While we all might experience painless clicking or cracking of the shoulder at sometime in our lives, considered a common phenomenon (the cause of which is not exactly known but it is thought to be caused by sudden pressures in the joints), painful clicking or popping of the shoulder is more likely to be of a pathological nature causing inflammation, stiffness and mobility problems in the more extreme cases.
It is important to remember that popping, grinding or clicking sounds coming from the shoulder should not always be cause for alarm. As we age it is normal that through wear and tear we lose some functionality. Years of use and day-to-day “abuse” of our shoulder may lead to cartilage breakdown causing the internal parts of the shoulder to rub together and make varying clicking, popping or grinding noises when doing so.
But when can we tell if that innocuous clicking or popping sound is something more sinister – something we should be worried about or seek medical advice on?
If you consider the following 3 questions they may help you decide what action is needed:
- The first and most important consideration is if there is pain associated with the noise (pain is an indication that the noise might not be harmless).
- Next, you should try to think about any recent trauma you may have sustained? Did you have a fall or blunt impact (during a contact sport activity) or accident recently? In some cases the injury need not have been significant enough for you to remember – but what occurred might have caused a worsening of the symptoms over time.
- Does your shoulder feel strange, loose, not stable?
- Is there a weakness in your shoulder?
The answer to these questions will help you ascertain if you need to seek orthopedic advice or not. To answer the second question you may need to go back in time, 5, 10, 15 or more years to discover if there was a trauma to your shoulder that could be causing your current pain.
Did you have an injury to your shoulder that you thought cleared up because the pain went away?
Could this injury, have caused further damage to your shoulder over the years leading to bigger and more persistent problems today?
To better understand what happens with shoulder pain and popping let us have a look at the anatomy of the shoulder:
The shoulder is made up of a ball and socket joint and is the most flexible joint in our body allowing a wide range of movement and flexibility. The long arm bone (called the humerus) has a ball-like structure at the top of the bone which sits into a shallow depression of the scapula bone, called the glenoid. Movement and stability are controlled by a series of ligaments in the shoulder which also help to keep the shoulder in place.
If the ligaments become loose, or stretched, due to an injury this will allow the shoulder to move too far either forward or backward. This new, extra movement is known as instability. Usually trauma, age related degeneration, use, and wear and tear can be the causes of the instability. If the symptoms are ignored they don’t always go away and more serious problems can arise such as shoulder labral tears and shoulder arthritis including inflammation and pain.
What is actually happening when my shoulder pops? As we saw before, the shoulder is a very complex joint, allowing a range of movement that no other joint in the body can give. It is made up of bone, ligaments, muscles and tendons. If we take a closer look at shoulder cracking and shoulder clicking we see that it often involves the rotator cuff. This is a group of four muscles and tendons that hold your shoulder in its socket. Otherwise the clicking may be the result of the labrum (tissue situated around the socket of the shoulder) or cartilage being injured causing the head of the humerus to move. Tears anywhere in this complex system of muscles and tendons or ligaments can create a loosening of the joint meaning that the shoulder can slide in and out of place – this sliding is what creates the popping and cracking noises. You can usually feel the sensation of your shoulder being unstable and will become aware of it very easily. If you should feel that your shoulder is unstable and it is accompanied with pain it requires treatment with a specialist. Learn more about rotator cuff injuries and its symptoms.
If you notice that your shoulder keeps popping and it hurts it may be time to seek medical help. Waiting to see if the symptoms pass with a shoulder that keeps popping, could actually cause more harm to the situation. If your shoulder always clicks when raising your arm, for example or your shoulder clicks when rotating it could lead to problems of complete shoulder dislocation, a serious and extremely painful condition.
Treatment for Shoulder Popping
Once your medical shoulder specialist has consulted with you on what your specific problem is and what is causing shoulder pain and popping when lifting your arm or carrying out simple chores, there are a few options for treatment which are usually non-invasive ( as long as the rotator cuff has not had tear damage which can sometimes require surgery).
A physical therapist will draw up a planned program of recovery exercises to do and, when you are ready, these will help to strengthen the shoulder, stabilize it and prevent further popping or clicking. The most common advice, and suggested treatment, is to rest the shoulder for as long as possible.This may mean taking a break from your favorite pastime or sport activity or reducing any activities which may have aggravated the shoulder pain. Think of the hiatus in doing your favorite activity as a recovery period that will see you feeling stronger and pain-free for many years to come in the future.
