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Did That Sound Come From Me?

Written by Chad
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Was that your hip that just popped? It sounded painful, did it hurt?  Welcome to the world of our body making noises.  The body is a wonderfully created and sometimes annoying thing.  It has the power to lift enormous weight, run at incredible speed, and move with grace.  As stress is placed on our joints, we adapt or compensate to continue doing what we must.  As we place force on our joints or use our body incorrectly, we can hear noises come from, near or around our joints.  The most commonly noticed joints are
the knuckles, hips, knees, ankles, and spine. 

Everyone pays attention more to a body part after it has been injured or is not feeling right.  Once you twist your ankle, every time you step and feel a pop or hear a noise, you notice it. One wonders, is this normal or is something wrong that I should get checked out?  I am asked this common question as I talk to patients on their first day of physical therapy: “My (blank) pops/cracks/makes noise, is this okay?  I follow up with a few questions of my own: “does it hurt when you perform a specific motion? Did you notice the noise before you were injured? After this happens is your function affected?”  Part of the physical therapy evaluation is figuring out the problems presented by the patient, laying out a treatment plan, answering patient concerns, and most importantly, educating the patient on the condition and physical therapy expectations. 

So one may ask, “What is the noise coming from my joints?”  Joints in the body make a variety of noises: popping, grinding, cracking, and snapping.  There are several causes for this.  Inside a joint is fluid (synovial fluid), and when that joint is stressed quickly, the fluid forms bubbles, which are made up of carbon dioxide.  The popping can be the bubbles forming and then popping.  Snapping can be from structures outside a joint rubbing against the joint or other surfaces.  This is common with muscles, tendons, and
ligaments.  As you move, you may get some of these structures out of place.  The snapping can be the tendons returning to their normal place or a tight muscle or tendon rolling over the top of another structure (bone, muscle, tendon, or a joint).  Grinding can occur in a joint with a lot of arthritis.  Over time, osteoarthritis causes a degradation of the joint and a buildup of extra bone in the joint, creating more surface area.  This causes the joint to move a little different that it should, and as a result the extra bone will grind.  One may ask, “When should a joint sound be cause for concern?”  If pain is associated with these noises, then one should seek out a health care professional.  Other concerns necessitating the need for medical attention would include a decrease in function following a pop, crack, or grinding or an     increase in swelling.

Most people are familiar with chiropractors and some of what they do: manipulate joints.  Many therapists are also trained in manipulations as a treatment technique. A manipulation is defined as a high velocity, low amplitude thrust to a joint. A manipulation will also create a joint sound, often in the form of a “pop”.   In some instances, moving a joint quickly is the only way to reduce pain and restore function.  The result of doing this elicits several pops from the area being manipulated.  While this can be a scary experience initially because of the noise, the quick movement, and being in a dependent position, it can be very beneficial for your musculoskeletal system.  How many times have you seen someone crack their knuckles or twist their neck and hear pops, followed by them saying “ah?”  Following a manipulation, a person will often experience decreased muscle tension, increased range of motion, and improved ease of motion allowing improved and pain-free or less painful function.

At the Center for Physical Rehabilitation we offer complimentary consultations if you would like to discuss the concerns you have with a physical therapist.  From there, an appropriate plan can be made. Consultation outcomes include recommendations for rest, assurance that current strength and mobility are normal, or if further physical therapy would be warranted. In this case, we would be happy to collaborate with your physician to obtain a referral for physical therapy and work with you to achieve you physical and wellness goals.

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