Creaky Knees: Audible Crepitus
I frequently have patients describing to me the situation of having creaky knees, frequently people complain of their knees making noises when performing squatting or bending movements or going up and down stairs. Sometimes these noises are associated with pain and sometimes there is the auidable creaking sound but without any discomfort at all.
This noise in the medical industry is referred to as audible crepitus and typically is easily reproducible in the clinic by asking the patient to flex or extend their knee or squat up and down. However often the crepitus may only be occasional or patients may report the sensation of experiencing creaking or even uncomfortable grating whilst flexing or extending their knee but there is no auidable sound associated with it, in this situation the crepitus can usually be easily palpated by gently placing your hand on the knee cap whilst they flex and extend their knee.
What Causes Crepitus?
Crepitus is a symptom caused by vibrations produced by articular cartilage during the flexion and extension movement of the knee, the underlying pathology causing the crepitus may be minimal.
Vibration waves are produced by articular cartilage of the knee joint during flexion-extension movements and the vibration waves are significantly different in asymptomatic patients with normal articular cartilage compared to patients with osteoarthritis.
Audiable Crepitus A Feature Of Osteoarthritis
Audible crepitus is a common feature of knee osteoarthritis however the degree of crepitus does not correlate to the amount of problems a patient experiences. A patient may have no crepitus yet have significant anterior knee pain and vice versa. Crepitus in the knee doesn’t necessarily indicate osteoarthritis, crepitus may indicate other ailments such as synovitis or an articular lesion occurring in the absence of any osteoarthritis.
What Should You Do If You Have Creaky Knees
As mentioned above creaky knees or auidable crepitus can mean different things and asymptomatic patellofemoral crepitus is relatively common and does not need treatment.
- Creptius is commonly associated with patellofemoral joint syndrome also called “runners knee” which does require treatment because in this situation the crepitus is associated with pain in the knee. Treatment for patellofemoral joint syndrome is multifaceted and typically requires among other things looking at lower limb biomechanics including foot biomechanics, as well as core, glute and lower limb strength especially the VMO (vastus medialis oblique) which is part of your medial quadricep muscle and also important is the patients lower limb flexibility.
Frequently the key to treating patellofemoral joint syndrome is to strengthen the VMO without provoking knee pain (which will inhibit quads activation). This becomes the challenge and typically why patellofemoral joint syndrome is frequently quite difficult to manage.
- Osteoarthritis of either the knee or the patellofemoral joint as stated earlier is another cause of crepitus of the knee and requires appropriate treatment. Treatment which differs in it’s management to that of patellofemoral joint syndrome one of the other main causes of crepitus in the knee.
Pin Pointing The Cause
Pin pointing the cause of the crepitus and it’s relevance is crucial in the management of any creaky knee/s because not all crepitus needs to be treated and crepitus requiring treatment is managed in different ways ultimately depending on the cause. Getting accurate diagnosis for the cause and significance of your crepitus is the first step towards managing any creaking knee complaint.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding the management of their creaky knees should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.