Why does my knee click?
Knee clicking, popping, cracking or grinding is one of the most common concerns people mention to a physiotherapist. It can happen when walking, squatting, climbing stairs, standing up from a chair, kneeling, running, or even just straightening the knee.
The good news is that knee clicking by itself is often not dangerous. Many healthy knees make noise, even in people with no pain, no injury and no major joint problem. In fact, current research shows that knee crepitus is common in the general population and can also be present in people without knee pain (Couch et al., 2025).
However, knee clicking can sometimes be a sign that the knee is irritated, overloaded, swollen, or not moving as well as it should. The important question is not just “does my knee click?” but rather:
Does the clicking come with pain, swelling, locking, giving way, stiffness or reduced function?
If the answer is no, it is usually less concerning. If the answer is yes, it is worth getting assessed.
At Trilogy Physiotherapy in Sinnamon Park, we regularly see patients from Oxley, Jindalee, Seventeen Mile Rocks, Mt Ommaney, Westlake, Middle Park and the wider Centenary suburbs who are worried about noisy knees. This blog will explain the common causes of knee clicking, when it matters, when imaging may be needed, and how physiotherapy can help.
What is knee crepitus?
The medical term often used for knee cracking or grinding is crepitus. Crepitus can describe a range of sensations, including:
- clicking
- popping
- cracking
- grinding
- crunching
- catching
- snapping
Sometimes it is loud enough for other people to hear. Other times, you may only feel it under your hand when bending and straightening the knee.
Knee crepitus can come from different structures, including the kneecap joint, cartilage surfaces, tendons moving over bony areas, small gas bubbles within joint fluid, or a swollen and irritated joint. It does not automatically mean that the knee is damaged.
A useful way to think about it is this:
Noise alone is not the problem. Noise plus symptoms is what matters.
Is knee clicking normal?
In many cases, yes.
Knees are not silent machines. They are living joints made of bone, cartilage, ligaments, tendons, muscles, joint fluid and soft tissue. As these tissues move, they can create sound.
Clicking without pain may occur due to:
- small changes in joint pressure
- tendons moving over bony points
- mild irregularity in joint surfaces
- normal movement of the kneecap
- previous injuries that have settled
- general age related joint changes
Research has also shown that imaging findings are common in people who have no knee pain. For example, MRI features associated with osteoarthritis can be found in asymptomatic knees, which means a scan finding does not always explain symptoms (Culvenor et al., 2019).
This is why a good clinical assessment matters. A physiotherapist does not just listen for clicking. They assess your pain, movement, strength, swelling, walking, stairs, squatting, sporting demands and injury history.
When should I worry about knee clicking?
You should consider seeing a physiotherapist, GP or appropriate health professional if your knee clicking is associated with:
- pain during or after activity
- swelling around the knee
- locking, where the knee gets stuck and cannot fully bend or straighten
- giving way or instability
- a recent injury or twist
- difficulty walking or weight bearing
- reduced range of motion
- worsening stiffness
- pain going up or down stairs
- pain with squats, lunges or running
- night pain that is not related to position
- redness, heat, fever or feeling unwell
Some symptoms require more urgent medical assessment. These include severe pain after trauma, inability to weight bear, significant swelling after an injury, fever with a hot swollen knee, suspected fracture, suspected infection, or calf swelling and pain that may suggest a clot.
For most people, however, knee clicking is not an emergency. It is usually something that needs a proper assessment and a sensible plan.
Common causes of knee clicking
There are many possible reasons your knee may click. Here are some of the most common.
1. Patellofemoral joint irritation
The patellofemoral joint is the joint between your kneecap and thigh bone. It is one of the most common sources of clicking, grinding and pain at the front of the knee.
Patellofemoral pain often feels like discomfort around or behind the kneecap. It may be worse with:
- stairs
- squats
- lunges
- running
- jumping
- getting up from a chair
- sitting with the knee bent for a long time
The 2019 clinical practice guideline for patellofemoral pain recommends that clinicians assess symptoms during tasks that load the kneecap joint, such as squatting, stair climbing and stair descent (Willy et al., 2019).
In practical terms, this means your physiotherapist should not only check your knee lying on a bed. They should also look at how you move.
At Trilogy Physiotherapy, we may assess:
- squat technique
- step downs
- single leg control
- hip strength
- quadriceps strength
- ankle mobility
- foot position
- walking or running mechanics
- training load
- recent changes in sport, gym or work activity
Patellofemoral pain often improves with education, load management, hip and knee strengthening, and gradually rebuilding tolerance to the activities that currently hurt.
2. Knee osteoarthritis
Knee osteoarthritis is another common reason for clicking or grinding, especially in adults over 40. It can also occur earlier, particularly after previous knee injury, surgery, high body load, or long term high impact sporting demands.
Symptoms of knee osteoarthritis may include:
- stiffness, especially after rest
- pain with walking, stairs or hills
- swelling
- reduced confidence loading the knee
- grinding or crepitus
- reduced range of motion
- flare ups after doing too much
A common fear is that clicking means the knee is “bone on bone” and that surgery is inevitable. This is often not the case. The 2024 Australian Osteoarthritis of the Knee Clinical Care Standard highlights that physical activity and exercise are important parts of managing knee osteoarthritis, and that exercise can be safe and beneficial when tailored appropriately (Australian Commission on Safety and Quality in Health Care, 2024).
The goal is not always to make the knee completely silent. The goal is to reduce pain, improve strength, improve function, and help you feel confident using the knee again.
3. Meniscus irritation or tear
The meniscus is a C shaped cartilage structure inside the knee that helps with shock absorption and load distribution. A meniscus problem can sometimes cause clicking, catching, pain or swelling.
There are two broad categories:
Traumatic meniscus injuries
These can happen during a twist, pivot, tackle, landing or sporting incident. They are more common in younger or athletic populations.
Degenerative meniscal changes
These are more common as we get older and may develop gradually. They can exist alongside knee osteoarthritis.
A meniscus injury may cause:
- joint line pain
- swelling
- catching
- pain twisting or pivoting
- difficulty squatting
- pain with stairs
- locking in more significant cases
Importantly, not every meniscus tear needs surgery. In adults with degenerative meniscal tears, high quality research has shown that exercise based physiotherapy can produce outcomes comparable to arthroscopic partial meniscectomy over the longer term (Noorduyn et al., 2022). A BMJ clinical practice guideline also strongly recommended against arthroscopy for most people with degenerative knee disease (Siemieniuk et al., 2017).
That does not mean surgery is never needed. True mechanical locking, significant traumatic tears, or complex presentations may require specialist opinion. But many meniscal presentations improve with a well structured rehabilitation plan.
4. Tendons snapping or moving over bony areas
Sometimes a knee click is not coming from inside the joint. It may come from a tendon or band of soft tissue moving over a bony point.
This can happen around the outside, inside, front or back of the knee. Some people describe it as a snapping sensation.
Common areas include:
- iliotibial band region on the outside of the knee
- hamstring tendons at the back or inside of the knee
- quadriceps or patellar tendon at the front of the knee
- popliteus tendon at the back outside of the knee
If there is no pain, swelling or loss of function, this type of clicking may be harmless. If it is painful or getting worse, physiotherapy can help identify whether it is related to training load, strength deficits, mobility limitations or movement patterns.
5. Ligament injury or instability
If your knee made a loud pop during an injury, followed by swelling, pain or giving way, it should be assessed.
This is different to a painless click during normal movement.
A pop at the time of injury may be associated with ligament injury, such as an ACL or MCL injury. Symptoms may include:
- immediate pain
- swelling within hours
- instability
- difficulty continuing sport
- trouble walking normally
- loss of confidence changing direction
In these cases, a physiotherapist can perform clinical tests and refer for imaging or medical review when required. Early assessment is important because the right management plan can reduce the risk of ongoing instability and secondary injuries.
6. Previous surgery or old injury
Knee clicking can also occur after previous injury or surgery, including ACL reconstruction, meniscal surgery, kneecap dislocation, fracture, or cartilage injury.
Some clicking after an old injury may be harmless. However, if it is associated with pain, swelling, weakness, reduced confidence, or difficulty returning to sport or gym, it may indicate that the knee has not fully regained strength, control or load tolerance.
This is where objective testing can be helpful. Strength deficits can persist long after pain settles, and many people return to activity before the knee is fully prepared.
Does knee clicking mean I have arthritis?
Not necessarily.
Knee crepitus can be more common in people with knee osteoarthritis, but it can also occur in people without pain or significant symptoms (Couch et al., 2025). This means clicking alone does not diagnose arthritis.
Osteoarthritis is usually diagnosed using a combination of:
- your symptoms
- age and history
- physical examination
- functional limitations
- imaging only when clinically needed
The 2024 Australian knee osteoarthritis standard advises that imaging is not routinely needed to diagnose suspected knee osteoarthritis, and that X-ray is generally the first line option when imaging is clinically warranted. MRI, CT and ultrasound are not recommended as first line tests for diagnosing knee osteoarthritis (Australian Commission on Safety and Quality in Health Care, 2024).
This matters because scans can show changes that may not be the cause of your pain. Treating the person, not just the scan, is the key.
Do I need an MRI for a clicking knee?
Most people with knee clicking do not need an MRI straight away.
An MRI may be considered when there are signs of a more significant injury, persistent symptoms that are not improving, suspected ligament injury, suspected meniscal tear with mechanical symptoms, or when the results would change management.
For many knee presentations, the first step is a thorough clinical assessment. This helps determine whether your symptoms are likely coming from the kneecap joint, meniscus, ligament, tendon, osteoarthritis, hip, back, or another source.
A scan can be useful in the right situation, but it should not replace good clinical reasoning.
What can physiotherapy do for a clicking knee?
Physiotherapy treatment depends on what is causing the clicking and whether it is painful. There is no single “clicking knee exercise” that works for everyone.
A good physiotherapy assessment may include:
- a detailed history of your symptoms
- checking swelling and range of motion
- assessing kneecap movement
- testing ligament stability
- screening for meniscal signs
- measuring quadriceps and hip strength
- assessing calf and hamstring capacity
- looking at squats, step downs, stairs or running
- reviewing training load and recent activity changes
- identifying when medical referral or imaging is appropriate
Treatment may include:
- education about what the clicking likely means
- advice on what to keep doing and what to temporarily modify
- progressive strengthening
- hip and knee control exercises
- balance and landing retraining
- running or sport specific progressions
- hands on treatment where appropriate
- taping or bracing in selected cases
- return to gym or return to sport planning
At Trilogy Physiotherapy, we focus on helping you understand the problem rather than simply telling you to rest. Rest may calm symptoms in the short term, but it often does not rebuild the strength, confidence and tissue capacity needed for long term improvement.
Should I stop exercising if my knee clicks?
Not automatically.
If your knee clicks but does not hurt, swell, lock or give way, you usually do not need to stop exercising. Many people can safely continue walking, gym training, running or sport while monitoring symptoms.
You may need to modify exercise if:
- pain increases during the activity
- pain is worse later that day or the next morning
- swelling appears
- your movement changes because of pain
- the knee feels unstable
- symptoms are worsening week to week
Modification does not mean complete rest. It may mean adjusting:
- depth of squats
- running distance
- hill or stair exposure
- jumping volume
- gym load
- training frequency
- exercise selection
- recovery time
A physiotherapist can help you find the right entry point so you can keep moving while the knee settles and gets stronger.
What exercises help a clicking knee?
The best exercises depend on the cause, but many clicking knees benefit from improving strength and control around the hip, knee, ankle and foot.
Common options may include:
- quadriceps strengthening
- glute strengthening
- calf strengthening
- step ups
- step downs
- sit to stands
- hip abduction work
- hamstring strengthening
- balance exercises
- controlled squats
- gradual running drills
- landing and change of direction work for athletes
The key is dosage. Too little may not create change. Too much may flare the knee. The right program should be matched to your symptoms, strength level, irritability and goals.
For example, a runner with clicking and pain going downhill may need a different plan to an older adult with knee osteoarthritis, or a teenager with anterior knee pain during sport.
When should you book a physiotherapy appointment?
It is worth booking an appointment if:
- the clicking is painful
- symptoms have lasted more than a few weeks
- you are avoiding stairs, squats, running or sport
- the knee swells after activity
- you feel unstable or unsure on the knee
- the knee locks or catches
- you are worried and want a clear explanation
- you have had a recent injury
- your knee is stopping you from exercising
You do not need to wait until the pain is severe. Early assessment can often help you understand what is going on, reduce fear, and stop a small issue becoming a longer term problem.
The bottom line
Knee clicking is common and is not always a sign of damage. Many knees click, crack or grind without pain or long term problems.
However, clicking that comes with pain, swelling, locking, giving way, stiffness, or reduced function should be assessed. The cause may be patellofemoral pain, osteoarthritis, meniscus irritation, tendon movement, ligament injury, or a combination of factors.
The aim of physiotherapy is not simply to “get rid of the noise”. The aim is to identify why your knee is symptomatic, improve strength and movement, guide safe activity, and help you get back to what you need and enjoy doing.
If you are worried about a clicking knee, Trilogy Physiotherapy can help with a thorough assessment and an evidence based management plan.
Book online or call Trilogy Physiotherapy on 3148 8785.
Frequently asked questions
Is knee clicking bad?
Not always. Knee clicking without pain, swelling, locking or giving way is often harmless. If the clicking is painful or associated with other symptoms, it is worth getting assessed.
Why does my knee click when I squat?
Clicking during squats may come from the kneecap joint, tendons moving, joint pressure changes, or irritation around the knee. If it is painless, it may not be a problem. If it hurts, your squat depth, strength, control and training load may need assessment.
Why does my knee click going up or down stairs?
Stairs load the patellofemoral joint more than level walking. Clicking with pain on stairs may be related to patellofemoral pain, quadriceps weakness, hip control, osteoarthritis or other knee irritation.
Does knee clicking mean I need surgery?
Usually not. Many causes of knee clicking improve with education, exercise and load management. Surgery may be considered in specific cases, such as true mechanical locking, major traumatic injury, or symptoms that do not improve despite appropriate care.
Can physiotherapy help knee clicking?
Physiotherapy can help if the clicking is associated with pain, weakness, swelling, poor movement control, reduced function or reduced confidence. Treatment depends on the underlying cause.
References
Australian Commission on Safety and Quality in Health Care. (2024). Osteoarthritis of the knee clinical care standard 2024. ACSQHC.
Couch, J. L., et al. (2025). Noisy knees: Knee crepitus prevalence and association with structural pathology. A systematic review and meta-analysis. British Journal of Sports Medicine, 59(2), 126.
Culvenor, A. G., Øiestad, B. E., Hart, H. F., Stefanik, J. J., Guermazi, A., & Crossley, K. M. (2019). Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured knees: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(20), 1268–1278.
Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care & Research, 72(2), 149–162.
Noorduyn, J. C. A., van de Graaf, V. A., Willigenburg, N. W., Scholtes, V. A. B., Poolman, R. W., & the ESCAPE Research Group. (2022). Effect of physical therapy vs arthroscopic partial meniscectomy in people with degenerative meniscal tears: Five-year follow-up of the ESCAPE randomized clinical trial. JAMA Network Open, 5(7), e2220394.
Siemieniuk, R. A. C., Harris, I. A., Agoritsas, T., Poolman, R. W., Brignardello-Petersen, R., Van de Velde, S., Buchbinder, R., Englund, M., Lytvyn, L., Quinlan, C., Helsingen, L., Knutsen, G., Olsen, N. R., Macdonald, H., Hailey, L., Wilson, H. M., Lydiatt, A., Kristiansen, A., Vermandere, M., … Guyatt, G. H. (2017). Arthroscopic surgery for degenerative knee arthritis and meniscal tears: A clinical practice guideline. BMJ, 357, j1982.
Willy, R. W., Hoglund, L. T., Barton, C. J., Bolgla, L. A., Scalzitti, D. A., Logerstedt, D. S., Lynch, A. D., Snyder-Mackler, L., & McDonough, C. M. (2019). Patellofemoral pain: Clinical practice guidelines. Journal of Orthopaedic & Sports Physical Therapy, 49(9), CPG1–CPG95.
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