A clicking or popping sound coming from the elbows during exercise, known medically as crepitus, is common, particularly during movements like push-ups. While the noise can be distracting or cause concern about joint health, it is often a benign mechanical event. Understanding the underlying structures and specific mechanics of the elbow joint during this loaded movement helps determine the cause of the noise. This helps determine when the sound is harmless and when it might indicate a need for a change in exercise routine or a medical consultation.
The Anatomy of the Click
The elbow is a complex synovial joint, encased in a capsule containing lubricating synovial fluid. The most frequent source of a sharp, singular clicking sound is cavitation, the same process heard when cracking knuckles. This occurs when the joint is rapidly stretched or compressed, causing a sudden drop in pressure within the synovial fluid. This pressure change forces dissolved gases to form a temporary bubble, and the distinct popping noise is produced when this bubble rapidly collapses. This type of clicking is generally painless and does not damage the joint.
Another source of clicking, often described as a snapping or thud, involves soft tissues moving over bony protrusions. This occurs when a tendon or ligament, such as the triceps tendon, momentarily catches on a bony landmark, like the medial epicondyle, before snapping back into place. This phenomenon is sometimes associated with the ulnar nerve, which runs close to the triceps tendon. A third, less frequent cause is mechanical crepitus, a continuous, grating sound caused by rough or irregular joint surfaces. This could be due to minor cartilage wear or the presence of a loose body floating within the joint capsule.
Why Push-Ups Exacerbate Clicking
The push-up places the elbow joint under a unique combination of significant load and a large range of motion, which amplifies clicking mechanisms. The joint sustains an axial force that can average about 45% of the body’s weight. This substantial compressive force, especially as the elbow moves from flexion to extension, increases the likelihood of a mechanical event occurring.
The clicking often becomes noticeable at the top of the movement, precisely when the elbow approaches full extension or “lockout.” Extending the joint fully creates the rapid pressure change necessary to induce synovial fluid cavitation. The rapid contraction of the triceps muscle also increases tension on the triceps tendon, making it more likely to snap over the medial epicondyle.
The speed of the movement also exacerbates the noise. Performing push-ups quickly significantly increases peak compression forces and the valgus moment (sideways stress) placed on the joint. This higher joint stress encourages cavitation and increases the likelihood of soft tissues shifting abruptly. Furthermore, a wide or flared elbow position increases the valgus torque, placing more strain on the inner elbow structures.
When Clicking is Normal vs. When It Signals Injury
Distinguishing between a benign joint sound and one that signals a potential problem is important for safe training. Normal clicking is generally painless, occurs inconsistently, and is not accompanied by other physical symptoms, typically resulting from harmless gas bubble formation (cavitation). If the clicking is accompanied by sharp, localized pain, swelling, or warmth, it should be considered a red flag. These symptoms can suggest underlying issues such as tendonitis, bursitis, or a partial ligament tear. A grating or grinding sensation, rather than a sharp click, may indicate friction from damaged cartilage or early-stage arthritis.
Another serious warning sign is a sensation of the joint catching or locking during movement, or if the clicking is accompanied by numbness or tingling in the forearm or fingers. This nerve-related sensation can indicate a condition like snapping triceps syndrome, where the ulnar nerve is irritated or displaced by the snapping tendon. Any persistent, painful clicking that limits the normal range of motion or interferes with daily activities warrants evaluation by a healthcare professional.
Strategies to Reduce or Prevent Elbow Clicking
Simple modifications to push-up technique can often reduce or eliminate the clicking sensation. Adjusting the tempo of the exercise is an effective starting point; slowing down the movement, particularly the eccentric (lowering) phase, significantly decreases peak joint forces and torque. This controlled movement prevents the rapid pressure changes that trigger cavitation and allows soft tissues to glide more smoothly.
Modifying the range of motion is also helpful, as clicking often happens at full extension. Consciously stopping the push-up just short of completely locking out the elbows prevents the joint from reaching the point where the pressure differential is created. This adjustment maintains tension in the triceps muscle while protecting the joint surfaces from hyperextension.
Experimenting with hand placement can alter the strain on the elbow. Moving the hands slightly wider than shoulder-width, or ensuring the elbows are tucked closer to the body, reduces adverse valgus torque. This positioning promotes better joint alignment and minimizes the friction of tendons and nerves over bone. Incorporating a dynamic warm-up, including gentle arm circles and light stretches, can also prepare the soft tissues for the exercise, improving tendon glide and joint lubrication.