It's because the tendon is not gliding smoothly in the sheath.' 'The sheath of the tendon gets irritated and swells really significantly and you get this real grinding noise. It commonly occurs in the Achilles tendon at the back of the ankle В– especially in long-distance runners В– or in the long tendon in your forearm (often seen in weekend kayakers). This usually happens only when the tendon is quite inflamed from repetitive movement, so you will probably notice the pain before the noise. Tendons rubbing over bones can also cause crepitus. Some forms of painful crepitus might be helped by physiotherapy to correct muscle weaknesses affecting the stability of joints. But it would be wise to minimise high-impact activities В– sports like basketball, netball or anything involving repetitive jumping В– which can aggravate symptoms and possibly speed up the deterioration in cartilage. This is because cartilage has a poor supply of blood and 'relies on movement to milk blood in and out' and so, obtain nutrients. In rare cases it can be caused by a fracture the two broken fragments of bone rubbing together is what makes the noise.Д«ut if worn cartilage is thought to be the cause, you should try to continue to be as active as possible, Vagg says. Severely painful crepitus is best checked out by a health professional. It seems to depend on how pain signals are amplified or dampened down in the brain but no-one's sure what influences that. Osteoarthritis is primarily controlled by your genes, although keeping your weight under control can help reduce symptoms.Д¬onfusingly, your degree of cartilage degeneration may not correlate closely with the amount of pain you feel, Vagg says. Unfortunately, once you become aware of these grinding sounds, there's little you can do to prevent further cartilage deterioration. This is osteoarthritis and the noise is most common in the knee and the neck. The creak and grind of crepitus occurs when the rough surfaces or exposed parts of bone rub against each other. When cartilage deteriorates it creates a rough surface and can even leave parts of bone exposed, Vagg says. While pops are probably innocuous, other rubbing or grinding noises, known as 'crepitus', can be a sign of damaged cartilage or inflammation. Muscle tightness in the neck can also cause these pops: 'As you try to turn your neck, there is resistance, which builds up pressure in the joint and then the joint moves suddenly and creates a pop.' Rubbing and grinding The same movement with a bit more weight on the joint, changes the volume more quickly so it happens.' 'For example, my ankle sometimes cracks when I run,' says Vagg.'It doesn't crack when I walk. But it has to be rapid the same movement done more slowly won't produce a crack. Any movement that causes a sudden change in joint volume will do it. But you don't have to crack your knuckles to create these sounds. ('Well, it's the best hypothesis anyone's come up with' Vagg says.) And the evidence from long term knuckle crackers is that it's harmless. This is thought to be the source of the sound produced when you crack your knuckles. And it's the popping that makes the snapping sound'. The resulting pressure and volume change, 'pulls some dissolved gases out of solution and the gases make bubbles that are unstable and pop. These are thought to occur when the fluid-filled sac within joints gets stretched by a sudden change in joint position. The most common noises are what he calls 'benign pops or high-pitched snaps'. But he admits it's hard to give a blanket answer because there are so many different sorts of sounds. Usually, if there are no other symptoms, you don't need to lose sleep over noisy joints, says Vagg, who is also a pain specialist with Victoria's Barwon Health. There's no denying the joints in our bodies can make a weird and wonderful array of perplexing sounds, says Dr Michael Vagg, a lecturer in medicine at Victoria's Deakin University.Д«ut do we need to see someone about those strange snaps, pops or crunches or are noisy joints better ignored? Do your knees creak? Does your neck crack? Do you get clicking noises in your ankles, wrists or hips?ДЄre you worried these noises are a harbinger of arthritis, or some other debilitating condition that sometimes accompanies advancing years?

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