From the Guidelines
Widespread tendon crepitus is typically caused by tendons sliding over bones or other tissues, creating audible sounds, and can be a result of normal movement of tendons in their sheaths, gas bubbles forming in joint fluid, tendons snapping over bony prominences, or minor inflammation. The exact cause of widespread tendon crepitus can vary, but it is often related to overuse or repetitive strain on the tendons, which can lead to degenerative changes and inflammation 1.
Common Causes of Tendon Crepitus
- Gas bubbles forming in joint fluid
- Tendons snapping over bony prominences
- Minor inflammation
- Overuse or repetitive strain on the tendons
Risk Factors
- Recent increase in physical activity
- Change in exercise routine
- Dehydration
- Anatomic misalignment, such as forefoot and heel varus or excessive pes planus or foot pronation 1
Prevention and Treatment
To address widespread tendon crepitus, it is essential to stay well-hydrated by drinking 8-10 glasses of water daily, perform gentle stretching exercises before and after physical activity, maintain proper posture, and ensure adequate intake of nutrients like vitamin D, calcium, and protein for tendon health. If the tendon popping is accompanied by pain, swelling, reduced range of motion, or follows an injury, it is crucial to consult a healthcare provider as these could indicate more serious conditions like tendinitis or tendon tears that may require medical treatment 1.
Diagnostic Approach
The diagnosis of tendinopathy is supported by physical maneuvers that simulate tendon loading and predictably reproduce the patient’s pain, and imaging studies such as plain radiography, ultrasonography, and magnetic resonance imaging can be helpful if the diagnosis remains unclear 1.
Treatment Options
Treatment should be conservative, and eccentric strength training is a particularly popular and effective option for Achilles tendinopathy 1. Stretching and deep friction massage of the gastrocnemius-soleus complex generally are considered helpful for Achilles tendinopathy. Anatomic misalignment can be treated with shoe orthotics to correct overpronation or pes planus problems. Many patients will benefit from heel lift orthotics to unload the tendon for pain relief 1.
From the Research
Tendon Crepitus Causes
- Tendon crepitus, also known as tendon grating or crunching, can be caused by various factors, including tendon injury or degeneration 2.
- Rheumatoid arthritis is a chronic systemic autoimmune disease that can lead to inflammation in joints and tendon sheaths, resulting in tendon crepitus 3.
- The use of corticosteroids has been associated with tendinopathies, including tendon crepitus, with oral and parenteral applications being the most prevalent routes of administration 4.
- Musculoskeletal ultrasound and magnetic resonance imaging (MRI) can identify synovitis and tenosynovitis, which are related to tendon crepitus, but US is less sensitive than MRI in the early detection of these conditions 5.
- Anti-inflammatory treatment, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may not affect gene expression in human tendinopathic tendon or lead to clear changes in tendon pain or function 6.
Related Conditions
- Tendinopathy, a condition characterized by tendon injury or degeneration, can cause substantial pain and loss of tendon function 2.
- Tenosynovitis, inflammation of the tendon sheath, is a common manifestation of rheumatoid arthritis and may often be mistaken for synovitis 3.
- Synovitis, inflammation of the synovial membrane, can be detected by US and MRI, but the sensitivity and specificity of these imaging modalities may vary 5.