3 Reasons Why Ankle Cracking When Rotating is Normal (and When It’s Not)

That cracking sound, also known as crepitus, happens in a lot of our joints. You’ve likely heard it from your shoulders, knees, and, of course, your ankles. Having said that, ankle cracking when rotating is usually normal.

But, it might also be a symptom of injuries and conditions, including bony lesions and cartilage wears.

Today, we dive deeper into that cracking sound. Here’s what you’ll find here:

Why does my ankle crack when I rotate it?

There are 3 reasons why it’s normal that your ankle makes that snapping sound (1):

  1. Gas bubbles in your joint
  2. Friction between tendons and ligaments from tight muscles
  3. The roughness of joint segments

Each of these can be present in your other joints – from your shoulders, your knees, and down to your ankles – but crepitus also gets more and more noticeable as you age.

When are the cracking sounds considered bad?

It all depends on whether or not you have foot and ankle pain.

You see, structures around your ankles naturally glide against each other, so friction and the occasional crack are a given.

But, when you have an injury, it also throws off your ankle’s mechanics, leading to ankle pain. As a matter of fact, research says that about 18% of popping sounds come from an ankle injury.

3 ankle injuries that cause joint popping (and how to treat them)

1. Peroneal tendon subluxation

Your peroneal tendons run along a groove on the side of your calf bone and attach to your outer foot. It helps turn your foot outwards and provides ankle stability whenever you walk. Your peroneal muscles are also the first to resist uncontrolled ankle inversion. (3)

But, 51% of the time, ankle sprains can damage the protective sheath of these tendons. (4)

This makes your peroneal tendon slipping outside its grooves more likely. When it snaps back to its original position, that’s when the clicking sound happens.

Treatment for peroneal tendon subluxation

  • RICE (Rest, Ice, Compression, Elevation) therapy. This is useful during the initial onset of your injury to help manage ankle pain, swelling, and discomfort.
  • Physical Therapy. A physical therapist won’t be able to directly repair the damaged covering but they can help strengthen your ankles, improve your balance, and improve mobility. In turn, this helps limit your peroneal tendons rubbing against your bone.
  • Surgery. Ankle surgery is the only way to repair the damaged protective sheath. Your orthopedic surgeon can also deepen the groove where the tendons run through.

2. Osteochondral lesions

Aside from ligaments, your ankles also have cartilage that helps absorb impact from walking. This connective tissue also allows smooth gliding between the bones of your ankle.

Now, an ankle sprain can damage your ligaments. But, when the sprain is severe, the injury can also chip off parts of your ankle cartilage from the bone, hence what’s called osteochondral lesions.

These small bits of cartilage float around your joint capsule and get stuck between your ankle joints.

The ankle popping when rotating your ankle comes when the loose fragments get unstuck.

Treatment for osteochondral lesions

  • Nonsurgical approach – This includes immobilizing your ankle, non-weight bearing, and the optional medication (NSAIDs). Note that conservative treatment only works about 45% of the time. (5)
  • Surgery – Ankle arthroscopy reduces ankle popping and removes the loose debris inside your ankle joints. After removal,  cartilage replacement via injection will be used to make up for the loss of cartilage.

3. Ankle osteoarthritis

Osteoarthritis is the degeneration of cartilage between your ankle joint. Aside from wear and tear, ankle osteoarthritis is also brought on by trauma. Of course, this includes ankle sprains that also came with osteochondral lesions.

In fact, 70% of those who had ankle bone trauma go on to develop ankle osteoarthritis. (6)

Whatever the cause may be, this condition will have your ankle bones grind against each other because of the loss of cartilage. This causes loud, ankle-popping noise.

This constant friction also leads to ankle pain, discomfort, stiffness, and swelling.

Treatment for ankle osteoarthritis

  • Medication – Anti-inflammatory drugs like NSAIDs can help quickly relieve pain and inflammation albeit temporarily.
  • Physical Therapy – The key to managing ankle arthritis is to strengthen the surrounding muscles. It can make up for the reduced ankle cartilage, thereby reducing friction and ankle noise.
  • Surgery – Ankle arthrodesis is a type of surgery that will fuse your cartilage-deprived ankle bones into one. As crazy as it sounds, this remains to be the gold standard for severe arthritis. (7)

In total, recovery may take up to 3 months.

3 tips to stop ankle cracking and snapping

1. Strengthen your ankles to improve stability.

Here are a few examples of easy ankle exercises:

  • Standing calf raises
  • Heel Walks
  • Ankle theraband exercises

2. Stretch your calves to promote ankle mobility.

This can be done through:

  • Ankle Circles
  • Calf Stretch
  • Plantar fascia rolls

3. Wear arch supports

Arch supports help distribute pressure which lessens pain and ankle popping. This is especially helpful if you have flat feet or ankle arthritis.

There are arch supports readily available in shoe stores. But, for a personalized fit, you should visit a podiatrist. They specialize in making custom foot orthotics.

FAQs:

Can a peroneal subluxation heal on its own?

Unfortunately, no. The damaged protective covering does not have a blood supply and requires treatment for recovery.

How do I know if I tore my peroneal tendon?

There will be a loud snap during the time of injury, intense burning pain on your outer ankle, swelling, and redness.

Do I have to keep wearing my orthotics if my feet feel better?

No. Once your foot pain resolves, you can stop wearing your arch supports. But be sure to check with your doctor or physical therapist just in case.

Conclusion

 We hope we answered your questions related to any clicking, cracking, and popping in your ankle.

In a nutshell, the popping sound you hear or feel when you rotate your ankles is more than likely normal. But, if there’s pain or a traumatic injury that happened before the ankle popping sounds started, please visit your trusted ankle clinic.

Resources

  1. “What causes the noise when you crack a joint?”. Science Reference Section, Library of Congress. 11/19/2019.https://www.loc.gov/everyday-mysteries/biology-and-human-anatomy/item/what-causes-the-noise-when-you-crack-a-joint/
  2. Fong, Daniel Tp et al. “Understanding acute ankle ligamentous sprain injury in sports.” Sports medicine, arthroscopy, rehabilitation, therapy & technology : SMARTT vol. 1 14. 30 Jul. 2009,  DOI: 10.1186/1758-2555-1-14
  3. Konradsen, L et al. “Ankle inversion injuries. The role of the dynamic defense mechanism.” The American journal of sports medicine vol. 25,1 (1997): 54-8. DOI: 10.1177/036354659702500110
  4. Davda, Kinner et al. “Peroneal tendon disorders.” EFORT open reviews vol. 2,6 281-292. 22 Jun. 2017, doi: 10.1302/2058-5241.2.160047
  5. Prado, Marcelo Pires et al. “Diagnosis and treatment of osteochondral lesions of the ankle: current concepts.” Revista brasileira de ortopedia vol. 51,5 489-500. 17 Aug. 2016, doi: 10.1016/j.rboe.2016.08.007
  6. Saltzman, Charles L et al. “Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center.” The Iowa orthopaedic journal vol. 25 (2005): 44-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888779/
  7. Grunfeld, Robert et al. “Ankle arthritis: review of diagnosis and operative management.” The Medical clinics of North America vol. 98,2 (2014): 267-89. DOI: 10.1016/j.mcna.2013.10.005

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