Shoulder clicking, a common occurrence during rotation, can often be unsettling. While these sounds, medically termed crepitus, are frequently harmless, they can sometimes signal an underlying issue that warrants attention. Understanding the reasons behind these clicks provides clarity and helps determine when to seek professional guidance.
Why Shoulders Click
The shoulder joint’s high mobility allows a wide range of motion, and many sounds are normal mechanical consequences. One common reason for clicking is the phenomenon of cavitation, which involves the formation and collapse of gas bubbles within the synovial fluid that lubricates the joint. This process is similar to the sound produced when cracking knuckles and is typically not associated with pain or underlying problems.
Another cause is the movement of tendons or ligaments as they glide over bony prominences or other soft tissues. As the shoulder rotates, these structures might briefly shift position and then snap back, creating a click. This can be a normal part of joint movement, especially if muscles are tight or imbalanced, and typically occurs without discomfort.
When to Be Concerned
While many shoulder clicks are benign, certain accompanying symptoms can indicate a more significant problem that requires medical evaluation. Pain is a primary indicator of concern; a click that consistently occurs with pain suggests an issue beyond normal joint mechanics. If the clicking is accompanied by a limited range of motion or stiffness, it may signal an internal joint problem affecting smooth movement.
Weakness in the shoulder or arm, particularly when attempting to lift or move the arm, is another red flag. A sensation of locking or catching, where the shoulder momentarily gets stuck during movement, can also point to mechanical interference within the joint. Additionally, visible swelling or bruising around the shoulder, especially if the clicking began suddenly after an injury, should prompt immediate medical attention.
Underlying Causes of Concerning Clicks
When shoulder clicking is accompanied by concerning symptoms, it can be linked to specific medical conditions affecting the joint’s intricate structures. Labral tears, which involve damage to the cartilage rim surrounding the shoulder socket, can cause clicking, catching, or a sensation of instability. These tears might occur from injury or overuse.
Rotator cuff issues, such as tendinitis (inflammation) or tears, are common sources of painful clicking. The rotator cuff muscles and tendons stabilize the shoulder, and when damaged, their uneven surfaces can rub together, producing a clicking sound often accompanied by pain and weakness. Shoulder instability or dislocation, where the upper arm bone partially or fully moves out of the socket, can also result in distinct popping or clicking noises.
Degenerative conditions like osteoarthritis can cause clicking as the protective cartilage within the joint wears down over time, leading to bone-on-bone friction. This often presents with stiffness and a grinding sensation. Bursitis, the inflammation of fluid-filled sacs (bursae) that cushion the shoulder joint, can also lead to painful clicking as swollen bursae create friction during movement.
Addressing Shoulder Clicks
Addressing shoulder clicks, especially those accompanied by pain or other concerning symptoms, typically begins with a professional assessment by a healthcare provider. This evaluation helps to accurately diagnose the underlying cause of the clicking. Depending on the diagnosis, conservative management is often the first line of treatment.
Conservative approaches include rest, applying ice to reduce inflammation, and using anti-inflammatory medications. Physical therapy is frequently recommended to strengthen surrounding muscles, improve joint stability, and restore proper movement mechanics. This often involves exercises focusing on the rotator cuff and scapular muscles, along with stretching to improve flexibility and posture.
In severe cases, particularly when conservative treatments are ineffective or damage is extensive, surgical intervention might be considered to repair or reconstruct damaged structures. Maintaining good posture, avoiding repetitive overhead activities, and incorporating regular stretching and strengthening exercises are general practices that support overall shoulder health.