Don’t Get Out of Joint Over Knuckle Cracking

It’s become quite a habit for parents to ask me whether it is unhealthy for their children to crack their knuckles, and if it will lead to arthritis up the road.  Well let me see if I can knuckle under to these questions and provide some information on the topic.

Before we can figure out whether cracking knuckles is dangerous, we need to understand what causes that noise.  When the ligaments surrounding the knuckle joint are stretched, gas bubbles in the fluid inside the joint pop, creating a cracking sound.  It takes a few minutes for that gas to re-form, which is why knuckles don’t produce a cracking sound when stretched right away again after cracking. 

So are there problems that can result from your child cracking his or her knuckles?  The good news is that there are no studies that have yet proven that cracking knuckles contributes to getting arthritis as you get older.

The bad news is that there is a study or two that suggests that persistent knuckle cracking can inflame ligaments around the joints – stretching them, inflaming them, and in turn weakening them – such that problems like hand swelling and reduced grip strength can result from frequent knuckle cracking.  In fact cracking knuckles too often can also make the hands feel painful, although this feeling, along with the swelling and grip weakness, will go away if the knuckle cracking stops.

Perhaps the biggest problem with knuckles cracking is that it bothers other people and can become quite the annoying habit.  In fact the more we call attention to it, the more our kids may want to do it just to see us get irritated by the knuckle cracking.

So what do I recommend?  Try to ignore the noise as much as possible and compliment your child when he or she doesn’t crack their knuckles.  Encourage your child to try stretching their hands and fingers rather than trying to crack the knuckles.  You might also try to figure out why or when the cracking occurs – and try distraction or other kinds of stretches if it looks like your child is going to “get cracking”.  Peer pressure also works – when your child sees their friends no longer cracking their knuckles in public, he or she won’t either.

So that hopefully tips like this will not leave you out of joint the next time your children crack their knuckles. 

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at http://www.FletcherAllen.org/firstwithkids