What's that cracking sound!?!

Clicks, grinds, pops. They speak volumes about what's happening in your body. When your joints crack, how can you tell the good sounds from the downright bad and ugly?

The most common one you'll hear is the straightforward pop, which often happens when your knees crack during the first grand plie of the day. These are really two separate sounds. In the first, the joint space is enlarged and a bubble called a cavitation occurs. Then the surrounding ligaments which have been stretched by the joint space opening, snap back into their proper anatomical position, making the second sound. Well is this good or bad? In and of itself, this simple cracking is not harmful. Dancers are creatures who move, and after the immobility of sleeping, the noises are the typical sounds of beginning activity.

"For many dancers, if they wake up in the morning and move without sound, they are probably dead," says San Francisco orthopedic surgeon Kevin R. Stone, M.D. "Joint noises that are accompanied by pain or swelling need treatment; noises without pain or swelling are the music of the body."

In the dance studio, I watch Hayley Farr, a member of San Francisco Ballet's corps. Her hips are so flexible that she goes beyond the proverbial 6 o'clock penche. She says she never has had to develop her stretch, only her strength. Every morning she lies on her back and splits her legs open, making a big crack. She's been dancing about 13 years and says she has absolutely no hip problems.

However, those sounds can signal trouble. Coaching Smuin Ballet's Shannon Hurlburt through rond de jambe on his back on a Pilates reformer recently, I noticed his hips made a klunking through the movement. This sound, usually called "snapping hip," can manifest eventually as hip tendonitis or bursitis. This tends to happen when dancers with very flexible hips don't have enough strength or control. Enough uncontrolled klunking can inflame either the tendon or the bursa, the little cushioning sac below it. A full-blown irritation can sideline a dancer.

The klunking often can be avoided with careful attention, especially in rond de jambe of all types. I showed Hurlburt that if he concentrated and guided his leg by reaching it out and lifting his pull-up in his abdominals, he could lessen the sound. Pilates work and floor barre also can help to re-pattern hip movement.

Knees can make another familiar sound, called "joint mice." It sounds like sandpaper grating and it may be the kneecap pressing into the bones behind it, or loose kneecaps. If your knees are tight, stretch your quadriceps or roll on the fronts of your thighs with a foam roller. If your kneecaps are too loose, sitting and lifting them up toward your hips can give you greater strength and control. You can also strengthen them if you lift them when you're in releve.

It's not uncommon to hear an ankle crack when a dancer goes into demi-plie or releve, especially an older dancer. Sometimes that can mean a ruptured Achilles tendon, but they tend to sound louder, like someone punching the floor. (You can help prevent an Achilles injury simply by performing ankle circles to keep the tendon warm.) If you do think you've got an Achilles injury, get emergency care right away.

It's also time to worry if you hear a walking-in-the-snow sound in your Achilles heel cord. This mushy sound means that the Achilles may rupture. This scenario is usually due to an overuse problem, like a painful tendonitis during a lengthy season or after performing on a hard surface. Try contrast baths at the first sign of Achilles pain to avoid a full-blown problem. Alternately immerse your calves and feet in warm water mixed with Epsom salts, then cold water with a few ice cubes. Do each cycle for 10 minutes, warm, cool, warm, cool, for 40 minutes total. Use plastic buckets and fill them with enough water to reach the top of your calves.

Knowing what your body sounds mean will pay off royally. Use your body wisely, crack judiciously, and heed the sounds of warning. This way, you'll have the longevity we all crave in the dance world.

Suzanne Martin is principal physical therapist of Smuin Ballet in San Francisco. She also has her own practice in physical therapy and Pilates.