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Is knuckle cracking on knee while doing physiotherapy normal?

Feb 2014
User rating for this question
Very Good
Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
My name is XXXXXXX 3 months ago (26th April) I fell down and fractured my tibia. I was diagnosed as follows

Comminuted fracture of superior end plate of lateral condyle of tibia (left leg).

I was wearing a cast for 3 weeks and was in no weight bearing for 12 weeks.
After that the doctor took an X ray and confirmed that the fracture is healing and advised partial weight bearing (not more than 35 kgs).
I have been doing physiotherapy for the last 6 weeks (active knee exercises and knee strengthening), with partial weight bearing walking.

When I do physiotherapy like quadriceps, I feel knuckle cracking on my knee or knee joints.
I want to know if this is abnormal or normal.
If it is abnormal, does it signify any problem, if yes what problem
Should I discontinue physiotherapy

I dont feel any pain and I feel a lot of improvement in bending my knee since doing physiotherapy.

I can upload my x-ray pictures if needed.

Kindly help
Posted Mon, 18 Aug 2014 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 51 minutes later
Brief Answer:
Do not worry, this is normal.

Detailed Answer:
Thanks for writing to us

Do not worry, this is normal. Sometimes as a normal phenomena, fluid (synovial fluid) that lubricate the joint release bubbles which pop and crackle with movement. This occurs very commonly after a period of inactivity or during certain movements. I am not sure if this is what you have, but this is my most likely explanation to your symptoms.

You don't need to worry if there is no associated joint pain. Continue doing physiotherapy and quadriceps exercises to improve the overall integrity of the joint - stronger muscle will take the weight of the joint and help to reduce the pressure on articulating surfaces, thus preventing any damage to the joint.

Hope this helps you. Let me know if you have any more concern.

Wishing you speedy recovery...

Warm regards.
Above answer was peer-reviewed by
Follow-up: Is knuckle cracking on knee while doing physiotherapy normal? 10 hours later
Hi Doctor,
Thanks for your response. There is no pain when the crackling noise comes. But occasionally, when I do exercises there is some amount of pain, this pain does not sustain and goes away when I continue physiotherapy.

For example, after some weeks of exercises I was recommended to wear ankle weights (not more than 2 KGs) and continue with the same exercises.
When I wear weights and lift my leg, there is some (bearable) pain but after 2 or 3 times I do the same exercises, the pain goes away and it is normal.

So when I do it first time for the day there is some pain (very negligible and completely bearable)

My major concern is the crackling noise, as it never came when there was excessive swelling. Now I can see the swelling has reduced (not completely gone, but reduced), and these crackling noise comes, thats why I was concerned.

Please let me know what will be your suggestion

Continue physiotherapy with 2kg weight despite the small amount of pain or do it without any weights.

Please let me know, if on a healing bone, for some reasons the bone cracks further, will it cause pain?

Thank you so much again for your assistance again.
Last time the conversation with you was very helpful to me, and I am hoping to get some advise this time also

Answered by Dr. Saurabh Gupta 27 hours later
Brief Answer:
There is nothing to worry.

Detailed Answer:
Sorry for late reply.

As there is no pain when the crackling noise comes, there is nothing to worry as I had already explained.

You can continue physiotherapy with 2 Kg weight if you are comfortable.

It will cause severe pain and you will be unable to bear weight, if the bone cracks further for some reasons.

Hope this helps you.

Take care.
Above answer was peer-reviewed by
Follow-up: Is knuckle cracking on knee while doing physiotherapy normal? 1 hour later
Hi Doctor,
Thanks again for the response. I am a lot relieved now.
I have only one more question after which I will close the discussion

Can I drive car?
My injury is on left leg, and left leg operates the clutch pedal. I have tried pressing the clutch pedal multiple times and tried to press and hold for some time (in a parked car for checking), I dont feel any pain. Please let me know if driving is also some kind of exercises or one should not drive until full weight bearing

Thanks again so much
Answered by Dr. Saurabh Gupta 2 hours later
Brief Answer:
You can drive car.

Detailed Answer:

You can drive car. As fracture is in healing stage and there is no any associated pain, there is no any harm in driving car.

Wishing you good health..

Warm regards.
Above answer was peer-reviewed by
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