Pops, Clicks, and Catches, Oh My! Understanding Your Knee Popping

Amy Graber PT, DPT

We’re tackling an oldie-but-goodie question today on the Fit Family PT blog: Should I be concerned that my knee is making so much noise?

This question is a frequent one in the world of orthopedic physical therapy and we’re here to ease your fears about that knee popping musical instrument attached to your body. In this article we’ll cover common causes of knee popping, causes for concern, and ways to treat your symptoms. Spoiler alert: physical therapy can help!

But REALLY, What’s All That Noise?

When it comes to knee popping and clicking, there are several physiological reasons that may be behind the audible sounds. Oftentimes, this is simply cavitation — a fancy way of saying passing of air bubbles through the joint space following a pressure buildup during movement. This can occur, for example, when you move your knee from a position of extension (straightened) to flexion (bent knee) or vice versa.

You may hear this similarly in other joints like the ankle, hip, or even neck and spine. Another well-accepted theory behind these audible knee symptoms is just the subtle variations in cartilage, ligaments, and tendons that may create some friction as they encounter other surfaces and tissue in the body. For example, you may hear a tendon move over a bony surface or protrusion that is unique to your body. This is typically harmless and a natural part of human movement, which has variability between individuals. There are some cases in which these variations in bodily tissue are actually problematic. We’ll discuss more about that shortly!

When Should I Be Concerned?

Knee popping and clicking is typically not a cause for concern. It’s a natural part of movement and rarely is accompanied by pain. If you do have pain, swelling, or “catching” accompanied by knee popping, it’s usually a sign to start looking further. Immediate things to rule out would be any type of cartilage defect or bony abnormalities. 

One of the cartilage defects often associated with popping is a meniscus tear. The meniscus is a round shaped piece of cartilage that is found on either side of your knee joint surfaces. It helps provide suction-like stability and shock absorption for the knee, and contributes to some stability with bending and straightening your knee. If there is a tear, the suction is less effective and this can cause some abnormal meeting or rubbing of surfaces within the joint, leading to pain or instability with upright movement or deep squatting.

If you experience any of these symptoms of pain or instability, as well as knee clicking or knee popping, check in with your primary care doctor and seek a referral. A referral can be sent to either an orthopedic specialist, or just directly to physical therapy! (Hint: we prefer the latter!)

How Can I Treat My Knee Pain and Popping?

So now that we have identified both harmless and concerning causes of knee popping, let’s discuss what you can do about it. Again, remember that nothing needs to be done about the simple popping and clicking without pain or other symptoms. Embrace your body’s musical talent and stay active! However, If you fall into the popping with pain category, start by visiting your local physical therapist.

While there’s a chance that surgery could be recommended for some cartilage defects or meniscal tears, most of the current evidence actually supports management of meniscus tears with physical therapy! A combination of strengthening exercises, range of motion activities, and general pain relief interventions would be recommended. Reducing pain is key at first to allow safe return to activity and function.

Providing strength around the knee joint can then help to provide additional support for lost “suction” or stability in the joint, or can improve biomechanics with movement to avoid unwanted friction between surfaces. Specifically, we would want to target glutes, quads, hamstrings in a variety of movement planes to help restore stability and function. Sounds fun, right??

Still have questions?

Concerned about your own symptoms? Contact us at Fit Family Physical Therapy for a free physical therapy consultation phone call. We can address your concerns and help you determine an appropriate course of action for your knee popping, clicking, and pain. Skip the line with physician and insurance wait times, talk to us, and start your path to pain- and symptom-free activity today!

About the Author

Amy Graber PT, DPT has practiced physical therapy in a variety of settings. She has worked specifically with the pediatric population, assisting infants and young children reach developmental milestones, or rehabilitating young athletes. Amy has also worked extensively with adult patients and finds equal joy in helping adults reduce disability and reach their movement potential. She has specific experience with orthopedics, gait & balance training, and geriatrics.