If you can’t get up from a chair without your knees and hips sounding like popcorn firing off in a covered pot, congratulations! You’ve probably reached Level 40 and above in the Game of Life.
Your 40s are most likely the period when your joints start to make cracking sounds – although they can begin in your 30s if you have joint injuries, perform physically demanding work or sports, or have excess weight, said Adjunct Associate Professor Fareed Kagda, a senior consultant and the head of Ng Teng Fong General Hospital’s Orthopaedic Trauma Surgery.
“For some, it’s simply a natural quirk of their anatomy,” said Dr Jerry Chen, a senior consultant orthopaedic surgeon and the medical director of Alps Orthopaedic Centre.
It's a sound that can be both satisfying and worrying to hear. Satisfying because, well, it feels like you’ve released some tension in the joint, especially if you deliberately crack it yourself or have it done during a massage.
And worrying because you can’t help but think: Is this a sign of arthritis?
(Photo: iStock/utah778)
Are joints that snap, crackle and pop when you bend them considered unhealthy? Can glucosamine supplements protect them? And what about the things people warn you about such as running?
“Often, this sound comes from tiny gas bubbles in the joint fluid (synovial fluid) collapsing or bursting as the joint changes position,” explained Dr Chen. “Sometimes, the sound is due to tendons or ligaments moving over bony surfaces, especially if there’s a change in muscle tension.”
For instance, if your shoulders crack when you raise your arms to shampoo your hair, you could have tendon calcifications in those joints – and the cause of those clicking or grinding sounds. Interestingly, about 20 per cent to 30 per cent of people have a pain-free calcified tendon somewhere in their body. They often don’t require treatment, unless the tendon becomes painful or interferes with function.
In some cases, said Adj Assoc Prof Fareed, rough cartilage surfaces caused by wear or injury can cause a cracking or grinding sound known as crepitus. So yes, the sound could signal that your joint is not as healthy as you think it is.
There are over 100 types of arthritis, but they all mean one thing: Joint inflammation, said Dr Chen. The most common form of arthritis is osteoarthritis, which is caused by the age-related wear-and-tear of joint cartilage, he said.
As for the oft-heard “rheumatism” or rheumatoid arthritis that you often associate with the elderly, said Dr Chen, it is caused by an autoimmune condition attacking the joint lining – and not by cold drinks, cold showers or rainy weather.
Regardless of arthritis type, the symptoms include pain, stiffness (especially in the morning or after sitting), swelling or warmth, and reduced movement, said Adj Assoc Prof Fareed.
But is painless joint cracking – without the abovementioned symptoms – a sign of arthritis or an impending one? “Painless cracking does not cause or predict arthritis,” said Adj Assoc Prof Fareed. “Many healthy joints pop or click occasionally,” added Dr Chen.
(Photo: iStock/Andrey Popov)
If you have previous significant joint injuries, said Adj Assoc Prof Fareed. You are also more likely to have joints that sound like percussion if you have a family history of arthritis, are above the age of 50, or overweight.
“Being overweight increases the strain on your joints,” said Adj Assoc Prof Fareed. “For example, for every 1kg of weight loss, you’ll reduce the load on your knees by about 1kg to 2kg with each step.”
“If the cracking is paired with pain, swelling, stiffness, or loss of function, it may signal early cartilage changes from wear-and-tear or other causes,” said Dr Chen.
Also pay attention to your joint when the cracking occurs together with a sporting or twisting injury, said Adj Assoc Prof Fareed. Or when the joint catches, locks in a certain position, or feels like giving way.
“It’s worth seeing an orthopaedic specialist,” said Dr Chen, “who can assess the joint, confirm the diagnosis with imaging and recommend treatments – from physiotherapy to lifestyle changes, medication, injections and surgery – to help protect mobility and slow the progression of the symptoms.”
While persistent joint overuse can lead to clicking joints and increased risks of arthritis, recreational running or jogging is “not generally considered overuse”, said Adj Assoc Prof Fareed. Running does load the joints – about two to three times your body weight, said Dr Chen. “But healthy joints are designed to handle it.”
(Photo: iStock/Edwin Tan)
In fact, running offers a host of joint-friendly benefits. “Running strengthens the bone and muscles around the joints, improves lubrication and nutrition to the cartilage, and may reduce arthritis risk,” said Adj Assoc Prof Fareed. “Some studies have shown that recreational runners have a lower rate of hip and knee arthritis than sedentary non-runners.”
Can you still run if you have knee pain? Have it assessed first, suggested Adj Assoc Prof Fareed, especially if the pain regularly recurs. After the cause of your joint pain has been evaluated, discuss with your doctor the pros and cons of running versus other exercise options, he said.
Should you avoid running or jogging if you’re overweight to minimise loading your joints? “It’s not necessary for mild or moderately overweight individuals to avoid running,” said Adj Assoc Prof Fareed. “Running can help with fitness and weight loss, which benefits the joints. But if running is painful for your joints, substitute it with low-impact options like brisk walking, cycling, swimming or cross-training that can provide low-impact cardio training for weight loss.”
Start slow, build gradually, and run on soft surfaces such as the stadium tracks, advised Adj Assoc Prof Fareed.
(Photo: iStock/Svetlana-Cherruty)
As for braces for the knees, ankles, wrists and elbows, for example, Dr Chen highlighted that they’re not a one-size-fits-all solution. “A brace may provide temporary support, especially after injury or with mild instability, but long-term reliance without strengthening the muscles can weaken joint support.”
Be discerning of soft-soled or cushioned running shoes, too. While such shoes can reduce joint impact for some, “overly soft soles may alter movement and cause other issues”, cautioned Dr Chen. “The best footwear choice depends on your foot type, activity and joint condition, which are ideally assessed by an orthopaedic or sports medicine professional.”
The jury is still out on this one, according to both experts. “Some patients notice less discomfort and better mobility; others see no change,” said Dr Chen. Moreover, “any benefit is usually modest and more likely in mild to moderate osteoarthritis than advanced cases”.
One thing's for certain: Glucosamine supplements are not a cure or prevention for arthritis, said Adj Assoc Prof Fareed. “It won’t rebuild cartilage. It doesn’t work for everyone. Benefits, if any, are mild.”
(Photo: iStock/Sveta615)
And it applies to the various forms of glucosamine such as glucosamine sulphate, glucosamine hydrochloride and N-acetyl glucosamine. “All the add-on ingredients may not make a difference,” said Adj Assoc Prof Fareed.
But if you’re keen to give the supplement a shot, “glucosamine sulphate has the strongest support in orthopaedic literature for knee osteoarthritis”, said Dr Chen, “though benefits are modest and not guaranteed”.
As for the dosage and duration, “many studies use about 1,500mg daily, with any improvement often taking several weeks to appear”, said Adj Assoc Prof Fareed. “I do not routinely prescribe glucosamine but if the patient requests, a three-month trial is harmless. If no benefit is noticed, the patient can stop after that.”
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Your 40s are most likely the period when your joints start to make cracking sounds – although they can begin in your 30s if you have joint injuries, perform physically demanding work or sports, or have excess weight, said Adjunct Associate Professor Fareed Kagda, a senior consultant and the head of Ng Teng Fong General Hospital’s Orthopaedic Trauma Surgery.
“For some, it’s simply a natural quirk of their anatomy,” said Dr Jerry Chen, a senior consultant orthopaedic surgeon and the medical director of Alps Orthopaedic Centre.
It's a sound that can be both satisfying and worrying to hear. Satisfying because, well, it feels like you’ve released some tension in the joint, especially if you deliberately crack it yourself or have it done during a massage.
And worrying because you can’t help but think: Is this a sign of arthritis?
(Photo: iStock/utah778)
Are joints that snap, crackle and pop when you bend them considered unhealthy? Can glucosamine supplements protect them? And what about the things people warn you about such as running?
WHAT’S CAUSING YOUR JOINT TO “CRACK” IN THE FIRST PLACE?
“Often, this sound comes from tiny gas bubbles in the joint fluid (synovial fluid) collapsing or bursting as the joint changes position,” explained Dr Chen. “Sometimes, the sound is due to tendons or ligaments moving over bony surfaces, especially if there’s a change in muscle tension.”
For instance, if your shoulders crack when you raise your arms to shampoo your hair, you could have tendon calcifications in those joints – and the cause of those clicking or grinding sounds. Interestingly, about 20 per cent to 30 per cent of people have a pain-free calcified tendon somewhere in their body. They often don’t require treatment, unless the tendon becomes painful or interferes with function.
In some cases, said Adj Assoc Prof Fareed, rough cartilage surfaces caused by wear or injury can cause a cracking or grinding sound known as crepitus. So yes, the sound could signal that your joint is not as healthy as you think it is.
ARE NOISY JOINTS A SIGN OF EARLY ARTHRITIS?
There are over 100 types of arthritis, but they all mean one thing: Joint inflammation, said Dr Chen. The most common form of arthritis is osteoarthritis, which is caused by the age-related wear-and-tear of joint cartilage, he said.
As for the oft-heard “rheumatism” or rheumatoid arthritis that you often associate with the elderly, said Dr Chen, it is caused by an autoimmune condition attacking the joint lining – and not by cold drinks, cold showers or rainy weather.
Regardless of arthritis type, the symptoms include pain, stiffness (especially in the morning or after sitting), swelling or warmth, and reduced movement, said Adj Assoc Prof Fareed.
But is painless joint cracking – without the abovementioned symptoms – a sign of arthritis or an impending one? “Painless cracking does not cause or predict arthritis,” said Adj Assoc Prof Fareed. “Many healthy joints pop or click occasionally,” added Dr Chen.
(Photo: iStock/Andrey Popov)
WHAT CAN INCREASE THE CRACKING AND POPPING SOUNDS?
If you have previous significant joint injuries, said Adj Assoc Prof Fareed. You are also more likely to have joints that sound like percussion if you have a family history of arthritis, are above the age of 50, or overweight.
“Being overweight increases the strain on your joints,” said Adj Assoc Prof Fareed. “For example, for every 1kg of weight loss, you’ll reduce the load on your knees by about 1kg to 2kg with each step.”
WHEN SHOULD YOU BE CONCERNED?
“If the cracking is paired with pain, swelling, stiffness, or loss of function, it may signal early cartilage changes from wear-and-tear or other causes,” said Dr Chen.
Also pay attention to your joint when the cracking occurs together with a sporting or twisting injury, said Adj Assoc Prof Fareed. Or when the joint catches, locks in a certain position, or feels like giving way.
“It’s worth seeing an orthopaedic specialist,” said Dr Chen, “who can assess the joint, confirm the diagnosis with imaging and recommend treatments – from physiotherapy to lifestyle changes, medication, injections and surgery – to help protect mobility and slow the progression of the symptoms.”
CAN RUNNING CAUSE KNEES TO "CRACK" AND LEAD TO ARTHRITIS?
While persistent joint overuse can lead to clicking joints and increased risks of arthritis, recreational running or jogging is “not generally considered overuse”, said Adj Assoc Prof Fareed. Running does load the joints – about two to three times your body weight, said Dr Chen. “But healthy joints are designed to handle it.”
(Photo: iStock/Edwin Tan)
In fact, running offers a host of joint-friendly benefits. “Running strengthens the bone and muscles around the joints, improves lubrication and nutrition to the cartilage, and may reduce arthritis risk,” said Adj Assoc Prof Fareed. “Some studies have shown that recreational runners have a lower rate of hip and knee arthritis than sedentary non-runners.”
Can you still run if you have knee pain? Have it assessed first, suggested Adj Assoc Prof Fareed, especially if the pain regularly recurs. After the cause of your joint pain has been evaluated, discuss with your doctor the pros and cons of running versus other exercise options, he said.
Should you avoid running or jogging if you’re overweight to minimise loading your joints? “It’s not necessary for mild or moderately overweight individuals to avoid running,” said Adj Assoc Prof Fareed. “Running can help with fitness and weight loss, which benefits the joints. But if running is painful for your joints, substitute it with low-impact options like brisk walking, cycling, swimming or cross-training that can provide low-impact cardio training for weight loss.”
Start slow, build gradually, and run on soft surfaces such as the stadium tracks, advised Adj Assoc Prof Fareed.
(Photo: iStock/Svetlana-Cherruty)
As for braces for the knees, ankles, wrists and elbows, for example, Dr Chen highlighted that they’re not a one-size-fits-all solution. “A brace may provide temporary support, especially after injury or with mild instability, but long-term reliance without strengthening the muscles can weaken joint support.”
Be discerning of soft-soled or cushioned running shoes, too. While such shoes can reduce joint impact for some, “overly soft soles may alter movement and cause other issues”, cautioned Dr Chen. “The best footwear choice depends on your foot type, activity and joint condition, which are ideally assessed by an orthopaedic or sports medicine professional.”
SHOULD YOU TRY GLUCOSAMINE SUPPLEMENTS?
The jury is still out on this one, according to both experts. “Some patients notice less discomfort and better mobility; others see no change,” said Dr Chen. Moreover, “any benefit is usually modest and more likely in mild to moderate osteoarthritis than advanced cases”.
One thing's for certain: Glucosamine supplements are not a cure or prevention for arthritis, said Adj Assoc Prof Fareed. “It won’t rebuild cartilage. It doesn’t work for everyone. Benefits, if any, are mild.”
(Photo: iStock/Sveta615)
And it applies to the various forms of glucosamine such as glucosamine sulphate, glucosamine hydrochloride and N-acetyl glucosamine. “All the add-on ingredients may not make a difference,” said Adj Assoc Prof Fareed.
But if you’re keen to give the supplement a shot, “glucosamine sulphate has the strongest support in orthopaedic literature for knee osteoarthritis”, said Dr Chen, “though benefits are modest and not guaranteed”.
As for the dosage and duration, “many studies use about 1,500mg daily, with any improvement often taking several weeks to appear”, said Adj Assoc Prof Fareed. “I do not routinely prescribe glucosamine but if the patient requests, a three-month trial is harmless. If no benefit is noticed, the patient can stop after that.”
Continue reading...