♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks! I'm Bob Schrupp, physical therapists.
- Brad Heineck, physical therapists.
- Together we're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today we're gonna talking about
what caused your knee to click,
or grind, snap, creak,
and do you need to worry about it?
- That's a good question, Bob.
I've had many people over the years come in
very concerned about noise making of one of their joints.
- And that's what it is really, joint noise,
you know, if we want to generalize it.
And we're gonna talk about all the possible causes
and in the next video,
we're gonna show you some of the ways to get rid of it.
- Sure.
- So let's talk about number one, Brad.
Probably one of the common ones is cavitation.
- Cavitation. Oh!
Cavitation, you know, it's one of those things
that in physics, you know about it
because it has to do with a fluid.
- I hated physics. - I loved physics.
It was my favorite.
But you know, a boat propeller cavitates all the time
and if you look down, there's air bubbles
- Right. - behind the boat.
And that's because the water has cavitated
because of the vacuum created by the prop.
The same thing happens in your knee.
There's liquid in there, there's fluid in there
and there's a vacuum that's created,
and then the liquid goes into a gas
and that's the cavitation, and that makes a pop.
Isn't that interesting? - I don't know.
That explains it all right. - All this happens
in your joints and that's how chiropractors get rich
because they cavitate joints and it pops.
- Brad, be careful. - Ah, whatever. It's true.
Anyways, I'm not saying it's bad. It's just the cavitation.
But we should mentioned that clicking and popping
in our professional world, we call it crepitus.
- Well, it could be a whole lot of different things.
- It's not called crepitus? - Oh, yeah.
A crepitus is one of those. - It sounds good.
- Yeah. So anyway, it's like....
Are we talking about nitrogen
is the gas? - Yeah. Right. Right.
And that has to do with when you scuba dive,
you go down and when you come up too fast,
the nitrogen goes from a liquid to a gas
and that causes the bends.
See it all fits together. - Yeah. All right.
So I think this is something that my knee had for years
from young age on.
I remember when I'd go to church
and as a good Catholic boy, you had to kneel down
and then I- - Genuflect.
- Genuflect that my knee would always crack and so..
(Brad chuckles)
- You hear a lot of that
in a Catholic church - Crack!
- where people got to do that.
You know everyone's pretending to-
- All right, we'll move on, Brad, here.
Next thing, ligaments and tendons.
Some ligaments and tendons can catch
as a sly over a bony bump.
So one good example is the IT band.
So the IT band, if you look at the Stripe on my pants.
- Yeah, that's a good indicator.
- It runs all the way that.
It's a thick, heavy band
and it runs and it attaches below the knee.
So if it's tight or if it's adhesed down,
it can actually cause that band too,
when every time I straightened the knee
and I go back over this way,
it actually goes over the bump here
and it gives you possibly some pain after a while.
But you can also just do it at first, without any pain.
- [Brad] And you can put your finger right on there
and usually it could feel - some snap.
- [Brad] some of that bump when you go off.
- So again, at time, over time,
it can get irritated and actually cause pain.
So a number three, a cartilage tear.
You want to talk about that, Brad?
- Well, typically, we're talking about the meniscus.
- Right.
- Which is not like the highly encouraged.
- Right. Right.
We're talking about something that gets actually torn.
It's a little thicker and it can get folded in on itself.
- It can rip and cause a open spot.
There's a number of actually different terms
on how the meniscus can
- get hurt. - have lesions or a tore.
But yeah, that can be a problem.
And that's one that will cause the knee to actually lock up.
- It can.
It's like having a pebble in your shoe too
if you have a small piece of it back off.
- Yeah. Yeah, they call those floaters.
- Right.
- Floating around in the joint.
- And unfortunately, it can happen to you without injury
as you get older. - Yeah.
- Everything can happen to you as you get older, Brad.
- Yeah. - You know that?
We know that.
- The aging process is an adventure.
- Well, let's talk out the other one, Brad.
Osteoarthritis. Let's talk about that hyaline cartilage.
So at the end of the femur,
you have the bone and generally you want it
to be nice and smooth
so it can articulate. - Right.
It's very slippery, shiny, and white,
and then it starts to rust.
- It starts to rust. Its flakes is off.
It flakes off and it becomes roughened.
- Right.
- So all sorts of problems.
And that could give a clicking, popping,
grinding sounds. - Yes, Ooh.
- Oh, you've heard that before.
- So you know, osteoarthritis.
Osteo means bone.
Arthritis, arthron means the joint.
Itis means inflammation.
So there you go.
- Hey, very good, Brad. (claps) Remember that.
- That's how these terms come about.
- But a lot of clinicians may refer to this condition
as bone-on-bone - Yeah.
- because the hyaline cartilage wears away
and you're just hitting bone on bone
- And it can be very audible.
- All right, next one. Patellofemoral Pain Syndrome.
So you have your kneecap and what you may not realize
is that the knee cap actually moves up and down
when you bend the knee.
- Yeah, it's floating around there.
- It follows along in a canal.
There's like canal that it's made for it.
And if it's not running in that canal, right?
Let's say it's running off to the side,
one side or the other, - Yeah.
- [Bob] It can rough it up to the bottom of that kneecap
and it can start making sounds, you know.
It can get roughened up.
It can have grinding, popping, crunching, and you know.
You'll feel it too. I just had people do this.
Put their hand on the kneecap and go like this,
and you can feel it crunching.
- [Brad] Yeah, it's very a palpable if you will
or you can feel it.
- [Brad] Sometimes, that just wears out due to age too.
- Yeah.
And yeah, things maltracking of the kneecap.
It all adds up.
- The final reason why you might have...
One of the reasons why you may have popping
is if you were injured in your knee at one point
and you have scar tissue somewhere, you know,
it could be in the muscles, it could be in the ligaments,
whatever, - Yeah.
- that scar tissue could catch on the surrounding surface
and actually create some joint noise.
- Yeah.
For example, you'll get a knee injury when you're young
and the doctor more than likely say,
"You'll know this when you get older.
You'll have a higher likelihood of arthritis in that joint."
And then you'll say, "Oh yeah, whatever."
And then 30, 40 years older,
you'll remember that. - You'll remember that.
- You'll feel the pain and everything comes together.
- So, you know, the question is
when should you be concerned enough to see a physician?
- Good question.
- Generally, the rule of thumb
is if there's no pain, there's no swelling,
there's no locking, there's no weakness,
you generally don't have to see a physician.
Sometimes there's a little bit of caveats to that
because some of the things
are gonna probably develop with the pain,
but you don't know that.
You don't know which one's are which.
- Right. Right.
- So I would generally,
if you're not having any one of those problems;
pain, swelling, locking, or weakness,
I probably won't see a physician.
- Right. I just monitored, see if it gets worse over time,
because sometimes these things,
we're talking about that before,
it can improve over time.
- Yep, exactly smooth out.
- The body adapts and makes a different...
- Very good. Good point. - Yeah.
That's happened to me in a couple of occasions.
(Bob and Brad chuckles)
- Well, I had injuries.
So next one.
When this is a real worry,
if you're having injury, especially athletic injury,
and you hear a loud pop, that's not a good sign
and it's followed by pain, swelling, instability.
- Right, yeah.
- We're thinking then you may be tore a ligament,
or you tore a tendon,
and you are at that point gonna need to see a physician.
- Mm-hmm.
- You often hear that,
like somebody they'll say it out in a crowd,
like, "I heard a pop." - Yeah.
- when somebody got hurt on the field
or hurt on the basketball court, so...
- Yeah.
I always wonder about that,
- Really? - but I've never heard a pop.
- I've heard people say that all the time.
- Wow. People say a lot of things, Bob.
(Bob laughing)
But I certainly believe in the person whose body it is.
- That they feel it. - Yeah.
And they might hear it or a little bit of both.
One kind of feeds the other.
But no, I suppose people hear it.
- I heard a pop one time just when I turned my ankle bad
and I don't think I even tore it.
- And maybe it was just some cavitation that was audible.
- Yeah. - I should take it all back.
(Bob chuckles)
I'm just being a little...
- All right, on our next video,
we're gonna show you how to fix your knee
from clicking, popping, and creaking, so check it out.
It's part of the series.
- Oh right! Did we talk about the series?
Or was that the last of it? - We'll talk about it now.
We'll talk about the series right now.
- Okay.
- So this video is a part of a series of videos
on knee pain. - Right.
- [Bob] So go to BobandBrad.com,
go to the program section, look for the one on knee pain,
and you'll see this title,
"How to Fix Your Knee From Clicking, Popping, and Creaking".
- [Brad] You'll have to scroll through the videos
and the title will be there.
Pick out the title that fits your question.
Watch it for about 10 minutes.
There is a PDF clicker you can click on.
It'll print out a review and exercises
from the whole video. - You mean a link?
A PDF link?
- What did I say? - Clicker.
- Yeah, well, you know,
you click with that little thing on the mouse
and that's the clicker. - Yeah, that's all right.
- Well, Bob, we need to talk to people
that understand computers like me,
'cause there was a few of us. - Yeah.
- Anyways, good luck.
- All right, thanks for watching.
- It's free by the way. Not even in email.
- Yeah.
(upbeat music)