Do your knee joints make lots of noise when you go upstairs, or your neck when you turn your head?

If the answer is yes, you are not alone and the aim of this episode of the Pain Free Living podcast is to provide you with a clear, jargon-free explanation of what causes those sounds and whether or not you should be worried.

The correct medical term for the crackling, grinding, clicking, or popping sounds when you move your joints is crepitus.

It is something that affects millions of people worldwide, particularly adults over 50, though it can occur at any age. The sound may be audible to others or just felt as a grinding sensation within the joint itself.

Joint crepitus can affect different areas of the body depending on what you are doing, with knee crepitus when climbing stairs or moving from sitting to standing, in the shoulders with overhead movements, and in your neck when turning or side-bending your head.

While occasional joint sounds are usually harmless and part of normal joint function, persistent or painful crepitus can indicate an underlying joint problem that needs to be reviewed by your favourite healthcare professional.

What Causes Joint Crepitus?

The main mechanism behind most joint sounds involves your synovial joints. When you move and stretch a synovial joint, gas bubbles can form in the fluid due to the change in pressure, causing the rapid release of dissolved gases (nitrogen, oxygen, carbon dioxide), which form bubbles. This process is called cavitation and causes the familiar and distinctive popping sounds, which are generally harmless.

Grinding sounds can indicate a more serious condition, with a recent 2024 study highlighting knee crepitus affecting 41% of the general population, occurring in 35% following ligament injury, to 81% in knee osteoarthritis patients. Osteoarthritis remains a significant cause of painful crepitus, where cartilage breakdown produces grinding sounds and inflammation leading to pain with movement.

Other situations that can cause crepitus include ligaments snapping over bone surfaces, age-related joint changes, previous injuries, and muscle imbalances.

Takeaways

• Crepitus is the medical term for the crackling, grinding, clicking, or popping noises that synovial joints sometimes make during movement.
• Most joint sounds are caused by gas bubbles rapidly forming and collapsing within the joint and are usually harmless.
• Some joints are more prone to crepitus than others, and it usually occurs in the knees, shoulders, or neck.
• Osteoarthritis can be a major cause of problematic crepitus
• While occasional popping sounds from your joints are harmless, grinding sounds and pain indicate an issue requiring professional assessment and care.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media, this is the place for you https://linktr.ee/Painfreeliving

You know the nervous system is complicated but do you appreciate how truly complicated it is?

The aim of this episode of the Pain Free Living podcast is to provide you with a clear, jargon-free introduction to the nervous system and how it can affect your pain levels and overall health whether you are an athlete, work in an office, or are an older adult.

The nervous system is complex and is responsible for coordinating your body’s 11 systems, including cardiovascular, digestive, skeletal, and respiratory functions.

It consists of the Central Nervous System (CNS), which is the brain and spinal cord, and the Peripheral Nervous System (PNS), which includes the somatic and autonomic systems.

The somatic nervous system (SNS) manages your muscles and sensory receptors in the skin, while your autonomic nervous system (ANS) controls vital functions like heartbeat, digestion, and stress responses.

The ANS consists of the sympathetic (SNS), parasympathetic (PNS), and enteric nervous systems (ENS) over which you have no direct control - see, I told you it was complicated!

Your SNS is the one that controls your response to stress by preparing you to either fight, flee, or freeze. Dominance of the SNS increases stress hormones like cortisol, and can contribute to problems like insomnia, digestive issues, chronic inflammation, and a weakened immune system. It can also increase your sensitivity to pain.

Your PNS & ENS work in opposition to your SNS and are responsible for your rest, digest, and repair responses, lowering your heart rate, reducing pain, improving sleep, and enhancing your rate of recovery from illness and other problems.

Takeaways:

The nervous system is a complex network that regulates many bodily functions essential for maintaining good health.

• The sympathetic nervous system prepares the body for stress, and can lead to various health issues if it's too dominant.
• Activating the parasympathetic nervous system through relaxation techniques can help manage stress-related health problems.
• Stress increases your pain sensitivity, which is why managing stress is vital for pain management.
• Carrying out activities that boost relaxation in turn increases the function of the parasympathetic nervous system and improves health.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving

Think of exercise as movement medicine rather than something that will leave you sweating and breathless, and you are more likely to do it.

In this episode of the Pain Free Living podcast, osteopath Bob Allen talks about the benefits of exercise but from a different perspective than the usual fitness industry conversations and he never says "No Pain, No Gain" (mostly because it's not true!).

The fitness industry always seems to prioritise how you look and aesthetic outcomes over any actual health benefits. While there is nothing wrong with having a 'Love Island' body most people just want to be able to go for a walk, play with their children or climb the stairs without getting out of breath or getting achy joints.

Thinking of movement as medicine and keeping movements simple makes exercise more palatable and accessible than the image of lying in a sweaty heap in the corner of a gym or endless hours on an exercise bike.

I like to give activities that can be done at home with no equipment but I'm equally happy providing advice on what you can do if you like the gym, swimming, running or any form of exercise. It doesn't have to be hard, and even five minutes per day can give health benefits.

Adding more physical activity into your daily routine, and most importantly, making it fu,n means you are more likely to start and carry on.

The episode ends with a reminder that the journey towards fitness is not about sticking to rigid standards, but needs to be personal and enjoyable, and it will lead to a better, healthier life.

Takeaways:

• The podcast highlights the fact that consistent exercise can significantly reduce the risk of various health issues, such as heart disease and cancer.
• Listeners are urged to reconsider their perception of exercise, recognising it as a fun, beneficial activity rather than a grind that you have to get through.
• Even five minutes per day can lead to substantial health improvements over time, and if you can't spare five minutes a day, what are you doing with your life?
• Exercise has to be fun, otherwise, you are unlikely to stick to it.
• The World Health Organisation recommends specific amounts of exercise, but any movement will be beneficial regardless of meeting those exact guidelines.
• Incorporating exercise into your daily routine, such as pairing it with existing habits like before a shower or your morning brew, will make it more achievable and feel less daunting.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving

You are not alone if you have ever been to a medical appointment and left it feeling frustrated and confused.

As an osteopath, I regularly see clients who have no idea why they are in pain because their healthcare professional has used lots of jargon and complex medical terms to explain their treatment.

In this podcast episode, I share some practical strategies to help you get the most from your medical appointments, ensuring you leave with an understanding of what your problems are and how they are going to be addressed.

The most important point of any medical consultation is that it is a two-way process, where you should be actively involved and empowered to ask questions, but in my experience, this rarely happens.

Following the advice in this podcast should ensure a successful consultation, based on clear communication and practical advice, meaning you fully understand your diagnosis and treatment plan.

Takeaways:

Bring Support: Take a friend or family member to your appointment to help remember details and compare notes afterward.

Record or Take Notes: If attending alone, ask permission to record the session or jot down important terms and instructions for later reference.

Ask Questions: Always ask for clarification if you don’t understand something, and if explanations remain unclear, keep asking or research terms afterward.

Symptom Diary: Before your appointment, keep a diary of your symptoms and what aggravates or relieves them. This helps your practitioner provide more accurate advice.

Discuss Treatment Plans: Be proactive and ask about the goals of your treatment, alternatives if current approaches aren’t working, and ensure you understand the next steps.

I hope that this podcast helps you to leave every consultation informed and confident, ready to maximise the benefits of your medical appointments and supporting your journey to pain-free living.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving

As an osteopath I regularly see clients that like to exercise whether that's a park run, ice hockey, powerlifting or some other activity. If they have an injury they will often ask if it's safe to continue training.

The answer that I always give is that "it depends"...

Welcome to the Pain Free Living Podcast with me, your host Bob Allen. I am an osteopath who has been successfully treating people's pain problems since 2008.

This week's podcast covers what "it depends" on and why "no pain, no gain" is a useless myth.

Should You Stop Training?

Bob highlights the fact that pain during or after activity, especially if it’s getting worse, should never be ignored. The common solution to pain problems like this is to rest which usually resolves the problem temporarily but the pain often comes back on restarting training as the issues causing it have not been addressed.

He also emphasises the need to take note of persistent pain, as continuing to train can aggravate any muscle and joint problems and will delay your recovery.

Case Study: Marathon Runner

Bob shares a story of a client training for a charity marathon who developed hip pain after increasing his mileage too quickly. Despite initial reluctance, he had to defer his event to allow for proper treatment and recovery. With a tailored rehab plan and hands-on osteopathic care, he was able to start running again and with the knowledge to avoid the same problems occurring in the future..

It Depends: Individual Assessment is Key

There is never a one-size-fits-all answer to an injury and Bob stresses the importance of getting a professional assessment to determine the cause of pain and the best course of action. Sometimes, modifying or temporarily stopping the activity is necessary for long-term improvement.

Expert Guidance Matters

Bob urges anyone experiencing pain to seek advice from a qualified professional who can diagnose the issue and guide recovery. There is no need to “put up with it” when effective help is available i.e. don't become a victim of the Region-Beta paradox

Why Listen?

Whether you’re a runner, gym-goer, or just trying to stay active, this episode offers practical, evidence-based advice on managing pain and training smarter. Bob’s approach is supportive, realistic, and focused on long-term health.

Get In Touch or Book a Free Assessment

If pain is holding you back, contact Bob Allen at Pain Free Living in Northampton for a free 15-minute assessment and expert advice on getting back to what you love.

Share this episode with friends, especially runners gearing up for marathon season, and leave a comment if you found it helpful!

Takeaways:

- Listeners are advised that persistent pain can indicate a worsening condition, and the need to reevaluate their training routine and highlights the need for proper recovery.

- The podcast discusses the need to assess when pain occurs during exercise to identify the best modifications to training. It underlines the fact that ignoring pain can make the underlying issues worse and can lead to more significant problems in the future.

- Listeners are encouraged to find knowledgeable healthcare professionals who can identify and provide tailored advice and treatment for their specific injuries.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media, this is the place for you https://linktr.ee/Painfreeliving

Everyone knows that ice is good for managing pain but most don't know how it works or when to use it.

There are many protocols for using ice ranging from old skool RICE (rest, ice, compression & elevation) to the latest PEACE & LOVE (Protection, Elevation, Avoid anti-inflammatories, Compression, Education & Load, Optimism, Vascularisation, Exercise).

I will cover the difference in approaches in another podcast but for now let's look at when you should use ice and when you shouldn't.

In this episode, I explain when ice can be helpful, its physiological effects, and the trade-offs involved, providing clear, actionable advice if you are dealing with pain or injury.

When to Use Ice

Ice is most beneficial immediately after an acute injury-such as a sprain, fall, or sudden trauma when swelling, redness, and pain are present. Applying it in the first 48–72 hours can help control excessive swelling and help to numb the pain.

How Ice Works:

Ice causes vasoconstriction (narrowing of blood vessels), reducing blood flow, swelling, and inflammation. It also dulls pain by slowing nerve signals.

The Trade-Off:

While ice can reduce pain and swelling, it may also delay the body’s natural healing process by slowing inflammation, which is crucial for tissue repair. Prolonged or excessive icing can lengthen recovery time and, in rare cases, cause tissue damage.

Best Practices:

Use ice for 10–20 minutes at a time, wrapped in a damp towel never apply directly to skin. Allow at least 30 minutes between icing sessions.

Ice is most effective within the first 48–72 hours post-injury

Avoid icing if you have certain conditions (e.g., diabetes) or impaired sensation.

When Not to Use Ice:

For muscle tears or injuries with minimal swelling, ice may not be beneficial and could hinder healing. After the initial 2–3 days, focus shifts to restoring blood flow and promoting natural recovery.

Latest Guidelines:

Recent approaches (e.g., PEACE & LOVE) emphasize protection, education, and gradual loading over prolonged icing.

Ice is a good tool for temporary pain relief and swelling control, but not for accelerating healing.

For detailed protocols and contraindications, see the links in the show notes.

Takeaways

• The application of ice can be beneficial in managing acute injuries, particularly when swelling and inflammation are present.
• While ice can provide temporary relief from pain, it is crucial to understand that it can also slow down the healing process.
• Individuals with conditions such as diabetes should exercise caution when using ice for pain management.
• Understanding the trade-offs of using ice versus heat is essential for effective pain management.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving

You have woken up with a sore neck, thrown something, and hurt your shoulder or twisted your ankle, then gone straight onto the Internet looking for the best way to treat the problem.

These days, when we have an injury, we either ask Dr. Google, YouTube, or Tik Tok for a solution, and we are guaranteed to get thousands of options for what to do next.

Welcome to this week’s episode of the Pain Free Living Podcast with Bob Allen, your friendly neighbourhood osteopath and pain management expert.

Today, we’re looking at the benefits of heat therapy for sorting out your muscle and joint problems. Using heat is a natural and effective approach for pain relief, which can also help improve your flexibility and speed up injury recovery.

Benefits of Heat Therapy

Applying heat to sore muscles or stiff joints increases blood flow, delivering more oxygen and nutrients to the affected area and taking away inflammatory products and carbon dioxide. This helps reduce pain and joint stiffness, and relaxes muscle spasms, making it ideal for chronic problems like arthritis, fibromyalgia, and old injuries.

Heat therapy can be as simple as a warm shower, a heat pad, or a soak in a hot bath. By helping your muscles relax, heat improves joint mobility, making daily activities and exercise easier and more comfortable. Also, regular heat therapy can lead to significant improvements in pain and function for people with chronic muscle and joint problems.

Things to know before using heat

While heat therapy is generally safe, it’s not suitable for everyone or every situation. Avoid using heat on acute injuries (less than 72 hours old), areas of recent redness and swelling, open wounds, dermatitis, or infections, as it can worsen inflammation and delay healing.

Also, if you have impaired sensation due to problems like diabetes, circulatory problems, or heart conditions, you should get advice from a healthcare professional before using heat therapy.

Limit heat treatment to 20 minutes at a time and make sure the temperature is warm rather than hot to prevent burns. If you experience increased pain, redness, or skin changes, remove the heat source immediately and seek advice.

Takeaways

• Heat therapy is a cheap and effective solution for relieving muscle and joint pain and improving flexibility.
• It is ideal for chronic problems like arthritis, fibromyalgia, and old injuries.
• Avoid applying heat to recent injuries where there is swelling and inflammation or altered sensation due to problems like diabetes.

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving

Did you know that unless you have had a trip, fall, or some other trauma, there is a good chance that your knee pain is not due to a problem with your knee.

Welcome to the Pain Free Living Podcast with me, your host Bob Allen. I am an osteopath who has been successfully treating people's pain problems since 2008.

In this episode, I cover the topic of knee pain, which is a problem that I treat almost as frequently as low back pain, especially with older clients.

While I will always be a huge fan of the NHS, the management of knee pain is generally not great. The options offered are generally anti-inflammatories, physiotherapy, steroid injections, an operation, or being told there is nothing that can be done, so live with the pain.

Typically, people come to see me as a last resort, but I have successfully helped the majority of them avoid injections or an operation with some hands-on treatment and targeted exercises.

I will discuss how ankle health is very closely linked to your knee function and how an ankle issue can often be the cause of a knee problem, especially where there has never been a direct knee injury.

Real-life cases of non-traumatic knee pain that I have treated include one caused by the poor rehab of an ankle sprain and a case caused by a fibula (outside of your shin bone) problem. I discuss these cases in more detail, covering how they were identified and resolved.

These examples highlight the importance of a holistic approach to treatment with a detailed diagnosis and effective rehab rather than just treating symptoms.

Takeaways:

• Knee pain can often happen without a previous injury, gradually developing with no apparent cause.
• Compensatory movements from an old ankle injury can lead to knee and/ or hip pain over time.
• Correct diagnosis is crucial; often, knee pain is a symptom of another issue.
• Rehabilitating ankle injuries properly is essential to prevent knee pain and other complications.
• Depending on the cause, balance and strength exercises targeting the ankle can effectively resolve knee pain

More about Bob

You can find out more about Bob and why he became an osteopath here https://bit.ly/BobsOsteoStory

Sign up for his very popular Monthly Pain Free Living newsletter here https://bit.ly/PFL_newsletter_signup

If you want to follow Bob on social media this is the place for you https://linktr.ee/Painfreeliving