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Creaky knees

I often get creaky knees particularly when bending my knees such as in squatting and climbing stairs. Is this normal and reversible?

What is Crepitus:

Crepitus is the medical term used to describe a grinding, crackling or grating sensation or sound. It can be likened to that of someone sitting on a bag of potato chips. Crepitus in the knee can be heard/felt when bending or straightening the knee. It can be occasional or felt with each knee movement. Audible crepitus can often be heard but may sometimes only be sensed by placing hand on knee cap during knee movements.

What causes crepitus?

Crepitus is caused by vibrations produced by articular cartilage during straightening and bending movements of the knee. Crepitus is a common symptom in those with Patellofemoral Pain Syndrome (PFPS) also known as ‘runner’s knee’, chondromalacia patella and Osteoarthritis. Those with Osteoarthritic knees and those without any cartilage damage or knee injuries display a different form of vibration. The resulting noise and sensation often experienced in the early stages of Osteoarthritis of the knee are normally due to a deterioration or absence of cartilage and meniscus in the knee joint structure.

What should I do if I have creaky knees?

The cause of the crepitus should be the prime purpose of treatment rather than the crepitus itself. Those with asymptomatic crepitus i.e creaky knees without pain or a pathological cause do not require treatment however if it still remains a concern and you feel it is affecting your everyday movement or performance then it is advised to get it checked by a health professional.

If pain is associated with crepitus then it is best to have it examined by a physiotherapist. The physiotherapist will assess the cause of the crepitus and tailor treatment accordingly.

If you are suffering from patellofemoral crepitus, treating the crepitus is not the goal but the cause of the crepitus which is usually multifaceted. This involves treatments targeting maltracking of knee cap, VMO (Vastus Medialis Oblique- part of your quadriceps muscle) weakness/ wasting, lower limb biomechanics including foot biomechanics, gluteal and core strengthening. If the cause of the crepitus is the osteoarthritis of the knee or patellofemoral joint then managing the osteoarthritis is crucial. Specific exercises will be given by your physiotherapist once a diagnosis has been made.

It is therefore important to get an accurate diagnosis for the cause and significance of your crepitus as this is the first step towards managing any creaking knee complaint.

Knee Crepitus Mythbusters

1.Creaky knees are not always associated with knee damage – if there is no pain with crepitus then there is usually no need for treatment

2. Creaky knees does not always mean you are suffering from osteoarthritis – creaky knees can often mean incorrect lower limb biomechanics or patellofemoral joint pain.

3. Treating creaky knees should not be the goal of physiotherapy treatment but the cause of the crepitus. I.e. if the cause of crepitus is osteoarthritis therefore treatment should be focused on managing OA.

4. Crepitus of the knee is not managed in the same way. Treatment differs depending on the cause of knee joint crepitus and patient’s goals.

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