Stabilization Exercises for Young Adults With Habitual Knuckle Cracking

Habitual knuckle cracking is a widespread behavior caused by intra-articular pressure changes and gas release in synovial joints; however, its long-term effects on hand sensorimotor function, joint laxity, and overall biomechanics remain debated, with no structured clinical exercise interventions currently established. This prospective, randomized controlled trial aims to evaluate the effectiveness of a 4-week targeted stabilization exercise program focusing on the radiocarpal, metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints in young adults aged 18 to 30 years with habitual knuckle cracking. Participants are randomly allocated to either an intervention group receiving twice-weekly stabilization training (8 total sessions) or an un-exercised control group. The study hypothesizes that structured joint stabilization exercises will significantly improve wrist and finger joint position sense (proprioception), enhance upper extremity functional performance, and reduce joint laxity compared to the control group.

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Key information

Conditions

Habitual Knuckle Cracking Joint Diseases Joint Instability Musculoskeletal Diseases

Age range

18 year–30 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Age between 18 and 30 years,
Voluntary agreement to participate and signing the Informed Consent Form following detailed study briefing,
Willingness to attend all assessment and intervention sessions.

Exclusion criteria

Having an occupation that requires intensive or repetitive use of the upper extremities and fingers,
History of prior musculoskeletal injury involving the upper extremity or hand,
Presence of physical or sensory impairments (such as visual or auditory deficits) that could interfere with study procedures,
History of congenital or acquired orthopedic, neurological, or rheumatological conditions affecting hand or wrist range of motion and function,
History of hand or wrist trauma requiring medical, conservative, or surgical management within the past 6 months,
Presence of active skin lesions in the intervention region, including burns, cellulitis, vesicles, bullae, psoriasis, open or closed wounds, scar tissue, active infection, or malignancy,
Body Mass Index (BMI) ≥30 or a history of morbid obesity.

Treatment and study plan

Stabilization exercise program

Other

A 4-week supervised hand and wrist stabilization exercise program conducted 2 times per week (8 total sessions, 30-45 minutes per session). The protocol targets the radiocarpal (wrist), metacarpophalangeal (MCP), and proximal interphalangeal (PIP) joints. Exercises focus on enhancing joint position sense (proprioception), motor control, isometric and dynamic stabilization, and balanced muscle co-activation around the digits and wrist complex. Progression is individualized based on participant tolerance, maintaining movements within non-painful ranges to prevent joint strain. All sessions are supervised by a physical therapist.

Primary outcomes

Change from Baseline in Joint Position Sense (JPS) Absolute Error at 4 Weeks

Time frame: Baseline and 4 weeks
Change from Baseline in Joint Laxity

Time frame: Baseline and 4 weeks

Secondary outcomes

Change from Baseline in Upper Extremity Functional Performance using the QuickDASH questionnaire

Time frame: Baseline and 4 weeks
Change from Baseline in Pain Intensity on Visual Analog Scale (VAS)

Time frame: Baseline and 4 weeks

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Sponsors and collaborators

Lead sponsor

Borna Farhoomand

Other

Registry information

Official study title

Effects of Stabilization Exercises on Functional Performance, Proprioception, and Joint Laxity in Young Adults With Habitual Knuckle Cracking: A Randomized Controlled Trial

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: Sep 11, 2026
Registry last updated: Sep 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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