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Knee Popping 
and Clicking
Is It Normal?
Difference Between Popping & Clicking During a Chiropractic Adjustment & Bending Your Knees
The majority of patients hear a popping and clicking sound during a chiropractic adjustment. This is known as a cavitation.  When a joint becomes misaligned or the joint becomes stiff gas can build up in the joint fluid.  When Dr. Sullivan adjusts the joint often you will hear a pop or click as the gas bubble releases. The gas bubbles are released and at the same time the spine is put back into position during a chiropractic adjustment.
Occasional popping and clicking is normal, however, if you have not always had joint clicking, and it is acute onset from particular sports, weightlifting, or other activities, it's important to reexamine the activity or seek medical attention to ensure that the clicking may not devolve into something insidious.
When patients have repetitive pops, clicks, cracks, and grinds in their joints, it is typically not normal or not an example of gas bubbles being released. The sounds you hear could actually be tendons rubbing over the bones and joints, or even bones rubbing over bones. Ligaments and tendons are soft tissues that are positioned around all the joints in our body. Sometimes, when you move a joint (eg your knee), a ligament or tendon may stretch slightly as it goes over a small bony lump around the joint and then snaps back into place making a popping sound. This is a condition known as crepitus. Crepitus is a crackling or popping sound that occurs as a result of tissues rubbing together abnormally, and can cause pain and discomfort.
Causes of Crepitus
The knees are two of the greatest weight-bearing joints in the body, and thus are subject to significant wear and tear and potential knee pain over the lifetime of an individual, and a a result crepitus can form. Crepitus is caused by tissues rubbing together in an abnormal way. The most common cause of crepitus is rough cartilage and bone rubbing together in a joint, and the most common cause of this type of crepitus is arthritis or joint injury.
Crepitus may be caused by rubbing of hard tissues including:
  • Cartilage tears or damage
  • Erosion of cartilage
  • Rough cartilage due to arthritis  
In most cases, injuries that cause crepitus can be boiled down to issues of: 
  • Posture
  • Biomechanics
  • Mobility
  • Muscle balance/tension relationships 
Crepitus and Osteoarthritus
Knee osteoarthritis is the most common form of osteoarthritis, and is caused by the deterioration of the protective articular cartilage in the knee joint. In terms of osteoarthritis, crepitus is a crunching feeling, like the sound of bone rubbing on bone.
Tell-tale Signs of Osteoarthritis:
  • Pain in one or more joints
  • Stiffness in joints
  • Swelling in joints
  • Crepitus in joints
What Dr. Sullivan Recommends for Treatment
Dr. Sullivan recommends that as a precautionary measure do not self adjust your own spine or other joints because you run the risk of making the situation worse.  Also nerves exit the spine near the joints and you can also irritate the nerves causing more pain and inflammation.


In terms of self help, strength training in the muscle areas that support the knees, such as your quads and hamstrings, will reduce the stress on the knee joint. Just as importantly, as your muscles strengthen from the exercises and become tight, stretching should be consistent in your workout routine. 
  • Exercises such as squatting correctly can work the quads, gluts, and hamstrings. 
    The couch stretch is effective for loosening up tight quads. 
  • Exercises such as deadlifts can strengthen the hamstrings. A great hamstring stretch includes standing on one foot, using your hips to bend over to touch the floor and kicking the other leg back straight. 
If you notice that your joints constantly pop or click it probably, even as you strengthen and stretch, it probably means the muscle tendons or ligaments in that area are very tight. To loosen up the tight muscle tendons and ligaments, Active Release Techniques and Graston Technique are effective to loosen up those muscles and ligaments. Once you loosen up the tight muscles, tendons and ligaments the amount of popping and click will resolve.  If the tendons or ligaments become painful and inflamed from the repetitive popping or clicking, laser therapy is a great treatment to heal the tendons or ligaments. 



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Note: The material provided in this newsletter is for informational purposes only. The opinions expressed herein may not always reflect the views of the NOVA Chiropractic, nor do they imply an endorsement. 
In This Issue
Is Popping and Clicking in the Knee Normal?
NOVA Chiropractic Blog Article
Can Poor Sleep Increase Your Knee Pain?
Time for Summer Athletes to be Mindful of their Knees
Laser Therapy
Ingredient of the Week
Stay Fit with Local Events
The Healthy Alternative
Contact Information
8992 Fern Park Drive
Burke, VA 22015
Office Hours
Mon  8:00 - Noon   2:00 - 7:00

Tues  8:00 - Noon  2:00 - 7:00

Wed  8:00 - Noon   2:00 - 7:00

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Fri      Closed 
Sat     Closed 
Sun    Closed 
Quick Links
K-Laser Therapy
 The Latest & Greatest at NOVA Chiropractic
The laser has proven to help dozens of patients at NOVA Chiropractic! Common conditions with current patients that laser therapy is helping to heal are:
  • Herniated discs
  • Knee arthritis
  • Carpel tunnel syndrome
  • Achilles tendinitis 
  • Neck and back pain
  • and much more!
For more information, call 703-912-7822 or email
Ingredient of the Week
Some foods contain antioxidants that are beneficial for knee osteoarthritis, almonds being one of them. Almonds contain Vitamin E, and its is known for its strong antioxidant power. 

Researchers found less vitamin E in the knees of the osteoarthritis patients, implying that they were getting less of the vitamin's protective benefits.

Almonds can be enjoyed raw, roasted, and made into almond milk. Try making homemade almond milk!

Stay Fit with 
Local Events!
08/03/13 - 08/04/2013 






2013 Seminars/Events 
Active Release Technique 

Re-Certification Seminar 

Iselin, New Jersey


Medicare Seminar

Richmond, Virginia


Health and Safety Fair

Fort Belvoir, VA


Health Fair at the Naval Research Laboratory

Washington, DC


The Healthy Alternative
The Healthy Alternative

A guidebook written by

Dr. Sullivan!

The Healthy Alternative: 

A Guide For A Pain-Free, Active Lifestyle empowers and educates the reader when confronted with back or neck on the treatment options available and integrating the safest, most effective ways to manage and prevent pain. Order Now!