Crunching in the knee during extension: causes, prevention

What can make your knee creak?

A crunch in the knee joint can be caused by its hard structures, including:

• Terminal section of the femur.
• Proximal tibia.
• Menisci and patellas.
• Articular cartilages and capsules.

Moreover, either one or several knee elements can crunch.

Sometimes extraneous sounds are caused by lesions in the soft structures of the knee, in which case they are explained by a violation of the equivalence between the hard articular surfaces.

Severe symptoms of the disease

The knee joints crack for various reasons, even when carrying a heavy bag in the hand or slightly bending/bending the joint. Therefore, it is necessary to pay attention to the accompanying signals:

Sometimes the symptom can be supplemented by an increase in the person’s temperature.

• knee cracks when moving;
• modifications of the affected knee, the appearance of swelling/redness;
• pain symptoms (periods of temporary occurrence/calming, effects on other areas of the body);
• increase in body temperature.

Causes of crunching in the knee joints

There are the following reasons that can lead to crunching in the knee joints:

• Gonarthrosis. This disease is accompanied by dystrophic changes in the tissues of the joint, as they cease to receive normal nutrition. As a result of this violation, the cartilage is destroyed and the joint itself is deformed. The disease often leads to people becoming disabled. More often, the pathology develops in women. Primary gonarthrosis develops due to hormonal, metabolic or genetic disorders in the body. The secondary form of the disease can manifest itself after trauma or surgery on the lower extremities. In addition to a crunch in the knee joint, a person will experience pain. As the pathology progresses, it intensifies, and the mobility of the joint is increasingly limited.
• Damage to the menisci. Most often, the menisci are damaged due to the influence of an external force on them, for example, during sharp extension of the knee, during sharp turns or jumping from a height. In addition to crunching in the knees, a person experiences pain and cannot sit down or even walk normally. During movement, the joint begins to click. Synovial fluid can accumulate in the cavity of the knee joint, which is released in response to inflammation of the synovial membranes of the joint.
• Rheumatoid arthritis. This pathology is of an autoimmune nature and most often affects women. Sometimes only one joint is affected, and sometimes several at once. The reasons for the development of the disease have not yet been established. Provoking factors are considered to be injuries, hypothermia, previous viral infections, etc. In addition to a crunch in the knee, a person will experience pain, which intensifies during movement and touching the affected area. In the morning, the joints seem to be stiff and the knees are swollen. The periarticular tissues themselves swell, and fluid may accumulate in its cavity. Crunching occurs while driving.
• Gouty arthritis of the knee.

  This disease develops due to the fact that the body's metabolism of uric acid is disrupted. Its salts begin to be deposited in tissues and joints, which causes corresponding sounds in them. It is rare for the knee to be attacked by gouty arthritis, but it does happen. Mature men are more often affected. In addition to crepitations, the patient complains of pain and limited mobility. The knee swells and the skin over it may become red and hot to the touch.

• Hypermobility syndrome.

  With this pathology, the knee joint is characterized by increased flexibility and mobility. The disease develops due to genetic abnormalities, but can sometimes be acquired as a result of injury, hormonal imbalances or neurological disorders. The main manifestation of the syndrome is crunching, which may be accompanied by pain.

• Disturbance in the body's metabolism of calcium and phosphorus.

  These microelements form bone tissue; if they are missing, this will certainly affect its condition. In addition to the crunch, a person will complain of limited mobility in the joint, of pain that can begin to haunt even at rest. If you do not get rid of the problem, the joint will become deformed.

• Excess body weight.

  Obesity places serious stress on the knee joint. This causes it to gradually collapse. If you get rid of extra pounds in time, the pathological process can be stopped. The higher the degree of obesity, the more serious the damage to the knee structures.

• Chondromatosis of the joint.

  With chondromatosis, metaplasia of the cartilage of the joint is observed. As a result of this process, chondromic bodies are formed, which block normal mobility of the knee. Most often both legs are affected. In addition to the crunch in the knee, the person will experience pain. The joint swells, which negatively affects the patient’s range of motion.

• Bursitis.

  With bursitis, inflammation of the synovial bursae occurs. The main cause of the disease is injuries to the joint and excessive physical stress on it. Sometimes pathogenic flora leads to inflammation of the synovial bursae. Symptoms of bursitis include: a crunch in the knee, swelling of the soft tissues, limited joint mobility and pain.

• dissecans
  or Koenig's disease.
  With this pathology, peeling of the cartilage plate that overlaps the bone is observed. With osteochondritis, it is the knee joint that most often suffers. The disease debuts in people aged 20-40 years. Its development can be triggered by injuries, impaired blood supply, and excessive stress on the joint. Pathology is always accompanied by painful sensations and crunching. In severe cases, complete blockade of the joint is observed.
• Osteophytes of the joint

  – these are growths of bone tissue that should not normally exist. They are growths on the bone. The reason for their formation is repeated stress on the joint, metabolic disorders in the body, as well as osteoarthritis. With large osteophytes, the joint will crunch during movement, stop functioning normally, and begin to hurt.

• Dislocation or fracture.

  Any injury to bone structures is accompanied by a characteristic crunch. Sometimes the joint may crack even after the damaged tissue has healed. This is observed in the case of the addition of a pathological process, for example, with the proliferation of osteophytes or with bursitis.

• Damage to the tendons and ligaments of the knee joint.

  Damage to tendons and ligaments leads to the fact that the structures of the knee joint lose stability, their anatomy is disrupted, which leads to crunching.

• Chondromalacia
  patella.
  With this disease, the cartilage tissue of the joint is destroyed. It becomes thin and cracks appear on it. As the pathology progresses, the patella and femoral condyles will suffer. Chondromalacia can be triggered by previous knee injuries and excessive stress on it. Crunching and pain will occur when the joint moves.

Video: Live Healthy program! “Why do my knees crack? Studying your body":

Main types of knee injuries

Anterior cruciate ligament (ACL) injuries

The ACL provides dynamic stability to the knee; it fixes the lower leg and prevents it from moving inward and forward. In fact, the ACL is the main stabilizer of the knee, and if it is damaged, then normal function of the limb is simply impossible. ACL injury is very common - it can occur both during sporting events and at home, when falling from a bicycle, etc. In most cases, it is caused by sudden braking, stopping while walking or running, and is often found in accidents and in contact sports.

Posterior cruciate ligament (PCL) disorders

It is much less common. The job of the PCL is to keep the tibia from moving backward. As a rule, if there is a rupture of the PCL, we are talking about a serious and serious injury. PCL rupture occurs only under very strong physical impact - for example, with a powerful blow to the leg during a sports competition, or when hit by a car bumper.

Meniscus injuries

Refers to the most common injuries of the lower extremities. The menisci perform a shock-absorbing function in the joint; they prevent friction from occurring even under the most severe loads. The underlying cause of injury is a blow, a fall, an atypical turn of the leg, or a sharp extension.

What can a crunch in the knee be like?

Most often, a crunch in the knee joint occurs during flexion and extension. It is the crunch that is the first symptom of damage to the structures of the knee. It may indicate deformation of cartilage tissue, damage to ligaments, joint capsule, cartilage or muscles. Although sometimes joints can crack simply due to the fact that a person leads a sedentary lifestyle.

During squats, athletes' joints often crack. Normally this should not happen. Therefore, if a person is actively involved in sports and notices a pathological crunch, he needs to see a doctor. It may be necessary to avoid strenuous physical exercises that place stress on the lower limbs.

A crunch in the knee is almost always accompanied by pain. The more intense the pain, the more severe the degree of the pathological process. The pain cannot be tolerated. It is necessary to contact a specialist and find out the reasons for its occurrence.

Crunching in the knees when straightening without pain

Why does the knee crunch when extending, and is this necessarily a symptom of the disease? In practice, this is far from true, and even a healthy joint can make sounds. The main difference is the presence or absence of painful sensations accompanying the sound.

If the crunch occurs without pain, then its cause is:

Crossing of ligaments and subsequent putting into place - elastic ligaments can regularly shift to a safe distance and, when restoring their position, produce a characteristic sound that is mistakenly attributed to the joint;

Ligament overlap is the same problem as with tendons. It is not a pathology and does not require treatment;

The penetration of the synovial membrane between the cup and the thigh is also not a pathology; it occurs due to slight twisting of the leg during awkward movements.

Carefully analyze your own feelings if your knees begin to creak, this will allow you to promptly identify an unpleasant and serious disease and begin treatment or relief of symptoms.

Diagnosis of crunching in a joint

During the appointment, the doctor will listen to the patient’s main complaints and examine him.

To clarify the diagnosis, the following studies may be prescribed:

• General and biochemical blood test.
• General urine analysis.
• Ultrasound of the knee joint.
• X-ray examination of the knee joint.
• Collection of synovial fluid and its analysis.
• Arthroscopy. This method can be performed not only for diagnostic, but also for therapeutic purposes. The procedure is performed under anesthesia. During this procedure, an arthroscope is inserted into the joint and the internal structures of the knee joint are examined on a monitor.
• CT or MRI of the joint.
• Scintigraphy.

Diagnosis methods

Methods for studying the causes of the disease are:

• General examination - control of laboratory data (blood/urine tests).
• Ultrasound is a visual examination of the soft tissue areas of the joint, displayed on the device’s display.
• Radiography is the study of joint pathology by exposing the organ to a beam.
• MRI is a topographic image of joint abnormalities.
• CT scan is a layer-by-layer examination of the bone and joint structures at the site of the knee disorder.
• Arthroscopy is a surgical intervention by introducing a special solution into the joint.
• Scintigraphy is the intravenous injection of a radiopharmaceutical into a joint to determine the intensity of accumulation in the tissues.
• Examination of the synovium - microbiological/microscopic examination, macroscopic assessment of the properties of the synovium using puncture of the knee joint.

Treatment of crunch in the knee joint

To get rid of a crunch in the knee joint, it is necessary to identify the pathology that led to the development of this symptom. In case of injury, the limb is immobilized by applying special splints or a plaster cast to the leg.

Depending on the cause of the crunch in the knee, the following medications may be prescribed:

• Drugs from the NSAID group. They help reduce inflammation and pain, relieve swelling. They are taken orally and applied to the affected joint. These may be medications such as Ibuprofen, Diclofenac, etc.
• Corticosteroids. These drugs are prescribed to relieve inflammation. Injections are administered into the joint cavity. Such drugs include Prednisolone, Hydrocortisone, Triamcinolone.
• Drugs for the treatment of gout: Colchicine and Allopurinol. They prevent excess production of uric acid in the body, accelerate its elimination and eliminate the symptoms of the disease. Medicines are taken orally.
• Basic anti-inflammatory drugs are aimed at stopping the destruction of cartilage and bone tissue of the knee joint. The following drugs are used as intramuscular injections: Azathioprine, Cyclosporine, Methotrexate.
• To strengthen bone tissue and restore bone strength, vitamin and mineral complexes are prescribed.
• To improve the condition of cartilage tissue and stop the process of its destruction, patients are prescribed chondroprotectors. These may be drugs such as: Glucosamine, Chondroitin sulfate and Hyaluronic acid. The drugs are taken orally or given with injections.

Video: Dr. Orlov “How to treat cracking in joints?”:

Diet.

If a patient is diagnosed with obesity or gout, then diet becomes the main focus of treatment.

For gout, limit the consumption of foods that can lead to the accumulation of uric acid salts in tissues. Exclude meat dishes, fish, broccoli, cauliflower, dates.

If you are obese, the menu should be drawn up by a nutritionist. In addition, a person needs to change his lifestyle and increase physical activity.

To normalize phosphorus-calcium metabolism, you need to enrich your diet with cottage cheese, fish, milk and fermented milk drinks.

General symptoms of injuries

Depending on the type of damage, it may be accompanied by various symptoms. The most common are the following:

• Severe swelling;
• Decreased mobility, blocking of a number of movements;
• Crunching, clicking, extraneous sounds;
• Deformation of bone tissue;
• Increased temperature in the kneecap area;
• Inability to lift a heavy object;
• Acute pain;
• Constant aching pain;
• Decreased sensitivity.

Surgical treatment for a crunch in the knee

If conservative methods fail to cope with the existing problem, then surgery is indicated for the patient.

Depending on the cause of the disorder, the following treatment methods may be used:

• Arthrotomy of the joint.

  In this case, the diseased joint is opened and the inflammatory exudate is pumped out of it. If necessary, foreign bodies are removed. This is a gentle operation that causes little trauma to the joint structures.

• Tenorrhaphy.

  This procedure is aimed at suturing tendons when they are torn or otherwise damaged. In this case, the person will be immobilized for 1-1.5 months.

• Arthroplasty.

  The operation is performed for contractures of the joint, which have led to a change in its shape, or to a pronounced dysfunction of the knee. It is possible to replace a damaged joint with a prosthesis.

• Puncture of the knee joint.

  During puncture, medications are injected into the joint cavity, and inflammatory exudate is pumped out. This reduces the pressure inside the knee and reduces the intensity of pain.

• Synovectomy.

  This procedure aims to remove the synovium of the joint. It is indicated for rheumatoid arthritis, provided that the inflammation cannot be controlled with medications. The native shell of the joint is replaced with a shell made of synthetic material. Surgery is used only in extreme cases.

• Synovcapsulectomy.

  This operation involves removing not only the synovial membrane, but also the capsule of the joint itself. It is practiced in advanced forms of arthritis, when the structures of the knee joint are severely damaged.

• Arthroscopy

  performed using endoscopic equipment. Local or general anesthesia is possible, depending on the extent of surgery. It is prescribed to patients with pathologies of the menisci or ligaments, and with osteoarthritis. The procedure is minimally invasive and is completed fairly quickly.

• Osteosynthesis.

  This procedure is indicated for patients with fractures. During its implementation, the integrity of the joint is restored by matching bone fragments. After the operation, the knee joint is fixed and immobilized until the bones are completely fused.

• Meniscectomy.

  The operation involves removing the menisci of the knee. Access to its structures can be open or closed. In the latter case, endoscopic equipment is used.

• Elimination of damage to the ligamentous apparatus.

  The operation is indicated for patients who have ruptured knee ligaments. During this procedure, the ligaments are sutured. Immobilization of the limb after the procedure continues for 1-1.5 months.

Knee joint reconstruction

After the main stage of treatment has been completed, the patient will need to maintain the health of the knee joint. For this purpose, physical therapy complexes are selected for him, and physiotherapeutic treatment is prescribed (massage, electrophoresis, paraffin therapy, etc.).

Swimming is good because in the water the joint does not receive stress that could injure it again.

Consequences

Creaking in the knees is the first sign of destructive processes in the tissues of the joints. If you do not treat in time and do nothing, then irreversible processes can occur, such as:

Delayed treatment can lead to joint deformation.

• complete/partial destruction of the cartilage tissue of the knee joint;
• inability to move the knee;
• change in the shape and structure of the joint;
• loss of articulation, which subsequently leads to disability;
• dangerous knee injury.

Which doctor treats a crunch in the joint?

If a person has a cracking joint, then the help of an orthopedist, traumatologist or rheumatologist may be required. It all depends on what kind of pathology provoked the occurrence of this symptom. If it is not possible to get an appointment with these specialists, then first you need to visit a therapist.

Author of the article:

Kaplan Alexander Sergeevich |
Orthopedist Education: diploma in General Medicine received in 2009 at the Medical Academy named after. I. M. Sechenov. In 2012, she completed postgraduate studies in the specialty “Traumatology and Orthopedics” at the City Clinical Hospital named after. Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery. Our authors