You squat down to sit on the floor, you get back up, and you hear crackling noises like a rice crispy. Or maybe you are walking up or down stairs and you hear a popping or clicking noise. Where is that noise coming from?
What you are hearing is your knees, or more specifically, your patella (knee cap), that is usually out of alignment. It is not tracking properly in its joint, causing the noises you are hearing when you bend and straighten your knees. The action is usually not painful, just noisy and may cause you some alarm when you first hear it. Even though it is not painful, you shouldn’t ignore it. Your body is telling you that it is out of alignment and needs fixing. If it does become painful or the knee becomes swollen, see your doctor, as you may have a more serious injury.
How does the knee cap become out of alignment? The most common reason for your patella to be out of alignment is due to an imbalance of your muscles. The main muscles that affect the knee are the Quadriceps, the four major muscles that make up your thighs. Often times, the outside quadriceps, the Vastus Lateralis, are much stronger than the inner quadriceps, the Vastus Medialis. Both attach at either side of the knee area. When one is stronger than the other, it pulls the patella out of alignment, causing the knee to not properly track in the joint, and thus leading to the noises you are hearing. Other muscle imbalances are if your Quadriceps are stronger than your Hamstrings (the 3 main muscles on the back side of your upper leg), or if your IT Band is overly tight, pulling your patella off to the lateral side.
So how do you fix your knee popping and crackling noises? There are two parts to correcting the imbalances. To help correct the muscle imbalances, you need to release and relax the tightened muscles and strengthen the weaker ones. Some of the best forms of releasing and relaxing the stronger and tighter muscles are massaging, stretching, and using a foam roller, and even using a tennis or lacrosse ball to roll on to help break up any adhesions, relax the muscles, and lengthen the muscles.
To strengthen the weaker muscles, you need to focus on the specific muscles that need strengthening. Doing isometric contractions of the quadriceps will help strengthen your Vastus Medialis. You need to focus on strengthening the inner part of your thighs. Leg extensions and leg lifts are both great to try. Leg extensions are easiest to do while sitting up straight in a chair. Extend one of your legs out to be parallel to the floor and point your toes up toward the ceiling. Contract your quadriceps and hold for several seconds before relaxing your legs. Repeat several times before switching to the other leg. Leg extensions are best sitting on the ground with your back against a wall. Sit on the ground, with your back again a wall and your legs stretched out straight in front of you. Flex your feet so your toes are point up the ceiling (at the 12 o’clock position). Contract the quadriceps and try to lift that leg up off the floor an inch and slowly lower it back to the ground. Repeat multiple times, then relax your leg and repeat on the other leg. For more ideas you can check out this page on other at home or in the gym strengthening ideas: http://www.healthline.com/health/fitness-exercise/vastus-medialis-exercises#8
It’s also important to make sure you strengthen your hamstrings to make sure that your quadriceps are not over powering and causing the imbalance there as well. Practicing doing deadlifts and bridge work are both great at this. For bridge work, you may either do static holds in the bridge position, or you may add leg extensions while holding your bridge for added focus on your Vastus Medialis.
In most cases, correcting the imbalance of your muscles will help alleviate the snap, crackle, and popping noises you are hearing whenever you bend and flex at your knees. This may take a few weeks of daily practice of correcting the imbalance before you no longer hear the popping and clicking noises, and it may reoccur again in the future. If you start to feel pain or notice swelling around the knee joints, go to the doctors to check to see if you have a more serious injury that needs to be addressed.
I talk a lot about self-care, mainly because I know how extremely important it is to do. In our demanding, busy, fast-paced lives, we need to remember to take time out to take care for ourselves. That is where healing begins and wellness can be achieved. If we constantly stay in the go-go-go, do-do-do, give-give-give mindset, we begin to loose ourselves, our energy, and our health.
I was reminded of this, yet again, over the past couple of months. This winter seemed to really have taken its toll on everyone this year, myself included, but even more so, on my employees that I manage at a massage clinic. I was noticing that they all seemed to be more worn down, stressed, emotional, tired, getting sick more frequently, and even had some wrist and hand injuries that were bothering them. In our monthly staff meetings, I like to talk about ways to be a better therapist, best practices, inspire them to look and start planning the directions of their future massage careers, and to discuss any issues or problems that they run across that they want to address or learn more about. In April I was concerned about their self-care regimes. All work multiple jobs and are in constant go mode. I brought up the topic of self-care to them. I asked them if they would like to talk a little bit about it and to have it as a main discussion topic in our next meeting. All eagerly responded with a resounding, “YES”! We talked briefly about what self-care was and about the importance of not only physical self-care, but emotional self-care. I then gave them the assignment to come to our next meeting with a list of some things that they do for both physical and emotional self-care, and to be prepared to share them with each other.
Self-Care in General: Self-care is an active role of engagement done to promote one’s own health to obtain and maintain optimal overall health and wellness. Doctors like to prescribe self-care in forms of regular exercise, eating a balanced diet, drinking enough water, getting plenty of sleep, and avoiding smoking and alcohol. Self-Care, however, is a combination of actively taking the time for yourself to address the physical, mental, emotional, and spiritual self. Some of these categories overlap, and for simplicity of my discussion, I broke them into two focus points of physical and emotional.
Physical Self-Care: Physical self-care is what most people initially think of when they hear about self-care. Taking the time to exercise, eat healthy meals, drinking water, getting plenty of sleep each night…after all, this is what your doctor tells you about. It is very important to take care of our bodies. We only get one to live in, so we need to take care of it and maintain it, just like we would with a car. Routine care and maintenance will help keep it running better and for longer.
Emotional Self-Care: Emotional self-care is a little more abstract or a foreign concept for people. I tend to combine emotional and mental together, for they tend to go hand in hand with each other. How we feel and how we think have a direct effect on our overall health. Our emotional and mental state allows us to cope with stress and to overcome obstacles in our everyday lives. If we do not take care of our emotional and mental self, we can easily become overwhelmed, angry, depressed, develop headaches, muscles tension, and lead us to a compromised immune system, allowing us to become susceptible to disease and illness. Everyone needs to remember to take time out and address their emotional/mental self. Healing from within, leads to healing without. If you feel good and are happy, you will enjoy life more, be able to handle your daily stressors with greater ease, and want to be more physically active and to participate in your overall health.
Things we do for self-care; physically and emotionally: I was very pleased with the thoughtfulness and energy that my employees gave this assignment of sharing what they do for self-care. It was a good reminder for them to actively think about and participate in their own self-care and to be able to give and share ideas that others may benefit from and apply to their own lives. Here are some of the things we do for self-care:
What are some ways that you practice self-care? Take a minute or two and write down what you do to help promote your overall health and well-being. It may be something as simple as cooking or baking, entertaining friends and family, or giving and receiving hugs. Maybe some of our ideas can be applied to your life, or maybe they inspire you to do more. Take the time to care for yourself, so that you can then continue to help take care of others in your life (and be there for support), and to lead you to a healthier, and happier life.
In April, I took an intro course in Fijian Massage. As an Ashiatsu Practitioner (a barefoot massage modality), I was curious and wanting to learn more about other styles of barefoot massages. This led me to looking into Fijian Massage. Like Ashiatsu, it is a style of deep pressure massage that is done solely by the feet, rather than the hands, and has been westernized to achieve a more comfortable experience for both the client and therapist.
Fijian Massage was founded by Lolita Knight, who had lived in New Zealand and Fiji for about 20 years. While there, she discovered and learned this barefoot massaging technique that had been passed down from generation to generation, from a local village doctor. She then took this style and modernized it be more adaptable and comfortable for Westerners.
Fijian Massage is typically done with the client fully clothed and lying on the floor or on a mat and utilizes all aspects of the therapist’s feet to deliver a deep tissue massage while sitting or standing. The therapist never fully stands or walks on you. When standing, they use one foot at a time, and the two footed techniques are done while the therapist is sitting or lying down. The client is lying comfortably on the ground with pillows or cushions for added support and comfort while receiving their massage, allowing them to fully relax and enjoy the deep tissue work. By using the feet, the massage is a lot deeper, with more pressure, and has the ability to move the facial tissue and muscles, breaks up adhesions, and increase mobility, all with a gentler and less sharp or pointed feeling than you may get from a therapist who uses their hands and elbows.
Some benefits of receiving Fijian Massage:
Fijian Massage is a form of deep tissue massage and sports massage, as well as relaxation massage. Each session is geared to each individual’s needs and goals. It is great for athletes, office workers, those who simply like a deeper pressured massage, or those who prefer to remain clothed. Fijian is not ideal for those who are pregnant, have osteoporosis, phlebitis, or varicose veins. As always, if you have any health issues/concerns, or recovering from an injury or surgery, you should always check with your physician to make sure that you can receive a direct, deep pressured massage.
Courtney Truax, LMT is a graduate of East West College of the Healing Arts in Portland, Oregon. She is licensed through the Oregon Board of Massage Therapy and a member of the American Massage Therapy Association. She has her own studio massage practice in the heart of downtown Lake Oswego, Oregon.