The shoulder is a complex ball and socket type joint that includes three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). These bones of the shoulder are all held together by groups of muscles, tendons, and ligaments, all which provide stability to the shoulder and the arm. Further, the joint is lined with a synovial bursa, which provides a smooth cushion between bones, muscles and tendons.
Because of the intricate nature of the shoulder joint, and its unique range of motion, it can easily be prone to a ‘clicking’ or ‘snapping’ sensation or sound. This is often due to everyday use and changes that occur naturally within the joint over time, such as a roughening of the surfaces within the joint or mild arthritis. Thankfully, if the popping, snapping and/or clicking are not causing you any pain, the noises are usually nothing to be concerned about. However, if the clicking and popping noises are causing you discomfort or pain, some investigation into why might be warranted.
If you have sustained a shoulder injury in the past, such as a torn labrum, rotator cuff or a dislocation, the popping and clicking noises could indicate that your injury has not healed properly.
Here are some types of injuries that, if not cared for properly, could cause painful clicking, snapping and popping of the shoulder joints.
Rotator cuff or SLAP tear – a tear of the superior labrum (anterior to posterior)
This injury can cause loose edges within the shoulder that catch on other ligaments or structures in the shoulder. Often, if the rotator cuff has been previously injured and has not healed properly, the instability of the tendons and muscles could mean your shoulder is sliding in and out of place, making that snapping and popping noise.
Labral Tears or SLAP lesions
The labrum is a rim of tissue around the socket of the shoulder. It serves as an attachment for the ligaments, and it helps the ball of the shoulder stay stable and in position. If the labrum or cartilage in the shoulder is torn, then it may be separating from the bone or becoming caught in the shoulder and causing a click or a snap.
An acute injury or repetitive stress can have caused the shoulder ligaments to be injured, resulting in the shoulder to become loose and dislocate. Consequently, the ball of the shoulder can slide up or over the edge of the socket. The snapping and popping may be heard or felt when the ball then falls back into place.
Shoulder arthritis can occur in the shoulder when the cartilage or the cushioning on the ends of our bones becomes depleted. Clicking, snapping and popping can occur if the cartilage is rough, thinning or absent, as the surfaces of the shoulder will be rough.
Other circumstances that can contribute to this noisy shoulder issue include repetitive and explosive use and movement of the arm and shoulder (e.g.: a baseball pitcher or football quarterback), bursitis (inflammation or irritation of the bursa within the joint) or contact injuries.
If any of these injuries have occurred to you in the past, or if you have any of these symptoms that are causing you to experience painful popping and clicking in your shoulder joint, there are several options available to you to help to remedy the issue. Some examples are as follows:
- Ice application
- Anti-inflammatory medications, such as ibuprofen
- Physiotherapy to strengthen the muscles
- Cortisone shots, which does not reduce pain but is a very effective anti-inflammatory agent
If these remedies don’t help, be sure to speak to your doctor or physiotherapist, as you may need a referral to an orthopedist or sports medicine specialist for a secondary evaluation.