A healthy living blog from Marshfield Clinic Health System

Knee clicks with pain? See your provider

If your knees snap, crackle, pop without pain when you squat, air bubbles in the joint may be the cause. Painful knee clicking, however, could be caused by a few conditions,  including torn cartilage.

Cartilage is the white protective tissue over the ends of the bones in your joints. It works as a cushion to keep bones from grinding together and to move freely.

“Cartilage can be torn, but it can also wear down,” said David Smith, a Marshfield Clinic Health System physical therapist. “Torn cartilage usually happens with an injury, whereas worn cartilage happens over time.”

How can cartilage become torn?

Bone and joint with a band aid over the top, illustration - Will torn cartilage heal?

Because there isn’t good blood flow to cartilage, the healing process is quite slow, if it heals at all.

Impact activities like jumping and landing, especially in your knees, can cause cartilage tears. If a hard force comes down on the joint with twisting at the same time, followed by pain, you may have torn cartilage. Deep repetitive squatting also can cause problems.

Most people don’t know they have a cartilage problem,” Smith said. “Usually, they just hurt. In more severe cases, you get clicking or grinding, and sometimes catching in the joint associated with pain.”

Will torn cartilage ever heal?

Because there isn’t good blood flow to cartilage, the healing process is quite slow, if it heals at all. Pain in the joint becomes worse with continuous impact and movement like standing, landing and squatting.

“You want to keep moving the joint,” Smith said. “Then take the pressure off the joint enough during the day to give yourself relief.”

If the injury is not getting better on its own within a couple months, Smith recommends physical therapy to make sure the joint can move fully and to learn ways to prevent further injury.

“We teach patients to protect the joint so they don’t do activities that cause excessive strain,” he said.

Smith shows patients how to properly squat with knee cartilage tears. Depending on your lifestyle, he also teaches ways to modify your motion and allow balance between activity and rest. For example, a carpet layer or electrician may squat all the time and their therapy is different from someone who stands all day.

“Both may have symptoms and problems, but I would do something different with each person,” Smith said.

Build your strength

With all cases, Smith highly recommends strengthening after your injury.

The stronger the muscles are around that particular joint, the more the muscles can take the strain off the joint,” he said. “You have a better chance of that joint letting you do what you have to do without flaring up, when your muscles are strong.”

Surgical treatment

Because cartilage tears may never repair, simple surgery like arthroscopy allows the joint to move smoothly again. If pain becomes worse and restricts movement, or there is locking and catching, there are different types of surgery your provider may recommend. Each treatment is individualized to the patient and severity of the injury.

“If it’s not getting better within a couple of months, talk with your provider about treatment,” Smith said.

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