The Mechanics Behind Shoulder Clicking
Shoulder clicking, or crepitus, is a common and usually harmless occurrence. It arises from benign mechanical processes within the shoulder joint.
A frequent cause of clicking is the formation and collapse of gas bubbles within the synovial fluid. When the joint capsule stretches or moves quickly, pressure temporarily decreases, allowing dissolved gases to form tiny bubbles. As the joint moves further, these bubbles rapidly collapse, producing a popping or clicking sound. This is similar to cracking knuckles.
Another cause of shoulder clicking is the movement of tendons or ligaments over bony structures. As the shoulder moves, these soft tissues can momentarily shift position. If they glide over a prominent bone, they create a snapping or clicking sound as they return to alignment.
Minor shifts in joint alignment during movement can also cause audible sounds. The glenohumeral joint, a ball-and-socket joint, allows for wide mobility. During complex movements, joint surfaces may slightly realign or adjust, leading to a subtle click. These adjustments are typically not associated with discomfort or movement limitations.
When Shoulder Clicking Indicates a Problem
While shoulder clicking is often harmless, certain accompanying symptoms can indicate an underlying issue. These signs suggest a mechanical problem, not a normal physiological occurrence. Recognizing them is important for seeking professional advice.
Pain with the clicking sound is a key indicator of a problem. If a click is followed by a sharp, dull, or aching sensation, it suggests joint structures may be irritated or damaged. Pain indicates the mechanical event causing the click is harming tissues.
Weakness or instability in the shoulder signals a problem. If the arm feels weak or “gives way” during movements that produce a click, it may indicate compromised muscle function or joint integrity. A noticeable limitation in the shoulder’s range of motion also suggests an issue.
Other concerning symptoms include a grinding sensation, indicating rough or worn joint surfaces. If the joint feels like it is catching or locking during movement, preventing smooth motion, this signals mechanical dysfunction. Swelling or bruising around the shoulder joint, especially after injury or if persistent, also warrants investigation.
Specific Conditions Causing Problematic Clicking
When shoulder clicking is accompanied by pain or other concerning symptoms, it can indicate various underlying medical conditions. These conditions affect the shoulder’s structures, leading to abnormal mechanics and audible sounds. Understanding these diagnoses provides insight into the causes of symptomatic clicking.
Rotator cuff issues are a common source of problematic shoulder clicking. The rotator cuff, muscles and tendons stabilizing the shoulder for wide motion, can suffer tears or tendinopathy (degeneration and inflammation). This can cause the humerus to move irregularly within the shoulder socket, leading to clicking or grinding as damaged or inflamed tendons rub against other structures.
Labral tears, injuries to the cartilage rim surrounding the shoulder socket, also frequently cause clicking. The labrum deepens the socket and provides joint stability. A tear can result in a piece of the labrum becoming displaced or catching between joint surfaces during movement. This catching often produces a clicking, popping, or grinding sensation, especially with specific arm positions.
Osteoarthritis, the degeneration of joint cartilage, can lead to clicking sounds. As smooth cartilage wears away, underlying bone surfaces become rough. When these rough surfaces rub during movement, it can generate grinding or clicking noises. This condition typically progresses over time and often results in pain and stiffness.
Bursitis or tendinitis, inflammations of the bursa (fluid-filled sacs cushioning joints) or tendons, can also cause symptomatic clicking. Inflammation can lead to thickening or swelling of these tissues, causing them to rub or impinge against surrounding structures during shoulder movement. This friction can produce a clicking or snapping sound, often accompanied by localized pain and tenderness.
Shoulder instability, where the joint is excessively loose due to injury or lax ligaments, can result in clicking. If the shoulder joint frequently dislocates or subluxates, the humerus may move abnormally within the socket. This abnormal movement can create clicking as joint structures shift in and out of alignment.
Steps to Address Shoulder Clicking
Addressing shoulder clicking involves knowing when to seek professional evaluation and what self-care measures are beneficial. If clicking is accompanied by pain, weakness, limited motion, grinding, locking, or swelling, consult a healthcare professional. These symptoms indicate an underlying issue requiring accurate diagnosis to prevent complications.
For clicking without pain or other concerning symptoms, initial self-care measures can be considered. Resting the shoulder by avoiding activities that exacerbate the clicking can provide relief. Applying ice to the affected area for 15-20 minutes several times a day can help reduce inflammation. Modifying activities to avoid repetitive or overhead movements that trigger the clicking can also be beneficial.
Professional interventions for symptomatic shoulder clicking often begin with physical therapy. A physical therapist can assess the shoulder’s mechanics, identify muscle imbalances, and design a targeted exercise program. These exercises focus on strengthening the muscles around the shoulder, improving stability, and restoring proper movement patterns. Stretches can also be incorporated to improve flexibility and reduce tension in the surrounding soft tissues.
Other medical options include anti-inflammatory medications to reduce pain and swelling, or injections like corticosteroids to alleviate localized inflammation. In severe cases where conservative treatments are ineffective and a significant structural issue is identified, surgical intervention might be considered. A healthcare professional can determine the cause of the clicking and recommend appropriate action, tailoring treatment to individual needs, as accurate diagnosis is important.
Shoulder clicking is a common occurrence that can often be alarming due to the audible sounds it produces. While frequently benign, understanding the origins of these sounds and recognizing when they might signal a more significant issue can provide clarity and peace of mind.