What Causes that Clicking Sound in the Knee?

author : AMSSM
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Member question

A couple of weeks ago I hit my knee on the house door - it really hurt.  I then noticed about a week or so ago that when I bend my knee from straight to fully bent I have a "click" in it about halfway through the range of motion.  It doesn't hurt or anything but I'm paranoid that I did something to it.  I've tapered back on running, have been wearing a knee brace for stability and taking OsteoBiflex but the click is still there.  Thoughts? 

Answer by Christopher Nelson, MD
Member AMSSM 

The good news is that you are not having any pain from your click. There are several sources that could be causing this clicking noise, and many of these can eventually cause pain so it’s a good idea to be proactive to stay pain free.  Here are some possible causes:

Your knee cap, or patella, could be tracking improperly in the groove of your femur.   This condition is known as “runner’s knee.”   Normally, your upper leg bone, femur, and your lower leg bone, tibia, and your patella slide along one other when bending your knee.  Your patella allows your quadricep muscles to attach to the tibia below and protects your knee and maximizes the force you can generate.  Your quads and IT band (which help to stabilize the patella) keep your knee cap in the proper groove between your femur and tibia.  Your patella has the most contact with your femur and tibia at around 45 degrees, which is likely when you hear your click. 

Between your femur and tibia is your meniscus, which serves as a shock absorber and lubricator for your knee.  Your meniscus is made up of two C-shaped flat discs.  The meniscus can also be a cause of clicking, especially if has been torn. But since you are not having any pain, a meniscal tear is unlikely.  Meniscal tears are usual a result of a twisting or “turning in” force on your knee.

Another possibility would be from the presence of extra tissue in your knee capsule, known as a plica. Sometimes this tissue can become trapped between parts of your knee while bending and cause clicking.

Of these three possibilities the problem with your patella, runner’s knee, is the most likely.  In order to make sure your patella is tracking properly there are a few exercises that you can do.  I like to talk about culprit and victim model when thinking about the knee. The knee is almost always a victim of some other weakness in the body, such as at the hips, a very common area of weakness for runners! So starting with exercises to help strengthen your hips, pelvis, and glutes is a good start. You can try some side lying leg lifts, clam exercises or the fire hydrant exercise while you are on all fours.

You can also do quad strengthening by doing straight leg raises while seated using only your body weight.  Terminal leg extensions are also great for your quads.  To do these place a basketball or soccer ball under your knee while seated then flex and extend your knee.  Secondly, stretching your hamstrings and IT band will also be useful.  For hamstring stretching start with simple finger-to-toes stretching on the floor, using a towel wrapped around your toes to help you if needed.  An effective IT band stretch is to lay down, place your ankle on the opposite knee, gently press the knee of your crossed leg away from you, and hold for thirty seconds.  For all of these exercises work up to three sets of 25 repetitions on each side.  You can also follow these with some light icing, twenty minutes on and twenty minutes off.  I would recommend that you stay away from pain relievers unless your knee starts to hurt.  If you work on these exercises you should see some results in the next 6-8 weeks.  Stick with these and stay active!  If you start having pain or new symptoms you should check in with your sports medicine doctor!

Sincerely,

Christopher Nelson, MD

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date: June 28, 2012

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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