’s most prevalent among people aged 20 to 45 and it’s typically experienced more by men than women. That being said, it can affect anyone with knees. The exact cause of PVS is unknown, but symptoms include swelling of the lining of the knee joint. The swollen lining is harmful to the bone around the joint and may cause painful fluid buildup (which causes the popping sound). Onset may occur slowly, and symptoms can ameliorate or worsen over time. As with runner’s knee, anti-inflammatory medicine and rest may help provide pain relief.

Bottom line: if your knee pops are painful, it’s best to get your knee(s) checked out by your health care provider. That way, you can get the treatment that’s best for you. However, if it’s just the popping sound you experience, it may be annoying, but it’s pretty normal and likely nothing to worry about. Hope this helps you crack the case of your mysterious knee sounds!

Alice!

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