Popping Sound? Not New Year's Fireworks, but your Shoulder!


I often hear this question in my practice: “Why is my shoulder popping?” There are multiple reasons for this common issue, as the shoulder is a complex and unstable joint. It is comprised of bone, ligaments, cartilage and tendons that allow for ease of movement in so many different directions, but this is also why the shoulder is a commonly injured joint that results in shoulder pain.

Why do I have shoulder pain and popping? Before you assume the worst, ask yourself the following:

1. Is the popping you feel painful?

2. Has there been a recent injury of your shoulder resulting in any pain?

3. Does my shoulder feel stable?

4. Is it accompanied by any weakness?

Clicking and popping can occur for many reasons. If it is painless, it can be just a harmless joint noise known as crepitus. On the other hand, if it is associated with pain it may be due to degenerative arthritis from years of wear and tear. This occurs when the cartilage that protects the bone has worn down and becomes rough. The result is increased joint inflammation and shoulder pain. It can continue to progress causing loss of motion, strength, and eventually inability to use the arm.

Clicking and popping can also be due to repetitive overuse of the shoulder, resulting in bursitis and tendinitis. The rotator cuff tendons can become worn down slowly over time, much like the sole of a shoe that eventually wears apart. If left untreated, the result is a tearing of the rotator cuff tendon, which causes increased pain, inability to sleep, lost motion, decreased strength and inability to use the arm with many daily activities.

Shoulder pain and impingement occur when the space between the top of the shoulder blade and the top of the upper arm bone is narrowed due to swelling and inflammation. This causes a pinching of the rotator cuff tendons and bursa. Untreated, this too can lead to tearing of the rotator cuff tendons and lost function in the shoulder.

Shoulder instability occurs when the head of the upper arm bone is forced out of the socket. In many cases, the ligaments are too loose. The result is additional damage to the cartilage of the shoulder and increased pain and weakness. If left untreated, the episodes can increase in severity and frequency.

Treatment of Shoulder Pain and Popping

If you are like me, you want the easiest, most affordable solution. A licensed physical therapist will perform an initial examination to identify the cause of the pain. One of our main goals should be empowering you on how to address the issue so it will go away—forever. Several clinical tests are performed to identify the problematic areas in strength, flexibility and muscle function. Typical treatments may include:

1. Protection of the shoulder is initially a must to prevent further damage. This may include relative rest for a period of time and education about damaging activities and movements.

2. Flexibility movements to increase mobility without pain or discomfort. These should be gentle and progressive with emphasis on proper mechanics of the shoulder.

3. Progressive strengthening exercises for different muscle groups. Examples include specific rotator cuff exercises and shoulder-blade strengthening (known as scapular stabilization).

4. Advanced techniques such as modalities like the 830 Cold Laser or dry needling therapy, massage, mobilizations and hands-on therapy under the expert supervision of the physical therapist can be effective ways to decrease shoulder pain.

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