Knee Clicking: When to Ignore It and When to See a Physio

By Emma Glynn - The Hip & Knee Physio

Heard that clicking sound in your knee during Pilates, a long walk, or while cycling up a hill? For active women over 45, knee clicking is surprisingly common, especially in low-impact exercise like reformer Pilates, walking trails, or long-distance bike rides.

But how do you know when it’s just a harmless quirk of your body… and when it’s a sign something deeper is going on?

Let’s break it down, so you know when to ignore the click, and when it’s time to book in with a physio who specialises in knees.

🤔 Why Do Knees Click?

There are a few surprisingly normal reasons your knee might make noise:

✅ Tendons sliding over bony surfaces

This is called crepitus, and it's basically your soft tissue moving over joints as you bend and straighten your leg. Totally normal and often louder when your muscles are tight or fatigued.

✅ Gas bubbles in the joint

Tiny gas pockets inside the joint capsule can “pop” during movement, like cracking your knuckles. No damage is happening, even if it sounds dramatic.

But not all clicks are innocent…

⚠️ Swelling or cartilage irritation

If clicking comes with pain, swelling, or the feeling of something “catching” inside the joint, it could point to something deeper, like an old ACL injury, meniscal wear, or early osteoarthritis.

✅ When Clicking is Harmless

Not every sound needs a solution. Clicking is usually nothing to stress over if:

• There's no pain during or after activity

• Your knee doesn't feel swollen or stiff

• You don’t feel any locking or catching

• It’s been stable over time and isn’t worsening

You can usually keep doing your Pilates classes or weekend hikes with confidence. But...

⚠️ When Clicking is a Red Flag

If your knee clicking comes with any of the following, it’s worth getting assessed by a physio:

• Pain with activity or afterward

• Swelling, especially the next day

• Locking

• Worsening symptoms over weeks or months

• A history of ACL injury, meniscus tear, or knee osteoarthritis

These could indicate mechanical irritation, poor load tolerance, or even early degenerative changes.

🧠 Take the guesswork out of it — take my free knee quiz and find out what your clicking really means...

Take The Quiz

💪 Why Strength Alone Doesn’t Always Fix Clicking

We often hear, “But I’m strong - I do squats, Pilates, and glute work every week.”

That’s great… but strength is only part of the story.

If your knee is still painfully clicking, the issue is often about:

• Load management (how much, how often, how fast you progress)

• Movement control (especially through hips and knees under load)

• Muscle coordination, not just power

In other words, it’s not just what exercises you’re doing - it’s how you're doing them.

👩‍⚕️ How Physio Can Help

An experienced physio doesn’t just hand you a sheet of knee exercises.

We:

• Do a full assessment to figure out exactly why your knee is clicking

• Test strength, control, range of motion, and movement patterns

• Build a personalised rehab plan that might target your hips, glutes, quads, and gait

• Help you avoid unnecessary imaging, injections, or surgery

Often, fixing knee clicking is about calming things down, loading smart, and building resilience from the top down.

🧠 Take-Home Message

• Clicking with no pain or swelling = usually fine

• Clicking with red flags = time to investigate

Don’t wait for it to worsen. The right plan can get you back to hiking, Pilates, or chasing after grandkids without that nagging click or post-exercise swelling.

👉 Book your Knee Consult Today — and get clarity on what’s really going on.

Book Online

Can't Find What You're Looking For?

Explore more of our most popular services and guides:

• Knee Physiotherapy for ACL, osteoarthritis, and post-op rehab

• Hip Physiotherapy for bursitis, tendinopathy, and arthritis

• Post-Surgical Rehab for hips, knees, and joint replacements

• Sports Injury Physio for runners, lifters, and young athletes

• Post Op Protocols

• Free Downloadable Hip and Knee Pain Reports

• Hip Physiotherapist Camberwell

• Knee Physiotherapist Camberwell

• Book your appointment online

Still stuck? Contact us and we’ll point you in the right direction

Disclaimer

The content provided on this website is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.

While The Hip and Knee Physio strives to present accurate and up-to-date information, we do not guarantee results or outcomes based on the information provided. Any exercises, strategies, or recommendations featured on this site should not be considered a personalised treatment plan.

Always seek the advice of a qualified healthcare provider before starting any exercise program, particularly if you are experiencing pain, injury, or a pre-existing medical condition.

Use of this website does not create a physiotherapist–patient relationship. The Hip and Knee Physio accepts no responsibility for any injury or loss arising from reliance on or use of this information.

By using this website, you agree to these terms.

References

1. Østerås, H., et al. (2013). Knee crepitus is common and usually harmless. British Journal of Sports Medicine. https://bjsm.bmj.com/content/47/8/532

2. Crossley, K.M., et al. (2016). Patellofemoral pain: evidence-based management strategies. British Journal of Sports Medicine. https://bjsm.bmj.com/content/50/14/865

3. Barton, C.J., et al. (2015). The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’. Br J Sports Med. https://bjsm.bmj.com/content/49/14/923

4. Dey, P., et al. (2016). Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear. BMJ. https://www.bmj.com/content/352/bmj.h6742