Crunching in the knees when bending and straightening - causes, treatment, what to do and which doctor to go to

Elena Pasternak

family orthopedist of the ORTEKA network of orthopedic salons

Why do my knees crack during exercise? Is it possible to continue studying? How to fix it?

Often, crunching in the knees is the result of improper functioning of the joint. If it is not accompanied by tissue inflammation, then the person does not feel pain or discomfort. That's why many people simply ignore it. In this case, crunching in the joints can signal orthopedic diseases. What are the reasons for its appearance and when should you worry? Does it affect your lifestyle?

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When to worry

Crunching in the knee joint (crepitus) is not necessarily a symptom of a serious illness.
Often this is a fairly harmless phenomenon: while walking, air bubbles can form in the synovial fluid, they burst, and the knee crunches. This phenomenon is usually encountered by people who lead a sedentary lifestyle. Sometimes such sensations in this part of the leg signal that not everything is in order in the body. For example, that bone structures rub against each other. Sometimes in such cases, after a crunch, the knee hurts and swells, but crepitus may remain the only symptom of the pathological process. Finally, crunching can be the result of injury or increased stress.

What are the causes of crunching knees?

To understand where the crunch comes from, you need to understand a little about the structure of the knee joint. The simplest analogy is a hinge joint, which is similar in structure to a joint. In the case of the knee, the articular surfaces act as moving elements that participate in movement and are responsible for shock absorption. They are covered with cartilage tissue, which ensures smooth movement. The cavity where these elements are located is covered with a capsule - a dense, sealed connective tissue. In the joint cavity there is a special fluid, the task of which is to act as a lubricant and prevent friction of the articular surfaces.

Photo: istockphoto.com

When walking, running, or playing sports, the capsule stretches, resulting in an increase in its volume. The pressure in it drops, which causes gas bubbles to form in the liquid. They burst when the pressure in the bubbles and the liquid becomes equal. We hear a click. The joint capsule, which is stretched during physical activity, can also crack. In addition, the cause of this phenomenon can be muscles and tendons. When moving, they rub against the protruding surfaces of the bones, which causes the click. The same applies to ligaments, the work of which is accompanied by a characteristic sound.

Crunching in joints in children and adolescents often worries parents. I hasten to reassure you that this is due to the fact that bone tissue grows faster than muscle tissue. Muscles, tendons, and ligaments become tense and cause crunching in the joints. But it’s still worth contacting an orthopedist so that a specialist can rule out the disease and confirm age-related features.

Unfortunately, over time, the cartilage in the knee joint wears out. The articular surfaces become rougher, so their friction causes crunching - crepitus. This process is accelerated by intense sports activities, work associated with physical labor, injuries, and excess weight. A sedentary lifestyle is also not good for joints, since in the absence of movement, blood supply deteriorates. This also negatively affects the condition of cartilage tissue.

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Causes of the condition - safe and dangerous

Pain and crunching can be caused by both physiological causes and pathological factors. If your knee constantly crunches and swells or hurts, if you notice limited mobility in your leg, you need to consult a doctor - a specialist will refer you for an examination, determine the source of the crunch and prescribe therapy.

Common reasons include:

1. Gonarthrosis is a condition in which the joint does not receive enough normal nutrition, which leads to dystrophic changes - the cartilage begins to collapse.
2. Rheumatoid arthritis: the knees crunch and hurt when squatting or moving, the pain intensifies when touched, and the joints look swollen.
3. Damage to the menisci. In this case, the knee will not only creak, but will also greatly disturb you - it will be very difficult to squat or even just walk. In this case, clicks will be heard while driving.
4. Gouty arthritis. If uric acid metabolism is disrupted in the patient’s body, salts will be deposited in the joints, which causes clicking.

Crunching often signals a serious illness. What to do if your knees hurt and creak? Don't wait, but go to the clinic.

Why do my knees crack during training?

Beginners and professional athletes often experience creaking knees during training. At a minimum, this is due to the fact that during exercise you often have to make sudden movements and turns, in which tendons, muscles and ligaments come into contact with the bones of the joints.

In addition, too intense training causes faster wear of cartilage tissue and abrasion of articular surfaces. Therefore, as professional athletes age, their knees and other joints begin to hurt. The crunch can also be a consequence of a previous injury during training.

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It is also worth considering that athletes are characterized by an excess amount of protein in the body. It increases the level of protein in the fluid inside the knee and “dries” it out. As a result, it softens the friction of the articular surfaces less.

Diagnostics: what tests need to be done

Crunching and pain in the knee can be signs of various diseases. Therefore, competent diagnosis, consisting of several stages, is so important:

• taking anamnesis;
• urine and blood tests: general and biochemical;
• Ultrasound;
• MRI;
• studies of synovial fluid;
• X-ray examinations;
• arthroscopy.

If the doctor needs to confirm or refute the diagnosis or clarify details, he may prescribe additional tests or studies.

Physiological prerequisites

Special attention should be paid to the crunch, which is not associated with pathological processes in the joint, there is no pain syndrome and no signs of inflammation, the knee has a normal appearance, without swelling of the knees and redness.

Orthopedic doctor Andrey Sergeevich Litvinenko comments:

The hard articular surfaces of the bones, shifting relative to each other, release bubbles in a liquid medium with dissolved gas. Scientists have found that synovial fluid contains up to 14% carbon dioxide. With sudden movements, the carbon dioxide bubbles do not have time to dissolve in the liquid and collapse, producing a sound resembling a crunch.

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How to treat and for how long

Therapy is carried out in two directions: symptoms are relieved and the cause of their appearance is corrected. So, if a patient complains that the knee has cracked and now hurts, the doctor may prescribe drugs from the NSAID group: they help reduce pain, inflammation, and swelling. Corticosteroids, which are anti-inflammatory hormones, may also be administered. If the knee crunches when straightening, but does not hurt, the doctor may prescribe vitamin and mineral complexes. Chondroprotectors can improve the condition of cartilage tissue and slow down destructive processes.

Important: even if your knee crunches when walking, but does not hurt, you should not self-medicate: without an examination it is impossible to make a correct diagnosis.

Diagnostic features

The first sign of osteoarthritis is pain when moving. If the disease has not yet entered the second or third stage, the pain subsides after rest. Some women also complain of pain after prolonged walking or other physical activity.

During pregnancy, manipulations and various instrumental research methods are prohibited, so pain becomes the main thing when making a diagnosis. If the period is still short enough and the woman is not yet aware of her “interesting” situation, she can be given an x-ray. In other cases, the diagnosis is made based on a survey, examination and general blood test.

X-rays and MRIs are contraindicated during pregnancy

Pain in the hip joint during pregnancy occurs much more often not due to arthrosis, but against the background of the woman’s “special” condition and hormonal changes, however, there are exceptions - thinning of the cartilage, which continues to manifest itself even after childbirth:

Which specialist should I contact?

Depending on what kind of pathology provoked the crunch, treatment will be carried out by an orthopedist, rheumatologist or traumatologist, whom you should go to if you have recently had a leg injury. But initially it is worth contacting a therapist, who will assess the condition and refer you to a highly specialized specialist. Or you can immediately go to a clinic specializing in the treatment of the spine and joints - here they will immediately carry out all the necessary tests, examinations and refer you to a doctor who will help solve the problem.

Treatment tactics for pregnant women diagnosed with osteoarthritis

In advanced cases, osteoarthritis can seriously progress, bring discomfort into everyday life and even lead to disability. Therefore, the success of treatment largely depends on how quickly the woman seeks help. Today there are a number of therapeutic methods that are not capable of harming the fetus, but at the same time significantly alleviate the condition of the expectant mother.

At the initial stage of osteoarthritis the following is prescribed:

• gymnastics to strengthen joints;
• massage;
• mud baths;
• visiting specialized sanatoriums.

It is very important to reduce the load on the joint: for example, in the case of osteoarthritis of the knee, keep the limb completely at rest. Fixed postures and excessive physical activity are also contraindicated. If the disease has progressed, an orthopedic rheumatologist may prescribe heat treatments to reduce pain. It is prohibited to take pills on your own for pain relief: many of them can harm the fetus.

In the case of pregnant women, orthopedic doctors are very limited in the choice of medications and treatment methods

Prevention of osteoarthritis during pregnancy

The main rule when carrying a child is to avoid injury and behave with extreme caution. If trouble happens and affects a joint, you should not turn a blind eye to it and let damage to cartilage and tendons take its course.

If a woman feels normal, she is recommended to lead an active lifestyle, move, and walk a lot in the fresh air. It is very important to avoid excessive weight gain, since excess kilograms create a dangerous load on the joints - both during pregnancy and after birth.

Features of the course and treatment of osteoarthritis during lactation

During breastfeeding, manipulations are already allowed for the purpose of accurately diagnosing arthrosis - x-rays, biopsy and analysis of synovial fluid, so it is possible to make a diagnosis much faster and more accurately. Treatment tactics depend on the stage of the disease. In addition to painkillers and anti-inflammatory drugs, glycosaminoglycans are shown to protect cartilage from destruction.

The doctor recommends the best physical treatments - magnetic therapy, exposure to electric currents, ultraviolet radiation. An excellent effect can be achieved with the help of thermal procedures, paraffin application and mud therapy. The massage is aimed at restoring the functions of the affected joint - reducing muscle spasms, increasing the tone of weakened muscles. Unfortunately, in severe cases it sometimes comes to endoprosthetics. The issue of intra-articular Noltrex injections is decided on an individual basis.

For osteoarthritis during lactation, exercise therapy is often prescribed

Intra-articular injections and surgeries during pregnancy

Only a doctor can recommend safe painkillers and anti-inflammatory drugs during this period. Intra-articular injections of synovial fluid substitutes, for example, Noltrex or preparations based on hyaluronic acid, are usually not given to women during this period, since many of them are hormonal and are contraindicated for pregnant women.

In difficult cases, when joint replacement is recommended, it is postponed until after the birth of the child, and before that, adequate supportive therapy is prescribed.