Knee popping, medically known as crepitus, is a common sound or sensation that prompts many people to seek professional advice. This noise can be concerning, especially when it occurs frequently or is accompanied by discomfort. Chiropractors focus on the musculoskeletal system, and their approach to the knee is part of a larger assessment of the lower body’s biomechanics.
Understanding the Sound: Why Knees Pop
Knee crepitus is a general term for the cracking, grinding, or popping noises that originate from the joint during movement. The most frequent cause of popping is entirely harmless and is known as joint cavitation. This occurs when a sudden change in pressure within the synovial fluid of the joint causes dissolved gases, primarily nitrogen, to form and then rapidly collapse, creating the audible “pop.”
Non-pathological popping can also result from a tendon or ligament briefly snapping across a bony prominence as the joint moves. This is common during activities like squatting and typically does not indicate an injury if it is not associated with pain or swelling. However, popping accompanied by pain, instability, or a locking sensation often signals a more serious, pathological issue. This kind of painful crepitus can be a symptom of conditions like the early stages of osteoarthritis, where cartilage wear causes rough joint surfaces to rub together. Other problematic causes include a meniscal tear, which can cause snapping or catching, or issues with the kneecap’s tracking, such as patellofemoral pain syndrome.
The Chiropractic Approach to Knee Issues
Chiropractors treat knee issues by viewing the knee as part of the body’s kinetic chain, not an isolated joint. Their initial focus is a comprehensive assessment of the lower extremity biomechanics. This involves evaluating the alignment and function of the hip, pelvis, ankle, and foot, as imbalances in these areas can place undue stress on the knee joint.
A key diagnostic tool is gait analysis, where the chiropractor observes the patient’s walking or running pattern. This analysis helps identify compensatory movements or improper foot mechanics, such as overpronation, that can lead to poor kneecap tracking. By pinpointing a structural or muscular imbalance far from the knee, such as a pelvic misalignment or weak hip abductor muscles, the chiropractor addresses the root cause of the abnormal stress contributing to the knee popping. This evaluation determines if the case is within their scope of practice or requires a referral to a specialist.
Specific Chiropractic Techniques for Knee Popping
Once the underlying biomechanical issue is identified, the chiropractor employs manual techniques and rehabilitative strategies. One common intervention is joint mobilization or adjustment of the knee itself, the fibula, or the talus bone in the ankle. These adjustments aim to restore proper movement and alignment to the joint surfaces, reducing mechanical friction.
Soft tissue therapies are often paired with adjustments to address muscular contributions to the popping. Techniques like Active Release Technique (ART) involve applying precise pressure to a muscle, tendon, or ligament while the patient actively moves the joint. This helps break down scar tissue and adhesions, relieving tension in the quadriceps or iliotibial band that pulls the kneecap out of alignment. Corrective exercises are prescribed to stabilize the joint and maintain the benefits of the manual therapy. These exercises often target strengthening the hip extensors and abductors, such as glute bridges and clamshells, to improve overall lower extremity stability.
When to See a Medical Doctor Instead
While chiropractic care is effective for many mechanical causes of knee popping, some symptoms necessitate immediate medical evaluation by a medical doctor or orthopedic specialist. Popping that occurs at the moment of an acute injury, especially if followed by intense pain and rapid swelling, is a red flag for a potential ligament tear or fracture.
Patients should seek urgent medical attention if they experience the inability to bear weight on the leg or feel a persistent sensation of the joint locking or giving way. Other concerning signs include visible deformity of the knee joint or the presence of fever and warmth around the joint, which could suggest an infection or acute inflammatory process. These symptoms indicate that a serious structural injury has occurred that falls outside the scope of routine chiropractic care.