We’re all lumpy, burpy, gassy organisms that make a lot of weird, loud, and gross noises. There’s nothing wrong with that, it’s what animals do. Biological functions are messy and awkward.
That’s a fact that can make it hard to figure out if something’s wrong when it comes to strange sounds emanating from the body. We spoke to Joseph LaVacca, DPT, CFSC, FMT-C, SFMA, an orthopedic physical therapist based in New York City to answer one of our most common questions: is it bad if my knees click when I squat?
“People will think it’s a tendon snapping, it’s connective tissue snapping, it’s this, it’s that,” he says. “The fact is, we’re close-pressured organisms and we’re filled with gas and fluid and liquid, and chances are you’re going to develop little changes in pressure and little air pockets and things like that can potentially make sounds with movement.”
Clicking knees, he says, is never a concern on its own – we make a lot of sounds when we move, most of which we don’t hear. Even if a joint clicks every single time it moves in a certain direction, it’s not really a clinical symptom of anything on its own. It’s when clicking occurs with pain and instability that it could be symptomatic of something else, and it’s worth visiting a physical therapist. But those are separate issues; if you’re just clicking without pain and there aren’t other symptoms, there’s almost certainly nothing to worry about.
But that doesn’t mean there aren’t ways to remedy it.
“Most people are clicking when they’re squatting, so the three components I’ll check are a person’s ankle dorsiflexion and their internal hip rotation and hip flexion,” says LaVacca. “A knee might be clicking because of limited internal rotation, for instance. In that case, it might behoove you for the long-term safety of your practice to get within normal limits. But if you get into normal dorsiflexion and hip movement and your knee still clicks, it’s not something that’s going to keep people from squatting.”
LaVacca isn’t inclined to treat clicking if that’s the only issue, but even if it doesn’t give a reason to be concerned, there are methods to help silence those cracks and pops.
“I can’t tell you how much clicking has resolved in shoulders and hips and knees with just a daily CARs practice,” he says. CAR stands for Controlled Articular Rotation, and they’re defined as active rotational movements at the outer limits of articular motion. They’re excellent tools for improving mobility and joint health; here’s Dr. LaVacca himself demonstrating knee CARs, which have remedied clicking in a significant number of his patients.
If you feel an area of restriction on the clicky knee that you don’t feel on the non-clicky side (those are LaVacca’s own, very clinical words), you can also perform self patellar mobilizations.
He notes, “In the same way you’ll stretch your quads or calves, if you ‘glide’ your kneecap, you can help keep that clicking from potentially recurring.”
Here are some examples of self patellar mobilization you can try out.
Clicking is seldom a problem in and of itself, but that doesn’t mean it can’t be a little annoying. If yours is bothering you, the mobility routines above are excellent remedies; but remember that if you experience pain or instability when you work out, it’s always a good idea to visit your doctor or physical therapist.