The Most Common Cause of Ankle Cracking, Clicking or Popping: Peroneal Subluxation / Dislocation.

Have you ever heard or felt your ankle “snap” when you walk, or run, or climb some stairs? Did this sound or sensation make you “feel old?” Don’t worry, there are other conditions which can cause this “snapping” in the ankle besides old age and they should be treated by your podiatrist before they become worse.

iStock_000012644456XSmallA number of foot conditions may cause a variety of sounds in the joints, such as “cracking,” “creaking,” or “clicking,” or a more general noise that is either heard or felt in the joint

Snapping sound in the ankle is most commonly caused by a tendon slipping over the bone. When this happens, it is common to hear a snapping or clicking sound.

Peroneal Subluxation / Dislocation: The Most Common Cause of Clicking and Snapping Ankles

The outer bone of the ankle joint has two tendons that travel behind it, one stacked upon the other, known as the peroneal tendons. These tendons, one short and one longer, work to stabilize the ankle joint, preventing excessive side-to-side motion of the foot as it “roles” during walking. These tendons sit within a groove in the bone and are kept in place via a band of fibrous tissue called a retinaculum.

Should the tendons slip out of this groove, the movement may be felt or the snapping sound may be heard. This condition is known as peroneal tendon subluxation or dislocation. It is usually the peroneus brevis (the shorter of the two tendons) that slips out of place.

The cause of this slippage of the peroneal tendons can vary from patient to patient, but will likely be caused by one of the following:

  • Secondary to an ankle sprain
  • Congenital shallow groove in the bone
  • Weak fibrous tissue band
  • Abnormal muscle position (people with unstable feet have more abnormal force on the peroneal tendons)
  • Unstable ankles
  • Injury

Whatever the cause of this condition, the patient may hear a snapping sound in the ankle, or may feel the tendons sliding over the side of the ankle bone when walking, running or climbing stairs. At the very least the condition is annoying, yet there may also be pain involved, limiting the patient’s activities. Left untreated, the tendons may become damaged, leading to more severe pain and more difficulty treating the condition effectively.

How To Stop Ankle Cracking and Snapping

First, it is not critical that you completely stop the ankle popping. As long as it is not painful it is almost never anything serious. The clicking in your ankles may be irritating, however, so below you will find the best professional and home treatments for ankle cracking. Keep in mind that in some cases it is not possible to completely eliminate the ankle popping.

Treatment of Snapping and Clicking of the Ankle

This condition is almost always treated conservatively and surgery should be considered only as a last resort.  Below are some products that we recommend regularly to our patients. They are also affiliate links so we may receive a small commission at no additional cost to you if your order from the link.

Strengthening Program for Peroneal Subluxation / Dislocation and Other Causes of Clicking in the Ankle

We will always include an ankle strengthening program when treating peroneal subluxation. This will usually include a combination of balance exercises and direct strengthening exercises.  In some situations we may refer you to a physical therapist to work on the most effective strengthening program.

During the first months of the strengthening program we have our patients wear an ankle brace such as this McDavid Lace-up Ankle Brace with Support Stays. We like this one because it gives excellent lateral support without taking up too much room in the shoe. The brace is important to maintain correct tendon position while the patient goes through a strengthening program.

We have patients wear this during the first 6 – 12 weeks of their exercise program to ensure proper alignment and prevent re-injury. It is important to remove the brace when doing the actual balance exercises but otherwise the brace should be worn all day.

Orthotics and Arch Supports for Peroneal Dislocation / Subluxation

Orthotics are often used to decrease stress on the specific tendon that is causing the snapping and to improve joint alignment. Orthotics act to keep the tendons in better alignment which helps prevent them from slipping out of place. Some patients do well in over-the-counter arch supports and other patients require a custom orthotic to more effectively stabilize the ankle.

Whether you use a prefabricated or custom orthotic we will modify the orthotic to provide the best stabilization for the ankle and the peroneal tendons.

Over-the-Counter Arch Supports for Snapping Ankles

If you try an over-the-counter arch support you should get one that is firm and conforms as close to the arch as possible in order to stabilize the ankle and the peroneal tendons as much as possible.

For lace-up shoes we usually recommend the FootChair Orthotic with adjustable arch height.  The FootChair Orthotic has a very supportive arch which helps in stabilizing the ankle. It also comes with pads that can be added to increase the arch height for even more support for those who need it.

For women’s flats and heels we recommend the PowerStep SlenderFit.  It also has an excellent arch but is designed to fit into women’s heels and flats. 

Custom Orthotics for Snapping Ankles

If you find that the prefabricated orthotics help, but don’t eliminate, the snapping of the tendons, then custom orthotics will likely help even more as they will provide greater support and better ankle alignment.

Orthotics for peroneal subluxation incorporate specific modifications that help stabilize the peroneal tendons. Some of these modifications will be included in the initial prescription and others will be added after you have worn the orthotics for several weeks.

Surgery for Peroneal Subluxation / Dislocation

In rare situations, surgery may be required to resolve the issue. This is especially true of patients with high levels of activity, such as athletes. While every effort will be made to stabilize and support the ankle to improve the condition, and while surgery is always a last resort, it may be required to deepen the groove in the bone or repair the fibrous tissue band, or both. Again, surgery should be considered only as a last resort and every effort will first be made to treat the condition conservatively before resorting to surgery.

Post-surgery therapy will include immobilization and physical therapy before full weight bearing activity may be resumed.

Contact Us Today if you have Snapping Sounds in Your Ankle

If you have begun to experience a snapping sound in the ankle, or pain in your ankles, make an appointment to see us today in our Seattle foot and ankle clinic.

Video: Peroneal Subluxation

Here is a video that we found that provides some good information on peroneal subluxation. The information on the anatomy of the peroneal tendons is excellent. They seem to jump to surgery faster than we would, however. Unless there is pain involved we find conservative care is usually effective.

Dr. Larry Huppin
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Dr. Larry Huppin

Podiatrist specializing in biomechanics at Foot & Ankle Center of Washington
Lawrence Z.Huppin, DPM is an internationally recognized lecturer and teacher on orthotic therapy and biomechanics.In his Seattle private practice his focus in on treatment of mechanical problems such as heel pain, bunions, ball of foot pain, athletic injuries and children’s foot conditions.In addition he specializes in toenail problems including ingrown and fungal toenail conditions. He is always focused on helping patients avoid surgery if at all possible and keeping your medical costs as low as possible.
Dr. Larry Huppin
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24 thoughts on “What Causes Cracking, Clicking or Popping Sounds in the Ankle?

  1. Hi, I have this problem in my ankle, however it doesn’t bother me. What has been bothering me, is I’ve recently started having this problem in my neck (every time I look left it cracks). Chiropractor thinks it’s caused by the same type of thing, ligament scraping over bone. I’m going crazy with hearing and feeling this every time I turn my head. My question is, could this be treated the same way? My ankle cracking has never gone away and I’m fearful this never will either. 🙁

    1. Hi Evelyn – I’m sorry, but I don’t know anything about necks. I would suggest seeing a physiatrist who specializes in the neck and back. A physiatrist is an MD who specializes in physical medicine. This would be the best specialist to see for a neck issue.

  2. So I injured my ankle and initially I had peroneal tendon subluxation but after a while it stopped and I cannot no longer recreate it but my ankle still feels unstable and the tendons appear to be swollen behind the fibula, is it possible that it has healed? As far as non-surgical interventions the only thing I have done is R.I.C.E principles and have kept it in a brace. I put myself in a walking boot for a week, but that was only to prevent the subluxation and soon after I didn’t need it. It’s been 5 weeks since the injury, thanks for any reply.

  3. Hi, I have a OCD in my left Talar Dome. However my right ankle has always popped but it’s getting worse and starting to become uncomfortable. I do not recall injuring it as I did to my left ankle years ago. Should I mention this to my surgeon
    ? Any ideas of what could be the cause of the Constant popping and slight pain? Thank you for your time.

  4. Thanks for the informative video. My granddaughter has this issue which most likely resulted from a sprain. It will be helpful when discussing it again with her doctor, who dismissed it lightly when she first complained about the constant popping. I’ll also see about getting an ankle brace for support.

  5. Hi Dr. Huppin!

    I ran my first marathon back in February. Since then I pop my right ankle constantly. Probably 15 times a day. It will feel like there is tension in my ankle, I’ll move it back and forth several times and it will pop. But then I have to do it again moments later. I mostly notice it when I’m sitting or lying down. I’m currently training for another marathon and it feels fine when I run. Any suggestions on how I could treat it?

  6. Hi, I was playing basketball and I went to block somebody’s shot, and I fell onto that persons ankle with my foot and I heard a loud pop in my ankle. At first it was very difficult to put any weight on, but has gotten better. There was hardly any swelling but pain on my fibula and behind it where the tendons are. About a week later, I am still playing on it but it pops and cracks a lot when moving it up and down and side to side. The popping when this happens is felt on my fibula like a tendon it going over and back on it. It feels just as you have described in this article. If you have any suggestions I am open for them. thanks.

  7. I’ve had problems with my ankle, foot about 3-4 times when I wake up in the morning. Very stiff and very painful to walk on. After a few hours it loosens up and feels fine. Doesent happen everyday. I’ve had problems with “turf toe”with both big toes, but the pain only happens in my right foot-ankle. I am left handed so my right leg gets more strain then my left, not sure if that matters, and I’m up and down stairs a lot through out the day. Any advice would be great, thank you.

  8. i am 14… my right ankle cracks every time i role it in a circle (no egxageration)
    so does my left but no every single time just about 1/5 of the time…it hurts a little but enough to bare… should i ask my parents to take me to the doctor… or is it just beacuse of my age… maybe it will go away when im older?

  9. Without shoes on, my right ankle clicks very loudly with almost every step I take. It doesn’t hurt at all so is there any need to have it checked out?

  10. hello! I rolled my ankle by jumping off the last step of my porch. My ankle inverted and i heard 3 loud fast cracking sounds. I was in severe pain for about ten minutes and after resting icing and elevating the pain decreased. I have some ROM but a little limited due to pain. Today my ankle is swollen and turning blue but i can still walk on it with a slight limp. Should I wait a few days and see what it does or should I go to the doctor for an x-ray?

  11. Dr. Huppin,

    I have had two tarsal tunnel surgeries on my right foot. I am 7 months post op on my second surgery. Apparently I have a propensity to scar up more than most people. What would be the best way to prevent further scarring at this stage of the recovery ? what would you recommend ?

  12. i have a problem with a bone spur at the insertion point of Achilles tendon and plantar fascia and my doc sent me to an or tho pedic doc what do u think they will do for the problem

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