Does collagen help joint clicking?

Three clicks and the twenty-minute test: cavitation, snapping and crepitus, how to tell them apart, and what each means

Does collagen help joint clicking is a question that cannot be answered until the click has been sorted, because a joint makes three different noises for three different reasons, two of them need nothing and one of them sometimes needs something, and a reader can tell the three apart in a minute with a test that costs nothing: try to make the noise again. The first noise is the crack or pop, the knuckle pulled until it cracks, the knee that pops when it is straightened after sitting, the shoulder that cracks when it is rolled, the neck that pops when it is turned, a single sharp sound, often satisfying, that cannot be repeated for around twenty minutes however the joint is moved. That is cavitation, and the twenty minutes is the diagnosis: a joint is sealed by its capsule and filled with a small volume of fluid, and when the surfaces are pulled apart quickly the pressure in the fluid drops, gas dissolved in the fluid comes out of solution as a bubble, and the bubble's formation or its collapse is the crack, after which the gas takes around twenty minutes to redissolve before the joint can crack again. It is harmless and painless, the people who cracked their knuckles for decades in the studies that looked had no more arthritis than the people who did not, and nothing a reader swallows changes the physics of gas dissolved in a fluid, so a crack that cannot be repeated is a click that needs no answer and has none. The second noise is the snap or clunk that can be repeated at will, every time the joint passes through a particular point in its movement and as often as the reader cares to move it there: the hip that snaps on the outside with every swing of the leg, which is the iliotibial band flicking over the point of the hip; the hip that clunks deep in the groin on a leg raise, which is a tendon over the front of the joint; the shoulder blade that clunks or grates against the ribs on a press or a reach, which is the blade's muscles and the ribs' surface; the ankle that clicks on every circle, which is a tendon over the bony knob; the wrist, the elbow and the thumb with their own versions. This is snapping, a tendon or ligament moving over a bony prominence or a band flicking across a ridge, a matter of soft tissue mechanics in which a tight band, a weak stabiliser or a movement pattern lets a structure cross a corner it would otherwise glide around, and it is answered by strength and mobility work for the muscles that hold the joint and by movement pattern changes, and by nothing swallowed; painless snapping is common, harmless and needs no answer, while snapping with pain is a physiotherapist's question. The third noise is the grind or crunch that comes with movement under load rather than at a single point, the knee that crunches on the stairs, that grinds under the hand placed on the kneecap during a squat, that crackles on a slow extension against resistance, which is crepitus, the roughened surfaces of articular cartilage moving on each other; it is the noise that worries readers most and the one the cohort studies have taken most seriously, and the studies found that crepitus is common in painless knees as well as in osteoarthritic ones, that many people with it never develop pain, and that its presence is only weakly related to pain or to the progression of a joint, so that a crunching knee is a knee to examine rather than a diagnosis, with the squat as the examination on the knee pain from squats page. Three clicks, then, and a test: a crack that will not repeat for twenty minutes is a bubble, a snap that repeats at will is a tendon over bone, and a grind under load is cartilage, and the first two need nothing while the third needs sorting.

What collagen does to each click, where the pain beside crepitus sits, what helps each noise, the clicks that need a clinician, and the worked example

Collagen's relationship to the three clicks is simple once they are sorted, and the honest page gives it click by click. To cavitation it does nothing, because no supplement changes the pressure, the gas or the fluid of a sealed joint; the joint's own oil, and the fact that movement rather than anything swallowed makes more of it, is on the lubricate joints naturally page, and a reader who takes collagen to stop their knuckles cracking will be cracking them in twenty minutes. To snapping it does nothing, because a band flicking over a ridge is a matter of the band's tension, the stabilisers' strength and the joint's path, none of which a protein digested to amino acids addresses; the shelf's suggestion that a snapping hip is a lubrication problem or a collagen deficiency has no mechanism and no trial. To crepitus itself it does nothing measurable, since no collagen trial has changed the surface of articular cartilage on imaging, and a roughened surface stays roughened. What collagen does touch is the pain that sometimes accompanies crepitus, and the honest page sizes it exactly: when a crunching knee hurts, the pain is usually the pain of early or established osteoarthritis or of the kneecap's cartilage under load, and the knee osteoarthritis trials of collagen hydrolysate at around 10g a day for twelve to twenty-four weeks found a point or two less pain on questionnaires than placebo, a symptom result with no structural change, so that a reader with a painful crunching knee has a modest adjunct available at powder doses beside the programme that the osteoarthritis guidance puts first; a reader with a painless crunching knee has nothing to treat and nothing the collagen could show. What helps each noise is what its mechanism says. Cavitation wants nothing, and a reader who finds the habit of cracking unpleasant stops the habit. Snapping wants strength in the stabilisers around the joint, the gluteals and deep hip muscles for a snapping hip, the scapular muscles for a clunking shoulder blade, the peroneals for a clicking ankle, with mobility for the tight band and a look at the movement pattern that sends the structure over the corner, and a physiotherapist if it hurts. Crepitus wants what the cartilage beneath it wants, quadriceps and hip strength that absorb load before it reaches the surface, moderate cyclic load that feeds the cartilage and raises its composition, body weight at around four kilograms across the knee per kilogram, and no fear of the noise itself, since a crunching knee that is used stays stronger than one that is rested from embarrassment. The clicks that need a clinician are the ones with company: a click that is new after an injury, a click with pain that persists, a click with swelling or warmth, a joint that locks or catches and will not complete its movement, which suggests a loose fragment or a torn meniscus, and a joint that gives way, which is a ligament question, and clicking that comes with the cluster of joints bending past normal, stretchy skin and easy dislocation belongs to the hypermobility assessment on the weak connective tissue page. The worked example is the adjunct for the pain beside one kind of click and not for any click, stated on its true terms: two capsules, 1200mg hydrolysed type 1 marine collagen with 12mg vitamin C at 15% of its reference value plus zinc, 120 for £16.99 at 28p a day, lab tested and UK made, below the 10g dose at which the knee trials found their point or two, carrying vitamin C's collagen formation sentence for the normal function of cartilage and no joint claim of its own. Does collagen help joint clicking: not the bubble, not the snap, not the grind, and modestly the pain that sometimes comes with the grind, which is a reason to sort the click before buying anything for it.

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