No matter your age, you might have heard a crackle or pop in your joints when sitting down, standing up or simply walking. Luckily most popping cases are not detrimental to your physical health. However, if left untreated, they could cause mobility complications.

Medically, popping in your joints is known as crepitus. If you’re experiencing a bout of crepitus, it could be from overworking your joints through exercise or stiffness in the joints after a long period of inactivity. While these causes may sound contradictory, it’s how our bodies adapt to certain stimuli — or lack thereof.

At the Orthopedic Institute of Pennsylvania, we can treat foot and ankle pain. Learn more about our services below.

Why Does My Ankle Keep Popping?

Ankle popping on its own is very common. If your popping ankle isn’t painful, it is likely caused by a gas release or tendon rubbing. However, if it is accompanied by pain or swelling, there may be an underlying cause. 

The most common causes of ankle clicking or popping include:

  • Gas release: Every time your ankle moves, the joint capsule filled with lubrication fluid is stretched. The fluid in the capsule can contain bubbles of nitrogen that can pop when you move, causing a loud popping sound — similar to when you pop your knuckles in your hand. Tight muscles can also contribute to gas buildup in the fluid, especially after inactivity like sleeping or binging a TV show. This is normal and does not signify an underlying cause.
  • Tendon slip: The peroneal tendons in the lower outside of your leg work to stabilize the ankle joint. Sometimes, these tendons slip from the muscle surrounding them, resulting in a snapping sound or feeling. A recent ankle injury could increase the ankle popping frequency. This is also common and not a cause of concern unless it is painful.

Less common reasons that may signify an underlying health condition include:

  • Tendon dislocation: The peroneal muscles surrounding the tendons can be pushed from their usual location, causing popping and snapping sounds in your ankle every time you move. This can happen during an ankle sprain. The inflammation, swelling and pain that occurs will need medical attention.
  • Osteochondritis dissecans: This condition causes a small segment of bone to separate and causes the cartilage in the ankle joint to wear away. This cracking sound could be painful after a lot of movement, like walking or running.
  • Osteochondral lesion: Lesions can form on the cartilage on the ends of your joint bones. Clicking and locking the ankle can occur, limiting the range of motion and causing swelling.
  • Ankle osteoarthritis: Osteoarthritis refers to a joint deterioration similar to osteochondritis with the wearing down of joint cartilage over time. While most common in the knees, it can also occur in the ankle.
  • Peroneal tendon injury: The peroneal tendons that may slip to make a cracking noise can also become injured.

Prevention and Remedies of Ankle Popping and Cracking

You can do several exercises at home to strengthen your popping ankles. These stretches both prevent ankle popping and reduce cracking sounds that already exist. 

Prevention and Remedies of Ankle Popping and Cracking

Ankle Circles

Performing ankle circles can warm up your joints and increase mobility. You can do this exercise from a seated or lying position:

  1. Sit or lay with your legs stretched out front. Prop your leg on a stable surface with the ankle hanging off the edge.
  2. Rotate your foot in clockwise circles 10 times with your ankle.
  3. Switch to counterclockwise circles 10 more times.
  4. Swap feet and repeat with the other ankle.

Towel Stretches

Relieve tight ankles with these simple towel stretches you can do at home:

  1. Sit on a flat surface with your legs straight out in front of the body.
  2. Loop a towel horizontally around the sole.
  3. Gently pull the towel ends toward the body, stretching the foot.
  4. Hold this position for 20 seconds.
  5. Repeat as needed.

Calf Raises

Strengthen your calf muscles to reduce pressure on the ankles in motion.

  1. Stand on the edge of a platform or the bottom stair step with the heels hanging off.
  2. Slowly rise onto the toes, driving the body fully upward with the calves.
  3. Let the heels gently fall, stretching slightly below the ledge.
  4. Repeat 10 times.

When to See a Doctor

When your ankle popping begins to cause discomfort or pain, consider getting a proper diagnosis from a doctor. They may order tests like an MRI or CT scan to look inwardly at the bone and cartilage.

If you recently had an ankle injury, rest is a major proponent of healing. A doctor may recommend anti-inflammatory medications to help with the pain and swelling.

A doctor can stabilize the ankle with a brace or orthotic to promote faster healing for more serious conditions. Physical therapy also works alongside any stabilization devices to slowly get your ankle back to regular functioning. If necessary, surgical options are available, including arthroscopy and total joint replacements.

Visit the Orthopedic Institute of Pennsylvania Today

At the Orthopedic Institute of Pennsylvania, our ankle and foot care center is committed to helping you regain full mobility. For more information on how our services can benefit you, contact us today!

MRI Upper Extremity (Shoulder, Upper Arm, Elbow, Forearm, Wrist, or Hand) Preauthorization Documentation Guidelines

1. Suspicious mass or tumor
      a. On initial evaluation or follow up
2. Staging of known cancer
3. Suspected or known infection (septic arthritis or osteomyelitis)
4. Suspected Osteonecrosis
5. Evaluation of Rheumatoid Arthritis or other autoimmune diseases
6. Evaluation of Post-op Complications
      a. Infection, delayed union, other
7. Suspected fracture with prior imaging non-diagnostic
8. Abnormal bones scan with non-diagnostic Xray
9. Significant injury with suspected ligament, cartilage, tendon, nerve or bone injury with non-diagnostic prior imaging
      a. Suspected massive rotator cuff tear
10. Evaluation of pain or more minor injury with initial imaging non-diagnostic:
      a. Pain lasting 3 months or greater
      b. Failed conservative therapy: Must include each one:
           i. Rest: modified activities or assistive devices/rigid splints or braces
           ii. Ice or heat
           iii. Medications and/or injections
           iv. Physical therapy or a physician directed home exercise program
           or chiropractic care
                1. Document instructions given
                2. Document compliance and results
                3. Document duration and dates

MRI Spine Preauthorization Documentation Criteria

1. Tumor, masses, or cancer: suspected or known
2. Neurological Deficits
3. Trauma or acute injury
       a. With neurological deficits
       b. With progressive symptoms during conservative treatment
4. Infection: known or suspected
5. Inflammation: Ankylosing Spondylitis
6. Pre-op Evaluation
7. Post-op Complications
8. Acute or Chronic Axial or radicular pain
       a. Pain lasting 6 weeks or greater
       b. ADLs must be affected
       c. Progressive neurological deficit or an abnormal EMG
             i. Must document specific dermatome, muscle weakness, reflex
abnormalities
       d. Failed conservative therapy: Must include each one:
             i. Rest: modified activities or bracing
             ii. Ice or heat
             iii. Medications, acupuncture or stimulators
                   1. Specific name of medication start date and duration and
                   results
             iv. Epidurals or other injections (not trigger point injections)
             v. Physical therapy or a physician directed home exercise program
             or chiropractic care
                   1. Document instructions given
                   2. Document compliance and results
                   3. Document duration and dates

MRI Pelvis Preauthorization Documentation Criteria

1. Musculoskeletal Pelvic MRI:
     a. Mass or tumor
    b. Significant injury to rule out fracture or other injury
    c. Osteonecrosis of hips
    d. Sacroiliitis
    e. Sacroiliac joint dysfunction
    f. Pain lasting 3 months or greater
    g. Failed conservative therapy: Must include each one:
            i. Rest: modified activities or assistive devices/rigid
            splints or braces
            ii. Ice or heat
            iii. Medications and/or injections
            iv. Physical therapy or a physician directed home
            exercise program or chiropractic care
                    1. Document instructions given
                    2. Document compliance and results
                    3. Document duration
    h. Persistent Pain not responsive to 4 weeks of conservative treatment

2. Prostate Cancer Evaluation, follow up, and surveillance

3. Mass or Tumors

4. Cancer detection, staging, or surveillance
    a. 3, 6, or 12 month follow up

5. Infection:
        a. Appendicitis
        b. Diverticulitis not responding to conservative care
        c. Inflammatory bowel disease
        d. Abscess suspected
        e. Fistula
        f. Abnormal fluid collection

6. Pelvic Floor failure

7. Uterine abnormalities

8. Undescended Testes

9. Pre-op Evaluation

10. Post-op Complication

MRI Lower Extremity (Hip, Knee, Leg, Ankle, or Foot) Preauthorization Documentation Guidelines

1. Suspicious Mass or Tumor
       a. On initial evaluation or follow up
2. Staging of known Cancer
3. Known or suspected infection
4. Suspected Osteonecrosis or Legg-Calve-Perthes Disease
5. Suspected SCFE, tarsal coaltion
6. Evaluation of Post-op complication:
       a. Infection, delayed union, other
7. Suspected fracture with prior imaging non-diagnostic
8. Abnormal bone scan with non-diagnostic xray
9. Significant injury with suspected ligament, cartilage, or bone injury
10. Evaluation of pain or more minor injury with initial imaging negative:
       a. Pain lasting 3 months or greater
       b. Failed conservative therapy: Must include each one:
             i. Rest: modified activities or assistive devices/rigid splints or braces
             ii. Ice or heat
             iii. Medications and/or injections
             iv. Physical therapy or a physician directed home exercise program orchiropractic care
                  1. Document instructions given
                   2. Document compliance and results
                   3. Document duration

MRI Chest Preauthorization Documentation Guidelines

1. Mediastinal or hilar mass
2. Myasthenia gravis with suspected thymoma
3. Brachial Plexus Dysfunction
4. Thoracic/Thoracoabdominal aneurysm
5. Suspected or confirmed Congenital Heart Disease
6. Thoracic Outlet Syndrome

MRI Brain Preauthorization Documentation Criteria

1. Suspected or known MS
2. Seizure disorder, known or suspected new or refractory
3. Suspected Parkinson’s disorder
4. Neurological symptoms or deficits
     a. Acute, new or fluctuating deficits
5. Mental status changes
6. Trauma to the head with neurological changes, vomiting, headache
7. Evaluation of headaches
      a. Chronic with change in pattern/character
      b. Sudden onset severe headache
      c. New onset headache in pregnancy
8. Suspected brain tumor or cancer
9. Known or suspected stroke
10. Suspected Infection
11. Suspected Congenital abnormality
12. New onset tinnitus or vertigo associated with visual changes

MRI Abdomen and MRCP Preauthorization Documentation Criteria

MRI
1. Suspicious Mass or Tumor
2. Surveillance of Mass, Tumor, or Cancer    
      a. 3, 6, 12 month follow up
3. Suspected infection:
      a. Appendicitis
      b. Peritonitis
      c. Pancreatitis
      d. Inflammatory bowel disease
      e. Cholecystitis
      f. Abscess
      g. Fistula
      h. Hepatitis C
4. Preoperative Evaluation
5. Post-op complication

MRCP
1. Suspected Congenital Abnormality
2. Chronic pancreatitis or related complications
3. Biliary tree symptoms
4. Pre-op Evaluation
5. Post-op complication or surveillance
6. Inconclusive abnormalities identified on other imaging