Elbow popping or elbow instability is a looseness in the elbow joint which is characterized by sliding or popping of the joint from its place with certain hand movements.(1) If not well managed, it can lead to major complications over a period of time. It can lead to tissue damage around the affected area along with bone and ligament injuries.
Causes of Elbow Popping or Cracking While Working Out
Popping of elbow while working out, though common, is not normal and can be alarming especially if it is associated with pain and tenderness. The most possible causes of elbow popping while working out are listed below:
- Gas Release at Joints as a Cause of Elbow Popping or Cracking: The most common cause of elbow popping without pain during any activity is cavitation, i.e., release of gas from empty spaces around joints.(2) This is generally harmless. The gas is created from the lubricating fluid (known as synovial fluid) found around the joints which contains nitrogen, oxygen and carbon dioxide. This does not require any treatment. In fact, release of trapped gases can make your elbow feel better as entrapment of gases may make your elbow feel tight.
- Rubbing of Tendons Against the Bone or Tight Muscles: Popping sound can be due to snapping of tight tendons while flexing or extending the arms. In addition to this, muscle tightness can aggravate the popping sensation and limit the range of motion and cause muscle pain around the elbow. Tightness of muscles can be avoided by doing proper warm up before working out and by doing proper cool down at the end of an exercise session. Any warm up schedule should include priming of muscle groups around biceps, triceps, shoulders and forearms. Elbow popping or cracking is commonly seen among people who do light weight overhead presses or modified push ups on a regular basis without doing a proper warm up first. Cool down session should include movements that allows static stretching, for e.g., foam rolling.
- Elbow Sprain as a Cause of Elbow Popping or Cracking when Working Out: Elbow sprain is a condition characterized by ligament injury or minor ligament tear in the elbow joints.(3) This causes popping or cracking sensation in the elbow with pain and tenderness. Elbow sprain can limit the range of motion of your elbow. It is advised to provide adequate rest to the affected elbow once a sprain is suspected. Other treatment modalities include ice application and compression. Over-the-counter pain killers can also provide relief.
- Presence of Loose Fragments Within the Elbow Joint: Presence of loose pieces of cartilages or bone within the elbow joint can cause cracking and popping of the elbow. This is detected with an X-ray or other advanced diagnostic procedures such as CT scan and MRI (Magnetic resonance imaging.) Treatment may require a surgery to remove the loose body from the joint.
- Separation of Elbow Cartilage as a Cause of Elbow Popping or Cracking when Working Out: This is a rare condition where there is complete or partial restriction of blood supply to cartilage and the layer of bone under the cartilage (subchondral bone). It is known as osteochondritis dissecans. This further causes separation of cartilage from the bone. The separated cartilages can get caught in the joint leading to cracking or popping of elbow with pain and limited range of motion. This is more common among people who do repetitive overhead and upper extremity weight bearing exercises on a regular basis such as overhead athletes, swinging athletes or throwing athletes. Any activity that aggravates the condition should be stopped immediately.
- Arthritis in Joints as a Cause of Elbow Popping: Arthritis is more common among the older population. Arthritis of elbow is highly common among people with history of rheumatoid arthritis and osteoarthritis.(1,4) Treatment involves management of the underlying cause and the type of arthritis. Management may include physiotherapy, lifestyle modification, rest and medications.
- Inflammation in Joints as a Cause of Elbow Popping or Cracking when Working Out: Some people may develop inflammation in the tissue bands within the elbow joints (also known as Plicas). This causes popping of elbow along with limited range of motion and tenderness. There is feeling of elbow ‘catch’ while bending the elbow. If left untreated, this leads to a condition called as plica syndrome or elbow synovial fold syndrome.(5) In some cases, the condition improves by itself. If it doesn’t, physical therapy, pain killers and anti-inflammatory medications helps.
Elbow popping or cracking when working out is a commonly experienced sensation among people who do exercises on a regular basis. Snapping of elbow without pain is often harmless. It can be ignored without any treatment. It may be due to escape of gases entrapped in the joints. Elbow popping with pain and difficulty of movement can be due to a serious underlying condition. Management includes treatment of the underlying cause. Other treatment plan includes rest, ice, compression, avoided movements that aggravate the condition, pain killer, anti-inflammatory medication, physical therapy etc. Proper warm up and cool down before and after a workout session is very important.(4) It is advised to consult an experience doctor when any symptom or cracking or popping of elbow is experienced when working out.
- Menta R, et al. (2015). The effectiveness of exercise for the management of musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.