Clicking knees and related pain in patellofemoral syndrome

knee clickingHaving recently been asked about clicking during squats, and how it relates to knee pain and the overall effects of patellofemoral syndrome, it seems like an apt time to revisit this topic. Clicking knees, with or without pain, can be very disconcerting, and it’s not something that’s always commonly understood. It is not uncommon to experience clicking even if you do not have knee pain. This can happen when there is a short section of the knee’s range of motion with poor tracking but the rest of the range is otherwise fine, so that the patella is not uniformly tight and painful throughout. The cracking is the sound of the air in the joint popping as the patella quickly moves into a new position. So why does this happen, and what can be done about it?


Why knees click

The reason for the quick move of the patella will be specific to the case at hand, but is almost always because the body’s mechanics are not entirely correct. For example, in my own training, I now know automatically when I am not orientating the left side of my pelvis properly in the squat as I too, will then get a painless crack in my left kneecap. On the subsequent rep this cues me to think about seeking out the proper stretch in my left hip-capsule, waking up my hip flexors on the left side and thinking of the feel of the left side of my lower back as I squat. This will then reward me with a click-free rep. But this is just my example, different people can have a variety of different biomechanical reasons for the problem which need to be identified and corrected.


Clicking in different exercises

You may find that different exercises bring about clicking in your knees – for instance in sissy squats but not squats, or vice versa. This is, of course, symptomatic of whichever movement is bringing about imperfect tracking.

It’s difficult to read too much into the clicking with sissy squats versus less clicking with bodyweight squats situation, but in such an example it could be that there is a good element of postural positioning that you are conscious of when doing bodyweight squats that you do not consider when doing sissy squats. Sissy squats are a very difficult exercise to explain in words or even pictures and videos – most people don’t really get them right until I talk them through how to do them live in a training session. And without getting it right, any number of minor body mechanics imperfections may be possible.

If you do experience knee clicking, in any movement, try slowing to a stop just before the first click is expected and then going into that range ultra-slowly, keeping great concentration on feeling as much tension through the target muscles as possible to try to keep the right level of activation to stop the click being needed.

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