I recently had a patient who came in for neck pain. When I asked her my usual follow-up question of what else she might have going on, she expressed significant concern about clicking in her knee during exercise. Her concerns were well-founded. Clicking in the knee, or any joint, may be of little significance or it could be something serious.
On the more favorable end of the scale, knee clicking may simply be a tendon passing over a bony surface. This is completely harmless. Moving up the scale a bit, I have found in many cases the clicking is coming from the patella, the kneecap, tracking improperly during leg movement. The occasional pop is fairly harmless. But if it is consistently clicking and popping during movement, it is indicative that the kneecap is moving too much to one side or the other as it goes through the normal up-and-down movement. This often comes about as a result of muscle weakness in the quadriceps-the thigh muscles. If this is the case, some quadriceps strengthening exercises are in order. For patients such as this I will also adjust the knee to correct the alignment of the knee and the kneecap itself. I will look at the ankle and feet. A flattening arch of the foot that is not supported properly can cause rotation of the entire leg as the foot rolls inward. This will also affect the tracking of the kneecap.
On a more serious end of the scale, a tear in a meniscus can cause clicking. The menisci are two half-moon shaped spacers that act as shock absorbing cartilage within the knee. A tear in this area is actually fairly common with increasing age. Most people who have meniscus tears are asymptomatic. For those who have pain due to meniscus tears, knee surgery to remove the torn portion used to be common. However, this type of surgery has increasingly been found to be ineffective and, in fact, results in more arthritic changes of the knee down the line. Studies have found physical therapy to be more effective. As a chiropractor, I can also treat knee conservatively by correcting any misalignments. Even though physical therapy or chiropractic will not fix the tear, restoring proper alignment and mobility to the knee can help symptoms tremendously.
Clicking during activity can also come from loose ligaments. If one or more ligaments of the knee are loose or torn, the knee will lose stability. This type of clicking due to excess motion can also result in arthritic changes to the knee. Addressing the torn ligament can be a bit more involved, but even here chiropractic can help with the symptoms and function of the knee.
A good rule of thumb to go by is that if the knee does not hurt or swell due to the clicking it will tend to be a less serious problem than if the clicking results in increased pain or swelling. In the case of the latter, a consultation with a health care professional is recommended.