Have you ever heard clicking or popping noises coming from your ankles? Although ankle pops when walking or ankle cracking when rotating the joint can be annoying, this is typically harmless and of zero concern. Painful popping and cracking, on the other hand, can be caused by a variety of ankle problems, which are causes to seek an experienced orthopedic evaluation of your ankle. Crepitus, for example, refers to a grinding sensation that occurs from cartilage wear in the joint and arthritis. Loose fragments of bone or cartilage in the joint or areas of scar tissue may cause painful popping, cracking, or even a sensation of locking in the ankle. These are often referred to as mechanical symptoms and may even require surgery to effectively treat. Tendons in the ankle sometimes cause popping. The key component of this tendon popping and what to do and what it may mean remains the same: pain.
To determine what causes ankle clicking and popping, it helps to understand the anatomy of the ankle joint. In addition to bones, there are ankle ligaments and tendons that stabilize the joint and allow for movement.
The ankle joint involves three bones:
- Tibia. The tibia, or shinbone, is the larger, stronger bone of the lower leg and the bone that makes up the inside, or medial, aspectof the joint.
- Fibula. The fibula is the thinner lower leg bone that forms the outside, or lateral, aspect of the ankle joint.
- Talus. The talus bone is a smaller block-shaped ankle bone found between the lower end of your tibia and the top of your calcaneus, or heel bone. It is largely covered by cartilage and many different ligament attachments.
Working in conjunction with the ankle joint is the subtalar joint, which includes the talus and the calcaneus.
Many ligaments stabilize the ankle and subtalar joints, including:
- Anterior Inferior Tibiofibular Ligament (AITFL). This ligament runs between the tibia and the fibula and is often involved in syndesmosis or “high ankle” sprains
- Anterior Talofibular Ligament (ATFL) and Calcaneofibular Ligament (CFL). These two ligaments are important parts of the lateral collateral ligaments of the ankle that connect the talus, calcaneus and fibula. These ligaments help are the primary lateral stabilizers of the ankle joint and are often injured during lateral ankle sprains
- Deltoid. The deltoid ligaments has numerous components and helps tostabilize the inside medial ankle joint by connecting the tibia to the talus and calcaneus.
The ankle and subtalar joints also are surrounded by numerous tendons that attach muscles to the bones. The peroneal tendons, for example, are ankle tendons that are often a culprit in popping around the ankle. Sometimes these tendons may “pop in and out” or sublux around the fibula for painless and non-harmful (genetic anatomic variants, for instance) reasons, but in other cases this may represent tendon tears that are the result of an acute injury or a degenerative problem over time.
Why Does My Ankle Pop?
Joint popping is often a minor issue and nothing to be worried about. Gas release and rubbing in the joint are not a cause for concern. Injuries and popping accompanied by swelling or pain are more concerning and might require treatment.
Release of Gas Bubbles
Gas bubbles can be released in the ankle joint when it is moved, resulting in a popping sound. This is usually harmless and nothing to worry about. Gas bubbles form when synovial fluid within the joint becomes pressurized. When the joint moves, the pressure is released and gas bubbles are expelled from the joint, creating a popping sound.
Tendon rubbing can also cause ankle popping. When the tendons in the ankle joint rub against each other or against the bones, it can create a clicking or popping sound. This is sometimes caused by tightness in the muscles and tendons around the ankle joint, which can be caused by overuse or lack of stretching.
Stretching and strengthening exercises can help to reduce tension in the tendons and muscles, which can reduce or eliminate the popping.
Peroneal Subluxation or Dislocation
Peroneal subluxation or dislocation is a condition in which the peroneal tendons become displaced from their normal position behind the fibula bone. This can cause pain, swelling, and instability of the ankle joint. It is usually caused by an injury to the ankle joint, such as a sprain or fracture.
Osteochondritis Dissecans (OCD)
Osteochondritis Dissecans (OCD) is a condition that affects the ankle joint and can cause painful ankle popping. It occurs when the articular cartilage in the joint becomes damaged, leading to pain and swelling. This can also cause a feeling of joint instability when cartilage fragments become stuck and irritate the joint.
Preventing Ankle Cracking and Popping
Ankle popping can sometimes be prevented by taking steps to strengthen and stretch the muscles and tendons around the ankle joint. Exercises that strengthen the ankle include calf raises, balancing on one leg, and improving range of motion with ankle circles and rotations. Stretching exercises should focus on the calf, hamstring, and quadriceps muscles.
It is also important to wear supportive shoes with good support and to avoid activities that put excessive stress on the ankle joint, particularly if those activities cause symptoms
When to See a Physician About Ankle Popping
If you experience ankle popping that is accompanied by pain, swelling, or instability of the joint, it is important to seek medical attention by an experienced ankle provider. This could be a sign of an underlying injury or condition that needs to be treated.
Additionally, if you have had a recent ankle injury or surgery and experience a lot of clicking and popping as a result of the injury, you should see a specialist. If the popping persists despite stretching and strengthening exercises, it is best to see a physician for further evaluation.
If a popping ankle and other symptoms concern you, it is time to see an ankle specialist at EmergeOrtho—Triangle Region. Request an appointment, self-schedule, or call (919) 220-5255 to connect with one of our foot and ankle experts.